Digital Dentistry Evolution: A Conversation with Dr. Meena Barsoum
Episode Description
Join us for an insightful discussion with Dr. Meena Barsoum, a leader in digital dentistry and CDOCS faculty member. Dr. Barsoum shares his journey from starting a practice during the recession to becoming a prominent educator in CAD/CAM dentistry, while offering valuable insights on technology adoption, clinical workflows, and the future of digital dentistry.
Episode Navigation
- 00:14 – Introduction of Dr. Meena Barsoum
- 01:50 – Dr. Barsoum’s journey into digital dentistry
- 08:23 – Evolution of CAD/CAM technology
- 13:06 – Discussion on material selection and bonding
- 15:04 – Transition to dental education
- 21:07 – Current state of CAD/CAM dentistry
- 28:28 – 3D printing and technology integration
- 31:00 – Clear aligner technology and workflows
- 35:55 – Simplifying dental workflows
Key Takeaways
Digital Dentistry Implementation
- Importance of investing in continuing education when adopting new technology
- Evolution from complex to simplified digital workflows
- Benefits of cloud-based solutions in modern dental practices
- Strategic approach to material selection between zirconia and glass ceramics
Practice Management Insights
- Value of delegatable workflows versus complex workarounds
- Integration of remote monitoring systems for clear aligner therapy
- Importance of team training in technology adoption
- Balance between cost and efficiency in technology investments
Featured Guest
Dr. Meena Barsoum: Graduate of Case Western Reserve University, practicing in the Chicago area. CDOCS faculty member, Spear Education instructor, and leader in digital dentistry. Early adopter of CAD/CAM technology with extensive experience in clinical education and technology implementation.
Featured Discussion Topics
- Digital dentistry evolution
- CAD/CAM technology implementation
- Material selection strategies
- Clear aligner therapy workflows
- Practice efficiency through technology
- Dental education and mentorship
- Cloud-based dental solutions
Connect With Simplify Dentistry
- Website: simplifydds.com
- Facebook Community: Simplify Dentistry Group
Topics: digital dentistry, CAD/CAM, dental education, clear aligners, dental technology, practice efficiency, dental materials, dental workflows, continuing education, dental practice management
Transcript
00:02
Intro
Welcome to the Simplify Dentistry Podcast. Join us as we discuss clinical, operational and financial aspects of your practice, help you enjoy life and dare to simplify dentistry.
00:14
Dr. Murtuza Shah-Khan
Welcome back to the Simplify Dentistry Podcast. I’m your host, Dr. Murtuza Shah-Khan. Today, along with Mustafa Shah-Khan, we’re happy to welcome Dr. Meena Barsoum to the podcast. Meena is a graduate of Case Western Reserve University and practices in the Chicago area. He’s a CDOCs faculty member, teaches at Spear Education, and is a leader in the world of digital dentistry. Meena, thanks for joining us.
00:56
Dr. Meena Barsoum
Thanks for having me. Appreciate it.
00:58
Dr. Mustafa Shah-Khan
Absolutely. We’re saying yours looks more professional than ours because you look like you’re on stage, but you’re kind of used to being on stage.
01:05
Dr. Meena Barsoum
Yeah, you know, it’s a green screen and zoom can really make you look as professional as you want, so.
01:13
Dr. Mustafa Shah-Khan
That’s right. I’m gonna start getting a green screen, you know, so obviously Simplify Dentistry, we’ve kind of started this community and podcast portion where we get to, you know, spend some time with guys like you, industry leaders and experts and just kind of have discussions on things that we think are relevant to the profession and kind of where things are going. I’m a dinosaur. Yeah, I’m 54. But, and so we had some of the other dinosaurs on earlier before you, we had Sam Curry and Mike Scrams, that kind of talking about, you know, where C docs and stuff like that kind of came from. And as were talking, you know, you’re kind of in the middle of it. You’re in the throes of it, you know, being the, I would say the main clinical guy over there.
02:01
Dr. Mustafa Shah-Khan
Tell us a little bit about kind of, you know, your story, where you kind of came from and then we’ll dive into, you know, CAD Cam, where it’s going now.
02:10
Dr. Meena Barsoum
Yeah, no, I, and thanks for having me, guys. I mean, I, I applaud you for building that community. I know there were some discussions about things that are super relevant to what we do on X ray sensors and things like that. So it’s to kind of chat about some of the valuable things in dentistry. So thanks for building that. I will say my foray into digital dentistry. I. I kind of went a little unorthodox. And how I started, I. I did a residency for a year when I moved to Chicago, just because I needed to figure out what to do. I just got married and moved to a new city. So it was a whole new thing for me. During that year, I couldn’t find a practice that I wanted to buy, Couldn’t find an associate position.
02:47
Dr. Meena Barsoum
So I decided I’m just going to hang up a shingle and build. And this was in 2010. So it was kind of the middle of a recession, not the best time to do any of that. And I had nothing but time. Honestly, when I first started this practice, it was slow. I was working three different jobs, like, six, seven days a week, just trying to make ends meet. And because there was so much time in the practice, I decided, you know, I need to differentiate myself. So I bought a cerec, like, within six months. I bought a scratch and dent unit from the Patterson showroom that was a compact milling machine and a blue cam. And, like, it was just. It was a dinosaur at the time when I bought it.
