I'm Nick Garrison. I am the VP of marketing here at Pearl, and I am extremely happy to, be hosting this particular webinar because I love this guest.

Doctor Lou Graham, he's somebody I've known for a few years now, and he is a really, really special man, dentist, educator.

He is a practicing clinician for those who don't know him.

He's been AI practice in Chicago for for decades. He is also the cofounder of Catapult Education.

I am, I'm very happy to have you here, Lou. Thank you for joining us. Guys, we're we're in for a real treat here. He's got a a fabulous presentation no matter what he's presenting on, and, I'll tell you, this is this is a good topic. So I'll kick it over to you.

Thank you, Nick. And, for everybody sharing their lunchtime with me, thanks.

If it's if it's morning time, wherever you're at, thanks for joining me today.

I love this topic.

And I love this topic as I will guide you through the story, how to use this technology, how it benefits all of you, how it benefits your teams.

So let's take a little walk in the past.

We'll go back seventy ish years, sixty nine to be exact, and we take a look at the practice of dentistry.

A dental assistant smoking a cigarette, I don't think that would occur today.

But when you kinda get a view of this doctor's practice, it's reminiscent of where dentistry has come, but also reminiscent of not that much has really changed. We still drill. We still use X rays.

We still seat the patients. There is the suction. Same thing.

We just have advancements.

And today, even as I take you from the fifties, where the average dentist had one employee and X rays really have advanced to a degree, but not that much.

Today is how we really take this technology to the next level.

Just a little information.

AI actually started in nineteen fifty six.

And when you read that the concept had the potential to open up several major avenues of research, including, which we'll get to, neural networks, natural language processing, aka chat GBT decades decades later, and the theory of computation, all of these were topics of interest back seventy years ago.

And yet, we're still in the infancy of AI, and we all know that. It's a little scary, but AI is here.

AI has been in dentistry, Invisalign, or aligners are an example of AI, and it will continue to permeate within our profession as it does our society. There's no doubt about it.

So today, my task is really to share with you two d AI and how it really applies to your offices. And it's really not about if you're gonna adopt the technology today.

It's really about when. And and when I say this, it's not an if because two d AI, three d AI, all of this is gonna be really, I believe, utilized by the majority of our practices within a very, very short time, and you'll see why in this presentation.

Because when you take an x-ray and you're looking at an x-ray, and I'm gonna talk about this case in a little while, this is really going back to the fifties.

And this is today with two d AI, where it allows you much more efficiently and your hygienist to far more efficiently read x rays, and in my eyes, also the dental assistant to read. So the entire clinical team is reading x rays far more efficiently and as you will see far more accurately.

And coming soon in Pearl will be Panarex AI. So two d AI with Panarex's within their software to read. So all of this, that's near term, is coming.

Not too distant in the future.

AI think you'll all love this. It's called action or act I'm sorry, activation mapping. And this solves a huge problem in dentistry, identifying what implant is that. There are hundreds of implants and every dentist suffers from a new patient, four different implants or two different implants, and they've gotta go find the records. Can you imagine instantly knowing the implant system? Of course, AI.

So let's take a step back.

I really wanna start our day off today with really facts about two d images.

And as you look at two d images, you have to understand there are limitations.

And the first limitation is obviously you're looking at three-dimensional structures in two dimensions.

So hard tissue loss is often underestimated.

Hard tissue loss would be enamel loss, dentin loss, cementum loss, that's hard tissue, and bone is hard tissue.

And it's routinely often underestimated.

In fact, you need forty to sixty percent of a tooth to demineralize or the enamel slash to demineralize to actually be detectable on a radiograph.

Two d x rays or radiographs underestimate bone loss, and the reason is is because you have to have a substantial amount of buccal or lingual plate bone loss in order to be visibly seen radiographically.

And I'll show you that in a second. This is an inability then also to differentiate because it's two d, whether it's a buccal defect or a lingual defect.

And in my practice, and I'd say also the hottest growing area in dentistry are CBCTs.

So routinely, when I identify non carious pathology, I need a CBCT, and I'll show you that in about fifteen minutes.

So imagine flipping a coin and its heads or tails, obviously.

