What Are the Latest in Dentistry and Why It Matters to You Introduction
Well, Dentistry, I mean, it’s something that most people have had contact with. In fact, surprisingly, only 50% of people have visited the dentist in the last year. But that’s another story. Everyone has had some contact with the industry in their lives, and today we are going to be talking about innovations in dentistry. And my guest is Dr. David Penn.
Now, David and I graduated from Sydney University in 1978. In fact, we used to share a lift into the university. And so I knew Dave very well. And we have very different professional journeys. I mean, I’ve been in my practice and absorbed with whatever holistic dentistry and all of that, all very interesting and very stimulating. David’s taken a different approach, and he has been an innovator and an educator in the dental profession. I mean, not just in Australia but globally, as you will hear.
He has been the owner of the largest dental laboratory in the world. Now it’s important to realize what we’re talking about when we talk about dental laboratories because dentistry deals with tooth decay and gum disease, and a whole range of other issues which every regular listener of my podcast will be aware of. And tooth decay and gum disease are the two most common diseases known in men, women, and children. And because of tooth decay, there is the destruction of tooth structures. So what a dentist does is restore teeth. And sometimes, that restoration can be as simple as just placing a small filling. But when a lot of tooth structure is missing, or when a tooth is missing, then prostheses need to be employed to make these parts of teeth to replace missing tooth structure and missing teeth. Things like crowns, things like dentures, things like implants. So that is what a dental lab does, and they are an integral part of any dental practice. They are the back end of what supports the dentists’ ability to restore people’s teeth. And so David’s dental laboratory really did achieve some great heights, but he’s been at the forefront of so many dental innovations. And as you will hear, some remarkable innovations coming your way. Coming our way. Anyway, I hope you enjoy this conversation I had with Dr. David Penn.
Dr. Ron Ehrlich: [00:00:00] Hello and welcome to Unstress. My name is Dr Ron Ehrlich. I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal People of the Eora Nation, and pay my respects to their Elders – past, present, and emerging.
Dr. Ron Ehrlich: [00:00:20] Well, Dentistry, I mean, it’s something that most people have had contact with. In fact, surprisingly, only 50% of people have visited the dentist in the last year. But that’s another story. Everyone has had some contact with the industry in their lives, and today we are going to be talking about innovations in dentistry. And my guest is Dr. David Penn.
Dr. Ron Ehrlich: [00:00:43] Now, David and I graduated from Sydney University in 1978. In fact, we used to share a lift into the university. And so I knew Dave very well. And we have very different professional journeys. I mean, I’ve been in my practice and absorbed with whatever holistic dentistry and all of that, all very interesting and very stimulating. David’s taken a different approach, and he has been an innovator and an educator in the dental profession. I mean, not just in Australia but globally, as you will hear.
Dr. Ron Ehrlich: [00:01:18] He has been the owner of the largest dental laboratory in the world. Now it’s important to realize what we’re talking about when we talk about dental laboratories because dentistry deals with tooth decay and gum disease, and a whole range of other issues which every regular listener of my podcast will be aware of. And tooth decay and gum disease are the two most common diseases known in men, women, and children. And because of tooth decay, there is the destruction of tooth structures.
So what a dentist does is restore teeth. And sometimes, that restoration can be as simple as just placing a small filling. But when a lot of tooth structure is missing, or when a tooth is missing, then prostheses need to be employed to make these parts of teeth to replace missing tooth structure and missing teeth. Things like crowns, things like dentures, things like implants.
So that is what a dental lab does, and they are an integral part of any dental practice. They are the back end of what supports the dentists’ ability to restore people’s teeth. And so David’s dental laboratory really did achieve some great heights, but he’s been at the forefront of so many dental innovations. And as you will hear, some remarkable innovations coming your way. Coming our way. Anyway, I hope you enjoy this conversation I had with Dr. David Penn.
Dr. Ron Ehrlich: [00:02:51] Welcome to the show, David.
Dr. David Penn: [00:02:53] Hi, Ron. How are you?
Dr. Ron Ehrlich: [00:02:54] I’m very well, David. It’s hard to believe that you and I graduated from dentistry together. Probably almost 45 years ago. Yeah, 44 years ago. Yeah. And, you know, we’ve been we are on professional journeys. You’ve been on an extraordinary professional journey while you’ve been in private practice. I wondered if you might just share with us some of the things that you’ve been doing in that time.
Dr. David Penn: [00:03:19] Thanks, Ron. Yeah, it’s hard to believe that the end of 1978, I mean, even when I say that, I just sort of shake my head. But yeah, that was when we both graduated. We had, you know, a lot of fun in dental school. We worked hard. But I think, actually, in reflection, that we were very fortunate that we were at a very good dental school and we got an excellent education.
And yeah, in relation to the sort of what I’ve seen globally and I’ve done, I’ve really been a total all over the world now. I think that we were very, very, very fortunate that the cost wasn’t prohibitive for us. We weren’t anchored down by some, you know, incredible sort of payments that we have an ongoing in which I see, you know, the younger generations of them.
Dr. David Penn: [00:04:01] So it has experience headwinds, and I think that the world was our oyster. I think, much as it might sound funny, the number of decayed, missing, and filled teeth ratios back then was fairly significant. So there was plenty of work to be done. I don’t think there was an oversupply of dentists. There certainly wasn’t an oversupply of dental schools. And we could talk about that the only to talk about in Australia.
And so there was a great opportunity, you know, if you went down one path, I went into practice immediately, unwittingly, blindly, stupidly, whichever side of the term you’d like to use. I went into private practice immediately, and I went into private practice up in Kings Cross in Sydney, which looking back on that, was sort of like really asinine. But it was a great opportunity in a way because it threw me in headfirst, and it made me really develop my skills quickly.
Dr. David Penn: [00:04:53] I went to the States early on, and I was very lucky that I spent quite a bit of time with Gordon Christensen. He was a very big influence on me in terms of looking at things and trying to develop things, sort of in terms of excellence, and really like here is Clinical Research Associates in Provo, Utah. And I went there, and I ended up working with him a lot so that when we built the Southern Cross, he was, you know, a big influence as well.
Dr. David Penn: [00:05:26] So, looking back on it, I sort of think that I was placed in an environment which I had to swim very fast because I had nobody around me. I had little experience. The dentist next door to me helped me sort quite a bit, which was great. Harry Rich. I love that guy. I don’t know if you ever met him.
Dr. Ron Ehrlich: [00:05:43] I do remember him.
Dr. David Penn: [00:05:44] A lovely guy. And he helped me a lot. I think one of the things that was really interesting for me early on was two things I think. One is that in the King’s Cross, we had a demographic which was almost from the sublime to the ridiculous, where we were getting a lot of wealthy people from Elizabeth Bay and then would get the butt down to the hobos on the street.
And that sort of let me sort of see again a thousand shades of grey on how to treat complex cases, how to relieve pain and everything in between, and how to deal with all walks of life. And that, I think, was in itself was a great experience, rather than just going into a bubble, perhaps in the Eastern suburbs or the city or anywhere, perhaps in Australia, where you’re sort of dealing with one cohort. I had to deal with all different sorts of sorts. That was really, really sort of significant.
Dr. David Penn: [00:06:34] I think the other thing from my perspective was that because this Harry Rich was next door to me, he was a Canadian graduate, and he did a master’s in Canada. He was actually intertwined with some of the major supply companies in the US. And I remember, I think, when I was a kid, I was 23 or 24. He was showing me these catalogs from Henry Schein and Darby. They were the two biggest supplier companies, and I was absolutely fascinated with these things that somehow or other the range of products and the sort of innovation that was even within these catalogs just fascinated me.
