COVID-19: An Accelerant For Dental Technology and Teledentistry





By Lexi Marino October 26, 2020

In this episode, we interviewed Dr. Bryan Laskin, DDS, Chief Innovation Officer at Dental Care Alliance, and CEO of Opera DDS to understand his belief behind COVID-19 being an accelerant for dental technology.

Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and asses differing views across the nation. In Season 2, we’re focusing on, “What’s Working and What’s Not”, where we’re debunking myths by assessing trial and error since the start of Covid-19. 

Watch this video to learn the following:

  • Getting ahead of the curve and incorporating technology
  • Utilizing teledentistry to boost ROI and efficiency
  • K-shaped dental economic practice recovery
  • Implementing engineering controls to keep staff and patients safe

Rolando Mia:

Good day, everybody. Welcome to Dental Voice season two with Zyris. My name is Rolando Mia, and we have a returning guest today. Dr. Bryan Laskin. Dr. Bryan joined us 5 ½ months ago. He is the owner of a dental practice in Minnetonka, Minnesota, Chief Innovation Officer Dental Care Alliance, and he’s the CEO of Opera DDS. Dr. Bryan, thank you so much for joining us.

Dr. Bryan Laskin, DDS:

Of course. I appreciate you having me back. Thank you.

Rolando Mia:

Awesome. When you first came on our show, you shared your thoughts on COVID-19. Now that we’ve been back 5 months into it since we last spoke, what has changed? What are you observing in dentistry overall?

Getting Ahead of the Curve by Incorporating Technology

Dr. Bryan Laskin, DDS:

Well, I think probably the appropriate answer is what’s changed this week because it seems like every week there’s a new issue that’s lifted to the forefront of our consciousness. There’s been a lot that has changed and there actually has been a lot that hasn’t changed. The importance of focusing on the patient experience has never changed. Other than that, I think that there’s been a tremendous amount of change. Right now, I feel like the issue of the week is having adequate team members. There’s been a lot of shuffling of team members and making sure that your team isn’t overwhelmed. Frankly, the demand is higher at this point than I would have anticipated. I feel like getting the team members and the pieces in place to meet the demand has been the biggest issue. To address that, everything from automating, using something like Isolite® to be able to act as an assistant when you don’t have one. Right? I mean, in addition to the infection control issues, I could just take half an hour to list everything, right?

Rolando Mia:

So, when we first talked, team members being able to deal with capacity, being able to deal with a different structure that’s going on treating patients, is a big issue. You introduced about 5-6 months ago, this idea of teledentistry and how going to change the industry. What are you seeing with regard to that currently?

Dr. Bryan Laskin, DDS:

We’ve been doing teledentistry with OperaDDS for about 3 years. When we first spoke, there were people that thought teledentistry was interesting, but not necessary. However, as soon as there was a shutdown, it became the hottest thing in dentistry. Now, there is massive amounts of focus on telehealth and teledentistry.

We actually developed an entire brand new, comprehensive teledentistry platform in response called to service, which it’s essentially a HIPAA compliant version of Zoom that integrates with your practice management system. So, you can see there’s a lot of things.

To back up, I think one of the dangers that happened, the things that people did wrong was they needed to communicate with their patients when we were shut down. So, they use something like zoom or a HIPAA compliant version of zoom.

That’s just not effective when we’re seeing patients on a daily basis and seeing people remotely via the HIPAA compliant Zoom, isn’t the most efficient way to do it. So, what we’ve done is kind of like layer on top of that experience with more efficient tools to help practices.

For example, when a patient checks in to the secure video chat, it asks them if they’re a new patient, there’s a chat bot that says, if you say yes, it asks for the patient to fill out their new patient forms. So, all of that gets incorporated back into the practice management system. So, you know, I could go down the touch points that we’ve kind of addressed and the inherent efficiencies in doing a secure video chat like this because I think people did that wrong. So, in a lot of ways, they did it for a while, it worked, and then they were like, “Ah, this isn’t going to work for me when we’re back in practice.”

So, what we’ve been doing at Opera DDS is implementing asynchronous communication. Think of this as HIPAA compliant, texting with patients where they can send you video and photos. This is massively efficient. There’s no downside to that at all. Then, we’ve incorporated this new feature set, which incorporates a live video stream like this, but we’re leveraging the texting components where it makes sense. This a long answer to your question, but I think teledentistry has really evolved because people understand the power of it.