It's fifty fifty. Those are the chances of it landing on a head or a tail.

Well, if you were to type into Google dental radiography sensitivity specificity, that's why we're here today. I know it's crazy, but that's why we're here today.

So sensitivity is the probability of a AI positive diagnostic test when disease is present. So if you have caries, the sensitivity, attitude should be you'd love it to be a hundred percent. So if you know there's caries, sensitivity would the best sensitivity would be a hundred percent.

The disease is there, you can diagnose it a hundred percent of the time. Specificity would be, if the disease isn't there, there's no caries.

It would be a hundred percent correct in saying there's no disease.

That's sensitivity and specificity.

But what I'm gonna show you, our current technologies in everything we have used for seventy years is flipping a coin. I know you don't wanna hear it, but it's flipping a coin.

Let's talk digital radiography with subgingival calculus.

The average sensitivity, if it's there, subgingival calculus is fifty percent flipping a coin.

Specificity would be eighty two percent. In other words, if it's not there, it's eighty two percent correct.

But if it's there, it's only fifty percent. That's the sensitivity.

It's just not accurate enough. Let's talk carries.

Caries has a sensitivity in this study and many other studies of fifty eight percent.

So in a tooth that actually has dentin caries, radio translucency or dentin or real radiographic translucency was detected only fifty eight percent of the time. So we are using a technology like flipping a coin.

An explorer is another technology. An explorer has a fifty percent chance of detecting fissure decay today. Fifty percent.

And this is what we use every day. I'm not talking about an open margin.

I'm talking about a virgin tooth, a virgin occlusal surface fifty fifty with an explorer, fifty eight percent with an x-ray.

So I love to bring in my cases. So here's Jim. He came in to replace a failing composite.

No symptoms. Here's the x-ray. I've cropped it from a bitewing right here.

So simple question.

How good is the sensitivity? Meaning, if caries is there, how good is this X-ray in determining whether caries is on the mesial, on the distal, or the occlusal. And how much time do you really spend reading an X-ray?

So in this case, I remove the composite and there is your mesial caries.

And there is I've shown this case to thousands of my attendees in live audiences, and less than fifty percent would say there's mesial caries.

Just guessing.

A case of mine in two thousand fourteen and fifteen.

What do you see on the lower bicuspids?

Let's take a closer look.

In two thousand fourteen, you could see virtually nothing on the distal of number twenty.

I flew this patient to the greater New York meeting, and he was a part of my hands on. Why? Because I was showing via transillumination that this was already d two well into dent and carries that you could not see radiographically because the eye is not necessarily trained to read everything as you will see that AI can read.

This is two years later on a recall visit. You can see the composite that was placed in two thousand and fifteen, but imagine if I had just let this progress.

It's an issue with reading today's X rays.

This is this is DEXA sensors.

It's still the ability to read the X-ray.

Periapical pathology and periodontal bone loss.

These studies show that on average, we do not identify correctly. Forty three point five percent of the time, we I'm sorry. We're only identifying periapical lesions correctly, and bone loss fifty seven percent of the time.

So, basically, just guessing across the board with radiographics.

Guessing.

This was AI the game changer in my practice. Patient comes in.

They had pain over this summer. It's now September. This is some years ago.

They're seeing the hygienist. They were swollen, had pain in their upper left maxilla.

My hygienist does her exam, takes a periapical, and maybe you can see something on the apical area of number thirteen.

Patient's totally asymptomatic.

Are you gonna drill into that tooth?

Are you gonna drill into that tooth and begin a root canal based on that X-ray? And the answer is no. You probably wouldn't. You'd wait for the problem to come back. But yet the same day, three dimensionally, this is what comes up.

Again, difference between buccal and lingual bone loss defects.

This is three d versus two d.

But if two d AI that periapical lesion with AI, then I'm gonna go to three d to understand the lesion and understand the canals. Is it one canal?

Is it two canals? Are there two canals? Are there two canals leading to one canal at the apical area? Is it one canal splitting to two canals? What am I gonna do, and what am I gonna refer?

I hate to say it, but my gray hair has given me wisdom what to refer and what to do. There's no such thing as a good dental AI, never a good dental surprise.

