Digital dentistry program takes root at SBU

Watch your mouth: With Dean Mary Truhlar (left) looking on, associate professor Ann Nasti (center) demonstrates digital cone-beam technology at the Stony Brook University School of Dental Medicine.
By GREGORY ZELLER //

Break out the intraoral scanners: Stony Brook University is sinking its teeth into a groundbreaking digital dentistry curriculum.

The university’s School of Dental Medicine is one of five U.S. dental schools (there are only 66 total) selected to pilot a new digital dentistry program developed by the Chicago-based American College of Prosthodontists. Stony Brook joins dental schools at the University of Kentucky, Rutgers University in New Jersey, A.T. Still University in Arizona and UCLA.

The curriculum framework, designed to help schools incorporate digital dentistry foundations and applications into existing curricula, follows two years of work by the ACP’s Digital Dentistry Curriculum Development Team, which had corporate backing from Melville-based global dental-products titan Henry Schein and other industry providers, including Glidewell and BioHorizons.

“Henry Schein recognized the need to develop a formal education to build not only awareness but knowledge of digital dentistry,” noted Lyndon Cooper, chairman of the ACP Education Foundation, adding the foundation ultimately worked with “45 volunteer members to develop this comprehensive curriculum.”

The course load is built to sharpen students on computer-controlled components added to – and in some cases replacing – traditional mechanical systems. Study areas include dental anatomy and implant dentistry, among others, with projected bite marks for future prosthodontists including improved workflow efficiency and easier professional collaborations.

And that’s on top of cutting-edge digital precision on things like fixed prosthodontics, a space-age boon for patients.

For each of the participating universities, the ACP has recruited an experienced “member volunteer” to mentor faculty about the use of next-level digital dentistry tools, which tend to be “complex, costly and thus, not rapidly adopted,” according to Cooper.

Hence the mentors, who will provide “a resource to these institutions through the piloting phase,” he noted.

“The pilot schools all have different needs as it relates to faculty training and plans to incorporate the digital dentistry curriculum into their institutions,” Cooper said. “Part of the role of the mentor group is to identify faculty training needs and answer questions as needed.

“As a practicing prosthodontist, I know that digital dentistry brings remarkable benefits to clinicians and their patients,” he added. “The ACP has developed a digital dentistry curriculum that enables faculty to teach students the digital technologies and prepare them to fully utilize these tools in practice.”

Lyndon Cooper: SBU has already cut its teeth on digital dentistry.

The opportunity to “comprehensively deliver digital dentistry training” is both an honor and a responsibility for SBU’s School of Dental Medicine, according to Dean Mary Truhlar, who noted a wide range of dental functions touched on in the ACP outline.

“Incorporating this into our current curriculum will advance our program in terms of teaching and training in diagnostics, dental care and oral function,” Truhlar said, with particular benefits for “restorative, surgical and orthodontic procedures.”

The dean is emerging as an instrumental partner in bringing the new curriculum to the masses, according to Cooper, who noted “strong support” from the SBU School of Dental Medicine.

“Dean Truhlar was one of the first people to recognize its value,” the ACP Education Foundation chairman told Innovate LI. “We’re really pleased Stony Brook is piloting this.

“We can’t just create a curriculum and hope it works,” Cooper added. “Schools like Stony Brook are really forward-thinking to test this.”

Stony Brook’s dental school is in a fairly unique position to implement the curriculum framework. The ACP selected the university as a pilot school in part for its class size, large patient base, experience with electronic health records and location – but also for its digital dentistry leadership, including the prior implementation of cone-beam computed tomography, “guided surgeries” and other computer-assisted training and practices.

Among the tech required by the ACP curriculum: laboratory scanners, oral cancer-screening devices and various computer-aided design/computer-aided manufacturing protocols, many of which are already in play in Stony Brook’s various schools.

Although digital dentistry technologies have slowly mainstreamed over the last 15 years, the ACP curriculum marks the first time a single syllabus has been developed to promote the uniform digital-dentistry training of U.S. dental students.

