A New Era of Preventative Care in Dentistry – AI Abstract

Abstract

With skyrocketing costs of dental care, rising signs of inflation, and over-worked healthcare providers all increasing at an alarming rate, the state of the US healthcare system is often painted in Sisyphean light. But lost among the ballooning costs, are a few advances that could entirely reshape the way Dental Care is delivered. And with a few champions leading the way, we may be headed towards a golden-age of patient-centered care in dentistry.

Setting the stage
When you read about the state of the US healthcare system, the rising costs of care is perhaps the number one headline you’ll see. With healthcare expenditures ballooning from 7% of US GDP in 1970 all the way up to 18% in 2019, one might think the US is a healthy nation.

After all, we are spending far more than any other developed economies on healthcare, as a percentage of GDP.

One effective method for combatting the rising costs of healthcare, as highlighted by Health Payer Intelligence, is in increasing the frequency of preventative care services, reducing the occurrence of chronic diseases, while decreasing hospital utilization admissions and utilization rates.

Signs for hope in Dentistry

In the dental sector, we are seeing the rise of a few trends that would enable a step-function increase in the ability to deliver preventative care. From telemedicine to provider search tools, access to care for consumers is increasing at a rapid rate. And on the provider side, teledentistry and AI-based diagnostics are equipping providers with the tools needed to detect signs of trouble early enough to intervene — and, in some cases — prevent the development of costly, painful, and life-altering chronic conditions.

In a study published by Guardian Life Insurance, increased utilization of preventative dental care accounted for 16% in cost savings for an employer group.

However, the application of preventative care as a means to demonstrably improve healthcare outcomes in dentistry requires bold leadership and a firm commitment to overcoming the growing pains that accompany innovation. The successful implementation of these methods requires substantial investment in new equipment, a disciplined focus on training and change management, and a provider culture that is dedicated to patient-centered care.

“Dentists are expected to fill the role of primary care physician, surgeon, specialist, and diagnostician all at once. The right way of operationalizing AI can help them tremendously to effectively tackle these highly specialized tasks in their practice.”- Florian Hillen, Founder & CEO of VideaHealth

Staring down a regulatory landscape placing ever-greater scrutiny on providers, and along with the dynamics of patient-provider relationships shifting with the rise of telemedicine, the goal should be to enable a future where doctors maintain clinical autonomy while enabling
patient-centered preventative care.

Heartland Dental
Heartland Dental hasn’t become the nation’s leading Dental Support Organization (DSO) by accident. Since 1997, Heartland Dental has been leading the way in providing new and innovative approaches to supporting its dentists, clinicians, and support staff nation-wide. Heartland Dental’s doctor led culture and business model provides supported doctors with the opportunities to focus on dentistry as they support with the day-to-day non-clinical administrative workflow with their innovative yet proven systems and processes so doctors can deliver exceptional oral care to their patients, and maximize their own clinical and economic growth now, and into the future. Heartland Dental is also widely known for providing supported doctors and hygienists with an abundance of continuing education programs and leadership development opportunities. Heartland Dental’s non-clinical administrative support allows dentists and their teams to focus on delivering high-quality clinical care and excellent patient experiences. With their strategic transaction with American Dental Partners and expanded affiliations, Heartland Dental’s support network has grown to over 2300 dentists, across 1400 locations.

It is important to remember, as we evaluate new and emerging technology, how these advancements fit into the workflow of a dental practice. Ultimately the goal is to provide better support options for clinicians in regard to their autonomy with diagnosis and delivery of the highest level of care to their patients. With all the enhancements in technology, it is imperative to analyze ways to elevate and enhance the provider/patient relationship. Clinical autonomy must continue to be the first and foremost focus in discovering how technological advancements can be utilized to assist doctors related to their clinical decision making. There is huge potential with this specific technology to offer much earlier intervention, enhancing preventative dental measures, and allowing patients to keep their teeth for a lifetime. Catching decay earlier in the process will allow for less invasive procedures and ultimately reduce long-term costs. As it is within the rest of our daily lives, AI and machine learning offer huge potential within dentistry to benefit every single patient and provider.

Leveraging AI to provide preventive care
One way in which Heartland Dental supported clinicians have been re-imagining the world of dentistry, is in the application of AI to improve the sensitivity (consistency) of diagnosis. Working with VideaHealth, Heartland Dental supported clinicians demonstrated the ability to detect 46% more caries lesions in a specific patient radiograph group when assisted by Videa’s AI software. This means earlier diagnoses, earlier intervention, and substantial cost savings to the patients through reduced invasive care.

Another way clinicians within Heartland Dental’s support network are elevating their approach to preventative care is in leveraging new methods to reduce false diagnoses. In the same clinical study, clinicians were able to demonstrate a 13% improvement in their already industry leading diagnostic accuracy, when equipped with AI assisted solutions.

To put this into perspective, Heartland Dental supported Doctors and Videa looked at what this means for a population of 200 patients. The findings show that with VideaHealth’s AI solutions, an additional 130 caries would be correctly identified from a population of 200 patients. Perhaps even more interesting, is the reduction in false positives that would result, from 75 down to 46. The increase in the accuracy of identified caries means earlier detection and earlier intervention, resulting in fewer high-cost, high-risk invasive procedures.

The methodology
To test the value Videa’s AI can deliver to Heartland Dental dentists, Videa and Heartland partnered to set up a controlled experiment. Randomly selecting 50 intraoral radiographs from a representative pool, the 50 images were then presented to a group of 6 Heartland Dental Dentists who were asked to review them for the presence of carious lesions and mark their findings (diagnosis) on the software. VideaHealth then ran those same 50 images through Videa’s Caries Detection AI and presented the images with the AI findings overlaid to the same dentists, asking them to review the radiographs again for the presence of carious lesions. The two reads — the aided read and the unaided read — were separated by a seven-day washout period, and the order of the images was randomized to minimize study bias. For both reads, the dentists were asked to emulate their clinical practice by using a similar monitor, spending the same amount of time, and following the same practices as they normally would when seeing a patient.

The results from both reads were compared to a consensus-based ground truth to produce the study results presented above.

A new generation of value-based care

With Heartland Dental’s reach as the nation’s largest DSO, continually seeking ways to provide opportunities for supported clinicians to focus on enhancing preventative care leads to improved doctor-patient relationships, along with substantial cost savings in lifetime care. And keeping the
patient/provider relationship, along with doctor clinical autonomy, front of mind must be the focus on these potential improvements.

“AI accuracy is 5/5. it is very rare that it would detect something that wasn’t there, it has not missed anything as far as I could tell! Even with overlap it does pretty good seeing cavities through that!” – Dr. Dunlap, Complete Care Dental

“Very cool. It pointed everything out, looks like it made it easier for them and made it easy for me to understand what is going on” – Patient, M, 30-40 age

Heartland Dental supported Doctors have long applied a unique and bold approach to innovative care delivery models. And with the backing of KKR, Heartland Dental is positioned as a world-class company, to assist in driving the Dental Support industry forward.

To find out more about VideaHealth and receive a demo visit VideaHealth.ai or email [email protected]

About VideaHealth
Founded in 2018 and born out of Harvard and MIT research, VideaHealth is on the mission to improve patient health through the power of AI. Videa’s platform drives improved quality of care for patients by using AI to augment the diagnosis and treatment planning capabilities of providers. Partnering with leading DSOs across the country, VideaHealth is committed to helping DSOs usher in the age of preventative care in dentistry. In 2021, VideaHealth raised $6.5M in venture funding to expand the engineering and customer operations teams, and to continue to invest in the sophistication of its AI.

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