Bottom line, for decades and decades of studies show, dental radiography, dental explores, it's like flipping a coin, an FAC.

And and today, I wanna show you why we have a need for two d AI, and there are three concepts to success with this.

Now candidly, I've I've been working with AI now in Pearl. I'm not an owner. I have I'm not part of the company. I'm a dentist.

But we started utilizing Pearl when Pearl really was in its infancy four years ago.

So I'm gonna share with you three concepts of success, and they are one is the opportunity, which I'll get into. What is the opportunity? I think AI is gonna show you more opportunity than just really diagnostically showing you things you may not see. I think there's such a huge amount of opportunity, which I'm gonna get into in just a minute.

The second's communication.

How do you communicate with your patients?

How do you get treatment plan conversions?

How do they say yes? I mean, here's a statistic.

Twenty two percent of all dentistry diagnosed is twenty two percent is begun that year.

Twenty two percent, which means we're bad communicators.

Why aren't dentists why aren't patients listening to us, listening to the hygienists, and following through on work?

And routinely, it's communication, which we'll get into.

And the third component of of two d AI is I see this enhanced diagnostic skills.

So let's understand that AI can detect far more shades of gray than the human eye.

And in this particular study, the human eye could distinguish thirty shades of gray, which is what a two d AI two d radiograph is, and certainly not between five hundred to eight hundred shades.

As you look further into these studies, and this is from just a few years ago, this was all about dental caries, and I bring forward sensitivity.

The sensitivity was in the eightieth AI, so we've gone from the fifty per fiftieth percentiles to the eightieth AI.

Far more acceptable in my eyes than flipping a coin.

And it's all based on algorithms and the algorithms with the potential to detect and segment out dental caries accurately and effectively on bitewing X rays.

And these algorithms really detail what they started with concept at Dartmouth in nineteen fifty six, deep learning. This isn't just colors. It's deep learning to assist clinicians in their clinical practice. And I think it makes us far better and far more efficient as diagnosticians.

This study related to periodontal bone loss.

And what they found again is that we're getting into the eightieth percentiles with sensitivity.

More sensitivity when it's normal, more sensitivity when it's very abnormal with bone loss, but still more sensitivity with mild to moderate bone loss.

So we have increased sensitivity based on the studies, not because you're using sensors that didn't dramatically change sensitivity.

It's the AI.

So let's look at how this data becomes reality.

This is what you've been looking at since you started practicing, since you were in hygiene school or dental school.

Now imagine this data turns into this, and this is with only subgingival calculus and periodontal measurements created. And it's not perio probing. It's the CEJ measurement to the coronal height of the existing bone.

And what AI does, and you can see the glasses on the bottom of the screen, and I'm gonna show you this in just a few minutes. Every morning when you open this up, it will show you opportunities in your practice, patient by patient who's coming in that day. This redefines the morning huddle. I'm gonna show you that. But this data is graphically showing you bone loss subgingival calculus.

Caries. Yeah. Of course, you'd see this caries. If you didn't see this caries, I don't know how you're gonna miss that. I mean, you're missing way too much.

But in my full day course, now I can explain to the patient, we may have to leave some decay. It's called selective caries removal.

Well studied. I don't wanna pulp out on an asymptomatic patient, but you easily could miss the other areas that AI is identifying with these other pink boxes.

This is again where AI data is crucial.

But the number one thing you have to understand is AI is only as good as your X-ray.

Garbage in, garbage out. You gotta take good X rays.

If you have overlapping, bad contrast, all that, it's not gonna be able to read it well. You can't read it well, AI can't read it well.

So let's dive into a little bit more an opportunity, which most people don't AI, and I do think this is a pearl standout of the AI that they derive from your practice when you onboard with their practice intelligence.

So you have these computers.

They're evaluating your x rays.

They're using their proprietary software, evaluating the algorithms, machine deep learning, and more.

With this information, computers then take this and they see the opportunities each and every day in your patient's x rays. And most people don't talk about this. This is really, really critical to me with this technology.

And in our morning huddles, all of this information comes front and center. So here's my morning, multiple doctors and hygienists, forty eight patient forty six patients, thirty eight needed x rays.

