Dr. Terri Dolan Spills the Tea on AI in Dentistry

[00:00:04] Welcome to the High Tea with Grace podcast, where we spill the tea on HIT. I'm honored to welcome Dr. Terri Dolan, Chief Dental Officer at Overjet. Thanks so much for joining us, Dr. Terri. Hey, thank you, Grace. It's a pleasure to be with you today. So tell us all about the career path that brought you to your role today. So it's really interesting because I've been in dentistry for a long time and I met the CEO of Overjet, Dr. Warda Enam, almost by accident.

[00:00:31] I happened to be at a conference at Harvard University. I was working for Dentsply Sirona at the time and we were sponsoring one of their key initiatives about how to better integrate medicine and dentistry. And they had invited Warda to give a keynote presentation. And honestly, I should be embarrassed to say this maybe, but that was the first time I ever thought of artificial intelligence or AI and its applications in dentistry.

[00:00:57] And she gave an amazing presentation and she told a personal story about her experience in dentistry, which I can tell you a little more about. And it just impressed me so much that this was a technology that could really be applied in dentistry in ways that would really benefit patients and clinicians. That is so interesting to think about this overlap between healthcare, dentistry, healthcare technology, AI, and what's happening in the space.

[00:01:25] And it's inevitable that it's going to do something, right? So tell me, how is the dentistry experience different for patients going to the dentist from in 2025 versus 1984? What's the difference? And are you going to start feeling it? That's a great question because I think about that a lot. There's so many things that have stayed the same. Of course, always putting the patient in the center of everything we do, working as health professionals to improve their oral health.

[00:01:54] All the ethics and professionalism and caring that's involved in care delivery. Of course, those things have not changed. And I'd say the importance of science and as a professional, our critical thinking skills and really applying that to provide comprehensive care to patients so that we're really addressing their needs. So those are things that haven't changed, in my opinion, but lots of things have changed. So I think about technology and all the technological advances.

[00:02:23] And of course, that's what enables AI in dentistry, big data and the ability to manage big data sets. One thing that concerns me is the cost of dentistry. I remember as a kid, my mother would pile up my brothers and sisters and take us to the dentist. And we actually would go to the New Jersey Dental School at the time and a filling was $5. And of course, that was in an educational environment.

[00:02:48] But you think about the cost of care today and that really becomes a barrier to people getting the care they need. There's other positive changes, though, too. Like I think people really better understand and appreciate the importance of oral health to their overall health and well-being. And I think the patient experience has become so much better. I remember as a kid going to the dentist with the belt drill and not so much concern about my comfort or anxiety.

[00:03:16] And today, I think the patient care experience is much better than it was many years ago. And I also think educational technology has really helped us do a better job teaching students, preparing them for dental practice. Yeah, it's so true. When you think about the experience back then to now, it is much better. You go there and it's almost like a spa experience for many. And I think about, too, when I was a kid, not all of my friends went to the dentist.

[00:03:42] But now my children, all of their friends go to the dentist despite how expensive it can be even with insurance. And so it's fascinating to think about those changes and how it's been evolving to be even more patient-centric. And how can we get that cost down? But I'm really interested in hearing your thoughts about AI. There's so much buzz around AI, how it's being used in healthcare in so many different ways. It's hard to separate fact from fiction. And so what is the reality of AI in dentistry right now? What can it actually do?

[00:04:12] And what should it not be doing? And that's, I think, something people don't really think about. Yeah, I love that question, Grace. And there's so much misunderstanding about AI. So that's why I'm really excited to be here with you to talk about that. So is it real? Absolutely. Is it here to stay? Absolutely. We might have thought about it as something for early adopters, et cetera.

[00:04:35] But I would say the technology has evolved to the point where it is really impactful and has great power and ability to really improve the care that we provide for our patients. I would say it really helps clinicians, the dentist, the dental team, the dental hygienist, helps us do a better job in the care that we provide for patients. Make sure we don't miss things. It aggregates data in a way that the data is more useful to us.

[00:05:00] It really highlights important clinical findings that in a busy practice maybe we miss or we want to make sure that we're always doing the best for each and every patient. And I think what it does currently, we can talk more about what it can do in the future, too, but it really improves my ability as a dentist to diagnose consistently and accurately and then also communicate that to the patient.

[00:05:24] Because many times a patient is looking, you can imagine in your own experience, you're looking at a black and white set of x-rays and you're nodding politely as the dental team is explaining what's going on in that x-ray. But when you colorize it and you really point out, this is what a dental decay or caries looks like, or here's why bone loss related to perinatal disease or gum disease is so important to you. And here's what it looks like on the x-ray.