Rolando Mia:

If I understand correctly, when the practice employs teledentistry, it gives the clinicians and the team the ability to interact directly with the patient and pre-diagnosis prior to in a way prior to them coming in. And if I understand correctly, they can actually charge for that. Is that right? Because you’re being evaluated. You’re interacting with a professional.

ll throw this out there, we’ve actually seen some “Do it Yourself At Home Stuff”. What are your thoughts on usind dental kits are home because you can’t get into the dental practice?

Utilizing Teledentistry to Boost ROI and Efficiency

Dr. Bryan Laskin, DDS:

Well, I think you brought a lot of good questions. When we think of teledentistry, we know our practice, isn’t limited to the walls of our office anymore, right? People want to communicate with you outside of your practice, whatever that looks like. That’s really what teledentistry is. People complicate it with a fancy buzzword but it’s really every time you’re communicating with a patient outside of your practice, that is teledentistry. I can’t even tell you the last time I picked up the phone to call a business, but that’s how we expect patients to interact with our dental office. Right? Teledentistry addresses that need.

Here’s a great example of the power of teledentistry. There’s a patient that I’d like to talk about, Joe, who hadn’t been to the dentist for 20 years. So, Joe has a lot dental needs, right? He didn’t need me to tell him he had a lot of dental needs because he can look in the mirror and see half of his teeth are missing. Somebody like that has shame and they’re worried about coming in. So, teledentistry allows somebody to give photos to the office, have somebody call them up, and just give them reassurance that there’s not going to be lectures when they come in. That’s the way you can bring in people who have high dental needs, but don’t know where to start.

So triaging emergencies, just setting appointments through something just as simple as a secure texting or filling out a form on your website or direct messaging in an appointment, that’s all teledentistry. I believe every practice should be leveraging this today. What will never change is addressing the patient’s experience. It’s always going to be where the puck is headed in dentistry, right? Directly addressing people’s needs. I think what we’ve ignored for too long in dentistry is that people don’t want to have to call us. They don’t want to come in and have an evaluation done. Right? Everything today is about convenience. I mean, if I can’t get something ordered to my house in a day, I’m like, “What is wrong with the world?” So, people don’t want to pick up a phone, call you, then schedule an appointment and have you do an evaluation. I mean, you can do it that way, but the industry is rapidly going a different direction.

Rolando Mia:

It resonates really strong with me by minimizing or almost eliminating the barriers. It makes so much sense. Also, the context that even patient communication is teledentistry is something that I hadn’t thought about. I would guess, a lot of practices out there haven’t recognized or acknowledged that’s the case. Would you agree?

Dr. Bryan Laskin, DDS:

Oh, definitely. I think people think of teledentistry as needing to be synchronized video chat, where you’re talking to a patient like this. Right? That’s drastic. In fact, that’s the last thing you should incorporate in my opinion. You should be doing everything else prior to that. There’s certainly a place for that. It’s powerful and necessary in certain amounts. I think it’s because of the way the coding has been done, to your point before about, can you charge for this? And the answer is yes, in some states. There are still all these misconceptions about teledentistry but there’s two codes that the ADA came up with asynchronous teledentistry and synchronous. Frankly, they don’t make any sense because if I said, “Rolando, I noticed you chipped number 31, could you show it to me?” Are you’re going to wrap your mouth around the webcam? No, you’re going to snap a picture and sent it to me. Right? So, it doesn’t really make any sense.

What I believe is a better distinction is pre-diagnostic care. Meaning, I’m talking to you or messaging with you with the idea of bringing you into my practice, something like a dental monitoring, which is a great for orthodontic, ongoing maintenance, right? That’s ongoing care. There’s a big distinction because I can’t reach through the webcam and do a crown for you. I can’t do an endo through teledentistry, but there’s a lot that we can do pre-diagnostically to get people into our practices. I think most dentists should be doing this today.

Like what can I do with patients who aren’t patients of mine or patients who have needs that can come into the practice to decide the best way to actually bring you in and see you in my practice? It’s going to make you massively more efficient doing what you already do, right? If you have a broken tooth, I’m not going to have you come in and say, “Oh, by the way, you need to have a crown come back in two weeks.” What I’ve done there is I’ve wasted your time and frankly, you’ve just spent money to do that as a dentist. If you factor in all of the stuff that goes into seeing a patient. If, however I say, “Oh, I can see you have a broken tooth. I’ve got my schedule right here. I’ve got an opening Tuesday at 9AM. We’ll get you taken care of that day.” I’ve just made this massively more convenient for you and massively more profitable for us.

