Are We Ready to Embrace a Bold New Vision for the Dental Profession?

By Raymond Cohlmia, DDS and Marko Vujicic, PH. D

We are at a critical moment for the dental profession. What we do now, or what we don’t do, will define the entire profession of dentistry for decades to come.  The pandemic has brought unprecedented disruption to our personal and professional lives, but it’s really what comes next that is the game changer.  What’s approaching us is not just a guess. We have seen and will continue to see major acceleration in several trends that will have a profound impact on the profession.  

The future is now being painted clearly and several factors once thought to be short-lived fads are now well established trends. From the patient’s perspective, we know that there is a shift in the mindset of how patients are perceiving health care overall. This includes dentistry and is particularly common amongst millennials. This phenomenon coupled with intensified consumerism and public and private insurance replacing the self-pay market is leading to a change in patient base.  This will challenge our previous outlook when we analyze the future consumers of our dental care services.

Furthermore, we know that practice modality is transforming at a dramatic pace. This is fueled by the transition of the dental workforce to a younger, more diverse generation that will soon assume their roles as the new recognized dental care providers in the next decade. A decreasing percentage of dentists own their practice. Most dentists in Florida and much of the U.S. now practice in groups, with solo practice slowly disappearing (figure 1). More and more dentists are joining dental support organizations (DSOs) and a conservative estimate is that 15 percent of Florida dentists practice in these models, much higher than the U.S. average. As millennial and Gen X dentists replace baby-boomers, these trends will continue to intensify.  

The educational format has also shifted to an integrated and holistic approach to patient care.  Dentistry has been very successful in supporting the thought processes of wellness and prevention.  This has become the main focus of the general public’s expectations for their individual wellness. However, we also need to acknowledge that our current system of dental care financing and delivery is not serving all Americans.  We know that half of the U.S. population is not going to the dentist regularly and that cost barriers are the biggest reason why.  Although we have made vast improvements over the last two decades in many aspects of children’s oral health, we have little progress to show when it comes to oral health for adults and seniors. In fact, income and race disparities are widening among adults and seniors for several indicators of oral health and access to care.

What is all this leading to?  It brings us to a critical point for our profession. What we do now, or choose not to do, is critical to our future.  Are we ready to accept that practice models are evolving and, inevitably, dentistry will too, like all other health care professions?  Are we ready to advocate for policies that will work toward finding a routine dentist for all Americans?  Are we ready to transition dentistry into a core component of primary care in order to align with the conversion to a holistic approach to patient care that we’re seeing within the educational format? Changes like these have the potential to grant access to primary care dental providers to millions of Americans. If the answer is ‘yes’ to these questions, then the ADA and FDA will need to shift priorities in terms of how we support dentists and what we emphasize in our advocacy efforts. 

This is a time for bold and defined leadership.  You have heard both of us say that what is in the windshield is much more critical than what is in the rear-view mirror.  The scenery around us will continue to change whether we move or not. The question is, are we choosing to move forward, or stand by and watch it all happen? Our profession is at a crossroads and our view through the windshield is vastly different than what’s staring back at us in the rear view mirror. We must ask ourselves: are we ready to embrace a bold new vision for the dental profession, or are we going to sit back and watch as change happens around us?

Reprinted from Today’s FDA 2022 May/June issue. Visit floridadental.org/publications to view Today’s FDA archives.

New “Chew on This” Focuses on Social Media for Dentists

Do you want to know more about social media marketing for yourself or your practice? Have you wondered what to post or how to cater to the audience you’re trying to foster on your social media pages? Did you know that new patients are more likely to respond positively to personable posts that draw emotion rather than clinical posts about dentistry? All these questions and more are answered in this episode of “Chew on This” with FDA Executive Director Drew Eason and special guest, FDA member dentist, Dr. Joshua Golden. Dr. Golden is a social media influencer who shares his knowledge about successful social media from a dental perspective. This is an episode you won’t want to miss! Watch it now

Hire for Today, Mentor for the Future: Finding the Perfect Associate

By Suzanne Ebert, DMD

Bringing in an associate can be intimidating. You’ve built your practice’s reputation on a certain style of care and may have known some of your patients for decades. You want to know that Mrs. Smith will get the same quality and level of care she’s come to expect, regardless of which dentist she sees in your office.