03:22
Dr. Meena Barsoum
And I remember specifically, like, as soon as I got it, I realized how much I didn’t know, which is important to understand as a young dentist. So I spent probably the first three years of my career, I probably spent easily close to six figures on ce, just in C docs and SPEAR or CEREC doctors at the time, and SPEAR and other implant curriculums and implants. I mean, because I had time, right? So I was. I was really investing in my education. And my first workshop I took. I went to Scottsdale center for Dentistry at the time, and I took a course with Sam. And Sam kind of taught me the basics of prep, powder, picture, and, like, things that we learned back in the day. And, you know, I. I didn’t have any money.
04:03
Dr. Meena Barsoum
Like, I remember sharing a taxi back to the airport with Sam just because I was like, I mean, I’m brand new, barely making ends meet. And that was my, like, first entry into friendship with Sam. And, you know, it’s been almost 15 years now that we’ve known each other. And I’ve known Mike just as long. So those two have been, like, really instrumental in my, you know, career. They’ve helped me along the way in so many different avenues. Sam, I can’t shake him. He’s followed me over to Imagine is our chief clinical officer and, you know, finally got rid of Scrammy. He’s on the SPEAR side now, so I can kind of, you know, float on my own. But I mean, I owe those two a lot in terms of what I’ve learned over the years.
04:39
Dr. Meena Barsoum
And you know, one of our big things in the CDOCs community now is we try to pay things forward. So what we learn, we teach others and we help now others become speakers and educators in the community as well. So that’s a little bit about, you know, where I am now. And you know, I, it’s part of a community that I’m going to be part of for the rest of my career.
04:57
Dr. Mustafa Shah-Khan
You know, talking about, obviously when you first started, you’re investing in yourself and you didn’t have any money. I remember, you know, when I first started with Spear courses and things like that. And I remember, you know, they be like, all right, this course, $5,000. And I was like, where in the hell am I gonna get $5,000 to pay for this? And you know, so you start talking to them, you’re like, all right, can I pay you this much a month for this many periods or whatever it was. And, and I think a lot of people go into this stuff thinking, well, all these guys have all this money and they, you know, so then they can just kind of fund it. And I don’t have that, you know, and I think that’s a misnomer.
05:31
Dr. Mustafa Shah-Khan
I think, you know, we all struggled at certain points to get the education and build on this and be able to become successful in this profession.
05:40
Dr. Meena Barsoum
Well, I mean, $5,000 is just five crowns, Doc. I mean, that’s all you got to do for itself, right? It’s easy math. I, I will say, like what Den Supply Sirona did and building those clinical accelerators with equipment purchases really has helped dentists not worry about that per se. I think it’s good and bad. I think when you pay for something, you value it more, you take it more seriously. I mean, you’re paying for it indirectly, it’s part of your equipment purchase. But I think it’s different when you have to write a check or make that credit card payment and really value that. And I had to do that, right? I spent, it was like five grand on FGTP that I took with Frank Spear.
06:15
Dr. Meena Barsoum
And that’s been like the most game changing education, I hate using that term, but it really changed how I look at patients and how I do comprehensive dentistry. And to me it was the best five grand I ever spent. So I mean, those are things that are good and bad. I think dentists now have better access to online education and, you know, less costly education, but nothing beats being in person and writing a check.
06:37
Dr. Mustafa Shah-Khan
No. And I think, you know, guys really miss. I think were fortunate to be able to sit down and listen to Frank, you know, or be. Be in a. In a. In a seminar with him and 30 other people. I just don’t think there. There is that anymore. Obviously, you know, he has had other people kind of come. Come in there who’ve taken his place. So there are excellent educators. But, yeah, I mean, it’s. It’s. It’s a crazy world. I remember one time I’d signed up for one of his courses because I was trying to get one of the last ones in, and I paid 6,000 bucks or whatever, and they were like, well, he’s not going to teach it. And I was like, well, I’m not coming. Yeah, exactly.
07:13
Dr. Meena Barsoum
I know, but the hard thing, I mean, just. And went through that. I mean, once when Sam left, people didn’t want to come to CDOCs, and. And we had to remind them. You know, Sam spent a long time educating, but he also spent a long time being administrator. And, you know, many of us learn from him, and we’re kind of carrying that torch on. So obviously, like, these people are instrumental to these companies, but there’s. There has to be room for growth. And I think, like, Greg Kinser’s done a great job over there taking the reins from. From Frank. And, you know, I see Frank every so often. I give him the same joke I always do, and he chuckles. But I know he’s a big wine guy, so I always offer him, like, the finest 2024 Franzia that I have. Knuckles and sarcasm.
