Volume 7 • 2020 • Issue 7

Q The last line of your journal article reads, “Is digital dentistry disruptive? Absolutely. Is it destructive? Absolutely not.” Could you tell us the story of one technology that you feel has been most disruptive to dentistry and how it has improved patient care? Dr. Dianne Rekow (DR): Computer-aided design and manufacturing (CAD/CAM) systems were one of the most disruptive technologies in dentistry. These systems have revolutionized, and continue to revolutionize, three major elements of delivering dentistry. First, with their introduction, it became possible for intraoral data to be captured digitally. Although the first intraoral cameras had many limitations, they made it possible to eliminate conventional impressions. Importantly, they also formed the basis of the proliferation of high-quality, high-resolution, fast, full-colour images possible today. Patients also prefer an intraoral scan to a conventional impression. Further, high-quality images that can be projected on a screen, chairside, in real time, facilitate patient-clinician discussion and patient understanding about treatment needs and options. Second, subtractive manufacturing (milling) and now additive manufacturing (often called 3-D printing) became possible with CAD/CAM systems, revolutionizing material choices. Perhaps most remarkable has been the possibility of all-ceramic restorations for both anterior and posterior teeth, providing excellent esthetics along with survival rates not possible before these digital manufacturing systems became available to dentistry. The third disruption is in the workflow for fabrication of restorations, and a host of appliances, drill guides, and aligners. Now workflow can be tailored to the interest and expertise of the clinician, in-house laboratory, or commercial laboratories. One can assume that this flexible workflow yields the highest quality dental restorations. Q You write about the “core digital data set.” Could you say why this data set is so important and what potential it has for the future of dentistry? DR: A core digital data set encapsulates the fundamentals of patient information, including information captured in the electronic patient records, radiographs, digital photographs, and intraoral scans. From this rich data source, critical information is available for a host of other functions that facilitate high-quality dental care delivery, enable research and education, and underpin practice management opportunities. Information in the digital data set enables at least 6 important aspects of dentistry. These include: 1.  Information for CAD/CAM-based design and fabrication of restorations, appliances of various sorts, surgical guides and practice models, as well as tissue scaffolds. 2.  Patient interactions during consultations, patient- clinician shared treatment decisions, and guiding and monitoring healthy behaviours. 3.  A host of clinical-based activities, including interprofessional consultations, treatment plans, and robot-assisted treatments. 4.  Educational activities including haptics—computer interface technology that mediates the sense of touch—and simulations, as well as distance learning, using anonymized real-patient information. 5.  Population health and research-based activities including epidemiology, forensics, and clinical and practice-based research. 6.  While not yet fully realized, the data set forms a basis enables marketing, measures of practice efficiency andefficacy of treatments, and automated inventory control/management. Clearly, this data set forms the basis for continuing improvements in a host of dental applications. Q There is often controversary, or discomfort, or even active resistance around the adoption of new technologies. Where did you see the most resistance to a new technology in dentistry? DR: It is difficult to determine which digital technology has elicited the most resistance. Willingness to accept and adopt a new technology has a host of underlying causes and effects. Some people are early adopters, willing to try new things as quickly as possible. Others are reluctant and may only integrate new technologies when the old ones are no longer available. And, of course, there is everything in between. I ssues and P eople 25 Issue 7 | 2020 |