Rolando Mia:

What great context. It enables you to get ahead of the patient, as opposed to dealing with them when they get there, in which case you have to reschedule. COVID-19 is what’s really driving and pushing this because it’s highlighting inefficiencies that our industry was doing.

Dr. Bryan Laskin, DDS:

Yeah, I wanted to touch on a point. Something very profound that I heard from NYU professor, Scott Galloway, was that COVID-19 was not a change agent. Right? It did not change anything. It was an accelerant of trends that were already in place that may have taken a decade to be realized and are here now in a month. Right. I think that’s the right perspective on, especially in dentistry for COVID-19. The things that we’re putting in place in response to COVID-19, you know, obviously, hopefully we don’t have to do car side check-in forever, but a lot of the things that like that were available as things that people probably should have, or they made sense prior to COVID-19. It highlighted those inefficiencies. Teams are demanding things that should be put in place. Even the aerosols that we weren’t dealing with before, but we should have, right? You know, using negative suction tools like Isolite® was the right thing to do pre-COVID. But now people are like, “Oh, I guess it really is the right thing to do now.” So, that’s not changing anything, rather, it’s an accelerant – not a change agent.

Rolando Mia:

That’s perfect. You mentioned, when we last talked, that the practices that are forward thinking in this situation, that it’s actually time to invest. How is that working out?

K-Shaped Dental Economic Recovery

Dr. Bryan Laskin, DDS:

Yeah, I appreciate that. I am part of the Dental Care Alliance group like you’ve mentioned. Frankly, I’m very happy during COVID because the leadership team there had managed through crisis’ before and the response has been phenomenal. I’d argue that I’m stronger today. What I said about now is the time to invest in yourself and your practice and other practices, that kind of a thing. I don’t know if you’ve heard of the concept called the, “K-shaped Recovery”, that’s really come into fruition. I’ve recognized this during COVID, it’s something I’ve been seeing going on in dentistry. What it means is that there’s two options on the curve. One is the goal up into the right quickly and the other one is to go down into the right quickly.

There’s not like a flat line, right? And the way I’ve explained this is that if you look at the average, like people would say, dental dentistry grew 5% this year, right? The average dental practice grew 5% when I got out of school 20 years ago, well, maybe one’s going up 15%. One’s flat, but the standard deviation is very small. That’s not going on today. The standard of deviation is very wide. You have practices growing 50% and dying 50%, and people just shutting their doors. Right? Frankly, that gives the people who are going up into the right and opportunity. It was probably the best opportunity that dentistry has seen in since I’ve been practicing. If you’re engaged and you’re doing the things that you should be doing to adjust your sales to the wins of the patients’ expectations, then I think there’s more opportunity today than ever before.

Rolando Mia:

One of the things that we hear a lot is the trepidation that teams are having because of the uncertainty of the potential that they may be compromising themselves. Are you noticing this? Are you keeping your team? How are keeping them comfortable with what’s going on?

Dr. Bryan Laskin, DDS:

Well, in full disclosure, we have had large turnover in my practice which has been the primary issue. I don’t think we’re alone in that. I think that’s going on across the board. I was like, “What is going wrong here?” Right? Then I talked to other practices and was like, “Okay, we’re all doing this.” So, there’s people are leaving the profession. We’ve had people who have sat at home for 2 months and they decided, “You know what, I want to do oral surgery, full time, not general dentistry.”, which life just happens like that. There are people who say, “I want to stay home with my kids”, or “I want to switch careers.” There are all sorts of reasons why people, when you’re sitting there for 2 months, they decide they’re going to make a change.

The biggest issue I think is that people counteract when we automate things as much as possible, right? Leveraging technology to do things that people could do, particularly things that people don’t want to do. We talked about that last time, for instance, paperless forms versus like having people just shuffle papers, using an Isolite® whenever you can in times where your assistant is new. If that handles a lot of it and it handles the aerosols, I think we really need to focus on training that technology. We’re going back to the basics in my practice right now and just had a meeting about this. We have new people who haven’t been fully trained and that’s what we’re working on now.