And I would pore over these things, I’d buy stuff from them. And I thought this is interesting that a mail-order business could be successful in dentistry. And I was fascinated. I mean, I was enjoying the clinical side, but probably at 25, 26, I remember saying to my wife at first after we got married, I said, “This is going to kill me. I can’t do the same thing for the rest of my life.”.
Dr. David Penn: [00:07:38] So when I was looking at these mail order things, these booklets, and they were thick, they were like almost like small telephone books. So very impressive. I actually went and studied all about mail-order businesses, and I remember these big, thick textbooks. And I read, and I read it, and I read, and I thought, well, this is something that I think that I can do. The only question is I needed a product and, you know, we had had a good education, and I thought, well, what is there to do?
And I looked at the business side of things, and I think that led me down the path of thinking. Well, dental laboratory faces, as you remember, were particularly high back in those days, and ridiculously I remember even back in 1980 that that was there was a guy on Macquarie Street, an Italian guy, I won’t mention his name, but he was charging $250 or up for a porcelain fuse to a gold crown from a laboratory perspective.
And we were charging, like six, $700 for a crown. And I thought this is asinine. This cost is prohibitive. The quality was good, don’t get me wrong. But it was slow. The guy was difficult to deal with. The results were good, but I thought there was going to be an opportunity here for somebody. We could make a value-for-money proposition.
And, of course, that’s where the concept of Southern Cross sort of started. And I thought, W”ell, I’ve got to find a quality manufacturer, I’ve got to find somebody who can do it at a value for money proposition. And I’ve got to set up a logistics chain that’s going to work and work consistently.” Now, when you look at all those three things, it’s almost like that’s a unicorn. It doesn’t exist.
Dr. Ron Ehrlich: [00:09:11] And this is all at 25. This is all at 25, David.
Dr. David Penn: [00:09:14] Yeah.
Dr. Ron Ehrlich: [00:09:15] 25-26.
Dr. David Penn: [00:09:16] Yeah, I was. I was only a kid. And I remember thinking to myself, Gee, look, I flew to Hong Kong because I thought, well, Hong Kong is close by. Cathay Pacific. We’ve got good, good sort of consistent routes, you know, 8 hours and 45 minutes there and back. So there I went in one direction, and then I thought, well, what if I can go up there and find a laboratory or find somebody that could produce some crowns, you know, all those things that I was looking for? And lo and behold, I went up there, and I made a plethora. I made like a bunch of mistakes. Like, you wouldn’t believe. We backed the wrong laboratory. We had probably used an agent. There was just everything that could have gone wrong went wrong.
Dr. David Penn: [00:09:54] But nevertheless, the interesting thing is I sent out a mailer because I’d been reading about this mail order to the concept to every dentist in Australia. In September 1983. Now China, if you put it in perspective, China had just opened up, Ron. It was remarkable. I went there… I’m not talking about Hong Kong.
I’m talking about crossing into Mainland China. Rice patties Shenzhen, which is now about 15 million people, had 50,000 people living in a shanty town. There were Sandhills. It was like it was so backward. It was incredible. And there were guns, and there were machine guns, and there were tanks. And I took my passport, and I thought I went to a hospital that had no glass and windows. It was incredible.
But what an experience for a young guy. But I soon realized that the Chinese and regardless of how critical you are about their sort of perhaps political regime at the moment, are remarkable people in terms of their work ethic and their ability to be able to reverse engineer and produce goods of quality. It’s phenomenal. And I saw that, and I thought, “Wow, if we can harness this, we’ve got something which is really, really, really special.”.
Dr. David Penn: [00:11:06] So I think the thing that sort of confounded me in a way I probably made my first year was we were making crowns of reasonable quality for $11. Right now, if you get to make them for $11 and the guy in Macquarie Street was charging 250, that gave us quite a bit of scope in between to sort of try and sort of say, “Well, look, I can make a margin here, and if I can get this whole gang together, we’ve got a proposition.”.
So got a lot of a long story, very short. We sort of developed that. And I spent a lot of time in the next probably 15 years developing this. I took a long time to get it right. I hooked up with the University of Hong Kong, which is a remarkable academic institution because the great thing about Hong Kong, in particular, is that the universities are highly revered, and one of the people pass on they leave a lot of their life savings to the universities.
And so the University of Hong Kong was a very wealthy organization with the best technology imaginable and a really, really, really good school. And I organized something with them. I met some nice people there, and then we formed this laboratory that went on to become one of the biggest in the world. And it was a great journey.
Dr. David Penn: [00:12:26] I think there was one story which I think is interesting, Ron, and I think for a lot of younger editors who may be listening to this or watching this, it was interesting talking about innovation. So I mean, making a crown hasn’t really changed much in certainly in the manual process, you know, putting up a model, you know, trimming a model, making a coping, adding some ceramic, firing it, making it pretty, and the rest is pretty straightforward. But one of the big problems we face was that we were getting an intervention from the… In China, the Internet was being watched, and any emails were sent, we didn’t notice that we were losing information on a consistent basis.
Dr. David Penn: [00:13:13] So Ron Ehrlich would send me a crown and said, David, I want CHA2. And if we would have an order form would send it to the lab. Everything would go nicely. But in the meantime, Ron had decided to “Hang on, A2 is not what the patient wants. Patients come back and said, I want a cross between A1 and B1. I want to B1, which is light up.” So then I sent an email to the lab and say, “Look, that the case number one, two, three, four, five, we’re going to change it from that color to another color.”
Now the problem was then the crown would come back, but it would come back with the initial color that Ron had asked for, and the email had not arrived because of the fact that the internet was being scoured and being watched carefully and edited by the government. And so we were losing information all the time. So we had to come up with a system that could manage an incredible amount of data and also circumvent the email process.
Dr. David Penn: [00:14:05] So I came up with this tracking system, which I probably think was about maybe ten years ahead of its time, whereby it was almost like an online spreadsheet, but it was color-coordinated. So if Ron made a change, I would change the color from green to red so that if there’s a problem. And then there would be a notation about what that was.
So all of a sudden, the lab could see, and we’re dealing with hundreds, if not thousands of cases a day, they could see a whole bunch of red marks all over the place. They knew that needed attention and that single-handedly that online tracking system, which I wrote manually, and then I gave it to a developer, this is in 2003, so it’s almost 20 years ago, and it’s still working. That singlehandedly gave us the ability to be able to look after massive amounts of data in relation to dental cases without any sort of fear or trepidation that that data was going to be interrupted by any government intervention.
Dr. Ron Ehrlich: [00:15:08] So David, you were collaborating with Hong Kong University, but the laboratory was in mainland China?
Dr. David Penn: [00:15:16] Now, the laboratory was in Shenzhen, which is a special economic region just next to Hong Kong. But the thing is, we got the staff from Hong Kong University. The thing is, they were trained. They had a great school, a technical school there, and a guy code, Godfrey Nye, who was a very brilliant man and a great educator. He basically took the guys out of the university, and we put them into the private enterprise. And I think we ended up with about 3000 technicians at one stage. And we built premises, or Godfrey built premises where we could actually house 1000 of them.
Dr. Ron Ehrlich: [00:15:58] Wow, as in live?
Dr. David Penn: [00:16:00] Yeah, it was a small town and had restaurants. It had a theatre, it had a basketball court. It had all sorts of stuff. So in itself, it was like people were coming from all over China. They’d get trained, they’d be given accommodation, and 90% of them were females. Remarkable, remarkable people. Right. I can’t give high enough praise for the quality of the people.
