The New ‘Golden Age’ of Dentistry: A Highly Desirable Profession with Unprecedented Global Opportunities in Industry Settings

ABSTRACT

Background

Dentistry 1.0, an era where the patient journey was embedded in fully analog realities gave way to a 2.0 era of select digitalization since the late 1990s. Now, we are arguably at another tipping point, where for the foreseeable future digital workflows and solutions are expected to influence every aspect of the patient journey and big data becomes the new healthcare currency. With this, the dental profession’s perspective on how to best serve the entire patient journey must also expand to explore unprecedented opportunities to unobstruct another layer of critical choke points and unlock further value in global oral health. Consider some examples. Today, the global patient journey is already obstructed well before the point of care due to insufficient global coverage and imbalanced geographic distribution of dentists. While there is a growing and aging global population, the majority of dentists serve only a minority of the human population. Such coverage gaps fuel the already growing trend of patients who consume health insights online. Going forward, those who respond to the needs of more empowered and well-informed patients are poised to be the partners of choice for modern patients who increasingly expect to take ownership in their own health journey. In addition, the Age of Information has decisively accelerated toward the Age of Intelligence. This expands our imagination in new ways, not only on how to keep up with, but also how to influence the latest scientific, clinical, economic, social, and technological developments for the greater good. Meanwhile, there are real dichotomies worth noting. For instance, the relevance of dental education to dental practice is under increasing pressure. The norm in dental education remains relatively analog curricula, which struggles to adapt considering the rate of change far exceeds the average dental school reality and capabilities. This means newly graduated dentists increasingly face this rapid digitalization alone. Such pressures further fuel other trends, such as the rise of corporate dentistry and acceleration of non-traditional players in the field. In a world when in any given week the equivalent of half of America passes through a Walmart, it is not hard to see why such big retailers find it attractive to enter healthcare. In this article, the authors explore key mega trends influencing dentistry and reflect on the oral healthcare ecosystem beyond the clinic, where clinical knowledge and skills are relevant and needed.

Description

Today’s global realities offer dentists unprecedented opportunities to expand their professional impact and presence well beyond established norms of clinical practice, academics, and research. The authors offer readers insights into relevant trends and give specific examples, from first-hand experiences, of professional pathways suitable for dentists in medical device and technology settings, including in contexts of innovation, development, marketing, education, sales, and post-market surveillance.

Keywords:

• Mega trends
• dentistry
• professional pathways

Introduction

It is hard to imagine now, but until the mid-nineties, analog clinical workflows were routine, clinics scheduled their patients on paper calendars, X-ray dark rooms were necessary spaces in clinics, and dentists served as the only source of oral health information. Then, a transitional era of selective digitalization brought luxuries such as electronic health records, digital radiography, early-phase intraoral scanners, and marketing opportunities for dentists who were both challenged and enabled by Dr. Google. Today, in the era of digital transformation, dentistry ranks among the most desirable professions due to its high relative median salary, work–life balance, and employment-rate scores, as well as its high ranking within the healthcare industry, esteemed as the second-fastest-growing industry overall for projected 10-year job growth.^1–3

Indeed, according to the ADA Health Policy Institute’s survey results in January 2023, dentists reported double the confidence in the economic recovery of their own practices and the dental sector compared to the overall US economy’s short-term outlook.⁴ Further, the Bureau of Labor Statistics reported an overall 4.0% year-over-year increase in the number of dental jobs in December 2022, further demonstrating recovery beyond pre-pandemic levels.⁴

The desirability of the dental profession is in part affected by key global trends, referred to here as mega trends, which are fundamentally and rapidly changing the landscape of dentistry. To set the base for this article, section one explores four such mega trends which the authors believe will influence dentists and industry leaders worldwide in the short- to mid-term. This is not an exhaustive trends list, but rather selected for high relevance to the evolution of oral healthcare and of potential interest to dentists open to alternative career paths. Then, Section Two reflects on example roles within medical device and technology settings and offers insights into how dental professionals may make impactful contributions in them.

Section One: Mega Trends Influencing Dentistry in the Short- to Mid-Term

Mega Trend I: Global Digitalization

Current estimates show unprecedented global digitalization, such as^5–7:

• Sixty percent of the global population is online.