And the opportunity button on the top, when you click on it, it will show you we have eight scaling patients who have not been diagnosed.

There are five endodontic patients today coming in who've not been diagnosed, eleven implant patients, six patients with recur with with recurrent decay, and four patients with new decay.

And in these boxes, you'll see multiple numbers of procedures. So when you click on each patient, it will identify those opportunities.

You identify one new opportunity, pays for your month with Pearl or any AI technology you're using.

But this is the a far bigger value add.

So consistency is this was one week in October, and I'm just looking at scaling opportunities.

And you're gonna I'm gonna show you how this translates to data.

Each day, all the opportunities were looked at, but I'm focusing on scaling. In one week, we identified fifteen scaling patients.

Patients with bone loss and subgingival calculus routinely. Not all the time, but often sub g and bone loss.

The data is in your practice.

So when you onboard and Pearl extrapolates and goes internally into your data and the computers are evaluating your data, the data turns into what we call opportunity funnels for each office.

So over the last twelve months, we had three hundred and seventy endodontic candidates evaluated seen along with five hundred and seventy scaling patients. As you can see the scaling patients, we'd only treatment planned and identified twenty four point six percent.

All the rest are gonna be identified as opportunities in the practice.

Implants, restorations that need replacement, impactions, and obviously, impactions you can see, not that many compared to restoration replacements.

My doctors had identified two thirds of the restoration replacements required.

Doesn't mean AI is always right, by the way. I wanna be clear on that. No AI is perfect. It will identify opportunities, and it's up to you to identify are those true opportunities.

And when I start looking at their data, this shows you the lowest treatment planned procedures we're scaling and planning. We were missing them. We had completed a lot of them, but we were missing, again, I'll go back, more scaling and planing than any other procedure in our practice.

And then in this data, you can see, is it due to bone loss? Is it calculus and bone loss? Is it all three conditions?

And you get all this data that helps when you walk into an operatory to communicate with a patient.

So now how do you use this in your morning huddles? Let me walk you through Brigitte.

Brigitte came in for a four month recall.

She's seventy nine years old at the time. No issues. She's edentulous in her upper arch, wears a denture I made her. History of gallbladder surgery and some recent cardiac issues with some arrhythmias.

So since o seven, my morning routine was to get to the office an hour early. I do. I like to be well studied, well prepared. My patients appreciate it. I go through the electronic charts and their x rays.

Four years ago, my routine changed, and it changed with Pearl. So here's my Dentrix and I'm a Dentrix AI, what we AI.

And my associate had identified twenty five distal decay.

And this is her note.

But instead of pulling it up in DEXIS, I pull it up in Pearl.

And I am now imaging. I'm looking at all my patients coming to me that day. I'm looking at my opportunities, and I'm also looking at their X rays.

And on one X-ray, you see all these things are on one X-ray. And how much time do you really spend on one X-ray? How easy is it to miss things?

So Pearl is part of my morning ritual and what can be missed.

This is what instantly pops up, and I'll walk you through how this instantly pops up and gives you instant data.

The instant data that I utilize is through second opinion.

And really, you can utilize Pearl and buy Pearl only with second opinion, but I really believe that you want practice intelligence because practice intelligence identifies all the opportunities in addition to just reading an x-ray with AI.

But second opinion absolutely impacts my diagnostics and our team and our schedule.

So this is really what it looks like.

This identifies the FMX tab. She's a dentalist. And for the record, I don't take FMXs anymore. I take vertical AI wings, horizontal bite wings, occasional PAs, and a CBCT every five years. It's less radiation, but you're still gonna have to take AI, occasional PAs. And for those of you who don't have CBCTs, you're gonna be taking FMX or bitewings and a Panarex, however you go.

In this case, when you when you open second opinion on Brigitte, you see two dots.

One dot is pink for caries and one dot is periapical pathology. If there's no dots, AI has not identified a problem.

So when you open up that X-ray and you move the cursor to number twenty five, it will give you an evaluation of the depth of the decay. So here's twenty AI.

Here's twenty two.

So AI has identified the depth of twenty five, but it's also identified carries that my associate missed on number twenty two.

It also identified a periapical radiolucency that my associate missed.