Dr. Ron Ehrlich: [00:16:27] Well, David, you know, you kind of… I’m not the only one that has moved major and highly technical manufacturing into China. I mean, you know, you were ahead of the game in the dental world, but every electronic device we have in my room here now, I put money on the fact that it was made in China.
Dr. David Penn: [00:16:47] No doubt, Ron. And a lot of the other devices which we might talk about this morning, we’ll have a …now I have a bunch of Chinese manufacturers who in every risk everything that we do from, you know, all the, you know, the acceleration devices to TMD devices to almost everything that we’ve got that we’re producing now is being made in China. But the interesting thing is, Ron, is that we’re going back to 1983. Well, it was like made in China was almost like and that was one of the big hurdles we had to overcome because back then, it was made in China.
It was well it was earmarked as rubbish and going to fall apart. But like with Japan, post-war Japan, the same thing happened. The attitude changed until, of course, you’ve got the, you know, the most incredible manufacturers now in Japan and China in Shenzhen. Now, Ron, it’s just, and I spent a lot of time there as well, I guess I did before up in the last couple of years where it’s been COVID, and it’s been more difficult politically. But I’ve spent time in the warehouses of the factories, and yeah, it’s incredible. It really is incredible.
The only thing I can sort of say just in relation to that is, generally speaking, innovation is not their strength. Reverse engineering is definitely the strongest. So, Ron, it would need a Ron Ehrlich or a David Penn to go there and say, “Listen, I need to make this, and this is how I want it. And I’m going to give you basically the blueprint of how to do it.” Now, if we do that, they take it like a duck to water. But if you sort of say to them, “I want you to invent that.” There’s trouble. They’re not… They’re not…
Dr. Ron Ehrlich: [00:18:25] But it’s funny, isn’t it? It’s funny that people feel somehow surprised that they will then reverse engineer and start. Well, people might call it stealing technology, but they’ve been used to making it for so long that they think, “Well, we might as well make it ourselves.”
Dr. David Penn: [00:18:41] Absolutely. And then invariably, they’ll make it better and cheaper, and they’ll get their production lines more efficient. So, yeah, very, very, very clever. But as I said, the only thing lacking I said aside from time is pure innovation. And it’s almost like if somebody said to me, “What is the essence of innovation sort of globally now?” I would sort of enter to commercialize, I would sort of say their sort of creative thinking needs to happen almost in a Western democracy. And then, the process is taken to a lot of production, which is cost-effective and where the quality is high, and taking it to China. And then you go back and market again in the Western democracies.
Dr. David Penn: [00:19:26] So I found that model, and I’ve done this all over the world, I’m not saying we get it right every time, but generally speaking, I’d sort of say, if you can do that, you’re on a winner, especially if you’ve got something which is particularly innovative. And Shenzhen now, Ron, if you went to Shenzhen, and I think a lot of the Americans in particular, they’ve got no idea.
I mean, they’re so xenophobic, as you know. But if I put you on the plane, I said, “Ron, we’re going to go to Shenzhen now.” And you think, “Well, what am I going to expect?” It’s like Gotham City. It’s like it’s not something where you’re going to see any races, you know, paddy fields and rice fields, you see this incredibly high-tech environment. It’s just like it’s more high-tech everywhere you go, and they’re talking about it. And the kids have got computers, and it’s like it’s part of their ethos now. It’s phenomenal.
So if people underestimate what’s happening in China, it’s understandable because I haven’t been there. But if you go there and you interact with the people, you realize phenomenal people, hardworking, very clever, highly organized, and you know, there’s no stopping them, in my opinion. And I spent time in the States as well. The Americans have just got no idea what’s going on. So.
Dr. Ron Ehrlich: [00:20:42] Yes, well, are you filled with, you know, we’re kind of… The press fill us with fear. “Oh, China is going to take over the world.” I mean, does that scare you?
Dr. David Penn: [00:20:54] No. No, it doesn’t. Look, obviously, some political parts. And don’t get me wrong, I’m not a fan of particularly the politics completely. But there are a lot of positives there, Ron, and it doesn’t sort of scare me. I mean, you can look at the other end of the political spectrum and without mentioning any names, that frightens me probably even more because, you know, that’s… Look, I won’t go into politics, but I just think we have to…
Dr. Ron Ehrlich: [00:21:24] No, no, no.
Dr. David Penn: [00:21:25] I think we have to be very respectful of the fact that the Chinese in Australia, in particular, take away Chinese manufacturing. If you look around your room and look at the tech and you look what’s in your house, etc., etc., and you take away Chinese manufacturing run as big that particularly Australia where our manufacturing sector has been decimated, high wages obviously. And you know, the rents, the real estate prices are ridiculous.
And you know, one of our family businesses is Lowe’s Menswear. And we sort of we are highly reliant on the again, the brilliant expertise of the Chinese again. And that’s for every you know, I’m a working man in Australia, you can relate to that particular product. Now, take that away, and what happens? The police that we saw for $24.99, all of a sudden, is $49.99. If you make it in Australia, it’s $69.99.
Now that makes a big difference. So we are so reliant upon the Chinese now. It’s going to be interesting for our grandkids, Ron, how they’re going to be coping with this because there’s a lot of grey clouds wandering around at the moment, dark clouds. But I just think my experience with China is, yeah, there might be some criticisms of their political process, but go down to the grassroots level, and they’re just remarkable, remarkable people.
Dr. Ron Ehrlich: [00:22:47] Yeah, well, I think we won’t go too deeply into it, but I think history tells a story of who we really should be fearful of. And I’m not sure it’s China that we should be that scared about. But let’s not digress too far into world politics because I think we’re both on the same page there.
Dr. Ron Ehrlich: [00:23:04] Let’s come back to innovations in dentistry. A much lighter topic. Because your laboratory, as you mentioned, just in people might miss it. But I didn’t, and that was you built what was literally the biggest dental laboratory in the world.
Dr. David Penn: [00:23:19] Yeah. Well, it’s, it’s…
Dr. Ron Ehrlich: [00:23:22] Which is remarkable, remarkable actually.
Dr. David Penn: [00:23:24] I was part of a process very lucky again that I was that we sort of this relationship I have with this Chinese guy called Godfrey Nye and a couple of his partners. We set it up almost inadvertently in a way that we basically said, well, you worry about the product, and I’ll worry about the marketing and the education and also and the innovation saying, look, this is where we’re heading.
This is the value-for-money proposition we’re on, and back it up by education. I think that was the one thing that I was determined to sort of say, look, if we are going to do this, this isn’t the technician. If a technician rings for an election to listen, buddy, your margins are rubbish. You’ll say, “Well, I’m a dentist, you’re a technician. What would you do now?” That’s generally the attitude around the world.
Dr. David Penn: [00:24:17] On the other hand, if a dentist rings around and says, I say, Ron, I’ve got an image of the impression you took, and we pull the model up, and if you can tell me where those margins are, you’re a better man than them. You mark out of yourself where those margins are now. Most of the time, Ron there was maybe sort of like a little bit of a grumble.
Dr. Ron Ehrlich: [00:24:37] Now, now. David, let me stop just there for the listener who may not be familiar with exactly what you’re talking about. When you say margins, you are actually talking about how accurately a crown fits onto a patient’s tooth. Go on.
Dr. David Penn: [00:24:53] Absolutely. So what we’re talking about is how actually did you record what was in the mouth and reflected sort of in this piece of silicon that you sent to us? Because if we’re going to make a prosthesis for this patient, we want it to be really, really good. We don’t want there to be any problems whatsoever. So, again, coming back to our education, Ron, our standards were high.