07:53
Dr. Meena Barsoum
But, I mean, it’s just, you know, it’s what we do. But he’s. He’s. He understands, like, he’s still got value, but there’s so many other clinicians out there that work with him that also have value, you know.
08:02
Dr. Mustafa Shah-Khan
So you entered into the CAD CAMs Eric world in 2010. That’s probably, you know, right around. Right when I entered. It’s interesting. You know, you talked to Mike, you talked to Sam. You know, Mike was talking about, you know, he entered, you know, early. Early on, and I think. I think Sam entered when Barney Rubble was still making it, but.
08:22
Dr. Meena Barsoum
Right, right.
08:22
Dr. Mustafa Shah-Khan
Yeah, but the crazy thing is, like, they were talking about, you know, the amount of mistakes they made. They knew the dentistry wasn’t as good at that point in time, but they were investing in it and kind of trying to figure it out you and I kind of entered into the point where I would. I guess we both entered right in the. In the max era.
08:40
Dr. Meena Barsoum
Exactly.
08:40
Dr. Mustafa Shah-Khan
You know, so the game was different. You know, talk a little bit about that.
08:43
Dr. Meena Barsoum
Yeah, it was kind of a cheat mode for us, honestly. And I will say, like, Sam and Scrammy are significant older than I am. Like, really significantly older. I mean, decades. But, you know, coming in, you know, Blue Cam was a learning curve, but the software was pretty good at creating single unit restorations that fit well. And we had material like Emax that, you know, ironically today I had to cut one of my old emaxes off because there was recurrent decay under there. And I remember, like, man, I was doing a good job bonding back then, apparently, because this sucks. And that material is really hard and it’s hard to cut off and it makes you, like, value the materials and where they are.
09:18
Dr. Meena Barsoum
And I look at today and we have, you know, the ability to put zirconia in there where we couldn’t, you know, put glass ceramics before and milling versus grinding and all the innovations that have happened. I mean, yes, it was kind of a cheap mode back then, but I think we’re in a bigger cheat mode now when it comes to, like, zirconia and the implant workflows and, you know, just full art scanning in general. I mean, I think I was probably the first person to try a full arch scan with the prime with the. With the Blue Cam. Imagine powdering and doing a full architecture. Patient looked like a Smurf when they were done. But that was what we did. I mean, we tried to push the envelope.
09:53
Dr. Meena Barsoum
And I think now anybody could pick up a prime scan too, and scan on a browser from any operatory. There’s no learning curve, really. And it’s a different world now than it was even when I started. Definitely when Sam and Scrammy were in there.
10:05
Dr. Mustafa Shah-Khan
Yeah. So I said when I picked it up, right around then you had to become a better dentist. You know, you couldn’t. You know, you didn’t have anybody to make up for your deficiencies. And the computer read in ones and zeros. You think that’s still the case, or do you think it’s. It’s gotten easier?
10:22
Dr. Meena Barsoum
I will say I have a love hate relationship with many things, Zirconia being one of them. I love, love zirconia. Just because I can be more conservative. My margins are clean and crisp and everything I can cement again. I don’t like it because I think it makes dentists kind of lazy with their preps because it’s so forgiving. You can be a lot less precise with your margins and the clarity of your margins and the smoothness and internal angles and things because you’re milling something, you know, 26 bigger and shrinking it down. So I don’t like that per se, because I think it’s making us a little bit lazier. But I do love it that it’s more forgiving. And at the end of the day, if it gives my patient a better final result, then I think it’s worth it.
11:02
Dr. Meena Barsoum
And that’s what’s happening in dentistry is a lot of dentists are prepping faster and less careful and zirconia’s solving those errors and they’re happy. Patients get good dentistry at that point. So, yeah, I mean, it’s kind of my weird thing with it. And yes, I do like 100% zirconia in the posterior now, so literally everything.
11:22
Dr. Murtuza Shah-Khan
So it kind of goes back to that, too. Did you ever take Bob Winter’s restorative course at Spear? Yeah, that was.
11:28
Dr. Meena Barsoum
You want to hate yourself and feel bad about your preps. I mean, that is the course to take. I got bigger loops after that course, thinking they were going to help and nope, you know, so. But it was a, it’s tremendous course to help you understand how important preparation is.
11:42
Dr. Mustafa Shah-Khan
I was ready to get a microscope when he was prepping posterior units with a microscope. I was like, this is craziness, you know?
11:48
Dr. Meena Barsoum
Yeah, no, I know. I’m as close as I’m going to get to a microscope. I have ergo loops now, 7 1/2x. That’s about as big as I want to see my shittier preps. So I, I’m happy with 7 1/2 x. And I think it’s, it just gives me. I, I try to microscope. Honestly, like in residency we used it for endo and I get this claustrophobia where I just feel like I can’t see my surroundings and the patient’s body language and response. And I just. To me, it wasn’t ideal, but yeah.
12:14
Dr. Mustafa Shah-Khan
I think microscopes are for endodontists. Yeah, that’s who that. Yeah.
12:18
Dr. Murtuza Shah-Khan
Or I guess Kendra’s wife. She uses microscope all.