And per the data, only forty three percent of dentists catch all their radiolucencies catch these radiolucencies.

This one's pretty obvious, but we miss things. We all miss things. We're all human.

Now routinely, all of this data is always on. I'm just showing you how I've separated the data.

Measurements are always on, and this again is showing you the CEJ to the bone height. So all this is normally on when I'm evaluating.

Now I can actually use, for example, a ruler tool, and I can measure the width, the height. It doesn't do circumferential yet, but it does give me some measurements and AI of the measurements we've been using on three d imaging and Panarex imaging.

So, basically, when you're going through your morning X rays, you're not looking at this. You're looking at this. You're gonna make a lot fewer mistakes and you're gonna see a lot more, and it will alert you to look. You will be AI. Go look.

If the carries isn't there, then you can edit it out of AI.

It takes you just seconds to confirm or not confirm, whether you need to pulp test or not pulp test.

So the question here was she had this lesion.

Had it been missed? If so, how long had the lesion been there? Was it growing?

So what are you gonna do? You're gonna go into your database of X rays.

So in two thousand and fourteen, we looked at the X-ray.

Nothing really there, but a short fill.

Two thousand fifteen, yep. It's starting to peek through right there. Any notes in the computer? Nope.

Two thousand eighteen, another dinosaur, no notes. It's growing. Two thousand twenty one, no notes again.

So missed multiple times. Hygienist missing, doctors missing. You go, how could that be? Trust me.

You all miss it. You all miss things. Maybe not this one, you would miss things. My associate felt terrible.

My hygienist felt terrible. I said, guys, this is why we have two d AI.

Now it's right now about six thirty in the morning in Chicago. My day starts at seven. My morning huddle starts at quarter to seven with my front office team and my assistant.

We we said we'd call the patient, and we would change their appointment from thirty to sixty minutes.

She needs two restorations.

A CBC would have to be taken. I'd have to take the time and explain why she would need either an endo consult or endo treatment.

And this is just one example of how AI takes the surprises out of my day.

I miss far far fewer things, and it's huge ROI on the practice.

I then take two d AI and realize I've gotta take a look at this on three three dimensionally.

Again, you're only seeing this two dimensionally.

So this is our cone beam in our office. It's a prexion cone beam. Great image.

We take it. I'm not gonna teach CBCT imaging.

I line up the planes.

I scroll down horizontally to the area of the apical lesion, and then I screen save.

I'm gonna take these images and send them to my endodontist and say, okay. Here's our short fill. Here's the buccal. Here's the lingual.

How do we wanna approach this asymptomatic lesion?

I routinely can minimize a patient requiring a separate endo consult and it goes right to treatment, or we may be watching. It's up to the doctor. It's up to the patient.

In this case, she decided to see our endodontist at the office. So we have an endodontist two days two days a month.

And given her recent health issues, she wanted to wait. I wasn't exactly supportive of that, but that's what the patient wanted to do. And the endodontist said, we'll wait for retreatment.

And it was retreatment that the endodontist wanted to do, not an apico at all.

Patient came back last year, saw my associate, still having arrhythmia, still having heart issues. She's now eighty one. She wanted a weight.

Patient came back this past April.

This is the new pearl the way it comes up on the screen.

And as you're looking at how we're looking at a patient, let's dive into some of the updates of what pearl can show you to speed up the way you look at things.

The purple dot with the pink and blue says it's about a notable margin. Well, let's just click on this.

So we have multiple things going on on this x-ray.

The first thing is is you can enhance the image with the pearl enhancement tool.

So this is let's go back. This is not this is not enhanced. This is enhanced. Same thing like on a cone beam.

Radiographic lucency carries identify not enhanced.

And in this case, you can see a zoom up mode. So we actually zoom the picture, wanna expand it, wanna see it and identify it for the patient.

Here it's AI.

Both lesions are outlined.

And in this case, you can see the notable margin in purple.

You can also see we've used the measuring tool to see has this grown. Again, this is only a two dimensional approximation, and the lesion really hasn't grown two dimensionally in the two years.

Identifying the caries, and in this case, I would go back and see is this a growing lesion. If it's not growing, the patient may wanna wait.

And a new tool that I love is now you can actually compare.

