It’s been a long time since I have written a blog post. No excuses. Life is busy with family and other concerns, and I’ve not been inspired… until now.
Tele-dentistry? Tele-braces?
Many of you may have already heard about online companies offering do-it-yourself orthodontic clear aligners. For many of us, the instinctive reaction is to scoff or laugh at such a silly notion. Some will dismiss the news and suggest that P.T. Barnum had it right about a “sucker being born every minute.” I suppose the consensus might initially be summed up with the single-worded vernacular, “WhatevAR!” What’s next? Do your own crown preps? Tele-crowns?
I submit that we not make such assumptions about the public who decide to go down this path. To be clear, this article is not intended to impugn the folks that pursue a course of self-treatment. Rather, I suggest we do our best to educate them, realizing that it may fall on deaf ears with assumptions about our efforts being self-serving. It’s simply human nature to jump to that conclusion.
No worries, right? If you visit this consumer review webpage and see their clients’ “before & afters,” you’ll likely be quite amused at the “results.”
Of course, we have many well-founded clinical concerns and objections to the concept of self-diagnosis and self-treatment. No need to review them here. The intended audience of this blog is dentists. As dentists, we know what they are. The club claims that each case is “reviewed” by a licensed dentist. The clients send in cell phone selfies of their smiles and self-administered impressions from the kit sent by the club. That’s it. Consider the standard of care here. How many of us would treat patients orthodontically without a comprehensive examination prior to treatment? These “hired guns” are approving cases based solely on selfies and models (of dubious quality)? No x-rays? No perio evaluation? Caries or defective restorations identified? Fixed bridges or splinted crowns? Impacted teeth? Implants? Retained deciduous teeth?
Can you imagine what might happen to any of us practicing dentists who did that with patients of record? If any of us started moving teeth without any attention to those details, we’d be practicing below the standard of care and at great risk for liability. It would be indefensible in court. Yet, these “tele-health” companies get away with it. But, the real point is that it’s possibly detrimental to the “patients.”
Best Frenemies Forever?
Recently, Align Technologies (Invisalign) purchased part of the club and is making their aligners for them. The folks at Align tried to assuage the concerns of dentists by claiming they just want to be “ahead” of the trend (of self-treatment or “tele-dentistry”) and that the aligners they make for the club are not the same technology as Invisalign brand aligners. Furthermore, in the merger announcement, Align said, “30% of the club’s interested customers do not qualify using the club protocols.” Yeah… Remember that 68% of all statistics are made up 93% of the time. 😉 Looking at the RealSelf.com club page, I’m hard-pressed to find a case that was turned away by club.
The club claims that every case is “reviewed” by a licensed dentist. Word on the street (DentalTown) is that they hire dentists in each state to look at the selfies and impressions (remotely, I assume) for $50 a pop. Fifty bucks. Wow. For the record, I have not verified this. It is hearsay. I wonder if there is an incentive to “approve?” Do the dentists get paid the same measly $50 if they use their judgement and reject a case? Who takes on the liability if / when the case goes south and the “patient” is looking for compensation or reparations?
It’s the same thing!
The problem with that is that the club will certainly market this as “made by Invisalign,” and consumers will perceive it to be the same.
To wit… Continue reading
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This article has been sitting in the “draft” folder for a while. I’ve written, lectured, and pontificated many times about my position that dentists should be creating their own website content. I’m not saying they need to create the actual website. I’m talking about the CONTENT. 
In Stephen Covey’s seminal book, “
We all get phone calls and emails from prospective patients looking for a new dentist. Very often the only question these prospects ask is, “How much is ________ (a cleaning, a crown, an extraction, etc.).” Another common question is, “Do you take my insurance / discount plan?”
A new patient came for a problem-related examination. He found us through our website. He had a four-unit bridge #28 – 31 (#30 missing) and an RCT on #29 finished about 3 weeks ago. His complaint is that one of the teeth is very sensitive to heat. He pointed to #31. Overall, the bridge looked decent, except for the facial and mesial margins on #31 being shy. The margin on #29 isn’t perfect, either. The RCT on #29 looked good, though that tooth was still sensitive to percussion (not unusual only a few weeks post-op). “I’ve got my x-rays.” The patient showed up with a copy of his FMX printed on a single sheet of plain paper. This shit drives me NUTS!
Attention all digital dentists: Stop giving out WORTHLESS plain paper copies of digital x-rays! It makes us ALL look bad! Patients don’t understand why we can’t use them (not diagnostic). And, they get upset that we either have to WAIT for proper emailed images or take them all over.