Innovative Platforms Changing How Business Is Done

Some of these solutions, such as the Amazon Business dental vertical, come from large players. Others come from operations that currently are only regional. Some were formed by established dental professionals, while others represent a first foray into the dentistry market. One thing they have in common is a desire to be disruptive and to offer solutions for dental professionals and/or patients that will change the dental landscape.

At the heart of any dental laboratory's operation is the purchase of supplies and equipment. For many years, laboratories—and dentists—have purchased the tools of their trade from representatives of vendors or manufacturers, either in person or by phone. As more digital natives enter the workforce and e-commerce as a whole becomes more established, however, that method of purchasing has made its way into dentistry.

"The dental profession is in the process of changing how it purchases products, but it is in the early stages," says Jim Wiggett, Interim CEO of The Dentists Supply Company (TDSC), an e-commerce site launched by the California Dental Association (CDA) that provides direct access to negotiated savings for members of organized dentistry in California and nine other Western states, with plans to expand to a national presence throughout the first half of 2019. "Even in retail, 10 to 15 years ago people were hesitant to use e-commerce, but that is the dominant channel now. We believe that will be true in the dental profession as well, especially as the number of dentists and laboratory owners who grew up with e-commerce increases. To them, having a sales representative visit their office or laboratory is just strange."

Part of the reason for that trend is Amazon's ascension; the e-commerce giant was the world's second-largest retailer, behind Walmart, in 2018.¹ Amazon is expanding its offerings to the dental industry through Amazon Business, which offers hundreds of oral healthcare brands and had a booth at the Greater New York Dental Meeting in November.

"Amazon Business serves healthcare customers of all sizes, and helps these customers efficiently source the products at lower prices with broad supplier choice, flexible shipping, and simple payment options," an Amazon Business spokesperson says. "We hear from customers that they want to simplify purchasing and reduce costs to avoid taking time away from patient needs. Our customers are able to refine their search and discover the equipment that best suits their needs. The Amazon Business analytics dashboard provides an easy-to-use tool for customers to see how they are spending on Amazon Business and use the data as needed to manage their purchasing. Having visibility into purchases is generally where Amazon Business customers see the most time and money saved."

The spokesperson adds that Amazon Business is constantly listening to customer feedback in order to continue innovating and improving its platform.

"The bottom line is that Amazon has the easiest interface on the internet," says Steven Pigliacelli, MDT, CDT, Vice President and Director of Education at Marotta Dental Studio. "They have been offering an increasingly large selection of products for dental laboratories recently. They still offer more for dentists, but more brands and products are becoming available on their platform for laboratories."

While the addition of large manufacturers to e-commerce platforms has been noteworthy, Pigliacelli says it is also helpful to have access to a wide variety of smaller manufacturers in one place.

"Small companies often produce very useful products, and these platforms give those companies more exposure," Pigliacelli says.

The convenience of purchasing via e-commerce is supplemented by increasingly quicker delivery times. The first supplier that moves to provide same-day delivery options of dental supplies will have a major edge in the market.

"Amazon's ability in some places to deliver within a few hours is incredibly convenient," says Betsy Bakeman, DDS, incoming President of the American Academy of Cosmetic Dentistry (AACD). "When it comes to running a practice or a dental laboratory, the ability to keep inventory low, control costs, and have anything you need in a few hours can be beneficial."

Of course, Amazon is not the only company offering e-commerce solutions to the dental laboratory industry. Competitors such as Alibaba and eBay offer dental products, too, and industry-specific solutions such as The Dentists Supply Company and Mush Dental offer similar interfaces with a focus on dental products.

Mush Dental, a startup that went live in early 2018, charges manufacturers and suppliers a flat rate of $0.50 per order received or inquiry received, with no sale commission and no monthly subscription. In addition to those cost savings being passed along, Mush Dental also benefits consumers by providing connections to companies around the world and, soon, an associated site for dental reviews.

"Dentists and laboratories can shop everywhere in the world through our platform," says Mush Dental Owner Luis Baquero, a software engineer whose family includes several dentists. "Each country has its own platform—the US, France, Space, India, China, Australia, Peru, Colombia, etc—and each has some dental products only available in those countries, but also some that are available in others."

In addition to the associated dental reviews platform—Review Dental Products—Baquero owns several other dental and medical platforms, including Medicogle, a global medical search engine to compare supply prices from thousands of websites around the world.

Meanwhile, getting the best price is one focus of The Dentists Supply Company, which functions as a purchasing group as well as an e-commerce site, negotiating prices with manufacturers for its members.