12:22
Dr. Meena Barsoum
He loves it. Yeah.
12:22
Dr. Murtuza Shah-Khan
Yeah.
12:23
Dr. Meena Barsoum
There’s a lot, I mean, there’s a lot of like the biomimetic guys that really do adhesive dentistry. I mean, they love microscopes. And I think you’re a single tooth dentist that focuses on like, Bonding and adhesive, I think it’s great. But if you’re working in a quadrant, it’s really hard to be efficient with a scope, you know, prepping three or four teeth or to me, it’s just, it’s. It’s not ideal for me.
12:42
Dr. Murtuza Shah-Khan
Yeah, same here. I couldn’t. I mean, there’s no way I can make it work.
12:45
Dr. Mustafa Shah-Khan
So are you still. So are you still using Emax much besides implants? Are you using it?
12:50
Dr. Meena Barsoum
Yeah, no, I’m doing a lot of. I mean, we do a lot of, like, full mouth cases and anterior aesthetic cases. I love Emax. I think it’s a beautiful glass ceramic. I think Tessera is a beautiful glass ceramic. I think the handling’s a little bit different. So some people just have to get used to using that new material. But I love glass ceramic in the anterior. Even though I’ve done some. A fair share of zirconia cases, I can characterize glass better. I can characterize, like, specifically emax, especially in the purple phase. I just see the light angles better. I can. I can put more definition in it, and I think the results are better. And I do like bonding, you know, Emax and the anterior, because I’m doing more conservative preps. I’m trying to stay in enamel.
13:27
Dr. Meena Barsoum
And I know you can bond zirconia and there’s a whole process for it. I’m just. I’m still a glass guy in the anterior and zirconia in the posterior.
13:34
Dr. Mustafa Shah-Khan
So getting back to Frank a little bit, I remember one time Frank was like, you don’t have to bond emacs. You know, emacs can be cemented if you have whatever. I think it was 80 microns of spacer and things like that. And I think you said there was not a huge difference. Do you exclusively bond your emacs?
13:56
Dr. Meena Barsoum
You know, they will tell you, the manufacturer will tell you. Avoclar will say you have increased bond strength or, sorry, fracture toughness when bond. Right. So you can go down to a millimeter with Emax. If you bond it, you want to be at one and a half. If you’re cementing more for traditional retention resistance form prep. And do I. Do I cement some of them? Absolutely. If it’s a traditional crown prep in the interior with feral and retention resistance form, I will cement it if I can. Because I look at these patients and I realize, like, no matter how good my bond is, if they don’t take care of it, there’s going to be recurrent decay.
14:29
Dr. Meena Barsoum
And this is going to have to get redone and I don’t want to make it difficult for the next person and over traumatize that tooth if they have to cut it off. So I’m mindful of that. But at the same token, I also want to be conservative. And if I’m staying in enamel, it’s a veneer prep or like a crown layer or something. I’m bonding it, I’m bonding it always. And just because I’m. That’s the workflow that we’ve done for years. And I still like that. I still like resin cementation, minimal thickness and maximum fracture toughness.
14:56
Dr. Murtuza Shah-Khan
I think that’s nice that you think about the next guy when you’re thinking about cutting off the crown. I, I wish I did that, but I don’t, I bonded and as long.
15:04
Dr. Meena Barsoum
As you’re not the next guy, everything’s great.
15:06
Dr. Mustafa Shah-Khan
Right? So, so something I was thinking about. Yeah, obviously we started probably in Sarac, close to the same world, same time. What led you to go down the educational path and, and change directions from just being a day and day.
15:23
Dr. Meena Barsoum
Out clinician, if you asked me, even 15 years ago. So I’ve been out of school since 2009. So 15 years I’ve been a dentist. I had to give our commencement speech for graduation. It was the most nervous I’ve ever been in my life. Like to be in front of. We had 100, we had 80 some students in our class. So imagine like 200 people with family and whatever. To be able to stand in front of that group and give a speech was the most nervous I’ve ever been. I swore after that I would never do any public speaking. Like I hate this and I mean, just a couple months ago I did a live procedure in front of like 5,000 people at DS World. And I’m comfortable with it. Like it, there’s no fear there for me anymore because I’ve done it enough.
16:04
Dr. Meena Barsoum
And I think it was something I never thought I’d be doing. I never thought I’d be like reasonably adept at doing it. But I realized like when it comes to technology, I mean I can lecture on technology and workflows and you know, simplifying things for dentists all day to me just comes naturally. And I can get up there and, okay, here’s what the software wants you to do. Here’s how you can think about it and really simplify things. I found myself like kind of good at it. And I gave a couple lectures at our local study club that Rich Rosenblatt started, you know, 20 years ago and that was kind of my start into speaking. And, you know, it was again, nerve wracking. I spent months preparing a 60 minute keynote that eventually got deleted off my computer for whatever reason by accident.