So let's just say you wanna compare the lesion.

You go up to the top arrow where it's a b and you hit that top arrow a, and then it will bring you previous x rays by years with the second blue arrow on the top left screen.

Then you can look for what box or what periapical, click on it, and now you can compare periapical radiolucencies of tooth number twenty three here.

It's all about efficiency and then communication with the patient.

This is called tooth parts. This is my favorite communication tool. Favorite, favorite, favorite.

Why? I can show the patient in this particular image what a normal nerve would look like, what the root canal looks like, what a post, what a crown looks like, but also identify the periapical lesion.

I have measured the periapical lesion.

I've identified the caries.

I've identified the measurements of CEJ to the crest of the bone.

And this is so much more visual to communicate with a patient, and this is called tooth parts.

So to me, communication has to be throughout the team.

My assistants are taking my images in my chair, and they are absolutely bringing these images up in front of the patients in Pearl.

And it's informational, and I'll walk you through our approach.

It really focuses on oftentimes, most of our x rays are taken, if not during initial exams, during a recall exam.

And our recall exam has really upped.

So when you're doing a prophy or a perio maintenance of forty nine ten in our office, we have four hygienists, and I believe my hygienists are my partners with my four associates.

If you're coming in for a hygiene visit for a prophy or a perio maintenance, active therapy, what I say therapy, which is the cleaning or cleansing part, is only twenty, twenty five minute.

The majority of the appointment really starts with clinical screenings, which I'm gonna get into.

Clinical screenings for seventy seventy five years have been an explorer, a perio probe, and an X-ray. That's what we've been using.

And if you get one thing out of this course, every one of those is you're just guessing. You're guessing.

And a probe may be most diagnostically accurate, but how you angle the probe, the pressure on the probe, that technology will be totally changed in the next two years with what's coming out with probing for accuracy.

But all three are basically flipping a coin for sensitivity and specificity.

Changing the hygiene routine leads to more treatment plan treatment plan conversions and a higher value in your dental practice. So I'll explain.

I believe if you just talk to a patient, they're gonna forget.

I think if you show them, they'll remember, but the key is involving them.

You've got to involve your patients. You You sit them up, you bring over your monitors, and you discuss your findings.

So clinical screenings today in my practice, every patient gets intraoral cancer screening. Visual, then you've got a feel, and then we screen with a Velscope.

This didn't do well in the marketplace, but I'm a huge CaryView fan. I think transillumination is a key part of our practice.

Fluorescence, whether a AI or other technologies that fluoresce teeth far more accurately than an explorer.

We take more CBCTs on our patients as they come in for recall appointments because they're due or we find pathology.

Every every operatory should have a camera, and this is Shofu's AI.

They're so inexpensive. They're so good.

Every operator has gotta have them to communicate with patients.

Intraoral scanning.

I believe the future will be hygienists scanning their patients and seeing what's available today, and here are the changes year over year, and that's how scanning will become involved.

And I think two d AI, absolutely.

So when I look at the wheel continued and we've taken our and we've used our clinical screening tools, now we're gonna have to share our findings with the patient and review these findings and prep the doctor when they come in with our AI, and that's the role of dental hygienist. And that's how I train my hygiene team. They are my eyes.

So my hygienist will review these findings with the patient. They will show the patient their findings and involve the patient, enhanced communication.

So let's just take Pearl.

Let's take this patient.

When the patient comes in, Pearl has identified now from the images, the patient has subgingival calculus, incipient caries, caries progression, and a radiolucency.

Instantly diagnosed after your x rays. Instantly.

And so let's just focus on subgingival calculus because if it was only calculus and there's bone loss, now the hygienist has got discussion points in all four quads about subgingival calculus.

So in this mode, I'm only showing you two d AI subgingival calculus.

Would you catch that? You could say yes.

But per the studies, it's only fifty percent of us are catching these. So there's your subgingival calculus.

Now let's add on CEJ measurements to crestal bone, and you start to see normal is in white, yellow is worsening, and orange is worsening worse or worsening more. I think that makes more sense.

So now here's the hygienist who obviously sees a reason, and this patient's a type two diabetic, Rose is.