• Forty percent of waking lives are online per person per day.

• Fifty percent of online time is on mobile devices.

• Fifty percent of the global population have home computers.

This global digitalization has transformed individual behaviors and intensified reliance on digital platforms for consumption, interaction, and even expectations surrounding oral care. By all signals, this digital shift is permanent, not only for global populations, but also for dental practices and their patient experience. Digitalization offers considerable opportunities against certain critical choke points in oral healthcare, and as the Internet of Things evolves to the Intelligence of Things, data becomes the new currency for driving improved oral health outcomes.

Consider the below highlights:

Digital Impressions^8,9

Modern technologies are revolutionizing the patient–dentist interaction. A notable shift is the rising adoption of intraoral scanning technologies. In certain developed nations, nearly half of dental practitioners have incorporated intraoral scanners into their practices, which offer certain advantages such as greater speed and efficacy, increased patient comfort, and easier use for clinicians as compared to traditional impressions. Moreover, these digital tools allow for the storage and comparison of patient data over time, effectively creating a ‘digital twin’ of the patient. However, it is crucial to exercise caution due to related data privacy and security laws and interoperability considerations with Electronic Health Records. Looking ahead, a comprehensive dental version of the EHR spanning a patient’s entire life might become a reality.

AI in Dentistry

Artificial Intelligence (AI) is the new frontier in dental technology and promises to refine and augment clinicians’ diagnoses and treatment plans. A recent systematic review showed that AI models in dentistry are blooming, including use in detection and diagnosis of caries, vertical root fractures, periapical lesions, salivary gland diseases, maxillary sinusitis, maxillofacial cysts, cervical lymph nodes metastasis, osteoporosis, cancerous lesions, alveolar bone loss, predicting orthodontic treatment needs, cephalometric analysis, age and gender determination. Indeed, the performance of AI-based automated systems is shown to mimic, and some even outmatch, the precision and accuracy of trained specialists.¹⁰

With its potential for early detection and prevention, AI stands to be a game-changer in oral health maintenance. For instance, using artificial intelligence to examine x-rays, scans or 3D images significantly saves time of the clinician in the diagnosis accuracy. AI-powered imaging systems can also create 3D models of patients’ teeth and jaws, which allow clinicians to design virtual smile mock-ups for patients with some service providers, such as Smilecloud or 3shape. AI offers ability to go through extensive sets of data and craft predictive models in dentistry. By discerning patterns, AI can forecast issues like decay detection or bone loss quantification and accurately identify missed periodontal and restorative treatments. Through AI-driven analytics, dentists can find and address potential risks earlier and transform patient care.^11,12

Integrative Health Through Smart Technologies

Smart technologies, wearables, remote monitoring devices, and teledentistry platforms offer a vast array of advantages that are reshaping patient care and dental practices. This is a secular trend brought in already from the need for wellness and empowerment of health consumerism which made fitness trackers such as Fitbit or Oura ring so popular. Constant and enhanced monitoring of health metrics and treatment progress are among the most pronounced potential benefits of health-related smart technologies, which enable early detection and intervention against potential anomalies. For example, salivary detection of pH level, glucose, and electrolytes through aligners embedded with sensors is in development at Lura Health, and while still in development, show promising results for concrete application of smart technologies in dentistry and as bridging health indicators between medicine and dentistry.^13–15

Another example, well known to dental professionals, is dental caries as the highest prevalent non-communicable disease worldwide caused by the elevation of the cariogenic microbiome in the oral cavity. Caries in permanent teeth is estimated to effect 2.3 billion people, estimated at a global prevalence of 35% for all ages.^16,17 In a recent study focused on the potential value of smart sensors, the challenges of in situ sensing and topical drug delivery within the oral cavity were explored via a miniaturized, battery-free, and wearable dental patch system which was developed for microenvironment monitoring and controlled fluoride treatment. This application of flexible electronics armed to the teeth via intraoral theranostic wearable system, provides an inspiring platform for point-of-care monitoring and treatment of dental caries and oral diseases.¹⁸

