A New Era of AI-Powered Dental Imaging

Planet DDS, a provider of cloud-based dental software serving over 10,000 practices in North America with over 60,000 users, has recently announced a partnership with Overjet, a dental artificial intelligence (AI) solutions provider, to incorporate AI capability into its Apteryx XVWeb Cloud Imaging software and all-in-one practice management solution, Denticon. The new AI integration will provide real-time decision support to dentists as they review X-ray images with patients and increase confidence in their clinical decisions, promote proactive and preventative care, and enhance provider-patient relationships.

This is the only partnership in the industry that collectively delivers:

An FDA-cleared solution that can quantify bone levels in addition to detecting and outlining decay.
The scalability of the Apteryx XVWeb software, allowing practices to use virtually any imaging device.

Group Dentistry Now recently hosted Eric Giesecke, CEO of Planet DDS, and Wardah Inam, CEO of Overjet, to discuss how technology, including artificial intelligence, can help DSOs centralize, streamline processes, and improve patient care. Here are some highlights from that discussion:

GDN: Some said 2022 was the year of dental AI. What are some 2023 trends and how does cloud technology fit into those trends?

Eric Giesecke: Outside of AI, the trends that we’re seeing from a DSO perspective are around patient experience. As a younger generation starts to care more about convenience technology: how do we make it easy for people to reappoint, how do we make it easy for people to find financing options, how do we increase treatment plan acceptance. I think the cloud helps with that in terms of being able to deliver that easily. Access and communication is easier through a centralized cloud solution.

The second trend I would say is centralization. I think RCM is becoming more of a focus and how we think about data standardization, which results in fewer adjustments, and how we build automation into the platform, so we don’t have as many errors in standardization. I think being on a single system that you can access from anywhere really helps either centralize and/or standardize.

And then the third one – something we’ve focused quite a bit on actually – is standardization of care (or experience) for patients. How do you make sure across all of your offices have a similar check in process with the front desk person asking the exact same information in all the offices? The DSO’s software should ensure that congruence, which helps provide a sense of control from a DSO perspective, particularly as DSOs are scaling and acquiring and training and there’s turnover.

GDN: Can you give us an update on Planet DDS, specifically Apteryx and Cloud 9?

Eric Giesecke: Apteryx is now a key brand within our portfolio of brands as a company, which is Denticon, our practice management software. Denticon is the core system of record software. Apteryx, our imaging software, and Legwork, which is patient acquisition and patient relationship management software. We’ve most recently added Cloud 9. We acquired Cloud 9 for those DSOs that are multi-specialty. It’s the leading practice management software for ortho, pediatric, and multi-specialty with a primary focus on ortho. We have roughly 800 customers serving thousands of orthodontists across the country. From our perspective, it rounds out our product suite as an integrated solution. Our intention is to integrate both Denticon and Cloud 9 such that if you are a multi-specialty office you have best in class. We are very excited about it. We were fortunate enough to acquire the customers of QSI Dental, the largest on-prem provider of product management software for large DSOs. Additionally, we brought on 20 members of that team as well as some really great customers. We’ve been pretty busy, but things are going well.

GDN: Wardah, last time we had you on it was April of 2021, so you were still in startup mode then. You were on the podcast with Dental Care Alliance and Heartland Dental. Can you provide a brief overview of Overjet’s dental AI technology and a few updates since then?

Wardah Inam: One of the reasons I connected with Eric was his acquisition of Apteryx in the middle of COVID. I think it was one of the smartest moves I’ve seen in dentistry, and I don’t think anybody is doing acquisition the way Eric is. So, kudos to you Eric, I don’t think I’ve said it to you in person before and I didn’t even know the Cloud 9 strategy here as well. So that’s pretty cool. And in terms of our podcast, I think you were absolutely right, we were just educating people around what they would be able to see in the future. And I think in a very short amount of time, I would say quite a few of your viewers and listeners are probably customers, if not of our technology, of other dental AI as well.