We were taught well at university. We had a set of standards which, again, wrongly or rightly, but I actually thought that every dentist in the world was like that. But I was a fool in that. And there were many, many people said, “Oh, David, just do the best you can.” So there were plenty of dentists around who would actually we would have a nickname or have an acronym on it. Let’s go. DBP – Do Best Possible, which means that they had absolved themselves of any responsibility and then said just almost like yes, where the margins work.
But Ron, that changed the whole game because all of a sudden, if I had an image and I knew what I was talking about, and I said, “Ron, you didn’t use your retraction code, you didn’t define the margin properly. It’s uphill, down, down, blah, blah, blah, blah. You can have an overhang, you can have this, you can have that. The middle coping can be too thin. It’s going to flex. The ceramics and it break up, and you’re going to blame me, nobody. It doesn’t work like that. If you’re going to work with us, this is what we need.”.
Dr. David Penn: [00:26:05] So I was and then, of course, in consternation, and some people told me to get nicked and guarded up, but a lot of people realized that we were serious and that we did have something which was evidence-based. And the fact that with the Internet coming on that, we could actually move data backward and forwards. I imagine I could send you, I’ll say, “Ron. I’m going to actually email you a picture of the margins. Da, da, da.”
Now, there’s no hiding. And you know that. And I know that there’s no hiding. And look, where does this actually join? So again, using the technology again was monstrous. And then using education as a sort of selling tool. And I went around a lot, as you know, I went around a lot. So I spent a lot of time sort of teaching people that margins about this and about that. And I think in innovation these days, one of the… It’s very hard to hang your hat on price.
If you go to look at Michael Porter’s ideas at Harvard, the two different ways of looking at a competitive advantage. You can have a niche product which is going to be highly innovative, which is different, or you can compete on price. Now, rarely do you get that combination. Where you get something which is niche and high quality but incredibly credible value for money.
Dr. David Penn: [00:27:18] Now we happened to hit upon that unicorn, Ron, because we had an incredibly high-quality product and we had incredibly low prices. So all of a sudden, we hit something which was, and don’t get me wrong, it’s a mile sound very easy to set this up. It took a long, long time to get it right. But when we did, we knew we had something which was almost unassailable.
And my mother actually said to me, and you met my mother. My mother said to me, he said, “David, you know, you’re going to kill the technician industry in a lot of places.” And I said, “Well, maybe not kill it. I said, But maybe I can, you know, we can manicure it so that the best ones survive.” But there’s no doubt about it, the model that we had created something was almost impossible to compete with.
And I would say that even a lot of the things I’ve done, even since then, you know, the Detroit one is an interesting one, which is I’m not saying somebody else can’t do it, but that’s something which is going to be a paradigm shift in dentistry as well from both from an innovation perspective to get all those pieces of the puzzle right. It made it, and it made it better.
Dr. Ron Ehrlich: [00:28:22] Now, listen. Let’s just fast forward a little bit here because you’ve set the stage there for other innovations which have occurred. And I know that when you and I graduated, one of the biggest innovations in the mid-eighties was the decision to wear gloves and masks when we were treating patients. Yes, it’s almost unbelievable. But that’s how far back we go. When we graduated, that was an option.
Dr. David Penn: [00:28:51] Absolutely.
Dr. Ron Ehrlich: [00:28:51] But then if someone had said to us 30 or 40 years ago, you’re going to be working with computers and spin. I know in my practice, I use CAD Cam (Computer-Aided Design) and computer-aided modeling in my practice. Tell us a little bit about some of the innovations that have occurred in this time.
Dr. David Penn: [00:29:12] Oh, look, it’s a really fascinating sort of stuff. I think one of the first things that I remember was… Probably one of the most significant things of the lot was there was a professor at Hong Kong University who said to me that he knows a way that we can bond ceramic to the tooth structure. Now we had been doing acidic stuff sort of, you know, I mean, even when we started, I remember one we actually had, you know, Part A, Part B mixed.
So mixing composites a lot. You had about 30 seconds to mix and get into the thing as quickly as you can and as curing him. Oh my God. It was like, how many times did you get it halfway? Then it had set temperature sensitive, technique sensitive. Just crazy sort of stuff. So obviously, when they built acid enamel, it was a big one. But then the ability to add hydrofluoric acid to certain types of ceramic and being able to burn a ceramic to the tooth structure.
And initially, it was on the enamel, and then it went to Dentine. But even the first time that I was in Hong Kong would have been about 1988. And I remember he said to me, Look, “David, come and have a look at these.” And they looked under a microscope, and I could see all the micro edges in the ceramic. And he said, “Well, we can get a resin in there, and we can bond it on there. We can actually put a piece of porcelain on the front of somebody’s teeth.” And that was really the birth of porcelain veneers.
Dr. David Penn: [00:30:43] Now, that was a major, major, major shift. Another Oh my God, this is going to circumvent the plastic veneers we’ve been doing, which, don’t get me wrong, were very good. And that was a really, really major innovation. So, I mean, that was really sort of something. Then I remember I was involved in the milling of Zirconia, which was great because this was obviously a material that was reasonably aesthetic, but it had physical characteristics which absolutely outstanding. It was a difficult material to work with, and then the ability to be able to bond conventional porcelain to zirconia. I was sort of involved with that as well. And that was another breakthrough.
Dr. Ron Ehrlich: [00:31:24] Because zirconia is a really hard material. I mean, I’ve heard it described as white steel.
Dr. David Penn: [00:31:31] Absolutely, Ron. And the big problem was that even today, a lot of people don’t understand that they put these full zirconia crowns on people’s posterior teeth and patients come back five years later, and that zirconia is sitting there pristine like nothing had happened. But look at the opposing teeth, and it looks like it’s done sort of 20 rounds with Muhammad Ali.
It’s sort of like it’s just beaten to a pulp because it’s just worn down. I’m really showing my age when talking about Muhammad Ali. But yeah, I mean, people go and look, I don’t know about, you know, the material sort of science, how much that’s being taught. I’m assuming the dentinal material in dental school is being taught to a certain extent, but I don’t think really people really understand the ramifications of putting something that rock-hard into somebody’s dentition. You know, you need like versus like a little bit softer.
Dr. David Penn: [00:32:20] So zirconia was great. But the only problem with zirconia is kind of it’s not aesthetic, very opaque, very hard, and very, very difficult to sort of match, you know, the fluorescence and translucency of human enamel. But certainly, in a lot of respects, the fact that we couldn’t CAD cam them, and as you said, you’ll be milling stuff. So the chair side really in itself was quite remarkable. Scanners were another thing.
First of all, we had lab scanners. All of a sudden, we could start to, and this came in about probably about 15 years ago, where we could scan impressions, and that really sort of quite accurately down to about 27 to 35 microns accuracy, which was sort of a big advantage. And then, of course, the scanners came in the mouth, the intraoral scanners.
And that was another thing in which I was very involved. It was a lot of this that came out of Israel, the defense forces, the tech there. And that made a monstrous difference because all of all the sort of the onerous issues with using impression material, accuracy, shrinkage of monopoly, you know, and a lot of inaccuracies there. That sort of has been…
Dr. Ron Ehrlich: [00:33:45] Because putting all these different materials into people’s mouths to take impressions from various devices was fraught with lots of variables that as how you mix it, what was the temperature of the room, did you pull it out too early, did it make the patient gag, did it do this? did it do that? And here we had a camera that you just put in the mouth and went *click*, and you got an image.
Dr. David Penn: [00:34:11] Yeah, well, I mean, even then, that was even back, I think, the first time I saw them out of Israel, and we bought ten of them. This is in 2000, about 2009. They look like small machine guns. They weighed about ten kilos. You needed to be Arnold Schwarzenegger to be able to manipulate the thing. Their hands were big. They were slow. That accuracy was probably about 50 to 60 microns. Which is really, you really want to get down to probably some 30 microns as far as, you know, with a leading light.
