Virtually Together

Much of the communication technology that has come to the forefront during the present crisis was already in development or existence, but increased need has caused acceleration in both progress and adoption.

The Many Faces of Video Conferencing

Video conferencing technology was already widely available and fully developed before the pandemic but was certainly not as universally accepted as it is today.

"A lot of people in the older generations had never used FaceTime before the pandemic, even though that app has been around for years," notes Jed Archibald, CDT, of Archibald Esthetics and Archibald Digital in Provo, Utah. "Because of COVID-19, all generations have become acclimated to using FaceTime, Zoom, and similar programs. It's brought everyone up to speed and become a lot more normal and comfortable."

As the number of remote workers has increased, professional usage of video conferencing has soared apace. In just the first few months of the COVID-19 pandemic, web and video conferencing software saw a 500% increase in buyer activity in the US.¹ Dentists and dental laboratories were no exception to this increased interest in professional-level video conferencing.

"Back when text messaging first came along, it was considered unprofessional and inappropriate," Archibald points out, "but it became appropriate over time. Now video conferencing has gone through the same evolution and is considered a professional way of communicating. It no longer has a stigma. Almost everyone in the dental laboratory profession is comfortable having virtual meetings and sharing digital photos."

Even email, a longtime staple of business communication, is starting to feel old-fashioned in some laboratories.

"Email is very formal, very elegant, but I've noticed that it takes forever to get anything done. I've been encouraging all my dentist clients to get on WhatsApp," says Jeffry Tobon, CDT, founder and CEO of DesignLab Dental Inc and co-founder of Digital Dental Craftsmen Inc in Westbury, New York. "You can message either through your phone or through the application on your computer, giving you access to effective, immediate communication. I also use Facebook Messenger for things like distribution deals. It used to take days through email, but now I can get a deal worked out in a single morning because instant messaging has allowed for a more personal way of communicating."

Laboratories aren't just making use of virtual communication methods to contact dentists, either. In cases where they would normally have a face-to-face interaction with the patient, video conferencing has also been extremely useful, allowing the technician to see the patient's facial esthetics without the current risk of in-person interaction.

"It's been a huge benefit to me to be able to do a quick video meeting with a patient. I can have a try-in appointment or a pre-operative appointment so that I can see their facial expressions, their mannerisms, how their teeth rest in their mouth. You pick up a lot of little details that aren't necessarily on a laboratory prescription," says Archibald.

Some, like Dennis Urban, CDT, Vice President of Education and Training for Dental Services Group and 2021 Chair of the National Board of Certification in Dental Technology, have been making use of virtual communication not only for case planning and communication, but also for chairside support of dentists.

"When the pandemic started, it definitely put me in a difficult situation," says Urban. "I had scheduled myself to support many dentists chairside with hybrid denture conversions, overdenture support with intraoral curing of attachments, and case planning with oral surgeons, periodontists, and general dentists. However, since I couldn't be there in person, I proposed virtual chairside support."

Urban's idea was initially met with skepticism, but after some explanation, he found that the response was positive. A video conference with the dentist a few days prior to the procedure laid the groundwork, allowing them to review the specifics of the case and form a plan together. Then, Urban would join the dentist in another video conference on the day of the denture conversion, sometimes with the computer in the actual operatory so that he could share a step-by-step slideshow throughout the procedure, until the treatment was completed.

"It works like a charm. I even incorporated hands-on demonstrations before the procedure began, using sample cases that were similar to the current case designs," says Urban.

Made for Dental

These generic virtual communication methods are doing wonders for keeping laboratories connected and in tune with the needs of dentists and patients, but there are also communication methods designed specifically with the dental profession in mind.

Beyond 2D

Digital dental cameras, designed specifically for this specialized form of macro photography, have long been available to assist in communication between dentist and technician. However, these 2D images are no longer the only option when it comes to visual communication.

"If the technician is able to be chairside, that's great, but if they can't, there are tools that allow for more and better communication with the laboratory, such as facial scanners, photogrammetry cameras, and intraoral cameras. These new tools can completely digitize a patient so that the technician can see them in 3D. You can actually see the smile and the midline, and really feel like you're working on their face," says Tobon.

Facial scanners, he says, have become the hottest new trend for dentists, and laboratories are seeing the benefits of that advanced level of communication.

"When you work in design software, you're manipulating a 3D object in the STL file. When you bring in a 2D image, it's hard to match it to the 3D object. However, if you bring in a 3D render of the face and the teeth, you can easily align it with the design. I really feel it's taking dental technology to a whole new level of communication and collaboration," says Tobon.

Of course, facial scanning can only go so far; it records what exists but doesn't have the capability to modify it on its own. That's where augmented reality technologies really shine.