Beyond wearables, smart technologies offer the potential to reshape treatment protocols. Consider, for instance, orthodontic treatments for young patients or on-the-go adults. Advanced remote monitoring solutions, such as Dental Monitoring, now allow dental professionals to oversee the progress of orthodontic treatments without necessitating frequent in-person visits, enable patients to stay connected with their clinical team from anywhere, optimize the treatment process and clarify instances which require in-person interventions, provide comprehensive data and analytics to optimize practice workflows, and improve the overall patient experience. Indeed, a recent systematic review and meta-analysis showed the promise of teledentistry using Dental Monitoring® software as an effective means to monitor the evolution of orthodontic treatment. This analysis showed that teledentistry during orthodontic treatment with aligners reduces both the time to start refinement and the number of face-to-face visits, without changing the treatment duration, nor the number of refinements or refinement aligners.^19,20

On a broader scale, the continuous data collection from these devices offers invaluable insights for aiding in the development of better treatment strategies and understanding patient behaviors. Lastly, these technologies empower patients, which serves their demand to take a more active role in their journey and emphasizes the importance of preventive care.

Embracing the Cloud Shift for Dental Practices

Cloud-based platforms and on-the-cloud PMS solutions offer real-time data sharing, ensuring seamless and transparent processes in practice management and along the patients’ journey. Features like online appointment bookings and shareable electronic records can save patients and practices from often-cumbersome administrative procedures and are more appealing for digital natives. Additionally, streamlined processes support dentists to focus more on fostering relationships with their patients.²¹

Mega Trend 2: Oral Care Coverage Gaps

The global patient journey is obstructed well before the point of care. Despite the presence of 1.6 million dentists and 4.6 million dentistry personnel worldwide, an estimated 3.3 million dentistry personnel are still needed to fulfill the effective coverage index for global public health. For instance, there are an estimated 608 and 810 dentists per 1 million population in US and Europe, respectively, as compared to only 175 dentists per million population in China. Estimates show that 69% of global dentists serve only 27% of the world’s population due to imbalances in geo-distribution of dental professionals, which further exacerbates gaps in global coverage. This may in part be due to dentist wanting to live in certain geographies more than others, targeting markets with higher relative discretionary income, and to better manage the high indebtedness of their dental education.^22–24

There is a fundamental need to address these coverage deltas, influenced by digitalization and expanded patient perspectives clear in their willingness to seek consultations across geographies. The Covid pandemic recently boosted these influences whereby tele-dentistry emerged as a beacon, providing patients with virtual consultations from the comfort of their homes. Dentists who welcomed this approach not only fortified safety during times when physical distancing was paramount but also streamlined scheduling for their practices.^25,26

Mega Trend 3: Patients as Own Cinical Partners

Today, patients are more capable than ever to address their own health needs as they increasingly seek healthcare insights online prior to engaging healthcare professionals, and as reflected in the previous section, geographic coverage gaps may even make this a necessity. A recent systematic review showed that while seeking online health information is prevalent, the reasons for seeking online health information are diverse and include perceived convenience, anonymity and confidentiality, time-efficiency, and ease of instant up-to-date information. Additionally, searching health information online supplies consumers opportunities such as gaining insights on sensitive health topics which may be hard to talk about in daily life, obtaining the diagnosis of new health-related problems, and accessing comprehensive information to make health decisions.²⁷

Nevertheless, well beyond healthcare, global macro trends in human-computer interactions have become undeniable. This trend further mandates online relevance in most aspects of the healthcare sector. Indeed, responding to the needs of more empowered patients ranks among the top key challenges of primary care clinicians. Patients are digitally pre-informed about their health conditions, which fundamentally transforms the doctor–patient relationship in favor of a dynamic in which the clinician serves as the partner of patients’ own health.²⁸

Patients may also have consumer-expectations and providers who more closely align with contemporary consumer trends tend to thrive by extending beyond mere treatments. Today’s patient-consumers are better informed, demand to be active participants in their care decisions, and welcome engaging various oral care providers to meet their diverse needs. Differences in the generations further influences this. While Baby Boomers tend to value and keep long-term relationships with providers, the younger digital natives, including Millennials and Gen Z, prioritize convenience and expect their dental clinics to be technologically sophisticated and aligned with their digital-first lifestyles.^29–32

This means there is a demand for dentists to offer:

• Portfolios and comprehensive digital workflows that allow for immediacy in care.