But in the meantime, the good news is that they’re taking the extra steps, wiping things clean. It isn’t a bad thing. It gives you a fresh start to decide where are we going to build from? I think we’ve done that well. That’s really the only way that if you’ve gone through turnover like we have, now we have fresh eyeballs with good brains attached to them. They can bring a new perspective that we can then add and be even stronger as a team after.

Rolando Mia:

Yeah. It’s interesting that the point you make is that although change can very distressing at times, it’s also an opportunity to kind of revisit what you’ve been doing and then revisit the “how and why”. You said it is with the advent of technology into the space with the advent of different perspectives is what helps. Let me ask you this, from an operational perspective and from a communication perspective, one of the key messages you gave last time was you need stay connected with your patients. You need to stay connected with your team. Are you continuing that process?

Dr. Bryan Laskin, DDS:

100%. Yeah. It’s that is communication is the key to everything, right? Right now, communicating with patients is as important as ever. It’s the beginning of October, which is a dubious anniversary 6 months from the shutdown. What that means is that 6 months ago, most dental practices for 2 months, didn’t see patients. So, it’s almost too late, but maybe not for November, but if you haven’t been communicating with your patients and for 2 months didn’t see patients that means in October, November, it’s called the October surprise, right? People don’t have patients in their schedule because they didn’t have an opportunity to pre-appointment them. 6 months ago, just shows the importance of always continually reaching out to people and letting them know you’re available and that they know the importance of dental care.

We’ve had the World Health Organization come out and say that dentistry is not an essential service. So, if you don’t have a dental emergency, don’t come in, right? The only way to counteract that is to communicate with people and let them know that if you don’t see a dentist for 12 months, you could have a major issue. I don’t think most dentists would agree with that World Health Organization statement. I don’t. If you differ with what the World Health Organization says, then you should certainly be communicating that to the patients.

Rolando Mia:

Wow. Are you seeing people coming in? We’re hearing that because people haven’t come in because of the increased stress and because of the lack of going in and maintaining oral care, are you seeing patient’s health being compromised?

Dr. Bryan Laskin, DDS:

Oh yeah. I think you mentioned it’s been kind of well-documented now and I think that we, as dentists, would always see, before the holidays, lots of broken teeth because people are stressed, right? Everybody like wants to idealize the holidays, but it’s a stressful time for a lot of people. So, there’s a lot of broken teeth during that timeframe. I do worry kind of long-term about the psychological effects of what this whole experience is. It’s oppressive on people. It does show its way itself in not just in missing dental appointments but things that people can’t feel that become much larger issues, right? That does happen. The stress of the time we’re living through manifests itself in broken teeth and other issues.

Keeping Your Dental Team Feeling Confidently Safe

Rolando Mia:

It’s not just the stress that the patients are feeling because of the uncertainty. We’ve had a whole host of hygienists on our program here and we’re hearing two very different sides of, “Use the Cavitron”, or “Don’t use the Cavitron”, because of all these aerosols and the CDC saying COVID-19 lives in aerosols. So how did you overcome this issue of Cavitron Ultrasonic polishers, all that type of stuff on your hygiene side?

Dr. Bryan Laskin, DDS:

Right now, there’s a different position in talking about COVID-19. There’s so much misinformation and frankly, just, I don’t think we have a lot of the answers, nobody does. So, how do you navigate that? It’s communicating with your team, like you need to get on board. Minimally, I think you need to use a product like the Isolite to manage those aerosols. I’m a firm believer that this is a virus that is in droplets and aerosols. So, you have to at least manage that. I think we really getting educated as the best you can because every week, we’re getting more information and I’m making educated decisions based on the information that you have at the time is really the only way to go.

We don’t want to put anybody at risk. There was this massive fear that dental practices would be like a super spreader of this virus.  I can tell you within Dental Care Alliance we have over l350 practices and there’s not been a single case that’s been from the dental. There’s been people, obviously, you can trace it back to like a barbecue or whatever, but I don’t feel like dentistry is spreading this virus around. Obviously, I mean, we should do whatever we can, not just from a patient health perspective, but from your practice health perspective. The worst thing that could happen to you is to have an incident where it’s a shut down for weeks and manage that. So, we have to do whatever we can do to minimize that.

Rolando Mia:

If you were to highlight the top technologies that are either emergent or we’ve already had that we haven’t used, or are things that people should look at, what would you say those are?