So what makes an associate “right” for your practice and patients? 

Every week at ADA Practice Transitions (ADAPT), I speak with owners looking to hire an associate or sell their practice. Many insist that any associate coming to work for them must have at least two to five years’ experience. Too often, this means that they refuse to even consider a dentist who would otherwise be a perfect fit.

At ADAPT, we strive to connect doctors who can work well together and respect each others’ professional decision-making. While experience is important, skills can ultimately be trained. Underlying personality traits cannot.

Sometimes it’s best to hire someone who has the right attitude, approach and personality for your practice, then help them gain experience under your tutelage.

Let’s explore why a doctor with a little less experience can be a great asset to your practice. 

Train them to your best practices

Recently graduated doctors often come with a clean slate. They haven’t learned any bad habits and are typically laser-focused on achieving perfection.

Meanwhile, you have spent decades developing your own best practices. You know exactly what to do when conditions dictate that a crown margin must be placed in a somewhat “less than ideal” location, a canal is blocked out or a tooth is broken off at the gingival level. Young professionals crave opportunities to learn these things from an experienced doctor, and you can mold them to your best practices. Yes, they may initially take longer, but patience will pay off. And watching someone grow into their career — and themselves — can be incredibly rewarding.

Get up-to-date about the latest evidence and technology

Even the most diligent doctor has limited time for continuing education.

A recent graduate who has devoted the last four years to learning best practices and studying the research can help you stay current on providing evidence-based care and understanding new technologies.

Support independent dentistry

While 86% of graduating dental students say they want to own their own practice within 10 years, many turn to dental support organizations (DSOs) for their first dental jobs. Some owners bemoan this fact, stating that the training early-career professionals receive in DSOs is not ideal for developing the clinical skills owners value. Even so, many of these same owners refuse to hire anyone with less than five years of experience.

This begs the question: Where do owners expect new graduates to gain that initial experience?

The reality is that DSOs are generally eager to hire new graduates. DSOs can be a fantastic place for young dentists to build their skills while earning a steady paycheck. Owners need to either embrace this model or take matters into their own hands and hire (and train) a recent grad to their specifications.

Young dentists have to get hands-on experience somewhere. Why not in your practice?

Gain a new perspective — and revenue

A new dentist can provide an outsider’s perspective and fresh energy that may enable you to grow the practice. They might offer a treatment you currently refer out, or be able to take over some of the “bread and butter” dentistry to free up your time for more complicated treatments.

Be sure to discuss your intentions with any prospective hire to ensure you’re on the same page.

Plan ahead for your own retirement

Many dentists plan a long, gradual path to retirement. I help some create an “associate-to-owner” pathway, in which both sides agree to a timeline during which the senior dentist sells the practice to the junior dentist.

Other owners find themselves scrambling to sell after an injury or illness. Too often, this leads to practice closures.

Hiring an associate helps future-proof your practice as you’ll already have an in-house dentist who can provide continuity of care to your patients.

Think of hiring as a long-term endeavor. Seek the right person to work with your staff and care for your patients for years to come, rather than seeking someone with a preconceived amount of experience.

To create a free ADA Practice Transitions profile and be matched with dentists who share your approach, visit adapracticetransitions.com

Reprinted from Today’s FDA 2022 May/June issue. Visit floridadental.org/publications to view Today’s FDA archives.

UF Researchers Help Develop Highly Accurate, 30-second Coronavirus Test

The motherboard of a COVID-19 rapid testing device that UF Health researchers helped develop is seen here. The device can return a coronavirus test result as accurately and sensitively as the gold standard of testing, a PCR test, in 30 seconds. (Photo courtesy of Houndstoothe Analytics.)

By Bill Levesque

It is crucial to get a test result for a pathogen quickly, lest someone continue in their daily lives infecting others. Delays in testing have undoubtedly exacerbated the COVID-19 pandemic.

Unfortunately, the most accurate COVID-19 test often takes 24 hours or longer to return results from a lab.

At-home test kits offer results in minutes but are far less accurate.