• A personalized care approach, tailored to individual needs and experiences.

• A diverse range of communication methods between a dental practice and its patients including flexible appointment schedule and rescheduling options.

• Digital patient education information and tools, catering to modern patients who want to make educated decisions.

Mega Trend 4: Industry Consolidation and the Rise of Corporate Dentistry

Dentistry is witnessing a surge in the demand for treatment precision and superior outcomes, primarily due to the consolidation seen in Dental Service Organizations (DSOs) and Group Purchasing Organizations (GPOs). These changes also drive a higher need for improved efficiency in treatment delivery, evident in the rise of rapid prototyping and complete digital workflows. The quest for administrative excellence in dental practice management is more pressing than ever. While the rise of corporate dentistry signifies a major shift in the industry, it is just one piece of the evolving puzzle. The consolidation offers benefits in terms of efficiency, technology, and accessibility. Interestingly, the technological advancements are not exclusive to large DSOs. Independent practices are also reaping the benefits of these advancements.^33–36

While the heart of dentistry lies in the relationship between dentists and their patients, technological advancements are undeniably enhancing the patient experience and can drive further growth for practices. Whether you lean toward corporate dentistry or independent practice, one thing is clear – the dental industry is in transformation.

Section Two: Pathways for Dentists in Industry Settings

Dentist-Driven Scalable INNOVATIONS In-line with Mega Trends are Highly Attractive to Leading Industry Partners

Central to the daily clinical reality of modern dentists is achieving treatment predictability while meeting patients’ demands for optimized aesthetics, reduced invasiveness and costs, increased efficiency, and durability of treatments. This combination of daily experiences offers unique end-to-end insights, which entrepreneurial dentists may harness to innovate in treatment workflows and develop such innovations into profitable ventures. Indeed, dentists often initiate clinical innovations.

Consider three such examples:

• Dr. Bill Dorfman of US whose Zoom teeth whitening innovation fundamentally embedded cosmetic dentistry into the consciousness of the general population and drove patients into dental practices demanding for brighter smiles enabled by one of the world’s most popular tooth whitening treatments. He co-founded Discus Dental which grew into the global leader in professional tooth whitening solutions and entered a definitive merger agreement with industry partner Philips.³⁷

• Dr. Ophir Fromovich of Israel who pioneering intellectual properties in tapered endosteal designs in dental implants led to fundamental enablement of immediate implant treatment protocols, ensuring immediate restorations with adequate primary stability. While early on he kept such entrepreneurial activities alongside his clinical practice, his innovative implant designs eventually led to partnerships with leading industry players and inspired other companies to create similar designs.³⁸

• Dr. Florin Cofar of Romania who co-founded Smilecloud, which is a smile-design and centralized collaboration platform. This innovation fundamentally advanced treatment simulation for patients by analyzing a patient’s photographic and radiographic data and using AI to optimize smile makeover options. Smilecloud recently entered a partnership with Straumann and will be accessible through the Group’s “Straumann AXS” digital platform.³⁹

These examples highlight the potential value which lies in bridging clinical and industry partnerships. Insights from interviews with other representative cohort of such dentists, whose inventions have resulted in global commercialization, revealed the following four noteworthy themes which may offer valuable perspective for budding innovators:

• To innovate, dentist must carve consistent space, funds, and time to play, learn and improve their innovations. To succeed it may be necessary to collaborate with committed teams with relevant tangible expertise.

• Scalable innovations aligned with mega trends are highly attractive to leading industry partners who aim to accelerate value-creation and grow their footprint. The absence of scalability is likely to be a deal breaker.

• Industry–dentist partnerships are rarely rigid and require flexibility and trust. Investing in professional legal representation is a key enabler of speed but must focus on win–win negotiations.

• In collaboration with industry partners, dentist innovators will join teams of brilliant minds with varying expertise, including technical, marketing, sales, and education profiles. These teams contribute to further develop innovations into marketable solutions and innovators must find balance between which of their ideas to let go and which to hold on.

