(upbeat music) (upbeat music continues) - And welcome to "Forum 360".

I'm your host, Bill Steven Saus, our program with a global outlook and a local view.

Today we're looking globally at the dentistry practice and how it is evolved.

Our topic is digital dentistry.

We're bringing the latest in computer science and dentistry together, merging.

And we have a guest who is a native of our area, and he is Dr. Barry Diamond, DDS.

Good to have you with us today.

- Thank you for having me here, I really appreciate it.

- Now, "Forum 360", as we said, has a concept that we're looking at a global, worldwide topic with a local view.

I've did a little research with you and discussed some things about digital dentistry, some of this started in Europe.

Some of the European dentist, started it and did the research then migrated, came to the United States.

Would you define digital dentistry?

- Digital dentistry?

Digital dentistry is all about basically computers, you know?

- Okay, alright.

- Computer taking over a big chunk of dentistry to make it a lot more convenient for the patient and educate the patient.

And it's amazing how much they have come through in the past few decades.

- Wow.

- The main aspect in digital dentistry has really been big in the past decade are digital impressions.

You could actually take a 3D digital impression in a patient's mouth using a camera rather than taking those old gooey impressions.

- Yes, and I think that this'll speed up dentistry, it'll speed up patient care and move things along quite well, right?

- For sure, I mean, when a patient had to sit down, they're getting a crown or just getting study models, you had to take an impression sometimes even two or three to make sure it's perfect.

- Right.

- But with digital dentistry, it's all about a scan, it just takes a few minutes to just roll around the wand in the patient's mouth.

A few minutes later you got a 3D view about 30 times the size of their mouth on a big screen.

- That could really be better accuracy in performance doing the dental work right now.

- Yes, so I mean you just mentioned accuracy, that's huge, because when you take a dental impression, think about it, the impression material kind of shrinks or it expands, once you pour the stone in there to make the model that also shrinks and expands.

So things aren't always as perfect when you get a crown or you get a denture, but with digital dentistry, everything is exact, what you see is what you get on the computer in pixels and when they print out that model, it's so much more exact than a regular old impression with the stone model.

- Now I'd just like to go back to your background.

You grew up in Northeast Ohio and little bit about how you decided to go into dentistry as your career.

- So I actually had a orthodontist, his name was Dr. Jeff Durkin out in Cleveland area.

And I was so inspired by the way he moved my teeth.

You know, I had a lot of difficulty 'cause I think my smile wasn't correct when I was a kid, it was hard.

You basically don't have the confidence when you don't have a nice smile.

And he gave me that boost in confidence over four or five years of orthodontics.

After that, it amazed me, you know, and I decided to go into dentistry.

- Wonderful, now after growing up in this area, you decided to find a dental school and you went to the east to University of Maryland, right?

- Correct, I went to University of Maryland, in undergrad I used to go there all the time and watch these surgeries in the OR and the reconstruction that happened there was amazing.

And I decided I wanted to go to that dental school and I learned a lot there because they were actually the first school to bring in digital dentistry and it's evolved a lot since then.

- Now you think about computers, oftentimes they could be expensive.

When the University of Maryland's School of Dentistry started investigating digital dentistry, did they think that they were gonna, is there a lot of assets that they are, did they need a lot of money or investments to increase their technology for this type of thing?

- That's a great question.

So when the faculty member that brought in all the material, I spoke to him, he said that, the first time he bought about six machines.

He went with the U-Haul truck, picked them up, brought them to the school, and he said it cost the school a ton of money.

Each one of the machines are about a 1/3 the price now for sure.

And looking in the school right now in some departments, you have other kind of digital dentistry, like placing implants, are basically on their own, which is not in private practice yet.

But the school is always looking to go to the next point and, you know, to be advanced and make sure, you know, technology stayed at its edge.

- So it was advantageous that you went to the University of Maryland because from general dentistry, they had a, you did a residency in what they called advanced digital dentistry or advanced dentistry.

- Right Advanced Education- - Advanced Education in Dentistry.

So tell me a little bit about what you were able to do in that residency.

- So to give you an idea, when I was in that residency, we used to do like, let's say a crown prep.