So how does someone control their diabetes if they have active mouth infection?

We all know periodontal systemic issues.

Case in point, involve the patient, get them involved, educate them on systemic disease. Here's two d AI treatment plan confirmed, book the patient.

Is she improving year over year?

Once again, you can go in and compare.

So now you hit the a tab on top. Now you compare. We're gonna just go back to twenty twenty three. And if you see worsening probing depths not probing depths, CEJ to crestal bone, it's a sign that she's losing more bone.

And here here's the full gamut. The full gamut is I'm now evaluating subgingival calculus, measurements, potential recurrent decay that you're gonna now look for, and periapical radiolucencies.

Now you're gonna go back and look on previous X rays. Look how two d AI is making you think.

The financial win is per Pearl studies, and we have seen this in our own practice, you're just gonna increase your production per visit. You just are. You're gonna see more. You're gonna treatment plan more, and you're gonna do more. And this has been profound with all my hygienists and my associates.

And finally, the value.

I think the when you're building trust, these are what I call the value the value in building trust. And this is what I try to teach to all my team members, all of them.

We have to be reliable, sincere, committed.

We have to be consistent.

We have to be competent, and we have to have integrity.

If you have all of these, I've never been involved in PPOs.

And I know I'm pre PPO, but PPOs have been around for decades.

You have this with your team, you will grow.

If you have these six traits, you will build trust. If you listen to the patient and use the appropriate diagnostics that I've shared with you today, it will allow you, I believe, far more success.

I think two d AI is a very easy transitional step into each office.

It will help you with opportunity.

It will help you with communication, and it will help you with your diagnostics.

My hygienist took to this unbelievably well, and over time, all my associates did too.

I wanna thank you for joining and thank Pearl for hosting me today.

You can join us at Catapult Education. This is our website. It's complimentary. We have thirty eight thousand subscribers, and we'd love to share with you every month what we do. I'll turn it back over to Nick, and we'll have some q and a.

Thank you, Nick. Thank you, everybody.

We have, a couple questions already.

There's one here, from Julie.

And, Lou, if you want, I think without since you're not displaying, you can actually open the chat and read yourself.

She says as as hygiene practice, we will most likely lose money with this by AI, referring patient for needed treatment.

Majority of patients, seventy five percent plus on three or four, three or four month hygiene. How much can we expect, this to help our bottom line?

So as I read the question, Nick, as a hygiene practice, we will most likely lose money by the patient requiring treatment. So I don't know and maybe Julie can type in a little bit more on this, but our hygiene practice has actually gone significantly up.

So we actually use data analytics to show per hour and our per hour hygiene treatments continue to go up, and we use these opportunity funnels to continually reinforce more what we would call active therapy.

So not only that, my hygienists diagnose or co diagnose Nick more restoratively driven dentistry.

We identify more dentistry. So whether you are doing your endo or referring it out, it doesn't matter.

You're diagnosing.

And if you're not doing endo, you will refer that out, but it also identifies for you far more. So it I I'm not sure how this at all would be a negative on growing what I would call production in an office. I I wouldn't Julie would have to come back and ask another question on that.

So Julie says, is it, let me just go through this. Is the compare feature available when you use Pearl with Oryx?

So I will say this, Nick. That's something you would have to answer Yeah. Because I am only using the compare tool with, obviously, we have the the I mean, obviously, I can't see why you couldn't use the compare tool, but you'd have to tell me.

Yeah. I I think that, I'm I've been trying to find an answers to that question for you, Julie.

In general, most of our features for our integrated partners in Pearl is integrated into a wide array of imaging systems, and integrated PMS systems like ORIX. So, I'm trying to get it to answer that for you. If it's not available now, it certainly should be available soon. It's just a question of getting it implemented into the ORIX system. But, I'm gonna get back.

And, Nick, Julie asked another question, so I just wanna keep everybody involved. So she's in Canada and a hygienist can diagnose.

Well, I will say loosely, I let my hygienist definitely diagnose and they have to read their own X rays.

But, openly, if it's a hygiene only practice and you're doing your traditional hygiene work, then I'm not sure what you're referring out unless it's restorative dentistry and more work that you're restore that you're sending to the general dentist in your area.