Dr. Ron Ehrlich: [00:34:42] Now, a micron for our listener is a thousandth of a millimeter. What about the sarik system out of
Dr. David Penn: [00:34:49] Yeah, well, sarik was okay, but again, there was a red one. There was a blue one, there was all these different versions of them. And as time has gone by, they’re getting better and better and better. But again, there’s if you and I write a few articles about this while they are as accurate as you’d think they are. And we can talk for hours about this.
But nevertheless, regardless of that, there was similar accuracy to an average impression. But from a comfort perspective, from the patient’s point of view, it’s much better if somebody else puts a little clicking camera in there and takes it takes a video of this tooth rather than sitting with, you know, half a kilogram of patty in your mouth, watching up down the patient’s throat and all the drama. So that was uncomfortable.
Dr. David Penn: [00:35:35] So what I’m looking for, Ron, in particular, that was a tech that has been remarkable, and it’s going to only going to get better and better. And we’ll talk about Dentro it’s sort of up in the robots and the moment. But there was, yeah, there were so many things, I think. Ron, the other thing, this is one innovation which I really would like to talk about.
If we wind back the clock to 1999, now the dot com boom was on in the States, and people were throwing money left, right, and center at Tech. There was plenty of venture capital around. And a guy called Zia Chishti, I don’t know if you ever heard of Zia. He and his girlfriend, they were the guys who started Invisalign. And he was a very, very, very, very, very clever fellow. I’ve spent a bit of time with him.
Dr. David Penn: [00:36:29] And they realize that back in 1947, inadvertently again, a guy called Quisling had noticed that an overextended denture leaning on a molar all of sudden if he overextended the danger and it hit on that prematurely, all of a sudden that tooth moved. And then he realized if he added a millimeter more acrylic on that tooth and landed up against the tooth more, is going to continue to move.
And now he realized there was a relationship between how much he added, how much time there was and where the tooth would end up. And he thought, well hang on, if you go and look at all the sort of variables in that equation, you’re going to come up with something which is somewhat predictable. So that all of us are, now, when you stop and think about it, it was pure serendipity. But nevertheless, this is not so. These young guys said, hang on a minute here.
We believe that if we put some plastic in people’s teeth and we push it against the premolars, the premolars are going to move towards the outside. The arch is going to be big. We’re going to make some space, and all of a sudden, I can put those front teeth back in because I’ve got more space, and we’ll see where it’s gone now. It’s a line taking to 60.
Dr. Ron Ehrlich: [00:37:43] Well, but David, hang on. Give us because I know what you’re talking about. And this is the birth of a revolutionary way of aligning teeth. Give us Invisalign 101 to someone that wouldn’t have a clue what you told me.
Dr. David Penn: [00:37:57] Okay, well, basically, Ron, in a nutshell, you’ve got a clear piece of plastic, which has a shape in it, which when it’s put into somebody’s mouth, it pushes teeth in a certain direction, certain teeth in a certain direction, in a chronological sequence, in a, you know, in a timely sequence to sort of say it’s like a game of chess.
I’m going to move the pieces at certain times in a certain direction, and I’m going to try and then move them into a pattern which is aesthetic, which is going to be functional and do it in a way where it’s not fixed in somebody’s mouth. It means you wear this piece of plastic 22 hours a day, and 90% of the time, it’s going to move really where you want them if you’re fully compliant.
Dr. David Penn: [00:38:45] Now, to get a patient to be fully compliant. A lot of people don’t realize that, you know, if you don’t have them in the mouth all that time, it’s not going to be completely successful. But the fundamentals are pieces of plastic to move your teeth, quite predictably, especially if it’s sort of that treatment plan is done well. So this is a remarkable innovation in relation to the fixed braces, which had been gone, have been around for, you know, more than 100 years.
You know, Orthodontics started at the beginning of the 20th century and is a remarkable process. And I’m still heavily involved with applying tech. A lot of the innovation process that I’m involved with today surrounds making that whole process even more predictable and faster, and more streamlined. We’ve developed a number of things, and I’ve got two or three more products that are about to hit the market, one globally with a line of tech, and it’s fantastic.
So the kids of today don’t have the fear of having to wear braces for a long period of time. I’m saying there are some people who do need braces, of course, but for different reasons, more complex cases, but from an aesthetic point of view, and for my mostly some reasonably complex functional perspectives, these clear pieces of plastic. Really work very, very well said. What a phenomenal innovation.
Dr. Ron Ehrlich: [00:40:09] And I mean, in terms of age in our practice, our youngest because of compliance is probably around 15, and our oldest is 82.
Dr. David Penn: [00:40:22] Wow. Well, that’s fantastic. Well, I think that’s incredible. And I actually had somebody this week who, again, a guy who, like 70, so was a former Qantas pilot, very techie sort of guy. He said, “I want you to move my teeth.” I said, “Are you sure?” Yeah, I get it. So, I mean, the fact that we can do that, it’s just phenomenal.
I would say, Ron, that was in itself one of the most incredible innovations that I’ve seen. And it’s heading. I’m not saying it’s flatlined, but it looks like if they had the right of innovation in that area, has slowed down obviously because it’s a… I’m not saying it’s perfect, but it’s getting better and better and better.
And there are a lot of copycats, a lot of direct-to-consumer models around where some patients think they can just order stuff online. It’s got to be done properly. And I think that’s very important for any of your listeners who may be considering stuff like this. It’s going to be done through a dentist, and don’t just sort of look up one of these, do it yourself, kids, because it’s going to be disastrous. So it’s got to be done properly.
Dr. Ron Ehrlich: [00:41:28] Now, another thing that I know you’re working on is this Dendroid System, which is… Tell us about Dendroid.
Dr. David Penn: [00:41:36] Okay, Ron, that’s interesting. So I use was it was in have a team of industrial designers, and we worked very closely. My daughter has got a double degree in manufacturing, in mechanical engineering, and also in materials science. So she and that’s at New South Wales University. So we needed in a lot of the stuff we’re doing, we need great engineering, we need to understand material science, but we also need industrial designers.
Now this team of industrial designers were approached by two guys who came along and said, “We’ve got this idea about building a little robot.” And we actually applied for a patent for miniaturizing a turbine. And the original idea was a miniature turbine and putting it into patients’ mouths and be able to control it almost like a PlayStation. Types of a scenario, Xbox, whatever you want to call it, where you’re using a joystick, etc., etc., where you can actually look at a computer screen because there are cameras inside this little device and where we can decide which to use what, how much to structure, we’re going to remove and do it in a controlled environment.
Dr. David Penn: [00:42:56] So they came to me, and they said, “Would you like to get involved? Because we know that you guys have been doing a lot of this stuff.” And I looked at it, and I went to General Electric because I thought, “Well if you’re going to do it, let’s do it properly.” And if I like to do it, I don’t like to sort of really half-do things. So we had a lot of discussions with General Electric. And we built some interesting ideas. And after a period of about maybe six months of looking at this, I said to the guys, from our perspective, it’s impossible.
We can’t get anything which is going to generate enough talk in this particular size with this size, dimensions, and the others. And I wasn’t going for a class one for just a small cavity preparation. I was going for the nuts. I was going for four, basically a crown preparation. I said if we can actually set up and do a crown preparation with this thing, we’ve really sort of circumvented the minefield anyway.