You're preparing a tooth for a crown.

When you do a crown prep, you basically remove a thin layer from the tooth.

You take an impression, you send it to a lab and they make you the perfect crown.

Once in a while they let us do digital dentistry and 1 out of every 5 cases I would do digital dentistry.

I would scan the tooth, send it into a lab, was a lot easier on the patient.

It was a lot more convenient and the crown would come back a lot quicker.

And I saw the future in digital dentistry.

When I started my own practice, I decided that's the first thing I'm gonna do.

And believe it or not, I scan in almost every single case and every patient that walks through for a cleaning, they get a scan, so I could educate them and show them everything in their mouth, which helps in many different ways.

- So that kept you looking for better ways to serve your patients, basically.

- Correct.

- And getting back to the local view, many dentists in the state of Ohio where you grew up here, went to the Ohio State University School of Dentistry, rather large operation, or the Case Western Reserve Dentistry school here.

And do you think these dentistry colleges are going to be implementing the same type of thing that the University of Maryland did for you?

- I'm sure at this point every school has digital scanners.

The question is how often do students get to use them and it's becoming the new standard of care because like I mentioned before, the education, showing patient what's going on in their mouth, there's nothing like it.

A patient's less anxious to understand what needs to be done in their mouth.

And you could show them signs of wear, which I really wanna discuss, 'cause signs of wear are very important when a person's 20, 30 years old or even when they're older, once they hit 50, 60, 70, there's things we could do about that wear pattern and you could only really show a patient that on a digital scan.

- So you can see where grinding of the teeth or enamel is being worn down.

- Exactly.

- See a really good picture.

- You could see that the enamel has been worn down, you could see the teeth are a little bit flat, and you could educate the patient about what they can do to correct that because I find over 80% of the patients that come through my office, they're either grinding or clenching the teeth.

Especially in today's world with all the anxiety and stress.

You know, people don't go to sleep relaxed and they grind their teeth a lot.

- So we want to say the effectiveness of this new digital dentistry concept in your profession is going to enhance people's, you know, their looks, their smiles, and their health.

What about periodontics?

Because now it seems like gums and the adjacent bones and structure and things like that, will this be able to help the periodontists also?

- Oh, for sure.

I mean I believe it helps every specialty in dentistry.

And the reason being is patients usually don't, when you try to explain to a patient where they should brush better, they have a hard time understanding it.

When I blow it up on a screen and it's 30 times the size- - They look excellent.

- I could show them where the gums are swollen, 'cause this thing is taking millions of pictures of your mouth and you could hone in on the digital scanner I have and show them the actual live images of that area.

So if their gum is a little bit swollen, I could show them you gotta brush a little better here.

Plus I take a scan every year.

So a year later I could compare that scan to the original scan and digitally it'll go back and forth both images and that one specific spot I hone on.

And for example, you're talking about peritonitis, you know, people are having gum disease.

- Right.

Right.

- So I could compare the photo from a year ago and now and show you how much gum you've lost, then you know, if a patient sees that, there's no question about it, a patient's gonna start brushing their teeth and really take care of their teeth.

- Right, they'll see the acute problem and they'll realize this is getting worse instead of getting better because it's very colorful, They see the changes in the mouth, and in the jaw area, and the teeth.

Dr. Barry Diamond, you know, you started out going to this special residency, the Advanced General Dentistry and you were introduced to digital dentistry.

Do you think that, let's say the American Dental Association will be following up and making this what they call, you know, standard of practice?

- So there's many things in dentistry are going digital.

For example, or we know basically more information, something called a CBCT takes a 3D scan of the gums.

So if you wanna place an implant, you know exactly where to place it.

And you could actually merge that with a digital scan.

So slowly it is becoming the standard.

Nobody has says it become, but I have heard that they're working on making specific codes, because when I take a scan of a patient when they come in for study models, I don't bill out the insurance anything currently.

But eventually they do wanna make a code to be able to specifically use the digital scanner, bill them and it become part of the comprehensive treatment that you get like that, you know, the patient knows exactly what they're getting and where they're going with their mouth, you know?