But I AI just think, Julie, you're gonna see a lot more. You'll be able to share more, communicate more with your patients. That's why I love the tool.

Jennifer asked, what makes you choose Pearl over other two d AI?

I am not an expert on other two d AI. What I can tell you is the key feature for me is practice intelligence.

For me, Jennifer, I believe that I wanna go in, look into the last eighteen months of my data.

And in my practice, I wanna make sure that I'm not missing things in my old data, and that data drives growth. I think practice intelligence, when you're looking in other two d AI systems, that's a key differentiator.

I think other differentiators will be accuracy, and I think the the AI world will continue to be more and more accurate. But, personally, I look at practice intelligence as the key differentiator now.

Pearl also has insurance modems, I mean, ways to bill insurance and other things. You and I I wanna be clear here.

This is far more than just reading radiographs with some cool coloring. You have to see what software comes with the two d AI, and I think that's how you make your decision.

I mean, Nick, I know you work for the company, and if there's anything else you wanted to add, you can add to that.

No. I I think that sums it up. I mean, look, I I I'm you're you can't ask the marketer to, to answer this question because Yeah. No that's my answer. So let's let's leave that with you there. Okay.

I actually have for you myself because I'm really interested in the patient experience. I'm not a clinician.

I'm not a front office person in a dental practice. You described a case where, you call the patient before their appointment to change the duration of appointment so you could, get treatment taken care of. How do you communicate with patients around the technology? That's obviously a very specific situation where you need to say, look. We we didn't see something earlier. We're reviewing it now.

I'm also just curious more generally in the chair how the patients are reacting to it.

So I live in Chicago.

If most of my patients demographically drive to my practice, traffic in Chicago is similar to LA.

If I can save the patient from coming back twice with two half hour appointments, they're almost eternally grateful. They will name their children after me. And so the fact is AI show commitment, reliability when I'm reviewing their case.

So when they come in, they know I'm already ready, already focused on what they're coming in for.

Some people go, well, they they realize you missed something or somebody else in your practice. Actually, they love the fact that I'm actually reviewing so we don't make added mistakes.

So that's a very big game winner in trust.

When the patients are there, I I will say this, digital scanning and AI truly take dentistry to the next level, Nick, with patient involvement.

They start touching the screen.

They wanna start asking questions, and you never see this with black and white images. You just don't see it. So I think if dentists and hygienists and assistants, this will enhance communication and their confidence in communicating to a different level. And so my feeling is AI think patients absolutely today want to see and understand more than they ever have, and that's why I think these kind of tools become essential in dental practices.

Awesome. Yeah. It looks like we have time maybe for one more question, and there's one here, from Roysen.

I hope that K. Name right. Do you find it easy to compare data to your preperl days? AI is it easier for you to look at how your profit add your profitability per chair has increased to become more efficient year over year in comparison to preperl days?

So the answer is is and and in your data so whether you're in dental intelligence practice by numbers, you can see year over year data.

Well, before Pearl was ever in my practice, I was always using well, I have been using data analytics because that's what drives we're running a business.

How I look at hygiene is are they doing more active therapy and hygiene?

I'm an adult practitioner. I hate kids. I don't see kids. No desire. I mean, I have five of my own, so it's not like I'm anti kids. I just don't like them as patients. I like adults.

And when we see more active periotherapy and you can see in your data how many what percentage of your patients are in active periotherapy or in perio maintenance, those numbers extrapolated drive dental hygiene tremendously.

So, yes, I can absolutely see those changes year over year. And even in my practice, I showed you year old data.

We now have treatment plan many of those patients who were opportunities into active periotherapy patients.

So the answer is analytics really do show improvements.

And and I think that's important because production per hour, I'm not selling.

I actually am more cautious than most dentists. If I don't see changes, I'm not necessarily gonna take out an old restoration.

If it's a translucent liner, I'm not necessarily gonna replace that restoration. I will then go in clinically and evaluate it and follow it. So I think your ethics is never compromised. It's only enhanced on how you wanna use this technology.

Awesome. That's great, Lou. Thank you so much for this. I love your presentation. I love all the cases you bring.

You are a a star in this field, and, I appreciate your, your AI

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