The Group Dentistry Now Show: The Voice of the DSO Industry

Dental AI Podcast

Welcome to the #1 DSO Podcast! In this episode we are joined by McKenzie Fagan, Vice President of Enterprise Sales at Pearl, to discuss the transformative advancements in dental AI and what to expect in 2025. McKenzie shares:

Overview of Pearl’s innovative AI products
The impact of AI on treatment acceptance and patient trust
Insights into Pearl’s funding and partnerships
Predictions for the future of dentistry in 2025

For more information about Pearl, visit www.hellopearl.com and connect with McKenzie on LinkedIn – https://www.linkedin.com/in/mckenziefagan/.

If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.

Choose your favorite listening app below and subscribe today so you don’t miss an episode! Full transcript is also provided below. See all of our podcasts HERE.

Dental AI Podcast Transcription

Bill Neumann: Welcome everyone to the Group Dentistry Now show. I am Bill Neumann, and we are in 2025. So a new year, exciting times, hoping for a better year in the dental industry and the DSO space. It was a little bit of a bumpy year for a lot of group practices. I think dental industry partners as well, although Pearl seemed to have a heck of a year in 2024. And we’re going to talk about all those accomplishments, those milestones in 2024. And we have McKenzie Fagan with us. She is the vice president of enterprise sales at Pearl. So Mackenzie, thanks for being here.

McKenzie Fagan: Thanks, Bill. Excited to be here.

Bill Neumann: Yeah, this is a lot of fun, and I’ve known Mackenzie for quite a while, and I’m sure a lot of people watching this, listening to this podcast, she is a familiar face in the industry. But maybe for a couple of the people that don’t know you, could you give the audience a little bit of a download on your background, and then a little bit about your role at Pearl?

McKenzie Fagan: Sure, more than happy to, Bell. First of all, just say thanks for having me. I’ve been a big fan of group dentistry now for several years since I joined the DSO space. It was one of the first new sources I was able to really learn about what’s happening in our economic environment, what DSOs are interested in, and really been able to learn so much from you over the years. So excited to be here. To introduce myself, my name is McKenzie Fagan. I’m the VP of Enterprise Sales here at Pearl. I joined just this last year in 2024 for what I think is a really good reason. I really believe in what Pearl’s doing in terms of AI, not just radiologic AI, but seeing how AI is now taking a deeper step into our dental space. And let’s be honest, it’s not just the dental space. It’s our whole world is embracing AI. And now it’s not a matter of if AI is going to work, it’s what’s going to work for you. And I look forward to being a part of that mission here at Pearl. To give you some background on me, I spent almost eight years with Henry Schein, focused specifically at Henry Schein. One, I led our enterprise team for several different products, our practice management systems, analytics solutions, revenue cycle management solutions. And really, I focused on partnering with dental service organizations, large multi-site organizations to create economies of scale, whether that was through centralization or standardization or really just embracing their technology stack to ensure that they have the right technology systems in place. Before that, I was actually the first female hired at a really small dental software company called Doctable. We were one of the first companies that did texting and email services. Isn’t it funny that that was a relatively new thing at the time? And now that seems standard across the board. So now I look forward to 10 plus years from now having AI be standard. just like texting is today in the dental space.

Bill Neumann: Yeah, that’s a great point, that perspective on how fast technology is advancing. And sometimes we, you know, you kind of think back to, you know, really not too long ago, we had flip phones and, you know, there was, texting really was a difficult thing. then for sure. And now we have dental AI, and we have all sorts of dental AI. So, you know, we’re going to talk about, you know, Pearl’s impact on the dental industry, both the patients and the practitioners, and how it’s really, really changing the way dentistry is done. So, like I mentioned before, Pearl has actually had a transformative year in 2024, and you have a great press release that came out January 2nd. I’ll drop a link to it in the show notes because it really does sum everything up, but I’d love you to go into a little bit more detail because You did a lot last year as an organization. And so maybe let’s start with product innovation. So a couple of new products. You have PreCheck, which is a groundbreaking AI-powered insurance eligibility and benefits verification tool. So talk a little bit about what that means. What is PreCheck?