"Our website allows dentists and laboratories to access a wide range of brands and products quickly and easily, with confidence that they are genuine and authentic, as we do not sell gray-market products," Wiggett says.

Longtime dental laboratory vendors such as Zahn Dental, Nowak Dental Supplies, and Benco Dental also have robust e-commerce solutions of their own.

"When I attend distribution meetings that include other industries, it amazes me how much further along the dental industry is on e-commerce than many others are," says Chuck Cohen, Managing Director of Benco Dental. "Amazon is starting to play a bigger role in other industries in part because strong e-commerce options have not existed in those industries. That does not mean some dentists or laboratories will not pick Amazon as time goes on, but there does not seem to be a desperate need for an e-commerce solution in dental distribution like there is in some other segments."

Cohen and other dental distributors say they can offer most of the same services as Amazon can, along with industry-specific benefits that Amazon often does not. Benco, for example, makes sure its online customers have access to special offers from manufacturers, such as "buy three, get one free" deals. Simple industry knowledge and experience can be significant as well.

"Zahn Dental is completely dedicated to helping the dental laboratory industry thrive by providing world-class supply chain systems and online ordering capabilities, laboratory management software, digital technology and equipment, and an extensive array of services," says Rita Acquafredda, President, Global Laboratory Business, for Zahn Dental. "This mode—focused on those four key elements and reinforced by education, service and support, software and innovation, and strong industry relationships—is what we believe sets us apart. Global e-commerce platforms may sell any number of items to any number of industries, and cannot provide the value-added services and solutions needed to help fulfill the dental laboratory's unique needs."

Still, while a lack of human interaction poses a challenge for manufacturers and consumers alike, the benefits sometimes outweigh those drawbacks.

"As a manufacturer using Amazon, you are just working with software," says Alexander Füller, who used Amazon for US distribution while working at a previous company before his current job as Director of Sales Dental, Europe, for Carbon. "It took 4 to 6 months to have everything running as we needed it to be, and a significant amount of upfront work was required. Once we learned the whole management software system, however, it was very useful. It was not cheap, but it offered a lot."

Despite these strong e-commerce options, many dental customers still find value in phone conversations with representatives who know the industry. Nowak Dental Supplies, for example, has invested heavily in a robust website but gets only 15% of its business through it.

"In our industry, not every product or purchasing decision is cut and dry," Nowak Dental Supplies President Shawn Nowak says. "For example, not all zirconia is the same; a representative can help select the right one for a bridge, or for specific esthetic needs. One reason people choose to work with us is that they know we have researched products. We know what is good and what is bad, and what to pitch to each customer based on the product history, not off a sale number."

Similarly, most of Zahn Dental's customers still purchase their equipment and technology by phone, according to Michael Reina, the company's Director of National Sales.

"Our equipment team, for example, interfaces with laboratories, asking them questions about the frequency, volume, and types of indications that laboratories are producing today, as well as updating them on current and future industry trends," Reina says. "There is no one-size-fits-all solution, but rather a series of touchpoints, including the sharing of education and information from educated resources.

"In addition to providing an outlook on future trends that will help customers make purchasing decisions or consider new applications to grow their practice, we have years of dental experience that online platforms don't have in the dental industry. Some of our telesales representatives have been with the company for 25 years and can help resolve issues that need to be addressed quickly. Our tech support team fields all customer calls for CAD/CAM equipment, helping customers who need immediate solutions. If customers use an online platform, they don't have access to a help desk to resolve error messages. If our team can't resolve an issue, we have an R&D team that escalates deeper issues. If we still cannot resolve an issue, we have support from our extensive network of vendor partners who also have decades of industry know-how."

Nowak plans to incorporate a function on the company's website that allows its representatives to live chat with customers on the site, but he still does not anticipate e-commerce ever eclipsing traditional purchasing methods.

"People will always have product questions, and they will continue to utilize a dealer that has the technical expertise they need," he says.

Cohen says vendors need to be agile, offering customers various options to utilize in different situations.

"Most consumers in any industry want multiple channels," Cohen says. "For some products and some instances, I want to talk to a live human being; for other transactions, I want to use a website because it is easier and more convenient. Customers do not want to be limited to one or the other."

Dental professionals' options for online purchasing extend beyond supplies; they can acquire services as well. Laboratories historically have connected with clients via traditional avenues such as networking and marketing, but in a global, digitally connected marketplace, laboratories or even freelance technicians can forge connections via online services such as Apollonix (insidedentaltech.com/idt1054) or DentFlow.