Budding entrepreneurs may find insights on how industry leaders scout for innovation opportunities useful. Company’s innovation-scouting efforts may include exploring intellectual property activities, actively or passively inviting submission of innovation ideas into their Innovation Portals, partnering with promising start-ups, and screening scientific literature base to identify key players and leaders in fields of interest. As such, dentists who commit part of their professional time to solving clinical workflow challenges would benefit from investing in building their intellectual property portfolio and assets, actively seeking collaborator companies, and publishing their insights. Today, this is especially relevant for dentists who embrace a digital mind-set as mandated by the overall digitalization trends.

While opportunities abound with potential to generate positive value in clinical and financial outcomes, there are limited resources. Therefore, awareness of how companies assess when deciding which solutions to prioritize in their innovation pipeline is important, which include:

• Clinical desirability:

  Companies often collaborate with dental experts to decide if an innovation candidate addresses clinical problems which are worth solving at scale.

• Potential scalability:

  Innovations with higher scalability potential are more attractive from a marketability perspective.

• Feasibility of successful implementation:

  Companies must secure internal and external resources and expertise, including collaboration with relevant dental professionals, to secure a successful rapid implementation.

• Market potential:

  Industry leaders tend to serve developing and developed markets which may have diverse needs and requirements; therefore, industry partners assess innovations for their relative relevance in various regions of the world.

Clinicians may Support DEVELOPMENT Projects in MedTech Companies

Companies in the dental field develop products under two continuous parallel lanes. One is to bridge a gap in the market or in their portfolio, and the second is to innovate. Either way, it is a race against time, because where there is opportunity, competition is certainly also working to commercialize it. Among opportunities where clinical experts play a pivotal role in companies, the development phase stands out as the stage where clinician experience is of utmost importance. This period integrates a dynamic and intense exchange of knowledge between clinicians (internal and external), developers, and product managers. On the one hand, clinical expertise sheds light on key clinical demands, and on the other, skilled technical engineers propose innovative product designs for optimized functionality considering market demands. Product designers must meticulously implement all the right engineering components, be conscious if similar predicates were introduced and/or withdrawn from the market due to a range of factors, including qualitative market feedback on potential lack of desirability.

During the development phase of a product, clinicians have opportunities to add value, such as:

• As experts on clinical needs.

  Clinical experts offer though leadership to development teams to navigate more precise paths.

• To assess and validate prototypes.

• In pre-clinical and clinical activities prior to and during product launch phases.

  These activities help to ensure product safety for human-use, and clinical experts support in shaping and executing these activities.

• During post-market surveillance.

  Occasional failures may occur in clinical care. In such instances, clinical experts contribute to post-market surveillance of clinical solutions rapidly and in constructive collaboration with the patients’ clinical teams, conducting root-cause analyses and triggering immediate, appropriate, and proportionate responses.

• In peer-to-peer activities.

  Clinicians who choose employment inside a company setting may serve to bridge with external peers. These professionals balance clinical expertise with in-depth knowledge about development projects and harness these insights in peer-to-peer activities for meaningful exchanges to influence the development of products in company settings.

Dentists may Contribute to MARKETING & EDUCATION Activities within and on behalf of Companies

Enabling safe handling of clinical products and solutions requires relevant educational offerings as well as communications related to clinical application for every phase of their commercialization.

In industry settings, educational efforts activate before first-in-human activities and remain active through limited and full market release of products. Dentists may contribute to educational activities in various contexts, including:

• In documentation of clinical case, especially of indications relevant to optimal use of products.

• In assessment and consolidation of scientific evidence-based into learning modules.

• In creation of technical learning content for the proper step-by-step use of products.

• In creation of indication-based learning content to show optimum clinical application of products.

• In creation of full curricula to support clinicians with relevant, individualized, and targeted learning pathways.

• In implementation of courses in their own clinics or academic institutions.

• As speaker educators to support podiums and workshops in professional congresses and events.

• As thought leaders to support activities such as testimonials, voice of expert inputs, consensus conferences and scientific debates.

Dentists may choose to take part in such educational activities through direct employment at the company of their choice, or through external collaboration, university affiliations or own academic institutions and practices.