16:47
Dr. Meena Barsoum
It’s just like you put in all this time and then after that it just became kind of muscle memory and just realizing, you know, once you get that first like 30 seconds going in a lecture, even now, like once I get through my first minute, it’s just like, okay, let’s go. And I have like this muscle memory of speaking and I love it. Like it’s. It’s such an important part of my career that I think it’s done a really good job at keeping me from burning out. You know, I think Dennis get to that 15 year mark and they start hating everything and everything around them. Not. I’m not there yet. I still love what I do. I love my team.
17:20
Dr. Meena Barsoum
And I think being able to travel and speak and lecture and kind of hear from other dentists has really helped me kind of avoid that burnout.
17:27
Dr. Mustafa Shah-Khan
What happens to a lot of guys is just not having any other outlet. If all you’re doing is dentistry all the time, I think it makes you want to beat your head up against the wall. And that’s what I was telling him. You know, when we’ve done other things in dentistry and now doing this, it kind of gives you that outlet and it allows you to kind of, to share kind of what dentistry has been for you know. So getting back into it, like did. Was it Mike and Sam talking you into joining in with them? Or was it Rich Rosenblatt or how.
17:54
Dr. Meena Barsoum
Did it know it was so. Yeah, I mean, like my first lecture was. It was. It was an. I remember this exactly. It was in Chicago. It was one of our monthly study clubs. Don Bell was in the audience. He’s the VP of everything at Ivaclar. And the lecture was on the Teleo Cat abutment block. When they first started launching it, no one could get me a block. No one could give me any information on it. They wanted a lecture on it. So I ended up buying these blocks from Germany overseas. And like, I didn’t have software to do and I built this lecture. I was so nervous to do it. And it was a great lecture from, you know, the feedback I got and that kind of started that process.
18:28
Dr. Meena Barsoum
And CDOCs or Sarah doctors at the time, we had this mentor group that I was involved in. And sure, you know, I would go probably five, six times a year. And I’d mentor workshops, and, you know, every so often, like, Sam or Scramy would let me do a demo. They let me kind of speak in front of the room. And that slowly led to me. And I literally cornered Sam. I said, I. I want to be part of this organization. I want to speak here.
18:52
Dr. Mustafa Shah-Khan
Sure.
18:52
Dr. Meena Barsoum
And I’m good at it, and I want you to evaluate me. And, you know, I asked for it. And. And he’s like, all right, good, because I’m ready to hang him up. So the timing worked out, and eventually Sam kind of phased down, and Mike and I worked together for many years, co teaching a lot of the workshops. And then now Dan Butterman’s the. The leader of the pack running CDOCs, and, you know, being so involved in spear, and, you know, we’re a different group now, but we’re. We’re growing. And I’m. I’m excited to be part of this new vision that we have.
19:20
Dr. Murtuza Shah-Khan
Yeah, that’s. I mean, the first place I met you and Mike and Sam was at the dense Western headquarters here in Charlotte when y’ all were teaching courses and that after, you know, I’m the late adopter in this group to Sirac. I got my prime scan, what, five years ago now.
19:35
Dr. Meena Barsoum
Oh, nice.
19:36
Dr. Murtuza Shah-Khan
And, you know, same sort of stuff with, you know, going to the courses here, that’s really changed the game for me. How much of your time is spent on the educational stuff and how much are you clinical? Is there. Is there an even breakdown for that for you, or.
19:50
Dr. Meena Barsoum
Yeah, I mean, I’d say probably for the last, like, seven years or so. I’ve been working Monday through Wednesday every day. Sorry, like, every week. It’s Monday, Tuesday, Wednesday. I work a full day. I. I’vehad an associate for a while, and that’s really helped me kind of be able to go out and speak on Thursdays and Fridays and the weekends. So Alyssa’s been with me for, I think, six, seven years now. And then now we just hired another associate, Lindsay, who’s going to be kind of carrying on. So we’re going to have three doctors here in the office, and I’ll be a little bit more free to, you know, take a Wednesday off and do something else and not work or, you know, not have to lecture.
20:26
Dr. Meena Barsoum
So it’s going to be nice for me to kind of jump into that phase of the career.
20:29
Dr. Mustafa Shah-Khan
But it’s a tough thing to be able to. To lecture without having the clinical. I mean, everybody’s has the clinical background, but if you don’t if you’re not in there and you can’t take pictures of what you’re doing and try different things, it’s impossible to lecture, it doesn’t matter.
20:41
Dr. Meena Barsoum
And, and so there’s a lot talented people that can do it, that have done it. I know myself. And if I’m not wet fingered and you know, practicing what I preach and failing and learning from failures and documenting materials and workflows, I’m not going to want to do it because I won’t feel genuine and authentic up there. You know, speaking about a case I did seven years ago that is material that isn’t possible now or that we don’t even use with a scanner that doesn’t exist. And it to me just wouldn’t be right. So I always want to be involved in practice. No matter how long I do this, I’ll at least work one or two days a week, forever until I want to like be done.
21:18
Dr. Mustafa Shah-Khan
So, so CAD CAM dentistry, CEREC dentistry, you know, it has changed obviously in all of our careers. Where do you see it right now? Where do you see it going?
