Driven by his commitment to an evidence-based approach and cutting-edge technologies, at the Align UKI Forum Dr Simon Chard offered insights into the future of dentistry, encapsulated by what he calls dentistry 3.0 – the new era of innovation, prevention and holistic care.
Dentistry, like computer power is growing exponentially, Dr Chard – the current President of the British Academy of Cosmetic Dentists who heads of a seven-surgery, multi-disciplinary practice in Staines – told the Align UKI Forum delegates.
Drawing parallels between the rapid growth of computer power using Moore’s Law – the rule that states computer power has been doubling every two years for the past 40 or 50 years, he said: ‘Since 2012, it’s actually been doubling every three or four months. That’s the artificial intelligence (AI) revolution.
‘So if I bring this into dentistry, you can see that the past 150 years – Dentistry 1.0, has been braces, amalgam, toothbrushes; things we take for granted today. In the 1980s technology started to get involved and that’s when the first iteration of CAD/CAM came in. I’m sure all of you in this room are using intraoral scanners, CBCT scanners and aligners – all those things that have played such a big part in our careers: That’s dentistry 2.0.
‘Now the key break point in the development of dentistry is going to be AI. It is going to change everything, and I don’t want you to fear that. I want you to really embrace and enjoy it. This is what I call dentistry 3.0.’
ABCDE of dentistry
To underline further how dentistry is evolving, Dr Chard explained what he believes are the five core pillars of dentistry today and in the coming decade which he dubbed the ABCDE of dentistry 3.0.
Airway
Dr Chard stressed the importance of understanding the oral health markers for sleep and breathing issues, such as snoring and sleep apnoea. He explained that sleep apnoea affects an estimated one billion people globally, contributing to other health factors, such as cardiovascular disease, heart attacks, strokes, depression and even road traffic accidents as a result of tiredness.
‘If you look at the States, airway dentistry is big business…the level of knowledge about the airway and the interrelationship between the mouth and the airway system is fascinating…If you imagine one in seven or eight of your patients walking through your door is struggling with sleep apnoea, that’s a scary statistic. We’ve got a really unique opportunity to screen these patients and get them the treatment they desperately need.’
Biological dentistry
This pillar, Dr Chard emphasised, expresses the link between periodontal disease and various systemic conditions such as diabetes, cardiovascular disease, and even erectile dysfunction.
‘This is looking at the mouth, not in a silo, but as part of the living, breathing human being – leveraging a modern focus on the synergistic links between oral and systemic health…The biological component of dentistry is mainly periodontal disease; almost half of the adults in the UK are still struggling with periodontal disease. This means half of our patients have perio and we’re not doing a fantastic job at stabilising this.’
He pointed out at periodontal disease is inflammation and suggested that to reduce inflammation in the mouth and the rest of the body more dentists should pay closer attention to vitamin D deficiency in patients. ‘Why is that relevant to us as dentists? Well, vitamin D deficiency is shown to lead to increased implant failure, while healthy levels of vitamin D have also shown to reduce periodontal disease.’ Dr Chard offers his patients simple screening tests as an optional extra in addition to treatment.
He also discussed the oral microbiome, explaining that his patients are now also screened as part of dental wellness assessments. ‘Studies have shown that the use of oral probiotics, as an adjunctive therapy, have led to a significant reduction in periodontal pocket depth and clinical attachment loss and bleeding.
‘There’s now a whole raft of different oral probiotics that can really help to reduce that bad bacteria and support good bacteria. You can retest and see how those patients are getting on.’
Cosmetic dentistry
‘There’s never been a more important time for us to be providing ethical, exceptional cosmetic dentistry,’ said Dr. Chard, pointing to the influence of bogus and even harmful DIY dentistry social media trends.
‘There are so many TikTok trends, such as filing your teeth as home with a nail file and bleaching your teeth with hydrogen peroxide. We really need to be combatting all of this misinformation…and we need to provide top quality dentistry because a lot of these young people, as we all know, are flying off to Turkey and having their teeth prepped for irreversible dentistry.
‘With the rapid advancement of technology, materials and techniques, we’ve got more of a responsibility than ever to be as biologically responsible and respectful as possible.’
Digital dentistry
Dr Chard acknowledged the pivotal role of technology in improving patient experiences, outcomes, and practice productivity, pointing out that AI-driven diagnosis via digital scanners such as the iTero intraoral scanner and advanced CAD/CAM systems were already integrating AI into dental practices.
‘My aim with digital dentistry has always been to use tech to improve the patient journey, to improve the predictability of my outcomes and obviously to improve the productivity of my business as well…and I think we can have all those things by using the latest advances in technology,’ he said.
‘AI is already integrated into all of the different technology systems that we’re using already…but maybe you’re not implementing it, or leveraging it as much as you could be.’
He emphasised that AI will not replace dentists, but instead enhance the treatments they offer, pointing to a coming launch from Align Technology in the form of Align X-Ray Insight; AI-assisted radiographic diagnosis software.
‘And Invisalign Smile Architect, which I use myself, and is clearly AI-driven. For me, it’s about enabling the conversation with my patients about what happens if we don’t do ortho treatment. It’s really, really powerful.’
He added that 3D printing was also now an essential element of digital dentistry at his practice. ‘I’ve been dabbling with 3D printing for a number of years. I didn’t really get on with it; I found it messy and inconsistent and there wasn’t really a clear workflow that I understood.
‘However, recently I’ve purchased a Sprintray 3D printer and am using it in combination with the iTero scanner, with exocad software and found you can really do a lot of stuff chairside and communicate significantly better with your lab.’
Environment
The final pillar in Dr Chard’s ABCDE is environment.
He reminded Forum delegates about the dental industry’s ethical responsibility to the planet, discussing the environmental impact of dental practice materials and encouraging dentists to adopt eco-friendly practices where possible.
Summing up, Dr Chard reminded the Forum delegates to think of the mouth as a part of the whole body: to always check the airway for signs and symptoms of sleep apnoea; to ask patients suffering from periodontal disease if they are supplementing with vitamin D; to consider the most biologically respectful option for cosmetic dentistry and leverage technology to achieve for best patient outcomes and to help practice teams and the overall business…and finally to consider working in the most sustainable way possible.
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