Plans are to begin incorporating the new syllabus at each of the five pilot schools during the Spring 2018 semester, with “full implementation” slated for the Class of 2021.

Ann Nasti, SBU’s associate dean for clinical education and the associate professor who will lead the integration of the new curriculum, said digital dentistry heralds major innovations in the art and science of dentistry – good news first and foremost for patients.

“The recent explosion in digital technology, software, scanning and manufacturing capabilities has resulted in a major paradigm shift in all aspects of dentistry,” Nasti said. “Patients treated with digital solutions benefit from the combination of the most efficient clinical processes, accurate high-strength materials and appealing aesthetics.”


7 Comments on "Digital dentistry program takes root at SBU"

  1. Darrell Pruitt | August 3, 2017 at 6:59 PM |

    Dear Lyndon Cooper, chairman of the American College of Prosthodontics Education Foundation, and contributor to Gregory Zeller’s August 3, 2017 Innovateli.com article, “Digital Dentistry Program Takes Root At SBU.”
    http://www.innovateli.com/pioneering-digital-dentistry-program-takes-root-sbu/

    As a practicing dentist, I have some basic concerns about digital dentistry.

    How do electronic dental records compare to paper dental records in cost and security, and what benefits do digital records offer patients to entice them to select paperless dental practices over paper-based?

    Sincerely,
    D. Kellus Pruitt DDS
    CC: spamgroup

  2. Darrell Pruitt | August 4, 2017 at 10:29 AM |

    How do electronic dental records compare to paper dental records in cost and security, and what benefits do digital records offer patients to entice them to select paperless dental practices over paper-based?

    Why do those who promote EHRs in dentistry ignore dentists’ concerns about cost, security and patient appeal? Anyone?

  3. Gregory Zeller | August 11, 2017 at 12:36 PM |

    Editor’s note: Dr. Cooper responded to Dr. Pruitt, a DDS in Fort Worth, Texas, via an email to Innovate LI. He wrote:

    “Dear Dr. Pruitt,
     
    The value of an EHR in dentistry is now quite well defined. Our own American Dental Association highlights potential advantages in improving care quality and patient safety by enhainging [sic] the information needed for informed decision-making. The highly structured nature of these records assists in accurate data recording and enables quality assessment. They can be programmed to provide important alerts to dentists and their staff regarding allergies, medical conditions or preferences. There is resounding support for electronic records in dentistry across the profession.
     
    Concerns about cost, security and patient appeal are certainly justified. The costs of implementation are real, but the benefits are tangible and easily measurable. This includes the cost of management, backup and eventual replacement of software versus the potential savings in terms of time to retrieve and sort records manually, the cost of space to store the records, and the potential cost related to the absence of realistic back-up systems for paper-based records. The savings in terms of communication through digital systems must be appreciated and will grow as dentistry becomes further integrated into primary care and payment and reimbursement systems require digital communication.
     
    As our patients change – and those millennials are now the largest segment of our population – we will see preferences change; our patients will find us online, schedule appointments online, and want communications digitally. The esthetic appeal of a faxed copy vs. a sharp, well-integrated report that speaks directly to their calendar and their insurer will have great appeal. I am certainly no expert in the security issues surrounding EHR or HIPAA, however, electronic records that are properly deployed and safeguarded offer advantages regarding HIPAA Privacy Rules and a person’s right to access his or her protected health information.”

  4. Darrell Pruitt | August 11, 2017 at 9:07 PM |

    Dear Dr. Cooper,

    Thank you for your well-considered response. However, I cannot say you completely answered my questions.

    Cost:

    You say, “The costs of implementation are real, but the benefits are tangible and easily measurable.” For relevancy, I suggest we disregard the 11 “potential advantages” that were mentioned by the American Dental Association in testimony to Congress 2007 – including “Cost savings to providers and plans will translate in less costly health care for consumers. Premiums and charges will be lowered.” – ADA representative Dr. Robert Ahlstrom, describing the benefits of EHRs in testimony to Congress on July 31, 2007. (See: “Association testifies on HIPAA transaction standards,” by Craig Palmer for ADA News, August 23, 2007).
    http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2641 .