21:28
Dr. Meena Barsoum
You know, I think we, many of us, I think CAD Cam, you know, users kind of fall into probably one or two or three different camps, right? You have your power users that want to do everything and like cheat the system and find workarounds and do all this crazy stuff. Then you have like your big majority. I just want it to work. I don’t want to be on the bleeding edge. I don’t want to try the latest software and then you have those that just want to scan, right? They don’t want to make anything in the office and it’s just like a CAD only type of workflow. And I think most dentists in the digital world fall into one of those three. I’m definitely on the bleeding edge where I want to try everything and be involved in.
22:04
Dr. Meena Barsoum
I think that group and the middle group are starting to mix a little bit more, right? Where you know, the simple use wants a little bit more. The power users want a little bit more like simplicity as well. Like I just want it to work when it works and I want to play when I want to play. So what I’m seeing happening is like we used to go through there’s in lab to do this and the ortho software to scan and do this and the CEREC software for this and which version of in lab and what’s CAD and what’s CAM and like all this crazy stuff and what license do I need and do I put the dongle in this computer and like all this crazy stuff of like managing, you know, basic like dongles and software and licenses.
22:41
Dr. Meena Barsoum
I see it going away and I see it for the good because what’s happening now, and obviously DS has built this DS Core platform and the Prime Scan 2 works on DS Core and you know, it’s no secret that’s where everything’s going to go is a cloud based kind of software. I like it because it’ll be kind of a pay to play. Right. So if you want to have advanced workflows, you pay this much per month. If you want to have basic bread and butter single units, you pay less. Right. If you just want to scan only, you pay even less. And I think that model is going to help fill many of the dentists.
23:11
Dr. Mustafa Shah-Khan
Yeah, I mean I didn’t realize it tears like that, you know, they don’t yet.
23:15
Dr. Meena Barsoum
Right. And I think, you know, right now the tiers are based on and I don’t want to speak out of place, I mean this is just like what I’m seeing kind of reading through the lines in between the lines, kind of understanding where the company’s going. You know, right now your tiers are based on storage, but I mean, moving forward, if there’s no such thing as like a on premise in lab and an on premise on a cart, you’re going to have to pay for it and you’re going have to have it on a software version on a cloud. Right. So that’ll eventually be what it looks like. And I think it’s a good way to do it.
23:43
Dr. Meena Barsoum
I, I think you get to purchase in a very easy way the features and the, you know, uses that you want out of the software and what you don’t want to have, you don’t have to pay for. And I think it’ll simplify things for those dentists that never want to restore an implant chair site or only want to do posterior teeth or those that want to do everything they can, you know, kind of pick where they fall in.
24:03
Dr. Murtuza Shah-Khan
So what’s your experience like or what’s your experience been like with the new prime scan too?
24:08
Dr. Meena Barsoum
I will say, and let’s be fair, I mean I was an early beta tester in IT and I felt some initial kind of hiccups and things. And I will say it needs right now a very dedicated and powerful Internet speed that will help support the upload requirements. And right now, I mean you need 50 megabytes upload, which is not, you know, super available to everybody in the market. So there is upgrade your infrastructure. But what I know is like on the back end the compression’s getting better and some of the development and engineering on the back end is getting better. So those requirements will go down over time. I love it.
24:46
Dr. Meena Barsoum
I mean I love the ability of pulling up a scanner and just, I mean I run Macs in the office so for me it’s always been a hassle like running any Windows based application. Like my Sarah could have to wheel in the cart or whatever. Now I can just open up Google Chrome and scan in any operatory and hygiene uses it, dental assistants use it, all the doctors use it. So it’s really improved that workflow for me. I think it’s got some room to grow right now in terms of what you can actually do with it. We have limited catalogs. There’s a little bit of a speed situation with it in terms of like processing behind the scenes. I know that’s going to get better because it’s already gotten better six or eight months that I’ve had it. So it’s the future.
25:23
Dr. Meena Barsoum
We just have to accept the fact that we’re going to be in the cloud for literally everything we do. I mean we’ve moved that way on the DPMS side of the practice management side. Like my software is all cloud based so you know, charts, X rays, everything and everything is going to the cloud. I don’t want to have a server in the office and I think that’s where now scanning is going.
25:43
Dr. Mustafa Shah-Khan
Yeah, you know were, I can’t remember if we had a guest or if Rick Offit, our other partner and I were on somebody else’s podcast but there was the opinion by somebody and they were like, you know, look, there’s a lot of docs out there that are pissed off at a line and they’re pissed off at Dense by Sirona and it’s because they feel like, you know, with a line you buy a scanner, you can’t sell it and after you know, three, four, five years it’s kind of obsolete. You got to get the next one right. You know, docs feel the same way a little bit about Denspa Serona. You, you buy an omnicam and then it basically becomes obsolete.
26:24
Dr. Mustafa Shah-Khan
In, in four or five years you buy Prime Scam 1 and I mean hell, I’m still paying for Prime Scan one another like Prime Scan twos out here and like what are they gonna do? They’re gonna make it obsolete. And I have to get Prime Scan 2. I mean, what, where do you see it?