- Very good, and also Dr. Diamond, I wanted to know if you could maybe through your website if you could allow people to, they're listening, they're seeing our program here, but they really might want to see the office and how you present this digital dentistry.

Do you have a website you want to share with us?

- Sure, my website is Barry, B-A-R-R-Y diamonddental.com.

Or you could just look up Diamond Dental in Beachwood.

You could actually go on my website and I have videos of me scanning people's teeth.

I mean it's such a straightforward procedure and I have so many anxious patients that come to my office, but once they see their scan it really calms them down through any procedure I do, 'cause I could explain it to them.

When people know what's going on, they're a lot calmer.

- So we see the evolution from the original style of dentistry in this country where, you know, you have to do the x-rays, they'd have to, you know, check all the teeth.

So that is all increased and with better accuracy today, as you had mentioned earlier.

- 100% - Do you still do x-rays and that type of thing to get underneath?

- Of course we still do x-rays, 'cause you can't see like in between, underneath the surface of the enamel, which is the tooth structure, it's a little bit softer there.

So you really want to get a good x-ray of that and see, by no means does it take the place of x-ray, but it definitely- - Enhances it.

- Enhances and makes it a lot more convenient for the patient and quicker.

- Now I would like to ask you, if you could tell us where the expense comes in.

You talk about billing and the insurances that has to cover this.

Will there be added expense or will this be less expensive do you think because of the efficiency?

- That's a great question.

To me, there is an expense for me every month, you know, because I have this machine, I have a cloud I pay for.

- Right, right.

- But there's no question that it's making dentistry cost less in a sense because for example, it's less chair time, when I take a scan of the patient's teeth.

Getting it to the lab makes it a lot easier.

I just hit a button, sends it before the patient even leaves my office, this lab already has the scan and they don't have to, we don't have to ship any cases to them.

- So time is of essence.

- Time, shipment.

- Shortens the time.

- Yeah.

Correct.

And once it gets to them, there's less labor.

Think about it in the lab, it used to be a bunch of people working in a lab and pouring models, now they're barely pouring models.

They just see the model on the computer, they design the crown or anything on the computer and they just mill it out or print it out.

- [Bill] So it's less labor intensive.

- A lot less labor.

- They move on to the next case.

- And a lot more exact, a lot less mistakes.

- All right, we are with Dr. Barry Diamond, DDS, Doctor of Dental Science.

He is a graduate of the University of Maryland School of Dentistry and he did his residency there in Advanced General Dentistry, which promoted the concept of digital dentistry using computers.

This is "Forum 360", I am your host, Bill Steven Saus.

Dr. Barry Diamond, give us a little bit more information on how people react when they first come into your office.

Traditional dentistry might not have this when you, you know, people that maybe have trained you years ago, they're seeing now this new concept.

What is the reaction of some of the patients that you've had recently?

- It's funny you asked me that, thinking about it, patients come in, I do their cleaning or my hygienist does their cleaning, they get X-rays, and then we tell them we wanna take a digital scan of your teeth.

They have no clue what it is, we roll in the computer essentially and it has a wand on there.

When I start scanning, or my assistant starts scanning their teeth, they keep on moving their head and looking at the screen 'cause they're so amazed by it, they're actually enjoying it.

And I always have to tell them, please turn back your head and at the end I'll show you everything.

- [Bill] Right.

- And then once this scans in there, I could actually show them where they're biting a little bit harder than other areas, for example, their dominant side of chewing.

- Right.

- And then I could also make it into a stone model and show them exactly where the wear in their mouth is.

So if you have a 22 year old patient that comes into my office, I usually ask them, "Do you grind or clench?

", once I see the scan.

Many times patients agree and they say, "How did you know that?

I do grind my teeth."

Other patients won't realize, and I'll tell them, "Pay attention."

And they usually come back six months later and they realize they have been grinding their teeth.

So what do we do about grinding with digital dentistry?

- Right.

- So for a younger patient I will make them an occlusal guard.

Basically it's something that they put in their mouth at night so you don't clench and grind.

As a patient gets older, their teeth actually get worn down and you could tell, they can't, when they smile, you don't see as much tooth structure.