"Augmented reality is a technology that modifies the appearance of the world as it currently exists," says Archibald. "It's a great way to communicate with our dentists, our clients, and our patients. There is an app that will allow the patient to look at themselves on a tablet, select different smiles, and then actually see those teeth appear in their mouth in real time. They can even move around and talk. They can make the teeth longer, wider, whiter, browner; it doesn't matter."

Augmented reality is, in Archibald's view, a great way of taking new teeth for a test drive. However, this is a technology that is still on the cutting edge, and it is not widely available yet.

Software for Easy Collaboration

Whether the dentist and technician choose to exchange 2D photographs or 3D scans, the industry has created specialized software to facilitate dental workflows.

"With a direct-to-dentist scanner interface, a dentist can send files straight to the technician, who can then review them and send them back to the dentist if they find issues such as unclear margins or missing scans. The dentist may even be able to address the issues while the patient is still in the chair," says Urban.

Other software will allow the technician and dentist to exchange case information and designs for review and approval. It can organize and send all the necessary information for a successful case, including 3D scans, treatment designs, and details such as color and shade measurement. Depending on the particular software, the recipient may be able to access the case information from their smartphone, tablet, or web browser—or all three. This can have a significant impact on how efficiently the case is completed.

"I make a link, I email it to the dentist, and then he can check the case and let me know whether it's good to go. That's it. I've found that tool to be very helpful," says Tobon.

Gathering Virtually

One of the things many of us miss most right now is gathering in large groups, whether professionally or personally. In the dental laboratory profession, virtual communication is doing its best to fill that role as well, providing ways to meet for virtual classes and events that would otherwise have been cancelled due to safety concerns.

One way in which we can still interact is through virtual reality technology. While it is still being developed, it is growing quickly in terms of adoption and applications.

"When we talk about virtual reality, we're talking about putting on a headset and being transported to a different world, taking yourself out of your current environment and going somewhere else," says Archibald. "It has wonderful applications right now. I can't do a hands-on course in person because of COVID-19—but I can do a hands-on course through virtual reality. The controls don't have perfect dexterity and tactile feel yet, but we're really close."

According to Archibald, the onset of the COVID-19 pandemic has really driven virtual reality forward in an exciting way. "We are diving into this new world. Virtual reality has been around for quite some time, but I believe that COVID-19 has forced everyone to investigate this new technology and push it forward rather than just waiting for it to mature," he says.

However, some attempts at education don't need virtual reality—just virtual machines. Tobon has hosted many educational courses, and while the pandemic has temporarily suspended live classes, he's not letting that stop him.

"We've developed a way to present online courses where participants connect to virtual computers that have all the necessary software," says Tobon. "The instructor and students can connect from anywhere in the world. It wasn't easy to build, but we were able to do it, and we plan to launch it soon."

Tobon has also taken another foray into virtual gatherings—this time through an interactive web platform.

"We have started an online virtual community. You can enter the platform at any time with your personal avatar and walk around the building, go to different floors, look at booths, view presentations, and chat with other people. All of this is going on inside this virtual world," Tobon says. "We feel this is going to be a way for people to communicate that is more personal than just direct messaging."

Still, he acknowledges that even this has its drawbacks and is no true replacement for the gatherings that we so crave.

"There's nothing like going out and meeting people in person," he says. "I think eventually we will end up with a combination of online and actual physical presence. At the end of the day, no matter how polished or innovative the technology, people are just overwhelmed and saturated with online interactions. They want to go back and have a regular event."

However, it's hard to say just how much events will return in their previous format, even after the risks of the pandemic have subsided. Archibald believes that even as things eventually return to normal, companies will continue to utilize new virtual and augmented reality technologies at events.

"It's a very big investment for a company to put on a well-thought out show at a typical industry event," he says. "Now that all these companies have started to look into virtual reality and augmented reality, they are realizing that they can reduce the size of their booth, ship less equipment, and send fewer personnel if they demonstrate their products through virtual reality headsets. Even if we get back to normal tomorrow, I do believe that they are going to move forward very quickly with virtual and augmented reality because it's a very smart move for them financially."

The Future Hybrid Model

It has become increasingly apparent that virtual communication is now a mature technology in many forms, and no matter what happens in the future, it is here to stay. Equally sure, however, is that people crave in-person interaction. Both virtual and personal interaction have their advantages, as well as their drawbacks and inconveniences; in-person interactions often require a greater investment in preparation and travel time, for instance, but you'll never need to reboot in order to hear your conversational partner. It seems likely, both in the laboratory and in life, that we will find ourselves making full use of both virtual and in-person communication methods—once we are able to safely do so—in a blended, hybrid model of communication that will hopefully incorporate the best of both worlds.

Reference

1. Scott R. Must Have Video Conferencing Statistics 2020. UC Today website. https://www.uctoday.com/collaboration/video-conferencing/video-conferencing-statistics/#:~:text=According%20to%20Grandview%20Research%2C%20the,this%20functionality%20than%20ever%20before. Published July 27, 2020. Accessed January 8, 2021.