Select dentists who have a leading professional voice in certain clinical fields, become known as Key Opinion Leaders, and often provide thought-leadership during the development and commercialization phase of product launches and therefore support many peer-to-peer activities and bridge their clinical followers to industry partners who can effectively serve them with relevant and reliable solutions.

Clinical Professionals may take part in RESEARCH Initiatives in Partnership with Universities, Academic, and Industry Partners

Medical Device companies face a multitude of regulations and requirements when it comes to offering products for human use. These requirements include conducting exhaustive fatigue tests and to ensure biocompatibility and suitability for human application. Each component undergoes meticulous testing, and like a full-fledged research endeavor, follows rigorous protocols. The documentation generated during these stages is like a master’s dissertation in its depth and detail. To give an example and a sense of scope, dental implant designs undergo Finite Element Analysis (FIA), followed by the physical parts enduring extensive fatigue tests involving millions of cycles of stress testing to simulate real chewing performance over time.

In addition, medical devices must satisfy biocompatibility tests. This requires pre-clinical research in surgical settings. Following favorable histological results, a comprehensive documentation package is created. This package serves to verify that the product is safe for human use and is later submitted to regulatory authorities for authorization to enter the market. Clinical teams responsible for the pre-clinical activities typically consist of both internal and external clinicians. Finally, research results published in peer-reviewed journals add value to scientific consensus conferences, such as that held by the ITI – International Team for Implantology.

Summary and Conclusions

The dental industry, including dentists and MedTech companies, are affected by global mega trends, including digital transformation, oral care coverage gaps, consolidation and rise of corporate dentistry, and patients as own clinical partners.

The desirability of the dental profession stays high whether in traditional career pathways, such as clinical practice, academics, and research, or in alternative pathways, including employment within, or collaboration with, industry partners.

Leading dental medical device companies create value from the key pillars of innovation, development, marketing, education, sales, post-market surveillance and product lifecycle management. Today, dentists have unprecedented opportunities to embark on alternative professional pathways within each of these pillars.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Artemiz Seif

Artemiz Seif, DDS, is a general dentist and Head of Global Medical Education, Launch Readiness & Innovation at Straumann headquarters in Basel, Switzerland. A graduate of the University of the Pacific Arthur A. Dugoni School of Dentistry in San Francisco, CA, her career experiences have included patient care in her own and group interdisciplinary practices, multi-center clinical research in collaboration with Mayo Clinic, academic service as adjunct professor in restorative dentistry, and organizational leadership in private companies, academies, universities, and international medical device settings. Dr. Seif is currently leading a global effort to expand the understanding of the role of education technologies in dental implantology education and their potential to improve access to care and treatment outcomes.

Christian R. Jarry

Christian R. Jarry, DDS, MS, PhD, holds a Master's in Periodontology and PhD in Implantology from Faculdade São Leopoldo Mandic - Campinas, Brazil, and currently serves as Associate Director of Global Clinical Affairs at Straumann headquarters in Basel, Switzerland. Since graduating at University of Santo Amaro, São Paulo, Brazil in 2005, Dr. Jarry has focused his career on advancing Dental Implant and Periodontal therapies, has authored, and co-authored articles and textbook chapters, and has served in multiple global initiatives focused on product developments and implantology education. He is also an active member of the International Team for Implantology and has taken part in global consensus conferences with the ITI.

Amélie Michèle Chauvel

Amélie Michèle Chauvel, BS, MBA, holds a Master of Business Administration from EDC Paris and currently serves as SVP Strategic Planning and Transformation at Straumann headquarters in Basel, Switzerland. Up to 2023, she managed the innovation and portfolio pipeline as well as pricing for the Group. She has directly supported the executive leadership team in steering all major initiatives aligned with the company’s long-term perform/transform strategy. She oversees the Transformation Office in which the strategic project management team drives digital transformation and overall change management efforts into new business areas. She has 20+ years of significant North American- and European-based experience in strategic planning, digital transformation, change management, and project management focused in the MedTech industry. Prior to Straumann, she worked at Nobel Biocare, Danaher and LG-Ericsson in South Korea and North America.