[00:05:51] And you see it in living color is just so much more impactful to a patient. And I think it really helps them understand what these disease processes are, why they're important and why they need to be treated. Because an interesting statistic, more than 65% of care that's recommended to patients actually doesn't get delivered. And that's a big miss.

[00:06:13] And so the better we can explain dental care to our patients, the more likely they are to accept that care and their health is going to be improved because of that. It's interesting you say that because there does seem to be a trust problem in dentistry where people think that a dentist is trying to pull one over on them. Oh, I don't really need that filling. And so what can dentists, hygienists do to help build a sense of trust to the patients?

[00:06:39] And does technology play a role in helping support some of that trust building and credibility building with their patients? Yeah, I think that's a really key point is that dentistry happens in a very personal space. There's distrust in general in society today. And even though dental professionals are among the most trusted professionals in our society, people still wonder.

[00:07:05] And I think they really wonder if diagnoses are inconsistent or they might question the accuracy of that. So the technology really helps clinicians be more consistent and helps them communicate more effectively. But I think that building trust is all tied into that consistency and effective communication. And so I think that the technology really facilitates that. It's not the only element of trust.

[00:07:33] But I think having almost an independent third party, in this case a technology, illustrating what a condition is, I think is helpful to a patient, especially when many dental conditions are asymptomatic. If you have an early decay or caries, you don't feel anything related to that. But the important thing is that you catch it early, that you do a preventive intervention or maybe a small filling before it gets bigger and more expensive and more challenging problem.

[00:08:03] And in order to do that, the patient and the dentist have to develop a sense of trust and effective communication about why that's important and why we need to move forward with a particular kind of care. So I think the technology really enables that. It's not the only thing that is important in building trust, but I think it can really help develop that more quickly and almost be that independent third party saying this is what the technology shows us. I love that. So interesting.

[00:08:32] And I've heard that AI is also being used not just for dental providers, but for dental insurers. So I'd love to hear more about how it's being used in that space. Like how tricky is it to balance that payer-provider relationship in the dentistry space? Is there an opportunity for both sides to work together better? And where is AI fitting into this picture? Of course, I'm an optimist on this topic. And I know it is. We all love the optimist, right?

[00:08:58] When you are a technologist and you're creating the future and solving problems, you can't help but be an optimist. And I love that. That's the way I see this as an enormous opportunity. And so it's not an us versus them, but all care should be delivered based on science and clinical standards of care.

[00:09:46] Let's think about how to accommodate all the back-end administrative delays. Let's speed up our decision-making and let's facilitate getting the right care of the right patient at the right time. and having agreement and maybe even we might say a common ruler or a common rule set about for this condition, this is what's really optimal for that patient. And let's make sure it's consistent with what the patient benefit is through their insurance. And let's pay it as quickly as possible.

[00:10:15] I think that's really the world that I'd like to live in where it's a win for the payer, the provider and the patient. We're not there today, but we're so close. And there's so much great work being done to help us get there that that's why I'm incredibly optimistic about not just where we are today, the opportunities to really make care patient centric, eliminate all those hassles and delays. And let's enable patients to get the care that they need. That's so interesting.

[00:10:45] There's a rising trend in dentistry on the insurance side right now for dental offices to have patients manage their own claims because they just don't want to deal with it. The abrasion is too tough. They don't have enough staff. They're feeling burned out by dealing with it. So they say, patients, you have to deal with it. And I have to say, one of my favorite dentists said, hey, this claim is a little complicated. So we're going to actually handle this instead of making you handle it like we usually make other people handle it.

[00:11:10] Do you think technology could play a role here to just help support some of this so they don't have to put it on the onus of the patient to be submitting claims? Like on that side of things, where do you think technology could fit in to solve that challenge? So at Overjet, we're already doing some pilots with some insurance companies and practices to test how to take that friction out of the process. I know dentists and dental practices are trying to do patient-centric care and make it easy for you to take advantage of your dental benefits.

[00:11:40] And so why can't we take some of those inefficient work processes out of the loop, use technology to facilitate it? There's so much information we know about you as a person, your dental care needs, and what your benefits are through your insurance company, most likely paid for either publicly or through your employer. We know that information.

[00:12:04] Why can't we aggregate it in a way that can facilitate fast decision-making so that you don't have to delay your care? You can get it right when you need it. And so I think we're very close to doing that. I know we're experimenting and working actively with payer partners and practice partners to really develop those workflows in a way that will really benefit patients. And again, I told you I'm an optimist.

[00:12:31] I'm really excited about that opportunity because oftentimes patients don't even use the benefits that they have that are accessible to them. And why not enable them and make sure that they're taking advantage of that opportunity to stay as healthy as possible? So true. So true. And I'm so glad, Dr. Terry, that you're at the forefront of this because we need amazing women like you leading the charge.