Our company uses computer vision technology to analyze dental x-rays in the same way that a dentist would. The difference is that our technology provides a more quantitative analysis and we can process large amounts of data consistently. This helps us identify areas where clinical improvement can be made in dental practices. Additionally, our technology provides dentists with a tool to communicate more effectively with patients about their oral health and provide a more comprehensive diagnosis. This can lead to increased treatment acceptance rates and better-informed patients who are able to make better decisions about their health, ultimately improving overall health outcomes. In essence, our technology automates the process of marking up dental x-rays to identify disease and tooth numbers with a high degree of accuracy.

GDN: Eric, talk about dental AI technology and how that works with both imaging and the practice management software.

Eric Giesecke: I’m really happy to have a partnership with Overjet. With Wardah, we’ve worked really closely with the team for many months on the AI imaging side of things and the benefits within the radiograph itself. Currently, the crux of our integration is through Apteryx XVWeb. When you open up an image or a series of images, we pass an image over to Overjet. Overjet runs their models to identify the areas of pathologies, they return back what’s called a JSON file. Think about plotting points, and then you click a button, you can toggle on the different pathologies to actually see on the radiograph the areas of potential issue like decay.

So, the cool thing about it is what Overjet’s doing in terms of thinking about the objectivity related to having a patient in the chair and being able to say, “It’s not just me who has identified this cavity that you may or may not have any pain with.” We’ve all been in a dental chair with someone saying you have three cavities. “Well, my teeth don’t hurt, so I don’t know if I believe you.” Having an objective AI engine to confirm will drive treatment acceptance. The current focus has been around the AI overlay with the imaging, which we’re super excited about and we’ve got around 50 customers using it today with really, really great response. There’s clearly a lot of interest in it.

Wardah Inam: I think treatment acceptance is probably one of the most important metrics for any practice to improve on because we know where these metrics are right now. On average it might be about 50%, and in some practices, even lower. And you’re talking about medically necessary treatments that patients are not accepting because they don’t understand their oral health, they do not know what tooth number two is, they don’t know what periodontal disease is.

So there is a lot of education that has to happen in dental practices for patients to better accept the treatments and get the treatments which is needed for their improvement of their oral health. The technology can help communicate and therefore increase acceptance. I would say we’re still in early stages but for those who have implemented the technology very seriously, they are seeing gains.

GDN: Wardah, from a clinical perspective, can you talk a little bit about Overjet’s technology and really maybe focus on streamlining and then how do you provide consistency when it comes to diagnosis and treatment planning?

Wardah Inam: The consistency of treatment plans and diagnoses may vary among dentists due to factors such as cost optimization and time constraints. Overjet’s AI technology helps dentists provide more accurate diagnoses by identifying conditions that may be missed and providing quantitative information for better communication with patients. The dentist still makes the final diagnosis and treatment plan, and the AI technology is just a tool to assist in the process.

GDN: Eric, technology is moving so quickly now and I think it can be overwhelming for dentists and groups alike. Sometimes it’s easier to say, hey, we might want to wait for right now, it’s too much all at once. What are some of the risks associated with that and how do you alleviate some of the issues that could happen if you fall behind with adopting technology?

Eric Giesecke: That’s an excellent question. I think the risk in a competitive consolidating environment like dental from a DSO perspective is that at some point people want to exit and when they exit, they will have a private equity fund that has a diligence firm that comes in and wants to see a bunch of data. And when you can’t answer their questions and you can’t pull reporting across multiple systems, it doesn’t look good, and it definitely impacts your valuation. So just from a scalability standpoint, standardization, reporting, if you’re not thinking about ways to be able to grow quickly, to move people on a single platform, standardized training across all your locations so the experience is the same, you’re going to be left behind I think in a competitive M&A environment ultimately, which I think every DSO is thinking about or should be thinking about when they bring on financial sponsor or thinking about the ultimate exit.