- Right, right.

- Which has an effect because when you don't see tooth structure, you don't realize it but the patient looks older than they actually are.

It can make a patient look a lot younger when they have longer teeth.

So I could actually show them everything in their mouth, that's going on in their mouth, on the screen.

And then using your own design, you could actually build up and show them what their teeth could look like on the screen.

And it could either do crowns, Invisalign, there's many different options.

But at that point you discuss what you could do to restore your smile, reconstruct your smile.

But my big thing is prevention.

Let's prevention you- - Prevention, right.

- Or let's prevent you from getting worse.

You know, let's make you a night guard.

You're 60, 70, 80 years old.

I have patients that come in, they use a night guard, and we, again, like I mentioned before, you could compare it to a scan a year before and see if they're actually losing tooth structure.

- Now when you're actually doing, once you locate on the computer and put it on the picture, the 3D, once that occurs, is this a, can you keep it on while you're doing the work?

You know, doing a drilling or some type of change of the mouth structure, can you actually see it up on the screen live?

Or do you have to just do without it because it would be distracting as you're doing your dental work?

- That's a great, great question.

I mean, it's genius, and eventually dentistry is going to go there and it already is.

We have to be doing this, we only see on the scanner what was scanned already.

- Okay, so it's past performance basically.

- Correct, but what you're saying is very true.

Like dentists usually wear like dental loops.

- Okay.

- We could actually connect the camera to our loop and they could, patients could see basically what we're seeing on a screen in front of us.

And we do that once in a while for a patient.

But I believe the most important thing is that beforehand the patients just see how big their cavity is or where they have deep crevasses so they can brush better in those areas.

- Right, right, exactly.

Make it practical.

- Exactly.

- And and you talked about sometimes there's a distraction if you're trying to locate something and they wanna look at the camera.

- Exactly.

Yeah.

- All right, I understand that.

But that's the changes in dentistry here.

Same in medical doctors with surgery and their, you know, as they look up they see the various points in the body that they have to deal with and you know, you see that being used, computers being used often by surgeons in medical surgery.

- There is actually a new machine is called X-Guide.

It's basically a piece, a bite block the patient bites on, and a scan code comes out, is sticking out of the patient's mouth, and it is a scanner above the patient.

It shows to tell the scanner exactly where the patient's mouth is and where the head is positioned, 'cause they're biting on a custom made guide in their mouth.

And then when the dentist is holding the drill in the other hand it tells the dentist which way to move the drill and where to hold it when they're placing implant.

- So that helps.

- Yeah, so you get an exact precise implant and the exact place that you want it.

So dentistry is going there.

- Like most industries, when computers come into play, they bring accuracy as we mentioned earlier.

And you were saying that the American Dental Association soon will probably be bringing all this to a standard where they think it should be introduced in a widespread area, right?

- I believe so.

- Across the board.

- They're slowly going to incorporate it into dentistry.

- You were talking about the equipment and some of the expense from the practitioner, from your side, and you said at the University of Maryland and Baltimore, they had to buy new equipment.

What are some of the companies that you think are gonna be at the forefront of making the digital dental programs?

- That's a great question.

So one of the original ones was Primescan.

Now it's called Primescan, it was called CAD/CAM originally.

They're really good at not just taking scans of your teeth, but actually of your soft tissue, your gums as well.

Think about it, if a person's missing a tooth, or missing all their teeth, you could actually scan the soft tissue with the Primescan and get a very exact precise scan.

- So the periodontic aspect of it.

- Correct and your dentists are even milling their own crowns in their own office.

So you could get a crown within an hour after the dentist removes the tooth structure.

Instead of getting a crown order from the lab, you could get it done right away with Primescan, they have their own milling unit.

- And this helps orthodontics, as you said earlier, you know, with the braces, and moving the teeth formation.

- Exactly.

- And correcting issues in the jaw that need to be corrected, this can enhance that, correct?

- Yes, so that's the other machine iTero, they're actually a sister company of Invisalign.

If you've ever heard of Invisalign, they're clear aligners that straighten your teeth.