Dr. Bryan Laskin, DDS:

Great question. So, number one, if you don’t have paperless forms, get them. That includes like Opera, DDS are paperless forms and a package costs less than $100 a month. We always have free trials and stuff. When you walk to Starbucks and they won’t even give you a piece of paper to sign because people freak out – the industry has to go there. We can’t give people clipboards with paper today. Right? So, and that includes car side check-in. There’s a lot in like that we can do through paperless forms. Everybody should be using them like yesterday. Also, I would say UVC sterilization, that’s something we’ve incorporated in our practice. You can, if particularly during the PPE shortage, like you could use UV lights to sterilize things. Also, we have to deal with the aerosols in our practice. So, for negative evacuation techniques we use Isolite®, I love it. It’s a great tool.

What I’m really trying to do is say like, what are the things for like almost no cost that you get an immediate positive ROI on? We all are going through so much change right now. I don’t think now’s the time to like make a big swing unless your office is shut down. I think it’s like do the things that just are obvious and are going to make you more efficient and make your team more productive right now. So, I would say the 3 things that pop to my mind right now are people, is paperless forms, UVC sterilization, and Isolite negative suction.

Rolando Mia:

Well, thank you. For the clinicians that are still apprehensive or who may even up to this point, haven’t opened yet or are just starting out and things aren’t quite working out what advice would you give them?

Dr. Bryan Laskin, DDS:

Well, I would say, go with your own judgment, right? If somebody is not open today, because they’re worried about spreading the disease, then I think just keeping abreast of the science and open whenever you’re comfortable. If it’s because they’re worried about the health of their practice, what I would say is that the patient demand is there. No doubt patients, the patients are there. I had thought that would be a struggle, frankly. I was wrong on that. The patient demand is there. So, if what’s holding you back is worrying that your patients don’t want to come in, that is a misnomer from my experience. So, get to work. This is what I would say.

Rolando Mia:

So, in other words, overcome whatever the fear may be, have proper protocols in place, making sure abreast of what’s going on, and making sure that you’ve got the systems in place.

Dr. Bryan Laskin, DDS:

100%. Yeah. By the way, we talked about convenience, if you’re not seeing your patients today, somebody else is, right? So, your practice is on K curve. There’s two options and your practice is going in one direction, so it’s time to get to work.

Rolando Mia:

That’s so cool. When I first met you, it was through Opera DDS, how’s Opera DDS doing?

Dr. Bryan Laskin, DDS:

Well, it’s insane. It’s grown over 4X during COVID-19. We just launched paperless treatment plans for offices. So, if you have paperless forms, recall and reviews with Opera DDS, you’re probably paying half of what you do with a similar system. Frankly, it’s better. I’m biased, but it’s better. What’s happened is, people have said to me, “Bryan, you’re selling umbrellas and it’s raining”, and I’m like, “Yeah, but I’ve been selling umbrellas in the sun for like the last 5 years.” So, it’s been a weird experience to be this busy having this much of a transformational shift to be positive for our business, but it’s a horrible global pandemic. Right? I’m glad that we at least are providing tools that are helpful for offices and for patients in this very stressful time.

Rolando Mia:

Well, cool. If people wanted to reach out to you, ask you questions or get information, what would be the best way for them to do that?

Dr. Bryan Laskin, DDS:

Well, they can reach out to me bryan.laskin@operadds.com. Or you can find out more about me by going to operadds.com.

Rolando Mia:

Awesome. And with regard to Dental Care Alliance. If people had questions about DCA, would it also be the same website?

Dr. Bryan Laskin, DDS:

Oh, it’s dentalcarealliance.com or they can reach out to me at the same email address. I’ll make sure to get people in contact. It’s great. It’s been phenomenal to be part of a group during this time. If you think about all of the things that you had to put in place, sourcing PPE, and sneeze shields and all this stuff, what’s been really nice to have is a group of people where that is their whole job. They just kind of say, “Well, here’s how to do it.” That’s been nice.

Rolando Mia:

Well, thank you so much. I could spend a lot more time talking, especially on the technology front.

Dr. Bryan Laskin, DDS:

I love what you guys are doing at Zyris. Great products, great people. I love what you’re doing.

Rolando Mia:

Thank you. For those of you watching, if you want to reach out to Dr. Laskin, he’s got some incredible things and we barely scratched the surface with regard to technology. Take care. We’ll talk to you soon.