I think that’s the risk. It’s hard. We work really hard to try to make it less hard. Converting software is not easy. I think I’ve heard it referred to as a root canal or open-heart surgery even, which I think might be slightly hyperbolic, but it is, everyone’s gone through a bad conversion in their lives because there’s data degradation they have to train.

So we as a company, because we focus primarily on the DSO space and work with half of the top 25 DSOs, have thought a lot about ways we can take some of the burden off the customer in terms of doing that, but I think it’s a necessary pain you have to take in order to scale. And I think that earlier you take it in your growth journey, the easier it is. And oftentimes we find that the right time for a lot of folks to think about that too is once they’ve made an acquisition and they’re on a couple platforms and it’s like, well what do we do with this next group of offices that are on an old kind of antiquated on-premise system? That’s a good time to then think about consolidation. But I absolutely think that you need to be in… Not just about Planet DDS, other class solutions out there, but you need to be on something that ultimately is going to allow you to present well when the private equity fund comes in and you want them to pay you a bunch of money.

GDN: Let’s switch gears to what DSOs love to hear: efficiency. Wardah, can you talk a little bit about the efficiencies that a group practice or a DSO can expect once they start using Overjet?

Wardah Inam: The experience of the dentist really matters. Newly graduated dentists sometime lack confidence around making a diagnosis. DSOs do depend a lot on young dentists coming out of school and providing them with tools to boost their confidence also improves efficiency. When using Overjet, they feel more confident in their diagnosis and the technology provides them an additional way to communicate with the patients resulting in increased treatment acceptance.

There are other efficiency gains just in general as we are bringing information such as charting information and linking it together with the imaging information. That’s where, for example, periodontal disease diagnosis comes into play – where you need the two pieces of information. In the future we’re going to see more in terms of auto charting, and I think that will be a game changer in efficiency. Right now, it is the practice management systems and how it is integrated a how data is pushed that’s going to change very quickly. I think that’s something that DSOs are very looking forward to as well, especially when you talk about a new patient. A new patient comes in and all of their information needs to be charted. Doing that more effectively is something that can improve efficiencies significantly.

GDN: Eric, another thing that’s important to DSOs is ROI, right? How can leaders at these groups measure ROI and then with AI, what are the metrics that they should be tracking?

Eric Giesecke: I think it’s treatment plan acceptance. If you’ve got AI imaging that’s tied specifically to something like Denticon or the PMS, you can see before and after treatment plan acceptance and you can see production increases in production associated with that acceptance. We’ve started running a couple of case studies with a couple of customers. There has been a lot of interest and a lot of adoption with AI. We’ve been doing this for a couple of months now with Overjet. Now people are starting to ask, “Okay, how do I figure out whether it’s really kind of driving the key metrics and the ROI that justified the increased cost?” I think a lot of it is running those reports and if you’re using Denticon and Apteryx and Overjet, then you can run a before and after treatment plan acceptance report by provider and you can AI run production by provider. You can even break that down by treatment code. I think that’s the fundamental ROI that you want to look at is how many people are accepting treatment that are using the AI technology to drive that and then how many people are actually doing that treatment associated with the diagnosis.

GDN: Any last words, Eric?

Eric Giesecke: I think we’re just scratching the surface from an AI perspective. On the imaging side, I know Overjet’s done a ton on the payer side I think is really innovative. But from a practice management integrated imaging AI perspective, there’s much to be done. One area is auto-charting. We’re thinking about real time claim adjudication, advancing against claims based on the way the AI engine determines whether that claim will be paid. There’s a lot of things about trying to figure out within a data set what treatment is available and how we communicate with patients to bring them in the office as opposed to just chairside diagnosis. We’re fortunate to have a lot of DSO customers that talk to us and we’re fortunate to have a partnership with Overjet, we’re really excited about the future.

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