However, researchers at the University of Florida (UF) have helped to develop a COVID-19 testing device that can detect coronavirus infection in as little as 30 seconds. The testing device is just as sensitive and accurate as a PCR or polymerase chain reaction test, the gold standard of testing. UF researchers are now working with scientists at National Yang Ming Chiao Tung University in Taiwan.

Researchers say the device could transform public health officials’ ability to quickly detect and respond to the coronavirus or the next pandemic.

UF has entered into a licensing agreement with a New Jersey company, Houndstoothe Analytics. They hope to ultimately manufacture and sell the device, not just to medical professionals but also to consumers.

According to a recent peer-reviewed study published by UF researchers, the device boasts a 90 percent accuracy rating and comparable sensitivity to that of a PCR test.

Fan Ren, Ph.D. and Josephine Esquivel-Upshaw, D.M.D. 

“There is nothing available like it,” said Josephine Esquivel-Upshaw, D.M.D., a professor in the UF College of Dentistry’s Department of Restorative Dental Sciences and a member of the research team that developed the device. “It’s true point of care. It’s access to care. We think it will revolutionize diagnostics.”

The device is not yet approved by the U.S. Food and Drug Administration. Researchers say they must first ensure that test results are not abstracted by cross-contamination. This analysis is ongoing as researchers work to identify other pathogens that might be found in the mouth and saliva that could precipitate contagion, such as other coronaviruses, staph infections, the flu, pneumonia and 20 others.

The hand-held apparatus is powered by a 9-volt battery and uses an inexpensive test strip, similar to those used in blood glucose meters. Coronavirus antibodies are attached to a gold-plated film at the tip of the device. The test strip is placed on the tongue to collect a tiny sample of saliva. The test strip is then inserted into a reader connected to a circuit board that houses the “brains” of the device.

If someone is infected, the coronavirus in the saliva binds with the antibodies and begins to dart around as they are prodded by two electrical pulses produced by a unique transistor. A higher concentration of coronavirus changes the electrical conductance of the sample which alters the voltage of the electrical pulses.

The voltage signal is amplified a million times and converted to a numerical value, which is essentially the sample’s electrochemical fingerprint. That value indicates a positive or negative result. A low value indicates a higher proportion of the virus detected within the sample. Researchers say the device’s ability to quantify viral and antibody load makes it especially useful for clinical purposes.

Esquivel-Upshaw confirms that the product can be constructed for less than $50. In contrast, PCR test equipment can cost thousands.

 The research team also is studying its ability to detect specific proteins that could be used to diagnose other illnesses, including cancer, a heart attack and immune health. 

Fan Ren, Ph.D., a distinguished professor in the Herbert Wertheim College of Engineering’s Department of Chemical Engineering and his team have been developing semiconductor-based sensor devices for nonmedical purposes long before COVID-19.

Ren notes that he finds inspiration for his work in the recent death of his wife which was unrelated to COVID-19. [SL1] He connects his grief to the mourning of the rest of the world amidst the COVID-19 pandemic.

“Almost a million people have died of COVID” in the United States, Ren said. “Those are so many tragedies. Old people. Young people. You name it. I said, ‘No, that’s it.’ That is too much.”

He told of several institutions working on devices that use a field effect transistor (FET) like that found in the COVID-19 testing device his team is developing. Even so, those devices are made for one-time use. The sample is applied directly to the FET, so the transistor is no longer usable and must be discarded.

Ren states that the expendable nature of those devices makes them expensive and impractical for mass testing.

The UF device is unique in its structure due to the separation of the transistor from the sample, like blood glucose meters that use test strips to collect a drop of blood after a lancet pierces a finger. This innovation sets the device apart from the rest in both affordability and ease of use.

Ren proposes that the device could be a crucial advancement in testing for venues with large crowds, such as concerts, sporting events or classrooms. Researchers say the unit would also potentially provide access to inexpensive and accurate testing in rural areas and developing nations.

Researchers also discussed the limitless opportunities for personal usage of the device such as parties, events, and other gatherings.

“Yes or no. You’re infected or not infected. You get the answer right away,” said Ren.


Reprinted from Today’s FDA, 2022 May/June issue. Visit floridadental.org/publications to view Today’s FDA archives.