wTechnology Doesn't Always Live Up To Hype

Thomas K. Hedge D.D.S., F.A.C.E.
The Cincinnati Business Courier
December 1997

About once a year, a news item is released that promises to revolutionize dentistry. A significant amount of media attention is focused on the new technology for a few days and the public never hears about it again.

Over the last decade, announcements have been made about drilless-decay removal with a harmless liquid (the Caridex System), lasers to remove decay, digital X-rays that reduce radiation exposure by 90 percent, electronic anesthesia without needles and recently, " the Wand, a new technology that conquers fear and pain.

"The Wand is a computer-controlled device that pumps anesthetic through a needle into the tissue just like a standard dental syringe. The company claims the handpiece doesn’t look like a syringe so patients don’t feel apprehension, but the Wand still has a needle on the business end and looks a lot like a syringe to me. The company also claims it’s better than a syringe because the computer delivers precise pressure and volume ratios of anesthetic.

As a practicing dentist, I know the secret to painless injection is the application of a topical anesthetic first, followed by a slow low pressure injection. The precise application of pressure and volume is being controlled through feedback loops to the most powerful computer known to man – the human brain. I can feel the pressure in my thumb and watch the patients facial muscles and eyes for signs of discomfort.

The cost for the Wand is approximately $1,000 per unit and since dentists give anesthetic injections in more than one room, sever units would be necessary.

Medical and dental costs are rising more rapidly than inflation. Many, if not most, of these new technologies do enhance patient care. However, closer analysis could prove new technology is not always cost-effective.

I am not one to reject up-and-coming technologies, but two years ago, I had a digital X – ray system installed in my office at a cost of $20,000. Following a week of comparing these images to my film based X – rays, I found that early decay was not being detected with the digital images.

I expressed my concerns to the research department at the company and after three months of attempting to improve the situation, they admitted they could not duplicate the resolution of the standard X – ray film. Fortunately, the 30-day money back guarantee was extended by the company. I could not justify the expense and loss of quality to my patients.

It is interesting to note the company that manufactures the Wand went public in July at $4.63 a share and climbed to $30.13 a share in late September. There seems to be a lot of Wall Street faith as to the prospects of this company.

Interest peaked just prior to the American Dental Association meeting in early October. Since then, price has fallen to the low $20’s and trading volume has diminished.

The company had a profit-earnings ratio of zero with few or no sales prior to the ADA meeting. On Nov. 3, after the meeting, the company announced orders of 8,000 units, which apparently went to distributors. Dentists have a 30-day free trial offer – still an enticement to me.

This is just one example of many new technologies introduced to dentistry and the companies behind them. Clearly, it is a big business and many of the technologies are excellent – but few really revolutionize dentistry.

For example, a laser cannot remove old worn-out crowns or fillings, or prepare teeth for any of the new indirect restorations like veneers, crowns, inlays or onlays. Someday, it will find a practical use in removing decay, perhaps without anesthetic. Currently, cost and lack of applications make it impractical.

Dentistry continues to improve slowly, one step at a time. Most significant improvements occur over a decade of small, but consistent development. Changes at any point in time may not seem momentous, but if we step back and look at 10 years of changes, we are astounded at the progress.