    None of the 11 “advantages” have yet materialized. They are still of no value.

    I am left with the original question: Can a dentist today expect a tangible return on investment from replacing a paper-based practice management system with digital? It is a common, straightforward business question whose answer is surprisingly elusive in the dental industry.

    As a matter of accuracy, I should respond to your savings point for EHR over paper, “…the potential cost related to the absence of realistic back-up systems for paper-based records.” I would suggest that the loss of paper dental records has never been an issue in dentistry. I think you agree that malware is a much greater threat to patients’ records than fires in paper-based dental offices.

    Security:

    Here is another of the 11 advantages Dr. Ahlstrom prematurely told Congress to expect from EHRs in dentistry: “Patient [electronic health] records will be adequately protected through organizational policies and technical security controls.” – 2007

    Reality: “The healthcare sector has reported 233 breach incidents this year so far and is on pace to exceed last year’s rate of one healthcare breach a day, Protenus says.” (See: “Insiders, hackers causing bulk of 2017 healthcare data breaches” By Jessica Davis for HealthcareIT News) – August 4, 2017.
    http://www.healthcareitnews.com/news/insiders-hackers-causing-bulk-2017-healthcare-data-breaches

    Are dental EHRs more secure than paper dental records? While paper records cannot be hacked, there seems to be very little evidence that HIPAA protects digital.

    Appeal:

    Do EHRs appeal to dental patients? Since dentists have all but stopped mentioning EHRs in their ads – probably due to increasing news coverage about hacking – there seems to be very little consumer interest in digital dental records at this time. In fact, photos in dentists’ ads seem to increasingly show paper dental records in the background instead of computer screens.

    I think I’ll wait. Thanks for your time, Dr. Cooper.

    Sincerely,
    D. Kellus Pruitt DDS
    CC: spamgroup

  5. Darrell Pruitt | August 12, 2017 at 10:57 AM |

    Is the dental EHR industry so wobbly it can be brought down with transparency? Yes.

  6. Darrell Pruitt | August 15, 2017 at 9:33 AM |

    “Why one practice ditched EHR in favor of paper records – The Illinois Pain Institute has done what many physicians only dream about doing. The practice, which has multiple locations in four Illinois counties, just ditched its electronic health record (EHR) and went back to paper records.” By Joanne Finnegan for FierceHealthcare.com, August 14, 2017
    http://www.fiercehealthcare.com/practices/unhappy-ehr-one-practice-ditched-it-and-went-back-to-paper-records

  7. Darrell Pruitt | August 15, 2017 at 11:57 AM |

    Dear Gregory Zeller, editor of Innovateli,

    I wish to thank you for hosting the (short) public discussion of the pros and cons of electronic dental records with Dr. Lyndon Cooper, chairman of the ACP Education Foundation.
    http://www.innovateli.com/pioneering-digital-dentistry-program-takes-root-sbu/#comment-2184

    Clearly, more open discussion of EHRs in dentistry should have taken place long before now – as providers predictably begin to abandon their digital practice management software for paper. Interoperable EHRs could have offered healthcare so much more than profit and/or power for vendors and other stakeholders.

    The impetus behind the promotion of EHRs in dentistry has never been patients’ welfare. A growing history of harm proves that, and cybercrime is only getting worse. HIT has become a “mandated” tool for taking control of healthcare from doctors and patients, regardless of how many millions get hurt.

    “The savings in terms of communication through digital systems must be appreciated and will grow as dentistry becomes further integrated into primary care and payment and reimbursement systems require digital communication.” – Dr. Lyndon Cooper.

    Regardless of the fact that dental EHRs are increasingly more expensive and dangerous than paper, and offer patients no tangible benefits, the mandate you suggest is tyranny, Dr. Cooper.

    D. Kellus Pruitt DDS
    CC: spamgroup

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