McKenzie Fagan: Yeah, so what we found is we started out with radiologic AI, essentially that is scanning the x-rays using computer vision, which is a type of AI, to read millions and millions of images to be able to decide where we should focus on that particular image on certain pathologies. What we found is when you’re reading all these x-rays, you get a whole lot of data. This is the very first time that we’ve ever been able to take data from images. Think about any aggregation platform that you might have used in the past or even are using today, whether it’s Power BI, Jarvis, Dental Intel. All of those are fantastic companies, but they all read from the practice management system. Well, where does the data come from in the practice management system? Typically, manual data entry. Your employees have to input that information to the practice management system and hope that it’s correct and hope that everyone’s doing it the same way. Well, we know that that’s not typically the case, right? So what Pearl is doing is able to read the x-rays to be able to take a large data set from your x-rays and now marry it with that practice management system. What we found is while we were working through all the intricacies of how we’re going to make this data work and be effective and useful for DSOs, we found that we had a lot of advantages in the insurance space. So I think everyone at this point probably knows when you attach an image to, or you attach an x-ray that has the AI annotations on it when you’re sending it to the insurance company, it’s a lot more likely that that’s going to get accepted. Essentially, you have an FDA clear robot saying, yes, we agree with the doctor. There is indeed a pathology right here that we need to submit and eventually get paid for, right? Well, with that, we developed what we call insurance pre-check. It’s essentially an insurance verification system. Now, I come from several years in the dental software space, and I can truly say I’ve never seen anything like this. What we’re doing with Pearl’s verification piece is running through four different clearinghouses simultaneously to get full breakdowns of every patient several days in advance. and the same day if we have patients coming in for same-day dentistry. Where this becomes really unique is that not only are we able to pull in all this information into one place regardless of practice management system, regardless of if they’re centralized or on cloud or on server base, but we’re also able to get the full history of every single patient down to the tooth number. This is information that we’ve never been able to see before. If you did, required a lot of manual entry. I know a lot of DSOs are hiring. different companies to do this manual work. This is one of the first times we’ve ever really been able to see it be successful from an AI perspective. So it’s been by far one of our leading products just this last quarter, and I expect it to really take off in 2025.

Bill Neumann: So we also have Calibrate. And so this is the first AI-powered clinical calibration and training tool. So really interesting, and the training aspect of it in particular is, to me, and I’m sure to a lot of DSOs, is you have younger clinicians that are able to use this tool. I think it probably is great from a mentorship standpoint as well. We talk a lot about the importance of education and training in DSOs. I think a lack of bandwidth sometimes with some of these DSOs to actually be able to provide that training. So talk a little bit about Calibrate if you don’t mind.

McKenzie Fagan: Yeah, I think the name explains where we’re going here. But essentially, Calibrate is the first AI-powered tool to assess and measure clinical excellence. So let me start with how Calibrate was created, as I think that gives you a better idea. So University of Pacific and UCLA actually started using Perl’s detections. We actually didn’t know, fun fact. They were using it for all sorts of different purposes. But what they did is they decided that if they could essentially create a standard, let’s just say we took 10 x-rays, it was more, let’s say 10, and we, across those 10 x-rays, said these are the pathologies that each doctor should be able to detect. Well, now they send a blank x-ray, when I say blank, I mean without the AI annotations, off to several different doctors to where they can put their inputs into what they see on that x-ray. Well, what we found is actually regardless of tenure of the dentist, several dentists disagree. They saw different things. It happens all the time. So what Calibrate is doing is it’s a tool for whether it’s schools or DSOs to essentially set a calibration of what the doctor should be seeing on that particular x-ray, then send a quiz, if you will, to each doctor to be able to show exactly what they’re finding, and then use it as a coaching opportunity. If there was something that they missed or something else that they should see, or even just talk about how they should be diagnosing, it’s a really, really effective tool to work with several doctors, especially when you’re a large DSO and you can’t be in the office with every single doctor every day. We’re seeing DSOs use it for a recruiting tool as well. So as you know, when you’re looking to acquire practice or even if you already have the practice and you’re looking to bring on a new doctor, you can interview doctors all day long and they all sound great. They all have a great resume, a great GPA, but they all diagnose a little differently. This is a great tool to be able to understand how that doctor works and what you’re getting before they come into the practice.