DentFlow connects dental service providers either directly with dentists or with laboratories in need of CAD/CAM services. In its first year, DentFlow only offered design services, but the company plans to add fabrication connections to its platform this year after seeing growth of 10% or more each month last year. Service providers are rated by users—only those who have placed an order with them through DentFlow—and set their own prices. Users can connect with a favorite service provider repeatedly or try different ones. Some of the service providers are employed dental technicians, while others work exclusively on a freelance basis. The customers include dentists, laboratories that have a surplus of work, and laboratories that do not yet handle enough CAD/CAM work to employ a designer.

"Many laboratory owners are struggling to find CAD/CAM technicians at the same rate that digital cases are increasing, and DentFlow offers an alternative to hiring a new employee," says Eitan Sapir, the company's CEO.

DentFlow's user ratings are based on communication, timeliness, and the quality of the design.

"Customers can balance the price they pay with the level of designer and turnaround time of the design," Sapir says.

While DentFlow's service providers thus far have been primarily individual designers, Sapir expects laboratories to come on board in that capacity for manufacturing.

"Any laboratory that owns a milling machine or printer can maximize its income potential and fill the machines to their capacity by providing manufacturing services through DentFlow," he says.

Laboratories can use digital platforms to optimize those machines' operation as well. FactoryFour offers software that it calls "smarter manufacturing management."

"Traditional laboratory management software programs are great for tracking orders as they arrive and billing once cases are complete, but on the floor of most dental laboratories are clipboards and spreadsheets to move the processes along," says Param Shah, Co-Founder and CEO of FactoryFour, which offers integration with LabStar laboratory management software. "Our system is essentially a cloud-based platform that replaces those spreadsheets and clipboards with a real-time system of tracking each case through the different tasks. The system tracks when someone activates themselves into a particular task and when they complete it, and it immediately tells the next person to start on the next step. We automate and orchestrate the process of moving products along the floor and understanding where every product is on the floor itself."

In addition to helping in real time, this tracking process creates valuable data to help the laboratory evaluate its costs.

"When each case is unique, knowing the true cost of manufacturing a product is difficult," Shah says. "With a huge wealth of data, our platform is able to show the average amount of time your technicians need to fabricate each product. You can track the true costs of labor, technician efficiency, on-time shipping, and more. It is bringing production management to the next level without sacrificing the artistry and craftsman quality. It can help laboratories exponentially grow their business."

Another way laboratories' businesses may grow is through innovative models on the clinical side that promote access to care.

Virtudent is a Massachusetts- and New Hampshire-based company that is in its fifth year of running a mobile dental practice in which dentists supervise hygienists under general supervision and visit businesses to treat employees who are too busy and do not regularly visit a dentist. The hygienists set up their equipment in a room and proceed with x-rays, intraoral photos, polishing, cleaning, and optional fluoride. A dentist remotely reviews all of the photos and x-rays within 5 days of the visit and provides a diagnosis and recommendations via a patient portal.

"People today are consuming their lives through technology and on-demand services," says Hitesh Tolani, DMD, Founder and CEO of Virtudent, which also provides free services to at-risk children and special-needs patients. "You can order a car via your phone. You can grocery shop online. Even for medicine, you can access a nurse practitioner or doctor via an app. Dentistry is really behind, and the ADA has shown that people have stopped going. As dentists, our job is to conveniently provide care in a patient-centric model, so we need to be thinking about how we can adjust to better serve our patients."

If Virtudent's dentists diagnose issues that need to be addressed through further treatment, they can refer the patient to a local dentist. The company says its average patient has not visited a dentist in 5.8 years, so restorative treatment sometimes is required.

"The increased patient volume literally has led some local practices to hire more dentists," says Tolani, who hopes to expand the business beyond New England eventually. "Oftentimes, the treatment requires laboratory services as well. It benefits everybody—the patient as well as the entire dental team."

Getting the best value is as important as ever for dental laboratories in today's competitive market. As innovative digital platforms become more commonplace in everyday life, dental laboratories will need to be aware of the newest options within their profession as they seek to provide the best services to their clients and optimize their own workflow.

"We refer to a persona called ‘Mary the Millennial' to understand our next-generation customers and suppliers," the Amazon Business spokesperson says. "Mary is a new healthcare employee who is up to date on the latest trends and technology. But when she comes to work, she has to log into traditional procurement platforms that don't give her the same value or efficiency she's used to at home."

Whether they are CAD/CAM equipment or new digital platforms that help laboratory owners manage their businesses more effectively, more and more options are becoming available, and determining which ones fit your business model is paramount.

1. Carbonara P. Walmart, Amazon Top World's Largest Retail Companies. Forbes. https://www.forbes.com/global2000/#41b9db3c335d. Published June 6, 2018. Accessed November 27, 2018.