Dr. David Penn: [00:43:55] So we aborted that. And I remember actually I’m sitting here in my house and you point pipe at the moment. I remember having brought the guys in. I said, Guys, I think we’re going to give up the idea about the turbine. How about we bring lasers in? And they looked at me, they were shocked, and I said, Oh, gee, you know. I said because, in my opinion, a laser is something that we’re going to be able to control a lot better. And I think that the possibilities and there’s a lot of work being done on this, and I think that to me could be the future of where this miniaturized robotic sort of type of device.
Dr. David Penn: [00:44:27] So we actually got one of my guys to draw up a very futuristic, and if you like, I can share this with you one day this picture of… Basically, they look like something in space, a young dentist sitting there with a joystick patient in their mouth. The patient’s got this sort of like virtual sort of real thing on to take them away. It’s got the robot in there. And basically, the dentist is controlling what’s happening in the mouth. That was like a very futuristic thing that we drew up. Now, to this day, even in the piece that we’re using today, we still use that diagram. That was really where the concept sort of started.
Dr. David Penn: [00:45:09] So Ron, the whole idea was that we wanted to be able to see if we could affix something to a patient’s teeth, surrounding teeth that we got one that we needed that no needs some work. And the idea here was to incorporate a laser, if, at all possible, that could oblate or could actually remove enamel and the underlying structure, and the dentine as well, in a manner without anesthetic, without cooling, without irrigation. So we’re not having air, we’re not having water, and we’re not the sort of heating up the tooth. So it’s going to absolutely fry the nerve inside that without any vibration. Which was rapid, which was incredibly accurate down to, I think, about seven microns. Right. And this is not sci-fi. This is happening. This is real. We’re doing it already.
Dr. Ron Ehrlich: [00:46:04] Wow.
Dr. David Penn: [00:46:04] And then to be able to do it, the idea then was to find a sort of a license and to get the right people to be able to do this. That was extremely difficult because there were a lot of so-called laser experts and a lot of old-fashioned and all different types of lasers, as I’m sure you’re aware. And so it took a long time. Now, I was the Chairman of the company for a while, but I simply didn’t have the time because I’ve been involved in a lot of my areas of expertise was in oral medicine products and also in orthodontic stuff.
That’s where I’d been really concentrating, but I invested heavily in this stuff. I’m one of the major shareholders, and I’m sort of an advisor to the company, so I removed myself as Chairman because I just didn’t have the time, and we brought in a whole bunch of experts who really knew what they were doing.
Dr. David Penn: [00:46:55] Now, this took a long time, put the team together and but now the team that’s there, including Lori Walsh from the University of Queensland, he goes by the Dean of Sydney. I mean, we’ve got a world-class team now working on this thing, and it’s happening. So a lot of the work is being done at ANU, which again doesn’t have a dental school but nevertheless a school of physics. And I’ve been down there, and I’ve seen the teeth being ablated and drawn. It’s like the accuracy of this thing, and not melting tissue, we just sort of… It’s ablation. It’s mind-blowing.
Dr. David Penn: [00:47:33] Now, the key thing for your listeners, in particular, to sort of to let’s take it to the next level. So we’ve got the ability to be able to remove two structures by enamel and dentine in a very, very biologically sound environment. Now, if you take that one step further, and this is where it gets really, really interesting, is that if you’ve got a small little box, little, a tiny little device that goes on top of the tooth, and the first thing that goes in there is the possibility is that it’s got cameras in there that can scan that tooth.
Now they scan the tooth, and it says, “Ron, you know what, we need to put a crown on this tooth.” So what are the ideal dimensions? Ideal dimensions? You take the human out of this. The ideal dimensions for the crown prep that we want to do if they’ll be able to fashion that tooth, to be able to a crown to be up, and we know that we want to reduce the top part by maybe one and a half to two millimeters. We want to reduce the size by 1 to 1.25 millimeters.
We’d like to put these little mats inside this bicycle track around the bottom of about one and a quarter millimeters. But we want to do that at certain angles of this and that we wanted to finish that sentence. But this particular device has the ability to be able to do that, to plan exactly what that is going to be. So it’s almost like a textbook. You’re going to get something that no human can actually produce. Or they may be they can’t, but they’re very, very high.
Dr. David Penn: [00:48:53] Now, then, of course, your mind is going to hang on a minute here. If I’ve got the ability to be able to cut that tooth down on my little on the side table here, I’ve got my milling machine. I’ve got a piece of zirconia or lithium silicate, which is another type of porcelain. Now, whilst the tooth is being cut down, I’m setting up with a block of this other ceramic, and the milling machine is cutting the crown as the tooth is being cut simultaneously. So you’re getting the prosthesis is being made whilst the crown is… The tooth is being removed. So 15 minutes later, all of a sudden, it’s like, “Ron, well, here’s the crown, and there’s the tooth.” And all I got to do is put a bit of glue inside that crown and go bang on that, and it’s game over.
Dr. David Penn: [00:49:42] Now when you stop and think about that in relation to where you and I were back in 1977, 1978, back in those clinics, and we were doing what we thought was state-of-the-art stuff. I was somebody would have said, “Ron. That all gets what’s going to happen.” We can envisage that we would have just slapped each other and said, look, you know, what are you smoking or what are you drinking? Because we just couldn’t even envisage it. But this is where it’s heading. So this is a reality.
So, you know, it might take by the time this is fully commercialized, it might take, you know, three or four years to really, you know, to get there. Maybe even longer. But I can promise you this is going to happen because we’ve got the ability to be able to a blade to cut the tooth extremely accurately, to scale. I mean, if you have to scan a tooth now, it’s not a big drama. We don’t need water. We don’t need air. Yeah. So, I mean, I think that. Yeah.
Dr. Ron Ehrlich: [00:50:40] Well, I remember attending a lecture you gave a few years ago. It was probably about four or five years ago, and you said to me we were working on a small robot that will fit over the top of the tooth and do what a dentist does. And now you’re describing even more, so I just kind of I went back to my practice, I told everybody, and we kind of just shook our heads, not doubting you, I have to say, just wondering at this incredible innovation. Now, something else I know you’re working on, which is an app, and we just touched on it before we started out that discussion. Share with us open wide.
Dr. David Penn: [00:51:15] Yeah, look. This is one of my very, very excited about, and we’re just scratching the surface really about this one. This was so back in the eighties when I went to the States not long after I graduated, I spent some time with Gordon Christiansen, and I remember Gordon showing to me. He said to me, Look, the ability to be able to see in people’s mouths and to be able to capture imagery and all sorts of things was so it was quite challenging back then.
And he showed me this sort of device, which was a series of mirrors at all sorts of angles, and it had a battery in it, it had a light in it, had a little bit of a fan in it. And I looked at this thing, and I thought, Well, that’s interesting. And if you remember, you need an SLR camera to be able to then look at the reflective surface of what you’re aiming for. The light wasn’t particularly good. The fan wasn’t particularly efficient. There was a lot of things wrong with it. And I looked at this thing and said, gee, yeah, that’s it.
Dr. David Penn: [00:52:10] And I remember it piqued my interest, and I just put this idea away for a while then about God maybe 13 years ago, back in 2010, probably about 11, 12 years ago now, I was in Germany, and I saw an upgraded version of this thing and the fan was better, the lights were better, it was still battery operated, it was clunky, but it was really effective.
And I was involved in teaching Invisalign. I thought, Wow, this is a great way to start taking into oral imagery using reflective surfaces again. But again, that was with a digital SLR camera. I thought, okay, that’s good. It was incredibly expensive there. And I remember even back then it was like €400, and I thought, no, no, this is okay. And they’re buying it because I thought this was something I was interested in. I thought I put it in the drawer.
