Below, we’ve compiled the key points discussed in the Jameson Files Episode 145. To enjoy the full episode you can watch on YouTube or listen to our podcast on iTunes, Google Play, or Spotify.

Jameson Files Episode 145: The Emergence of AI in Dentistry with Mike Buckner from Pearl

Carrie Webber :

Welcome to the Jameson Files. I’m your host, Carrie Webber. Thank you for joining us once again for another episode. I hope that you are a plugged in part of our Jameson Files community. Our goal at the Jameson Files is to not only bring you the stories and the successes of your dental peers, but to also bring resources and tools and keep us all on the forefront of what is cutting edge in our profession. And so we are recording live right now from ADA’s SmileCon 2022 meeting in Houston, Texas, and I’m thrilled to have a good friend joining us for this episode: Mike Buckner of Pearl. 

Mike is the Executive Vice President of revenue for Pearl. And if you’re wondering what Pearl is, that is going to be the topic of conversation today, because what we are talking about today is artificial intelligence or AI.

What role does artificial intelligence (AI) play in the dental profession?

Carrie Webber :

So when you follow the breadcrumbs of Mike Buckner, he’s usually following along the cutting edge wave of what’s happening in dentistry. And today that’s the early stages of artificial intelligence making an impact in our profession. What is this gonna do? How does this serve our community? What are the differences this could make for dental practices? 

But to start, can you share a little bit of the story of AI in industry and how this has originated and what are the solutions artificial intelligence is starting to bring to the table?

Mike Buckner:

Sure. So it’s really exciting to bring this kind of technology into the dental space. Like you said, I’ve kind of been a dental tech junkie. In the early days I was over at Solutionreach and helped grow them. And then I had the opportunity to go over to Dental Intelligence, was with them for a period of time, and then with Weave for the last four years, right up until they had an IPO. At that point I kind of thought, “You know what, I’m gonna kind of take a step back and do some consulting. Cause I really wanted to be thoughtful of where that next move was, though I knew it would be in the dental space. 

1. Newly Emerging: AI Technology for Dentists

And I happened upon this AI technology! It’s not something that was in the dental space; and that’s kind of shocking to me because it’s been utilized in medicine for quite some time with mammograms, X-rays, and such. Artificial intelligence is not new in the medical space, but it’s very new in dentistry. And this year, Pearl was the first company to be able to have comprehensive FDA clearance to bring this into the dental arena. And in doing so, this new technology really grew and impacted practices. 

And really the one thing that kind of pushed me over the edge to be a part of this cutting edge technology was that for the first time ever with Pearl, a practice can actually get a very comprehensive report of all of the undiagnosed treatment in a practice. Not unaccepted treatment, but undiagnosed treatment in a practice. And we can do that by analyzing these x-rays with artificial intelligence. AI basically will go in and highlight all of the pathologies.

The software generates a very comprehensive report of all of the undiagnosed—not unaccepted treatment, but undiagnosed treatment—in a practice.

Carrie Webber :

It’s a little mind blowing, you know, I think it’s one of those things where seeing is believing. Because through the technology, you’re able to pull up your patient’s radiographs, and the AI software is pinpointing areas of potential concern or areas that it’s identifying as concern.

2. Pearl’s Dental AI Software Product — Second Opinion

Mike Buckner:

Right. So we have two platforms at Pearl, and one of them is called Second Opinion. It really is kind of your second set of eyes. And when you think about it, with all the radiographs and x-rays that are taken and that our practices are viewing every day, this is super helpful. These are the black and white x-rays. And what’s interesting is that the human eye can only pick up between 30 to 50 different shades of gray. That’s it. And with AI, we give it these digital x-rays, and it can break those down, pixel by pixel. It can differentiate between 550 to 750 different shades of gray. So we are able to see things that are oftentimes too easily missed by the human eye. 

Carrie Webber :

Wow, that’s incredible. And you had said something earlier about FDA clearance. Tell me about that. What’s so key about that and where does Pearl stand in that realm?

