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Dentistry, just like other medical fields, is not immune to digital disruption, and significant technological advancements have taken place in recent decades. Dr Les Kalman is an assistant professor in restorative dentistry at Western University in Canada and a researcher with a dedicated focus on innovation in medical devices and technologies, and in this interview with Dental Tribune International, he discusses the benefits of developing new tools and workflows to advance healthcare. He also talks about his novel dental software, the Dental Thermal App, and explains how it could enhance the clinical experience of dental professionals.
Dr Kalman, what is thermography, and what use does it have in dentistry?
Thermography is a process whereby a thermal camera captures and produces an image by using infrared radiation emitted from an object. The image provides an opportunity to visibly record infrared energy or heat that is invisible to the human eye. Thermography is a non-invasive, non-contact and portable imaging method. It has been used in various industrial fields, such as engineering and construction.
Thermography is now an evolving field in medicine, and its use as a possible diagnostic tool is being investigated. It is currently used to aid in the diagnoses of vascular malformations, thyroid nodules and different intra-ocular tumours.
Thermography has had only limited use in dentistry until now but, with recent advances in technology, it has been employed to assess changes in the temperature of restorations, to monitor inflamed periodontal tissue and disease of the temporomandibular joints and to identify intra-osseous temperature changes during dental implant placement. Thermography has also recently been used to monitor inflammation after dental surgeries and has shown promise as a tool to diagnose pathological conditions.
What motivated you to develop the dental thermal app, and what specific applications does the app have in dentistry?
My motivation has always been to improve the clinical experience and explore new possibilities. Our research has focused on the development of medical devices and mobile technologies to provide novel workflows and applications. At a pre-pandemic Consumer Electronic Show where we were pitching our SmileShade app, I had the opportunity to meet and engage with the Teledyne FLIR team, who are arguably the leaders in thermography. After some discussion, it was apparent that FLIR did not have a dental application. And so, the collaborative relationship began.
We worked for several years to develop the software. Its initial application was aimed at additive manufacturing and 3D printing as a novel method to assess the fit of printed implant bars with dental implants. As we expanded testing, we soon realised that there were so many other possible applications in dentistry and teledentistry.
We have explored a few notable applications. These include using the thermal app as an alternative method for visualisation, providing an unconventional method of identification and assessment of the patient’s surface temperature and temperature generated from surgical procedures. Another possible application is in infection control. Hard surfaces can be imaged to assess disinfection and the fit of KN95 masks can be assessed. The thermal app can be used in education to assess procedural metrics. It can also be used to evaluate the fit of prostheses. We are thrilled to have had the app approved by the Teledyne FLIR Developer Community and Google Play!
Why should dental professionals be excited about this technology, and how will it facilitate clinical workflows?
Digital dentistry is exciting, and there have been remarkable developments in image acquisition, digital design and output. Technology can improve the clinical experience for both the patient and clinician while maintaining or exceeding the standard of care. That is exhilarating! I hope that clinicians and technicians welcome the new technologies with open arms and assess their value in their workflows.
We developed the Dental Thermal App with a simple, yet intuitive, clinically based workflow. It provides the tools needed for a novel approach to imaging and the appropriate documentation. How this technology will have an impact on clinical workflows is the most important question. The pandemic has disrupted dentistry and steered us to a digitally connected space. There is now a remarkable opportunity to explore this space by developing new tools and workflows to expand the connected oral healthcare platform.
Are there any challenges that may impede the use of the app by dental professionals?
Change is always a challenge. Dentistry is grounded on tradition and history. Many people, including clinicians, do not like to change their way of doing things. However, we should be mindful of new technologies and workflows that may improve the clinical experience. Any new technology will require evaluation, feedback, revision and support from the dental community. Keeping an open mind and being aware of possibilities is crucial. If we think back to the original iPhone, we will realise that technology evolves as we embrace it.
“Dentistry needs to be well represented on the tech stage”
Digital technology continues to change the future of dentistry, offering novel ways to diagnose dental conditions and plan treatments. How did these advancements shape your career as a dental professional, and do you think that change always equals progress?
As a lifelong technology enthusiast and a researcher in the dental device space, I believe advancement is the key. If advancements can improve efficiency and patient experience and reduce costs, then that is a win–win situation for both the clinician and the patient. These advancements also have the opportunity to improve sustainability and accessibility for patient care. These factors foster passion and excitement, and that fuels my career!
Change does not always equal progress. We have to evaluate all drivers of change and ensure that the standard of care is maintained, sustainability is improved and that new ideas are supported by scientific evidence. But let us not be too rigid, as change has to start somewhere, and not all new ideas are bad ideas.
Would you like to add anything else?
I would like to stress that the more tools we have in our toolbox, the better. Tools provide alternative methods of imaging, assessment and documentation. However, they cannot be a substitution for principles and fundamentals. They are just tools, and as clinicians, we need to know when to use them. However, let us not fear technology but embrace it. Dentistry needs to be well represented on the tech stage. Just think back to film cameras, and consider how taking pictures and recording videos has evolved. Let us bring this evolution to our profession in the hope of improving the clinical experience!
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