Dr. David Penn: [00:53:00] Anyway, again, moving forward, about two years ago with our Chinese friends, I was talking to these people, and I said, Look, this is something that I thought, I just wonder if we could manufacture something like this. And I really upgraded it, and I put these turbo fans inside. I put an array of LED lights in it, and we change all the mirrors to all these different shapes and sizes.
And then we put millimeter notches, and I put odd shapes, and I put mid-lights on it, all sorts of things on the mirrors. Again, this was all aimed at orthodontics to capture imagery, and then all of a sudden, I realized, hang on a minute here, I can create a fog-free environment on this mirror, with these incredible mirrors where I can see with incredible detail.
And that was used initially, I was using an SLR camera, but hang on, all of a sudden, the cameras in phones and mobile phones started to become better and better. So I just hooped these two technologies together, and I thought, well, hang on a minute here, we’ve got something mind-blowing.
Dr. David Penn: [00:54:01] So about two years ago, we were about like it was less about 18 months ago, we completed the first prototype of what’s called the Demystify, that’s the name of the product with and it was a fan for us. It’s a basic turbo version of fans, with lights and five different mirrors. And this is very useful for doctors, in particular a dentist, to be able to take patients’ images using their iPhones.
And now, iPhone 13 Pro Max, whatever it is, all the imagery from these things, Ron, is like mind blown. I can see stuff that I’m thinking, well, it’s better than I can actually see. If I sit there with a small mirror and I’ve got fog and saliva, the patients are capable of now taking quality imagery like you wouldn’t believe. So I thought to myself, Hang on a minute here.
Well, if the patients can do that, so if I’m a dentist and I get my patient, one of these kits and I say, look, you don’t need to come and see me in six months. If they need to see me in 12 months. But six months from now, I want you to put this device in your mouth and take some images, and I’m going to just have a look to see if your gums are okay. If anything’s broken, anything’s cracked. Anything which is heinously obvious. I’m going to look down the back of your front teeth to see if there’s any calcified stuff.
We can look at the flow of your mouth, and I’m not saying this is definitive. It replaces the dentist. That’s not the case. But as an interim thing in this COVID environment, in this time-sensitive environment, all of a sudden, the patient can get involved. And once a patient are involved, they realize what’s in their mouth, not scared takes away fear. Saves time. Saves energy. Saves chair time, and all sorts of things all of a sudden popped into my head.
Dr. David Penn: [00:55:50] So I built this kit, then around this, and my team thought I was absolutely lost it because all of a sudden I started putting disclosing material in there that says, check the quality of the gums, cleaning devices, the retractors, cotton rolls, everything. So all of a sudden, we have got the ability for people who are geographically indisposed in nursing homes. It doesn’t matter where they are.
All of a sudden, you give them one of these kids, and they’ve got the Internet, they’ve got the app, and all of a sudden, we say, “Take these images. If you’ve got a toothache, if you got this, you got that, Baba.” The kids got this. The healing of implants. There are all sorts of possibilities here. I thought, “Wow, we just need it.”.
Dr. David Penn: [00:56:32] An app. Now, it’s for the patients to be able to have to be hyper compliant, which is an important thing from a privacy perspective, but for the patients and to be able to basically upload the images from there, they’ve taken themselves to the dentist, and there’s a chat facility on this app, and you’re basically looking to say, “Hey, Ron. How are you? Look, today, I think I brought my thing. I took a photo of this. What do you think?”
Now, Ron gets a notification. Ron writes back and said, “Oh my God, you’ve got this, you got that.” He then annotates it puts a circle around it puts an arrow. So it’s like, this is where the crack is, this is where the nerve is. You’re going to come and see the same dadada. Or, on the other hand, “Look, it’s nothing that’s happened. You might have thought this ended up dadada. We’ve given them bite paper. We’ve given them all sorts of possibilities in this kit. So the patient can almost, like, be very involved.
Dr. David Penn: [00:57:20] Now, once the patients got the kit, again, they’re educated, they’re more interested, and they’re not so fearful. And the whole game sort of changes. So just by using the tech by combinations of lots of tech, throw it all together, my daughter and a team we got to have we put a team together of four people to build this app, and they’re building an app, as you know, is not so easy, but certainly, one which is HIPAA compliant and it’s got they’ve got a lot of storage for a lot of images and portals for dentists to be able to look after all the patients. Extremely powerful.
So this is something where it just hasn’t been released yet in Australia. We released it in the US. We presented this thing called The Next Big Thing in Las Vegas at the end of June. An incredible approval rate. It was like a shocking thing for dentists, and the reception was just phenomenal. So we’ve sold already a lot of I don’t even know if I could make them fast enough, but into capturing the dentistry around to capture images even in the practices, even just use that alone is phenomenal.
Dr. Ron Ehrlich: [00:58:33] So what is the kit? What is a kit consist of? You’re talking about the mirrors and the face.
Dr. David Penn: [00:58:38] Yeah. So the basic kit, if I just see if I’ve got one. I just happened to have one here, Ron. Yeah. Inside this kit, and I, you know, it’s called the Open Wide Kit. Inside here, we’ve got. Yeah. Yeah. So a patient basically goes home with his kit. So here is I mean, I really wasn’t going to talk about this, but there is a little series of mirrors, Ron. I’ll just get this out. There’s a series of mirrors. I don’t know if you can see that.
Dr. Ron Ehrlich: [00:59:17] Yeah, yeah, that’s okay. Just describe it for our listeners.
Dr. David Penn: [00:59:20] I know. What’s interesting, Ron is I’ll just show you this because I think this is one of the most interesting bits of tech that we’ve come up with.
Dr. Ron Ehrlich: [00:59:27] Now. This is exactly to our listener why we’re encouraging everyone to go on our YouTube channel because the graphics that are coming in on some of our podcasts are not to be missed.
Dr. David Penn: [00:59:36] Well. If you have a look at this, Ron.
Dr. Ron Ehrlich: [00:59:41] Yeah, that’s a mirror attached to… wow.
Dr. David Penn: [00:59:43] And then if I put…
Dr. Ron Ehrlich: [00:59:44] That’s a dental mouth mirror. Yeah. Yeah. Yep.
Dr. David Penn: [00:59:49] You got too much light there. But what I’m sort of saying is…
Dr. Ron Ehrlich: [00:59:51] That’s right.
Dr. David Penn: [00:59:52] Put that in your mouth, and then get your iPhone. Get your iPhone and take an image. And all of a sudden, we’ve got something which is pretty incredible.
Dr. Ron Ehrlich: [01:00:01] That’s the sort of mirror we use in our practice every single day on every single patient to take high-definition photos. And I agree with you, the iPhone… The phones. I mean, with the iPhone 13, we don’t need to do a commercial. I’m sure there are other phones similarly, but the quality of people’s cameras is now at another level.
Dr. David Penn: [01:00:22] Ron, it really isn’t… So what we did was we took it a step further, and then we made a nozzle, and then the nozzle actually hooked onto the back of this. And this allows the patient than to blow the saliva away. It’s got a light on it. And this actually acts as a…
Dr. Ron Ehrlich: [01:00:42] Which is important.
Dr. David Penn: [01:00:42] It drives the saliva away. So all of a sudden, you say to the patient, I want to be able to draw this. So we built that nozzle with our industrial designers. As we design this, it fits in the back like that.
Dr. Ron Ehrlich: [01:00:53] Wow.