3. Importance of FDA Cleared AI Software for Dentists

Mike Buckner:

So this  was kind of new for me because all the other software companies I had been a part of in the past, we didn’t have to worry about FDA clearance. But with this software being utilized as a medical device, as a disease detection device, it needs FDA clearance. And especially as this is designed to be patient facing. So if you think about it, you go into the dental practice, and he pops up the x-rays, and he proceeds to point out, “Yep, we have this and this and this.” And I’ll be honest, there were times when I didn’t know what he was looking at. It didn’t make sense to me. I could have been looking at a bunch of ink dots. 

But now for a doctor to be able to say, here’s what’s going on in your mouth, here’s what the AI is pointing out. See 62% of the caries is in the dentin, 5% in the enamel, et cetera. It shows the full breakdown of where that’s penetrated and how much, and it helps the patient truly understand what’s going on. 

And when the doctor can say, “Mike, all of our x-rays are analyzed by an FDA cleared software,” we’re not saying we have diagnosed this, we are just highlighting what the AI has detected. So, yes, when we talk about FDA clearances, right now Pearl is the only company that has a comprehensive list of FDA clearances, meaning not just one or two things that are FDA cleared, but clearance for caries, for periapical radiolucency, for calculus, a number of different pathologies, as well as having FDA clearance for the age of 12 years and up, as well as we are the only company now that is FDA cleared for bitewings and periapicals. So it is, again, if you’re showing AI detections to a patient, and these AI detections are not FDA cleared for what you are showing them for, it is illegal.

Pearl is the only company that has a comprehensive list of FDA clearances. And if you’re showing AI detections to a patient, and these AI detections are not FDA cleared for what you are showing them for, it is illegal.

Carrie Webber :

As I’ve thought about this and I’ve processed this, you know, learning more about Pearl and other companies coming into the AI space right now, my initial response is, “Wow, this is amazing for DSOs and emerging groups. This is a very interesting resource for your clinical directors to mentor and train young up and coming dentists in treatment diagnosis, treatment planning, and quality control.”

But at the same time, I’ve seen you present this, and the thing that finally rang a bell for me for solo practices was exactly to your point of the Second Opinion piece. What we know in patient education and treatment presentation is how important visual aids are for learning and understanding. We as human beings are visual learners, and that’s why we’ve always been huge proponents of photography, internal cameras, scanners and so on. And I feel like this fits in that space for patient education.

So it not only helps the provider in diagnosis, but also in education. And we always talk about building trust, need, urgency, and value in the relationship with the patient. And this can really help build that trust in what you’re diagnosing. Is that what you’re seeing or experiencing?

Mike Buckner:

So when it comes to case acceptance, there’s a few things that really play into that. Especially when the doctor comes in the room, you have a very limited window of time to build trust and to get that patient trusting you on a level where they accept treatment. They have to trust the practice, they have to trust the dentist, and they have to understand what’s going on. And so especially for an educational component here, that’s everything. We’re in a day and age where you go to the doctor, the doctor tells you what’s going on, and first thing they need to check with “Doctor Google.” You can tell the patient straight up what it is, but the patient’s in the background going, “Hold on, let me look at this.”

So to have that technology that is backing up and supporting what the dentist is seeing. But then also what’s really cool is AI can come in and analyze the anatomy of the tooth. So now the conversations with the patient aren’t seen just as jargon, like “that cavity is really encroaching on the pulp.” AI can come in and color code the anatomy of the tooth, showing all the different colors and layers and help them understand what’s going on and why they need to get treated today versus putting it off.

4. Advantages and Disadvantages of Being an Early Adopter of the AI Software

Carrie Webber :

Yeah. This is a lot. I mean, if this is the first time you’ve really been introduced to what AI services are, it’s a lot, and it’s taken me a minute to really wrap my head around it. So I’m curious about the early adopters  of this software that have been like, “Let’s do this.” What was it about this resource that those early adopters were on board with? Are there some commonalities?

Mike Buckner:

Absolutely. I mean, we see that the practices that are early adopters are cutting edge. Honestly, you think about it, right now in the United States less than 1% of dentists are utilizing AI in their practice. So we talk about having a competitive edge. And really not just a competitive edge to present treatment, because we do find that case acceptance on average increases by up to 35% in practices that are utilizing this. Strictly because they are able to present what’s going on and take the emotion out of it. They see that everything is backed by an FDA cleared AI platform and that really increases trust.

We find that case acceptance on average increases by up to 35% in practices that are utilizing this, strictly because they are able to present what’s going on and take the emotion out of it. 

