Eoin O’Sullivan tells Guy Hiscott why partnership with his dental lab is at the heart of his successful digital approach to dentistry.
‘The biggest misunderstanding about digital workflows is that all they’re all about impressions,’ muses Eoin O’Sullivan.
‘It’s a very expensive way to take impressions if that’s all you’re using your scanner for!’
The truth, Eoin points out as we sit down to discuss all things digital, is that intraoral scanning is the tip of a very large iceberg. Indeed, it’s an iceberg that has transformed his own practice, the No 8 Partnership in Chelsea, very quickly in the last few years.
Eoin started using Itero scanners more than 10 years ago, before Align purchased the company. He has always used them for restorative scanning.
When Align bought the company it was initially focused on orthodontic workflows. Only recently has it started to focus on the enormous potential of the scanners in restorative dentistry.
Compared to today’s Itero scanners, the original scanner was big and clunky, says Eoin. Although it produced excellent scans, it was considerably more challenging to use than scanners are today.
It is the ease of use of the latest generations of Itero scanners and the huge developments of digital technologies for restorative and surgical dentistry that has unlocked the power of digital workflows.
Challenging tradition
Eoin doesn’t see himself as an early adopter in the traditional sense, despite his long-standing scanner ownership.
‘I’m not drawn to things because of the technology itself,’ he explains. ‘I’m more interested in how that technology improves outcomes – it’s all about the end result.’
Established in 1926, the No 8 Partnership is one of the oldest dental practices in the UK. It has a reputation for a high quality but somewhat conservative approach to dentistry.
The practice receives a steady stream of referrals to be treated by its seven specialists. However, there is also a significant general dental care element to the practice. This offers routine care to multiple generations of local families.
As result, the work that comes through the door is varied. Although, throwing caution to the wind and adopting the latest craze has not been the approach.
Nevertheless, when the digital revolution came to Number 8, it came swiftly.
When the partners saw the huge benefits of using the latest generation of scanners they were quick to embrace the technology. No sooner had one scanner entered the practice than three more swiftly followed.
Now, they are in play everywhere, facilitating everything from routine care to the more complex work that Eoin undertakes as a specialist prosthodontist. They open the doors to a digital workflow that is streamlined, faster, and more efficient in practically every way.
And to hear Eoin describe it, the process was relatively painless.
‘As soon as the other partners saw what we could do with the technology, they came on board immediately,’ he explains.
‘We had some involvement with digital dentistry already. We were a paper-free practice, that sort of thing – but our workflows were largely analogue. But once the technology caught up with its potential, we went deep into digital quite quickly.’
Teething pains
The ramifications were swift – though not all of them were positive.
‘I value a really close relationship with my laboratory,’ Eoin explains. ‘I like to have control over every step of the process – especially so in the more complex cases that I do.
‘That was the relationship that I had with our previous lab. We were fortunate enough to have one of the best labs in London operating out of the basement floor of the building our practice is in. While they were a separate entity, it was about as close to having your own in-house lab as you can get!’
But this lab, esteemed though it was, was not willing not to embrace the digital workflows and they decided to close within a year of Number 8 going fully digital.
For Eoin, that sums up some of the teething pains of the growth of digital technology. ‘That’s the biggest challenge facing labs, I think,’ he says.
‘The future is digital and that means a change in skillset – however, you can’t just expect youngsters who are great with computers but have no experience as technicians to produce great work. To operate at the highest level, you need experienced technicians who can combine that skillset with a digital workflow. That’s a dramatic change for the lab world to overcome.’
Faced with the challenge of finding a new partner, Eoin needed a new lab that would embrace communication as well as the digital journey. He found that in Angelo Plini, whose Estetica Dental Lab ticked all the boxes – even if it wasn’t quite downstairs.
‘We’re fortunate, geographically speaking,’ Eoin laughs. ‘Our practice is at one end of the King’s Road, and Angelo is at the other!’
Research and partnership
Crucial to the their collaboration is the fact that both Eoin and Angelo use Exocad as a fundamental part of their workflows.
‘Exocad is software that allows me to design wax ups and restorations digitally,’ Eoin explains.
‘It’s the “CAD” part of what we talk about when we discuss CAD/CAM dentistry – computer aided design.’
Exocad fills in the gaps of the digital workflow between the scanning and manufacture stage. When used in conjunction with the physical technology, it streamlines the entire process, Eoin explains. This allows him to concentrate on the outcomes.
He continues: ‘When planning restorations we can interact together through the software to digitally ‘wax up’ the restoration and this allows me to approve or modify designs virtually’
‘Previously, I would have to go through so many steps and physical interactions both with the lab and the patient, to get to the same point. This allows for much efficient workflows.
‘In fact, the biggest issue is that it’s making my appointments so much shorter. I’m concerned about whether my patients are going to start questioning my charges because everything is so much faster!’
Technician’s role
Crucially, the one thing that the digital workflow doesn’t do for Eoin is to make the technician’s role obsolete. If anything, they become more central to the process – because the lab is one of the best places to turn for advice when diving into digital, he says.
‘Labs are well ahead of dental practices when it comes to going digital,’ he points out. ‘We’re really only playing catch up with them on that front. And the lab is the place that’s going to be turning your digital work into a restoration, so getting their help before purchasing anything is really crucial.
‘It’s really difficult to differentiate between systems when you’re talking to the companies that make them. But your lab will see scans from different places and they can give you a real-world answer.
‘Your technician can tell you before you invest what a system is like to work with. How sharp are the scans? Is the system open – will it pair well with what you want to do, or already use? This sort of information is invaluable when doing your research.’
Evolution in practice
Aside from a brief foray into chairside milling, there is very little that Eoin would do differently.
(He explains: ‘The chairside milling technology is incredible, but it’s not a great fit with our practice – our patients don’t have the time to wait, and there are people who can produce much better restorations with a more effective use of time than we ever could in our practice. They’re called dental technicians.)
But he warns practices to prepare to make investments into their infrastructure that may not immediately be obvious.
‘For example, in order to have a broadband connection that is fast enough and reliable enough, we have had to install our own private fibre optic broadband line into the practice,’ he explains. ‘We’re that reliant on it. But then again, that’s where things are headed more generally now, so we view it as part and parcel of what’s needed to be a modern practice.’
And ultimately, Eoin points out, that’s what it boils down to. Yes, the adoption of digital technology requires some planning and investment, but it’s all in the name of progress.
He concludes: ‘I’ve been very privileged to practise dentistry in an environment that doesn’t force me to compromise on any aspect of treatment for a lot of my career.
‘But the evolution of technology is bringing some of those benefits to everyone now. Digital workflows can only make it easier for us all to practise better dentistry. Isn’t that something we should all support?’
For more information on Eoin and his work at Number 8 Partnership, visit no8partnership.co.uk.
For more information on Exocad, visit www.exocad.com.
This article first ran in Implant Dentistry Today magazine. Read the latest issue of Implant Dentistry Today here.