Bill Neumann: Yeah, that’s great from the recruitment standpoint, too. Another huge challenge throughout the last three, four years in the DSO space. And I think in 2025, that’s not going to go away. And I am sure younger clinicians are expecting technology like Pearl in a practice, certainly that they’d want to work for, or DSO that they’d want to partner with. So moving on, you’ve also had, beyond the product innovations, had a lot of interest from investors. You had, let’s see, $58 million in Series B funding recently, last year. And then also, which I find fascinating, you had the Dental Innovation Alliance, which is a VC fund in the dental industry, investing into Pearl, and the American Dental Association, which is pretty surprising and exciting at the same time. So any insight, background on those investments?

McKenzie Fagan: Really exciting. 2024 was a really great year for AI, I think, in every landscape, but specifically in dental. We’re proud to announce that Pearl received the largest investment ever in dental artificial intelligence with that $58 million in Series B funding. I think that maybe that’s not old news, but that happened earlier this year. To your point, the ADA just made a very strategic investment in Pearl’s AI platform. So, I’ll read a quick quote from Roger Liu, the chair of ADA’s Innovation Advisory Committee. He called Pearl a forward-thinking business that re-envisions the needs of the industry and said investing in Pearl represents their ongoing commitment to transformational dentistry that positively impacts the industry, as well as the oral and overall health of the public. So how I look at this investment is we see that medical is trending in this way, and we now see that dental is finally following in that direction. To your point, Bill, I think not only are new dentists expecting this type of technology and practices that they work with, but we’re also seeing patients start to expect it, right? Patients want to see that They know that this type of technology is out there. It’s becoming a basic human right to understand not only what your doctor is saying, but also what the FDA cleared machine is seeing on that image as well. Of course, this helps with case acceptance and really helps with patient trust in the long run.

Bill Neumann: 2024 was also a year of partnerships for Pearl. And I do want to say this about Pearl. This is the other thing that I noticed compared to maybe some other companies in the industry. You have a real global presence. So you’ve got, you have clinicians, I believe the number is 150,000 practitioners globally, meaning Canada, U.S., Europe, Asia Pacific. So you truly are a global company. And you have practitioners all over. But the partnerships, which are also global, you’ve got partnerships with practice management software companies, platforms, you have distribution partnerships, you have partnerships with DSOs. So talk a little bit about that because that’s also exciting.

McKenzie Fagann: Yeah, in the last several years, as much as we were obviously working on the AI developments themselves, a big part of our strategy has been focused on our partners. So we are cleared in actually 120 countries. So FDA clearance is obviously here, you know, domestically in North America. But we are working in several different countries. We’ve got team members all over the world that are selling and implementing Pearl’s artificial intelligence solutions. Fun fact, Pearl is actually the only AI-cleared medical or dental device in the country of Japan, and we don’t see us slowing down any time soon. So that’s been a big part of our global strategy. Now, of course, working domestically, there’s probably the majority of your audience that’s listening is located in North America. We’ve focused a lot on partnerships, not just with imaging companies, but also with practice management system companies. At Pearl, we truly believe that artificial intelligence is successful when it’s part of a native workflow. No one wants to leave to go to a separate solution. When it is part of your imaging system or part of your practice management system, that’s when you can really transform the workflow of your practices. Also, keep in mind, less training. It just becomes a natural part of that user’s workflow. AI is relatively language agnostic. You don’t really have to speak any certain language to be able to hover over and see a circle on a cavity to see what percentage of it has progressed into the dentin when that number pops right up. So we’ve really been able to expand globally and with our partners domestically by integrating to several different management systems.

Bill Neumann: So 2024 again, big news, leadership expansion, you being one of the leaders. So, and you mentioned it earlier that you started in, I believe it was September of 2024. So yeah, that you’ve expanded and you’re focused on enterprise. So meaning group practices, DSOs, is that what enterprise means to Pearl?