[00:12:55] I would also love for you to dive a little bit into the AI in dental education and research. So you mentioned that earlier just quickly that AI is being used to help just push education and research forward. Do you have any case studies or interesting examples to share about how they are using AI to improve dental education and research? That's one of the favorite parts of my role at OverJet.

[00:13:21] You may know that for many years, I was on the faculty at the University of Florida College of Dentistry. I spent my last 11 years there as a professor and dean at the college. And so when I went to industry, I saw the opportunity to really collaborate well with industry and universities. Because universities are working hard to provide the best education to their students. And technology can sometimes be expensive.

[00:13:50] Or there's ways that industry can, that companies like OverJet can partner with universities to enable them to adopt new technology. I've been doing that with our team. And it's been a lot of fun, one, to be back in the academic environment. And I can give you an example. I was at the University of Florida. Of course, they're one of the first universities that I approached and said, hey, here's some great technology.

[00:14:13] What can we do together to incorporate it into the curriculum and to really advance the education of the dental students? And, of course, they were great partners. And I'll mention one person in particular, Dr. Anita Gohel, although Dean Isabel Garcia, two amazing women who partnered with us along with other faculty and said, sure, what can we do together? Of course, being an academic environment, the first thing they want to do is I'm going to have to validate this first to make sure it's accurate.

[00:14:43] And I said, that's fine. They did a research study and validated the accuracy of caries detection. How good is the technology in identifying dental decay? And I would say that I'll laugh a little bit that Dr. Gohel at first was a little reluctant or even questioning whether it would be good enough. And when she got the results from her study, she was amazed because it was better than she thought it was going to be. Humans make mistakes. Technology are not perfect.

[00:15:11] But what we've demonstrated time and time again is that humans plus technology actually improve a clinician's ability to make an accurate diagnosis. So she had to prove that to herself. I think it was great that she demonstrated that at the University of Florida. And based on now her confidence in this, she actually incorporated into the curriculum. So she incorporated into her lectures, into the radiology rotation for the students.

[00:15:39] And then she did another great thing, which I really appreciate. She actually tested the improvement of students' diagnostic accuracy using the technology. And she's published this in an abstract. And I hope the paper's out soon so that we can share it more broadly. But what she found was that dental students' ability to accurately detect dental decay improved by more than 40% using the technology. Because they don't have a trained eye yet, right?

[00:16:08] They don't have that natural instinct that you get once you see it more often. And so it probably just helped them train their eye even better to say, oh, did you notice this? And for them to say yes or no at that point. That's interesting. That is exactly. In retrospect, that's exactly what it is. Because you look at a black and white radiograph for the first time and you don't know what you're looking at. And she tested this on both first-year and third-year dental students. And they both had more than a 40% improvement. And then you might say, oh, that's going to lead to overdiagnosis.

[00:16:38] She also tested that. And that was not the case. They had a less than 1% increase in false positives. I think people worry we're going to be detecting more decay and disease inaccurately. And that was not the case. Yeah, because I think if anything, the human's still in the loop. Like at the end of the day, the dentist is making the choice. They're looking at it. And if the AI is accurate, great. And if they can always use their own judgment to question anything, right? And I think that kind of shows how critical it is to have the human in the loop when it comes to AI.

[00:17:08] I'm glad you brought that up because I was supposed to also comment on what AI cannot do. And what AI doesn't do is replace the critical thinking and the diagnostic skills and responsibility of the clinician. It's an assistive technology. And so you're absolutely right that it's the dentist that owns the responsibility for diagnosis and has the opportunity to use tools to do that more consistently, more accurately, more efficiently. So you're spot on that.

[00:17:37] It just seems like an ethically critical thing to do to charge the future generation who's going to be using technology no matter what to do it correctly and how to do it. Do they feel that way as well? Because I feel like it just seems if the future generation is going to use technology, you should be learning how to do it properly when you're training to be a dentist, right? That's exactly right.

[00:18:02] And I would say I've learned a lot by having the opportunity to give lectures to dental schools across the country. And myself and my teammates have probably visited 80 percent of the U.S. dental schools and done some kind of lecturing to students, faculty, etc. And we think about dental students today as digital natives. And of course, they have excellent digital literacy and would know all about AI. And the truth is that's true for some, but honestly, not the majority of dental students.

[00:18:30] And so we really have a responsibility to teach them about technology, how to assess it. How do you decide when to adopt a technology or not? And we've been working with schools. I think that's a really important part of the curriculum.