Carrie Webber :

Yes. It’s everything that we teach in terms of clinical presentation, to say, “Here are your teeth. Here Is your mouth. Here’s what’s happening. Here’s what I see, and here’s what the software is identifying.” And it supports what I see with my own eye as well.

Mike Buckner:

Exactly. And the FDA clearances really came into the space this year, in 2022. And even though it is early on, the accuracy, even just from the few months that’s gone by, has continued to improve. And that’s a key component with AI, is the machine learning concepts. The more practices that use it, the faster it learns. 

And I will say that there is a misconception often that basically says that AI is perfect, right? And the best example that I can give you is—and I might be teaching you something—but on your iPhone, if you go to your photos app—

Carrie Webber :

Oh, you’re 100% gonna be teaching me something.

Mike Buckner:

—but on, on the iPhone, if you go to the photos app and you go down to the search bar and type in something generic like a dog or a cat, AI on my iPhone goes in and analyzes all the pictures that I’ve taken and compiles all of the pictures of dogs right there. It’s easy to find. However, when I did that, the best example was, out of all of those 330 pictures, I had two pictures in there that were actually deer. Iit looked like a dog. But the thing is, it got pretty close. 

But what AI can see is based on the images that are in there. So, as I’m looking at that, I’m also saying, “Oh, yeah, I could totally see how AI would mistake this.” So is it a hundred percent accurate? It’s not. But I’ll tell you what we do find is when a doctor is left alone to analyze everything on the radiograph without any assistance, the accuracy of what is found is between 70% to 75%. When AI is used alone, without the doctor to support it, just AI left alone to highlight everything on the image, your accuracy is now between 80% and 85%. But when both the doctor and AI come together, the accuracy is now in the 90s percentile. 

A doctor alone accurately analyzes radiographs in 70-75% of cases. AI software alone accurately analyzes 80-85%. But when the doctor and the AI work together, there is a 90-95% accuracy!

So this is in no way a replacement for the provider, for the doctor, the clinician. It is a tool to be used in conjunction with the doctor. So it’s increasing accuracy and elevating the overall standard of care that we provide to our patients.

5. Uses and Benefits for the Entire Dental Team

Carrie Webber :

What do you see as the team’s role in the utilization of this kind of software in a practice? Where does the team fit into this?

Mike Buckner:

So this is kind of where I really nerded out when I found out about this because so much of my time in the last few years has really been spent on reactivating patients and filling the schedule and patient communication. But I would often get the comment from office managers or from doctors saying, “Mike, I don’t want to necessarily reactivate every patient that’s overdue. I don’t want to bring in every patient if I have a hole in my schedule.” So now with AI, with the Practice Intelligence leg of the software, we can generate these AI-driven lists where we can get a very specific list of patients who are overdue for treatment, and now with all of the AI analysis to show what truly is undiagnosed, we can filter that and prioritize it—so that instead of your Wednesday two o’clock opening being filled with the prophy, we’re now bringing in your SRP, we’re now bringing in your implants restoration cases—and that production visit and overall patient care just goes up.

AI-driven lists of overdue patients can select high-priority and high-profitability cases to fill your schedule with.

Carrie Webber :

Wow. It’s really remarkable. We have said before that the profession is evolving at light speed. And I feel like this is a perfect example of that speed of evolution. It was my husband Jess that actually first caught wind of AI coming into the dental space, and I remember him saying, “There’s something coming that is interesting.” So I certainly recommend this. These are the trails that are being blazed at this point, and the impact is just beginning. We’ve only seen the cusp of what this could do in the profession. 

So if this piqued anyone’s interest, Mike, where do they go? How can they learn more about Pearl specifically and learn a little bit more about AI in dentistry and the role it could play in their practice?

How to Find Out More About the Pearl AI Platform

Mike Buckner:

Sure. Our website is HelloPearl.com, and when  you go to the website, there’s several case studies that you can pull up and look at. You can also register for someone to reach out, and they’ll kind of walk you through what the platform does. And you’re more than welcome to reach out to me as well with any questions. My email is mike@hello pearl.com. Shoot me an email with any questions you have, and I’d be happy to follow up.

Carrie Webber :

Okay. Awesome, Mike, and thank you so much for joining us today!