26:41
Dr. Meena Barsoum
They’re not going to do that. And, and I can tell you right now, I mean, I can start a scan on my prime scan, my original prime scan from dscore. Like, I can send it, I can go into dscore, pull up my patients chart, send the scan administration right to my prime scan and start scanning and it goes right back to DS core. So that workflow exists today and that’s not going to go away. And I think, you know, there’s always like, again, more love and hate relationships, right? Like, sure. I love the fact that they’re innovating. Absolutely. Do I hate that it’s frequent with certain technology? Yeah. I mean, it’s kind of frustrating when you just bought something and now the newest thing is out.
27:16
Dr. Meena Barsoum
And I think it really hurts the late adopters that come in, like at the very end of prime scan and all of a Sudden Prime Scan 2 is out. Now you’re upset. If you’re a bleeding edge prime scan owner, you’ve had it for four or five years and you’re like, all right, probably time for a new one anyway. Sure, I, I will give them credit. I think they priced the Prime Scan two in the right place.
27:34
Dr. Murtuza Shah-Khan
That’s what I was going to say. Yeah.
27:36
Dr. Meena Barsoum
You know, we didn’t get the typical DS tax that we normally get where it’s another, you know, five more figures of whatever. And I think they priced it well and I hope that continues with more innovations in the future.
27:47
Dr. Mustafa Shah-Khan
So one thing that came up obviously on simplified dentistry was, you know, being sure Smile or being a, an Invisalign kind of guy. You know, I know you said you’re a sure Smile guy. Are you a sure Smile guy because you’re a bigger believer in the prime scan technology and Sirona, or do you feel like it’s as good a product as Invisalign or do you feel like it’s a better product than Invisalign or where are you there?
28:15
Dr. Meena Barsoum
I want to be fair with my comparison of Invisalign because it’s probably been almost 10 years since I’ve used Invisalign. Sure. And so the last time I used Invisalign, our only option was the Omnicam with the Ortho software and guided scanning, and that was probably what, 2015, 2016. Sure. And then the prime scan came out and obviously politics. They didn’t want to allow the prime scan, even though it’s a better scanner than the omnicam was. And that bothered me. And then, you know, so there was kind of this like middle time when sure Smile wasn’t even a thing and Invisalign was still kind of the king of the road. And so I went to ClearCorrect. For a while I didn’t love that product. And then all of a sudden dents by bought Orametrics, which is now sure Smile.
28:55
Dr. Meena Barsoum
And what I loved about that product is it was fully open. Any scan can go in and you can export stls of different models. So I went through this phase in my career where I was doing my own in house aligners which was like psychotic when you think about it like printing 40 models and making aligners on each model. But I love the ability to do it. And that got me into the sure Smile workflow. And then now, I mean everything is, you know, I, I have them manufacture everything and I will say primarily that the reason for me right now is my equipment supports it even though I have an Itero. I would rather scan with the prime scan for an ortho case. And my cost is significantly less with sure Smile than it is with Align.
29:36
Dr. Meena Barsoum
And you know, results wise, we’ve done hundreds of aligner cases and yeah, every so often you’ll get one, maybe two refinements if the patient’s really picky. But most of the cases finish without a refinement and that’s all I care about. So I get them done and they get the retainers and they’re on their way. So it’s predictable. I think the movements are better tracked because a person is doing it versus AI, even though AI is probably getting better on the align side, but a person is doing it on the sure Smile side. So those are things that I value still when it comes to that. And you know, I mean, not to be like funny about it, but with imagine my pricing is ridiculously inexpensive with Smile. So it makes no sense not to use it. And I’ve used it successfully for years.
30:22
Dr. Mustafa Shah-Khan
I think that’s interesting that you said that you almost have no refinements. You know, there has been discussion on, on our platform where guys are saying, yeah, I don’t have refinements with sure Smile. You know, I do Invisalign and I always have refined. I mean I almost always have refinements, but I also almost always do kind of mid course corrections and things like that, you know, so I don’t know if it’s a me issue or if it’s an a line issue or if it, I mean, if it’d be the same thing through. Sure, smile. But that’s good to know.
30:52
Dr. Meena Barsoum
There’s just so many philosophies around it. Like Galler’s got his whole like, curriculum on how you set up a clincheck and nothing should be less than 20 aligners or more than 20. Like it’s just, to me, that was too variable. Right? Like, why should I follow this process versus the company’s process? And why do we have to, you know, basically, you know, game the system to get a better result? Like that bothered me, you know. We use a product called Dental Monitoring. So we use something called Dental Monitoring, which allows us to track our patients remotely. So I give my patients every aligner at the first visit. So we put the attachments on. Usually I preserve like IPR for the fifth aligner. So I’ll give them like their first four, see them back in, you know, two months or whatever.