McKenzie Fagan: Correct. Think of any multi-site organization. So some are called DSOs, some are called DPOs. I’ve heard probably 10 different acronyms, but essentially for large organizations. So we also work with very large consulting groups, even groups that are part of any affiliate organizations. Essentially, we want to partner with them to enhance their level of care. But yes, we’ve made quite a few strategic hires this year. We brought on Brian Kin, who was our chief product officer, who has worked for several years in computer vision and brings an incredible breadth of experience to our team to help us launch more products and get really, really good at the products that we have today. Secondly, something that is really near and dear to my heart is we’ve invested into our customer success team. We brought on Bobby Cooper as our VP of customer success. Really, what Bobby is focusing on is embracing our onboarding and initial experience with our customers. Large DSOs, of course, but also with all of our private practices. As we serve 150,000 dentists globally, that’s a lot of customer support. anticipate that to grow rapidly this year. We’re really working on enhancing our experience with custom trainings, custom workflows, because every doctor that I’ve worked with does something a little bit differently than the next. So as much as AI is intuitive, ensuring that these doctors know how to embrace it, that is the absolute key to success when it comes to AI. It’s not just having it populate there, it’s knowing how to have that conversation with the patient. how to turn the computer, show the x-ray to the patient, and have the patient actually understand what’s going on with their mouth rather than just being a diagnostic tool. Of course, parole is both. It helps detecting where the doctor does the diagnosing, but it really helps when you have the patients understand what’s actually going on and then, of course, move forward with treatment. So that’s where Bobbi’s focus is today. And we’re planning on making several other hires in the beginning of this year that we’ll be announcing on the next podcast.

Bill Neumann: That’s great. That’s great. We’re going to get into what to expect in 2025 in a second. I would, so our audience is fond of data and statistics. So he took a little bit about, and I’ve got some in front of me here, but, you know, using Perl compared to somebody that is, is not using AI in a practice, Any stats on what they see having this AI versus not having it? And then what’s the impact on the practice, whether it’s treatment acceptance, whether it’s uncovered opportunities? Discuss that a little bit.

McKenzie Fagan: Yeah, I also want to just discuss some myths about AI too, as I think that that ties really well to the data that I’ll share as well. I think that there, in the past, has been a fear about AI, you know, or I’m a dentist, I’m really good at my job, I don’t need AI. Well, the reality is we don’t probably need spellcheck either, right? I’ve written emails my whole life. I have my college degree. I know how to write sentences. I know, you know, I have pretty good grammar, I’d like to think. But the reality is I keep spellcheck on all the time just to ensure that everything is set or spelled properly and the grammar is done correctly. Think about AI in that way now. If you’re a doctor or a dentist that is really, really good at your job and you’ve been doing this for several years, the reality is we’re not perfect. So I’ll give you a good case study is we had a series of doctors read images and they did very good, let’s say, at reading those images standalone. We then had the AI go and read those same images. And it did pretty well as well. But what happened when we had doctors read the x-rays with the combination of the AI, we found that the dentists were able to identify 37% more decay than if they didn’t have the AI alone. So, the reality is, AI is just detecting. Again, it’s not diagnosing, right? It’s bringing everything to the surface that you could possibly find on that image. But when you combine that with the tenure and clinical experience of a doctor, that’s when you find these incredible insights on each of these images. So, we’ve seen practices uncover an average of $31,000 to even $52,000 per month in previously undetected monthly production opportunities. It’s absolutely incredible. We just launched a case study that you can send the link to in this podcast for on-site dental. They onboarded Pearl across several of their locations, and their result was a 20% network-wide increase in treatment. per patient. So that’s not just in the detections. That was in accepted, completed treatment moving forward. So what we’re finding is Pearl is obviously helping detect more. Again, not diagnose. That’s on the doctor to do. But detect and highlight what areas the doctor should be focused on. Then when you couple the ability for the patient to actually see what’s happening on that image, we’re seeing patients accept that treatment and want to move forward faster. We’re also noticing doctors can see such a big difference of images that were taken 12 months ago or six months ago and an image that was taken today. Because think about it, AI can see several hundred more shades of gray than the human eye can. We can get really granular to see how much That cavity has progressed in the last 6 to 12 months. So now the doctor can make a really good decision to say, is this something urgent? Do we need to handle this right now? Or is this something that can wait another 6 months? It also helps the patient understand when the doctor says, this can’t wait. This is going to be a severe problem if we don’t move forward with it. Really helps the patient to understand why this is such a critical piece to move forward with.

