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Remember that thing about dentistry being part of medicine which is part of healthcare and how it’s unacceptable to experiment on people without the proper permission?

Over the last decade or so that seems to have gone out the window and the large corporates in dentistry seem to be happier to push products and technologies onto the marketplace which are less than ready or fit for use with patients.

Activating and working at the leading edge of some of that technology has shown us this in full force, but the urban myth is such that it started with one of the big implant companies and the CEO of that company at the time, who boasted about researching in the marketplace.

As a result of that strategy that business nearly went under, only to be rescued by becoming more customer focused once again.

They do that big corporations – they become customer focused then product focused then customer focused after they lose their customers. They keep doing it in cycles and I’ve watched it time and time again over the last 20 years.

But there’s a more sinister story to this.

Very few of the digital companies are doing anything but paying lip service to adoption of the technologies and this is seen clearest in things like CBCT scanners, intraoral scanners and milling machines.

First let’s take CBCT scanners because they are the ones that can do the most damage and harm to patients.

We’re still at the stage where a lot of guys will put a scanner in your practice and let the engineer do half a day’s teaching before they let you loose. When will we get to the stage where you’re not allowed to provide a scanner to a dentist unless he signs up to some sort of certifiable course to make him competent and safe to use it?

If you were a dentist in Finland you wouldn’t be able to buy one unless you were a qualified dental radiologist which would take further qualifications.

Worse still, the dose data that you get from the CBCT companies is at best misleading and at worst completely absent despite multiple asking’s.

This must be referenced against the quality of image you get for the dose that you inflict on the patient and there is an algorhythm and an equation that you can use to calculate that as a number.

We’ve commodotised CBCT so people and corporates are buying the cheapest model but forgetting about image quality and dose to the patient.

For the lowly independent GDPs, the biggest issue is when they break down and who’s responsible for fixing or servicing them.

Don’t settle for anything less than a five-year guarantee and if you won’t get one then question the build quality of the product.

Let’s move onto introral scanning though, because although it’s less damaging from a radiation point of view, it’s been thrown out much more widely with much less adoption involved.

Within the Straumann portfolio there are more iTero units used as coffee tables than anything else because people just couldn’t get them to work and there wasn’t any training in place.

It’s not much better with Cerec, and certainly our experience with Cerec training was that we pretty much had to find our own and I had to employ someone to come into the practice who knew Cerec so that we could adopt it in there. I don’t know how you do that otherwise.

Of course, there are ‘courses available’ but we have to be really careful who’s providing them; the experience and motivation they have and the qualification for teaching.

They’re also chargeable, so not only is it bad enough that they sell you one of these products for an enormous price but then they charge you for any form of adoption, which is in fact the responsibility of the company that sells you it and is in their interests.

The flip side of this is actually quite laughable.

The company that promotes adoption will win the market race and none of them seem to see it.

In 2016 we bought a 5-axis milling machine made by Sirona that we purchased from Henry Schein.

This was a machine that was made for labs and we bought it as part of our lab capability in the practice so that we could mill discs of zirconia, e-max and acrylic for surgical guides.

We used that machine within its protocol and for the purposes for which it’s designed and we did everything that was asked of us. Six months later it was broken again for the umpteenth time and we have six weeks without a machine.

We had nothing from Sirona during this time and saw no one from Sirona to help us through that. We had no offer of a loan unit and no help with adoption of the technology or difficulties in the first year of use.

Henry Schein provided us with a new unit.

Six months later the second one was broken in the same way and we had another six months without it.

It took weeks to hear from Sirona and eventually we saw someone and they finally agreed to provide a third unit which has been in the practice since then.

Credit where credit’s due – unit number three has not broken down (yet) but then, debit where debit’s due – nobody from Sirona spoke to us in anyway about the difficulties we had, the lack of support or the lack of loan units. This was a machine that had catastrophically failed twice in its first year of operation (two units completely failed)

That was seven months ago and this week someone from Sirona turned up to have a chat about it.

I was very suspicious and didn’t understand why they had finally attended seven months later. But none of the UK staff for Sirona contacted us and nobody has had a conversation with me about the difficulties we’ve had, the costs that we incurred and the problems for our patients and the other people who use the lab support.

They did give us a set of free burs this week though!

I single out Sirona because our experience of this nature was with Sirona, but I’m sure the other guys are no better.

Independent dentists have been made out to be fools because they’re buying expensive pieces of kit like this without service level agreements and then no one is pulled in to fix them, or to give them loan units to see them through so they have business continuity.

It’s fine to be at the cutting edge of the market but researching in the market place, products which don’t actually work is utterly unacceptable and we need to stand up and say that enough is enough.

Blog Post Number: 1702