31:35
Dr. Meena Barsoum
And then I do the IPR when the teeth have unraveled and there’s a little bit more room to do it safely. And then they get the rest of their trays and Dental Monitoring allows them to scan the tooth position and the tray seating. Every week on an app, my team looks at the pictures. The AI, you know, recognizes that the trays aren’t fitting well. So we do mid course corrections. I guess we can call that a refinement. But if I see that a tray is not tracking and the patient isn’t doing well, I bring them in, we scan again, and we do a, an adjustment there versus having them continue to not track for sure trays and then starting over.
32:09
Dr. Meena Barsoum
But what I like is if I do that and they track to completion and the final result looks like what I planned and the patients are happy. And if there’s little minor tweaks, sometimes they’re restorative tweaks, sometimes they’re orthodontic tweaks. And we call them, you know, fine tuning, not a refinement. So it’s just verbiage for the patient. But that monitoring system allows me to catch issues earlier than, than later.
32:32
Dr. Murtuza Shah-Khan
We had another guy talk about what? Candid Pro. Another.
32:35
Dr. Mustafa Shah-Khan
Yeah, I think that might have been Tarun talking about Candid Pro.
32:39
Dr. Meena Barsoum
Is that a, is that a DIY aligner or what am I thinking?
32:42
Dr. Mustafa Shah-Khan
I don’t think so. I think it’s supposed to be Something that like a track practitioner is doing. Yeah, yeah.
32:47
Dr. Murtuza Shah-Khan
And you can also do the patient can do the at home tracking for you too, as we know.
32:52
Dr. Mustafa Shah-Khan
I mean, we don’t have anything.
32:53
Dr. Meena Barsoum
We, I mean, yeah, he’ll try whatever and then, you know, poo, everything else. So. I love Tarun. I’ve learned a lot from him too over the years and I’ve, he and I have debated heavily on things and we still do. But I, I will say, like, I don’t have ortho like periodic visits anymore. Like that’s not a 20 minute or 10 minute appointment in my schedule because I don’t need it. Right. I can track them and if there’s an issue, we call them, my team texts them back and forth in the app and there’s a cost to it, but it’s worth it because I, I eliMeenate.
33:23
Dr. Murtuza Shah-Khan
Yeah, I didn’t think about it that way.
33:25
Dr. Mustafa Shah-Khan
Thank you again for joining us today. Obviously, lots going on in the CAD Cam, lots going on in the CEREC world. Kind of, we like to always, kind of, this whole platform is, you know, how can we make things simpler for our docs and how together can we like to say, you know, how can we dare to simplify dentistry? You know, kind of what are your takeaways for our audience or, you know, for our listeners about, you know, what can you do to simplify their day in, day out lives and you know, kind of what takeaway messages do you have?
33:58
Dr. Meena Barsoum
You know, I will say this, and I say this a lot. This is kind of my philosophy with things. There’s always a workflow and a workaround and sometimes the workaround is cheaper and involves three or four different softwares and you can end up getting to the same result. But what I’ve learned over the years is you can’t delegate a workaround. Okay, you can delegate a workflow. And what makes my life easy in my practice is that I’ve delegated a lot of the technological workflows to my team. And it’s one of the things why, I mean, I love Dents by Sirona for making simple workflows like CEREC into the mill, you know, scanning into Sarek and all that works well.
34:35
Dr. Meena Barsoum
But when I start getting into, okay, here’s this like inexpensive scanner, but you got to bring it into this CAM software and then this export STL and bring it into here and it becomes like this jumbled mess. Yes, you saved a few dollars on the front end, but what does that look like? On a day to day basis when, I mean, I’m looking at my schedule. We had seven. I had seven crown patients today and they were just staggered around and I still had five hygiene, you know, columns that I had to like, manage. So I could only do that because my team can manage the design and the milling and the manufacturing. So my advice to anybody getting into technology, look for workflows. Those are going to make your life easier.
35:09
Dr. Meena Barsoum
You may spend a few more dollars up front, but you will be happier later on because you won’t have to do everything yourself. You’ll be able to delegate more.
35:16
Dr. Mustafa Shah-Khan
You must like, you must like having a lot of staff to have seven crowns in one day and staggering them around.
35:23
Dr. Meena Barsoum
Yeah. And it’s like that would not be my ideal day would be eight crowns one patient and then I go home. Instead of seven single units all day. That’s. But it’s fine. I mean, this is, it’s the way we practice. We’re a busy office and you know, my team, they know if my door is closed, leave me alone, I’m designing something or frustrated. So. And then they handle the rest. So it’s been great. I’ve been fortunate.
35:44
Dr. Murtuza Shah-Khan
That’s awesome. What a great team to have.
35:47
Dr. Mustafa Shah-Khan
Well, thank you again. We really appreciate you taking the time and kind of sharing some of your knowledge with our listeners. We appreciate everything you’re doing in the SIRAC world and everything you’re doing for the profession. Thank you.
35:58
Dr. Meena Barsoum
Thank you guys.
35:59
Dr. Murtuza Shah-Khan
Thanks.
36:00
Dr. Meena Barsoum
Take care.