Bill Neumann: Kenzi, as we start to wrap up the podcast, I want to, you know, we talked a lot about 2024. I think we would love to talk more now about 2025. And, you know, what, what should we expect from Pearl? And then what do you think are some trends in the DSO space when it comes to technology, when it comes to AI? Just, it’s, everybody likes to kind of get out the crystal ball. And we mentioned it earlier on in the podcast, Technology is advancing so rapidly. AI is really, I mean, when you kind of think back, Pearl has not been in existence really that long. So what’s 2025 look like?

McKenzie Fagan: Yeah, great question. Lots more development. The good news about AI is we can roll out new products really fast. And the AI just gets smarter every single day that every doctor uses it. So my prediction for 2025 is we’re going to see a shift in dentistry from reactive dentistry to proactive dentistry. Meaning everyone has heard of a daily huddle, whether your team uses them or not, or it’s chaos in the morning, or you have a very structured plan. Most offices do some version of a daily huddle where they look and see everything that’s happening on, that’s on the treatment plan for each of the patients coming in that day. With AI, we’re now able to read those images historically. For Pearl, we can even go back 18 months in advance and annotate the AI on each of those historical images to now make predictions about what that patient might need that’s coming in today. What this means, when we go back to the daily huddle, is that now we can not only look at what’s treatment plan for the day, but also what the AI has predicted at the same time. This means that now when it comes to proactive scheduling, we can decide a few days in advance if we should call a patient and extend the length of their appointment as we found something that we should probably have time to talk to the patient about, see if we can move forward with same day dentistry. I also think coupling with this, in 2024, we saw a lot of same-store growth. I know on Group Dentistry now, this was a very big topic. We saw a lot less acquisitions. It was a lot more expensive to buy practices and a lot of DSOs focusing primarily on increasing the businesses that they have today. Well, Pearl is a great resource to increase same-store growth because you’re still – you’re not diagnosing anything unnecessary for the patient. All you’re doing is maximizing everything that’s already there in that patient’s image database, right? So now what I foresee is that we’re going to get very predictive in where we need specialists. We can decide which practices among the 100 location DSO have the most SRP patients where we should really be focusing on and making sure that we bring in a periodontist. We can now get very tactical at where a DSO invests, what type of investments they make, where they expand, where they might decide that they want to open up an orthodontist or a different type of specialist down the road from other practices. I really think we’re going to get a lot smarter in 2025 and I’m really excited to see how DSOs embrace that.

Bill Neumann: Yeah, exciting times and congratulations on a great year in 2024. And we’re going to have another podcast soon together. And I’m sure we’ll be having different conversations about what you’ve been doing in 2025. But I’m excited. I think that there is this increased adoption with AI in the dental industry, definitely more of a comfort level with it. I think you talked a little bit about the, you know, maybe a fear factor a little bit, is Big Brother watching me? But no, it’s really, it’s a tool to assist and not necessarily diagnose. And I love the analogy. The spellcheck analogy is wonderful. And it makes a lot of sense. Yeah, and yes, I feel like I am relatively good at spelling, but do I have spellcheck on? Absolutely. And does it catch issues? All the time. So I think that is a wonderful analogy and should give give dentists, you know, some comfort that you’re using something like this as a backup and in some cases for some younger clinicians as a way to train them and help them feel more comfortable that they do have that support when they are diagnosing. If people want to find out more about Pearl or McKenzie, if they want to get in touch with you, what’s the best way to do that?

McKenzie Fagan: More than happy to email me, message me on LinkedIn. I try to be pretty responsive. My email’s pretty simple, McKenzie@hellopearl.com. We’ll put it in the link here. So please feel free to reach out. We’re more than happy to chat.

Bill Neumann: That’s great, and the website is hellopearl.com. We’ll drop that URL in the show notes as well. And you can also, if you want to get a demo there, you can sign up for that as well. But yeah, reach out to McKenzie Fagan. She’s on LinkedIn all the time, or you can email her, and you’ll probably see her at one of the many dental DSO events in 2025. You might even see her up on stage. She has been known to be on stage quite a bit. I’m looking forward to seeing you this year, McKenzie Fagan, in person. And thanks for taking the time with us and letting us know all the great things that are going on at Pearl. Exciting times in the dental industry and with AI, for sure. And thanks, everybody, for watching this podcast. 2025 is going to be an exciting year. And until next time, this is the Group Dentistry Now Show.