So I have an iTero in my office, I take a scan of the patient's teeth if I believe they could use Invisalign to straighten their teeth, right then and there, that machine, the scanner, will actually move the teeth, put them in the correct spots.

- Wow.

- And show the patient what their smile could look like.

Further than that, we could even take a photo of your face, put it into the system, and they'll match your teeth aligned with your face so patients could see a live image of themselves.

- Yeah, this is amazing.

And as I said earlier, doing realtime dentistry with the cameras on, with the computer on, sometimes as you said earlier, the patient gets a little distracted, correct?

What are you telling them?

Just wait a little bit, I'll show you this later.

We'll evaluate everything later, but you know, you want to keep still, you know, what are you telling patients, coaching them a little bit?

- I usually tell patients in a nice way, I tell them, if you keep your head straight, it'll go a lot quicker and we can get this scan done.

At the end I'll be able to actually zoom in on every spot and you'll be able to see a lot better.

But I'll let them take a few glances because it is where dentistry's going.

People are impressed by it, I'll let them enjoy the technology that's there.

- I can see sports medicine and sports dentistry, a lot of injuries to the mouth, you know, baseballs hitting the mouth.

Football players, basketball players, hockey players.

I can see this would enhance sports medicine also, and sports dentistry, correct?

Because the players, young men and women that are playing certainly don't want to, you know, have a problem that will make them look less at attractive, you know, as they go out in the public, you know, so I think this might help that.

- Correct, so yeah, I mean, it's super advantageous if you have a dentist that has a scanner and they already scanned your teeth.

I always tell patients that if something happened to your teeth, I could have my lab within a few hours, print out a model of your original teeth and we could make a crown- - Exactly the way it was.

- Correct.

Because we have all data in the cloud.

- That's a great idea because oftentimes people do get injured in sports, or vehicular accidents, or things like that where you, it would be great to have that baseline to see what your teeth were and how you can remedy them, and get them back to normal.

Our guest is Dr. Barry Diamond DDS, whose office is in Beachwood, and he is an area dentist who has moved from more traditional dentistry to advanced general dentistry, specifically digital dentistry.

For people that have just tuned in, again, redefine digital dentistry and how it is manifested now in doctors and dentists office.

- Digital dentistry is basically a reconstruction, a view of your teeth, a 3D model on a screen, without needing an impression.

It just taking a camera, putting it in the mouth, scanning all of your teeth and having it in front of you.

And you get to see everything that's going on in your own mouth.

You can educate yourself, dentists can help you educate yourself and you could decide what's good for you for your teeth.

- When you were at University of Maryland, when you left Ohio to go to study dentistry, what were some of the, maybe the mentors that brought you up to date with what was going on, what was some of the concerns they might have had about this new technology versus the advantages?

- That's a good question.

- The negatives and the positives or the pros and the cons.

- The only big negative that dentists have in their head, I believe, before they get one, is the price for them to get it.

But more than that, they think it takes up more chair time.

They don't realize that if you just spend two hours on a weekend to learn the system, it's, to me is at least five times quicker than a regular standard impression and a lot more comfortable for your patient, because they don't have anything.

They could breathe normally, they could take breaks while you're taking a digital scan.

They can't take breaks and they're taking an impression with that material going down their throat.

- More intensive work can be changed for more efficiency basically.

So there is effectiveness, many advantages to digital dentistry.

We've gotten about a few seconds left, Doctor I wanted to have you give your phone number in case people want to call and do a follow up question.

It's 216-206-8075.

Is that right?

- Correct.

- And your website again is barrydiamonddental.com.

- Yep, if anybody wants to call me or if there's any students that are interested in going into dentistry, you're more than welcome to come to my office and take a look at what's going on.

- Thank you, and thank you for being a part of "Forum 360" and bringing us up to date, a global outlook on dentistry, changes that are happening right now.

And our local view, our Dr. Barry Diamond in Beachwood, Ohio, centrally located in Northeast Ohio.

So we thank you for being a part of "Forum 360", Doctor and we hope to have people give you a call or at least you know, participate with digital dentistry in their own doctor's office.

- Correct.

- Thank you.

- My pleasure.

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