Dr. David Penn: [01:00:53] And then, of course, we’ve got all the other sorts of things that go with it. We’ve got cotton rolls, we’ve got articulating paper. We’ve got all sorts of bits of retractors and stuff. So you give this to one of your patients, Ron, and if they’re living in Bathurst or Broken Hill, or they’re going away, or you want to monitor their Invisalign treatment, or they’ve got gum disease, I mean, doesn’t really matter what it is…
Dr. Ron Ehrlich: [01:01:16] It’s fantastic.
Dr. David Penn: [01:01:17] You can just for this one kit, you can manage. So that’s full of Open Wide Dentistry Kit. It’s got things for TMD in there. It’s got it can measure their mouth opening.
Dr. Ron Ehrlich: [01:01:30] Temporomandibular that’s TMD to the listener. The temporomandibular joint, yeah, your jaw joints. And the reason, of course, dentists keep blowing air on your teeth is so they can see. If there’s saliva or a tooth, they cannot see it.
Dr. David Penn: [01:01:43] So that’s why this is so fantastic.
Dr. Ron Ehrlich: [01:01:44] So wow! what an innovation.
Dr. David Penn: [01:01:45] Yeah. So that’s one where we’re just putting the final touches to the app. We did a trial, Ron. I gave a lecture in Lexington, Kentucky, with one of my good friends because I do a lot of study clubs over there, like all over the States. And I was in Kentucky recently, which was a lot of fun, and this was when it went down well. So we’re just been doing little groups here and there and getting them into practices now, so we’re just rolling it out now. And yeah, this is very exciting.
Dr. David Penn: [01:02:16] So this is where we see the future of dentistry that a dentist is going to have a hybridized practice where they’re saying again 75% of their revenue is generated, you know, through seeing patients in the chair and the other day interacting with patients in a virtual environment. More from a monitoring perspective than anything else. So you know, after post-surgery, after this, after that, and for the kids, in particular, takes the fear out for the kids.
My little grandson is a master at this. He goes around with his little device and takes images of his schoolmates, you know, probably spreading COVID. But that’s another story. But he’s out there with his little device, and he thinks it’s just a toy. He just, he looks at this thing and think, well, everybody’s got one of these, and look at my teeth, and I can show you how healthy that is because I brush them because there’s no fear going to the dentist.
He knows what the dentist is looking at. So I think this is a very, very, very big game changer. It’s taken a lot of work to get to this level. Again, we’re just too, but we’re just on the edge of releasing it now. We’re going to the greater New York meeting, the general big dental meeting at the end of November. But so far, the shows we’ve been out, the orthodontic shows, the response to this has been phenomenal.
Dr. Ron Ehrlich: [01:03:34] David, it’s just been so great to catch up with you and to hear the amazing things that you’ve been doing since. Well, all those years ago, we shared a lift into the university together and graduated together. It’s fantastic. Listen, I wanted to ask you this, taking a step back from your role as a dentist, as an innovator, and as a lecturer because we’re all on a health journey together in this modern world as individuals. I’m interested to know what you think are the biggest challenges for us on that journey for an individual trying to be healthy. I’m not talking about dentistry here, just generally.
Dr. David Penn: [01:04:12] Yeah, that’s a good one. Ron, I think there are a couple of things here that in this advice are my experience is that number one is that I think that to be informed. I have access to information and not misinformation because I hear so much misinformation, and you must hear the same thing. I think that being sort of spread misinformation is very dangerous. So I think the ability for and the sort of the attitude towards an individual to be looking for information, the poor quality information from quality sources because everybody can use the Internet. Now, there’s a lot of misinformation.
Dr. David Penn: [01:04:54] So I think you have the best of all the needs that you want to be able to be proactive. And I think that’s important because I think so many people still stick their heads in the sand and won’t be proactive. So I think to be proactive is the first thing, and I think to be informed and to be educated enough.
And I’m not saying educated from a formal perspective, but being able to get that information then to be able to act upon the information, to be able to have the consistency there, the drive to give yourself every opportunity that the pathology or wear and tear in your body is taking place, that you’re aware of it.
We know that we’re finite, that we’re not going to live forever. But I think if you can give yourself every possible chance if you’re vigilant and you’re educated, and you’re informed, I personally think that you know what they say, the price of you know of eternity, some of it is eternal vigilance. I mean, liberty is eternal vigilance.
Dr. David Penn: [01:05:52] So, and I really believe that because when you sort of think, okay, you don’t want to overdo it, but if you do the right thing and you have some checkups, and you do this, and you do that, and your diet is good, and you’re active, and you’re following most of the guidelines and that sort of thing. It’s, in my opinion, that’s a guarantee.
But at least when you lay your head on the pillow for the last time, you think, well, I eat out every moment that I could because I was vigilant and responsible as I could. So I think to take sort of two to be aware and to take a positive action all the time, I think that’s all anyone can really, really do.
Dr. David Penn: [01:06:27] So I encourage my patients to be like that. I tried to be like that. I try for my family to be like that. And you know, if it’s examinable, then get it examined. People don’t want to be examined. A typical example is Ron, as many men with the prostate, with a colonoscopy, with endoscopies. Yeah, it might be uncomfortable for a day, and it might be uncomfortable for this and for that.
But to me, if you’re being vigilant, so that’s sort of my take on it, I think being access to good information because, you know, I have said that the amount of misinformation out there and you must hear it every day. And when I travel, in particular, I hear the amount of misinformation that’s being carried around. Maybe it’s fake news, Ron. Maybe
Dr. Ron Ehrlich: [01:07:11] Who knows?
Dr. Ron Ehrlich: [01:07:13] David, thank you so much for joining us today. I really enjoyed catching up with you and hearing about all the wonderful innovations in the industry in the world out there.
Dr. Ron Ehrlich: [01:07:22] Now dentists get involved in minutia, and for very good reason. If the fit of a crown or a filling is not good, then bacteria will find their way into underneath that restoration and cause further tooth destruction. So accuracy, or as David was referring to margins, is actually the joint between a filling and a tooth or a crown and a tooth. And the fit of various prostheses like dentures and implants and bridges, and crowns is critically important.
And in Dentistry, we measure accuracy in microns. Now a micron is a thousandth of a millimeter, a thousandth of a millimeter, and David was making reference to accuracies of ten, 20, and 30 microns. And that is when you consider that a hair is 20 microns, that’s accuracy, and that’s what dentists get into. So it’s not hard.
You know, I often will acknowledge that it’s not hard to imagine why dentists don’t always think holistically because we are, at the end of the day, dealing with literally such minutia and people’s mouths are so sensitive that if the bite of a filling or a crown isn’t right, they can pick up ten microns. Remember, hair is 20 microns. So a patient can pick up that a filling is not quite right by half the thickness of a hair. It’s enough to give dentists grey hair. I mean, when I started doing dentistry, I had no grey hair. So look what it’s done to me.
Dr. David Penn: [01:09:02] So look, it was great to catch up. I couldn’t think of anybody better than Dr. David Penn to share with us where dentistry is headed in the future. I’ll have links to some of those things that David was talking about. I mean, they’re still very innovative, but things like Invisalign are very much part of an ordinary or not ordinary, but a part of dental practices. And that has certainly revolutionized.
It’s interesting to consider why people would align their teeth. And as I mentioned, our oldest patient doing that is 82 in our practice, and our youngest doing Invisalign, which requires you to wear these thin aligners that are removable, making it easy to clean your teeth, and you remove them to eat. You do have to wear them 22 hours a day. But the reason to create more space is not just the aesthetics.
In fact, I would argue the main reason to do that is to create more space in your mouth for your airway and your tongue. But that’s the subject of many other podcasts we’ve covered. Look, it was great to connect with David again after all these years that each other for such a long time. I hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well.
This podcast provides general information and discussion about medicine, health, and related subjects. This content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.