[00:18:45] And helping students understand what AI, for example, can and cannot do and what you can more or less delegate to a technology, but then what the clinician's responsibility is for still owning the responsibility for doing the dental diagnosis. It's been very interesting that I think we still have a lot of work to do to incorporate that into the dental curriculum and help students be better consumers and evaluators of technology.

[00:19:15] Because the development's only going to ramp up and they need to have those assessment capabilities so that they make good decisions for themselves, for their practice, and how they're going to benefit the patient. So true. So true. We talked a lot today about how AI is being used and so many different facets of dentistry. I'd love to hear now about what you think it will be able to do in the future. 20 years, 30 years in the future, or maybe even just 10 years.

[00:19:44] What do you think the future of AI and dentistry will look like? So Ogrejet started really as a computer vision company. And our products are FDA cleared for that purpose. So it'll take a dental x-ray and it'll colorize common clinical findings and aggregate data and make it very apparent to the user what clinical findings are important and how to incorporate that knowledge into a treatment plan. But now we have all of this generative AI.

[00:20:14] And lots of data is collected all the time through the patient care experience. How do we aggregate those pieces of data in a way that connect the dots and help the clinical team provide even better, more comprehensive care for a patient? So I would say natural language processing, reading chart notes.

[00:20:35] If we had an interoperable medical dental record, better connecting dental conditions to, say, chronic conditions like diabetes or hypertension or heart disease. Even simple things like checking in with a patient, have you had your flu shot or your pneumovax or your HPV vaccine? There's so many ways that we can connect the dots and really help patients monitor and improve their overall health care in addition to their oral health.

[00:21:05] And I think that the technology will make all that data aggregated in a way that it's so much more useful for the clinician. But then also feed information back to the patient. Here are your five clinical findings. Here are the five things you can do to improve your own health. Really empower the patient to own their health and do a better job maintaining their health because so much dental disease is preventable.

[00:21:33] Let's do our best to share information and empower patients so that they can maintain their own oral health. Absolutely. I like that future where that data was more interoperable and more usable than ever before and really inform a future, more holistic health world for patients. It's truly incredible. I love that idea. Thank you so much.

[00:21:57] The high T listeners always like to hear about technology trends, but they also like to understand what drives women leaders in health care technology. So what are things that you do as a leader, a busy Dr. Terry, chief dental officer, human being? What are things you do to help work your best to make a difference?

[00:22:16] This is something we probably all women struggle with, but I would say one important thing I always do is carve out a little bit of time for myself to maintain my own health and being. Right. So my favorite passion right now in my life is Pilates. And I love my Pilates studio because it's technology enabled. I can schedule my session online. I put it on my calendar and I try to do that at least five times a week.

[00:22:44] Little things like that, because I think when you're passionate about your work, it's very easy to be all in and just trying to be mindful of what you need as an individual and also all the people in your life that you love and care about that you reserve enough time for them as well. So true. I love Pilates as well. And I'm very sore right now for my recent Pilates workout. It was a Pilates and yoga workout.

[00:23:10] It was a little too much, but anyway, it's just wonderful to be able to keep your body strong so that you can keep up with the work. And so I'm wondering if you could give your younger self a piece of advice, like just whether it be personal or professional, however you want to take the question, what would that be? When you ask that question, I think about a fabulous mentor of mine who I was enrolled in a health services research fellowship program and it was fascinating.

[00:23:38] And I was getting my master's in public health at UCLA. But then I kept thinking as a dentist, what am I going to do with this? How am I ever going to get a job? And so I asked my mentor, I'm like, I'm starting to get stressed. I love what I'm doing, but I'm worried I'm not going to be able to earn a living doing this. And he said, Terry, don't stress. He said, just do what you love, do it as well as you can, and the rest will take care of itself.

[00:24:04] And I have found that's been true throughout my life. And I have passed on that advice to many of individuals that I work with. I can imagine that being the case. And I could also imagine that trials would come your way as you're on that journey. What are some of your resilience strategies to just keep yourself going when things do come your way that you want to knock you down or keep you back? I think we, as women leaders, we have to be courageous and we have to be willing to take chances.

[00:24:34] And we have to realize that not everything might work out perfectly and be okay with that. Probably surrounding yourself with really good people is helpful people that you know and respect and trust that will give you good advice and honest feedback. It has always been very helpful to me. And then I also think being willing to pay it forward. So as much as I've been a beneficiary of wonderful advice and terrific mentors,

[00:25:03] then I believe it's my responsibility to pay that forward and to help women on their journey as they're developing their careers. So inspiring. Thank you so much, Dr. Terry. I appreciate that so much because I think about the amazing women who just keep me going and encouraging me and supporting me and wanting to give back to them too. And what that does for your personal life, your career and everything, just keeping you going no matter what you're facing. So to finish this conversation off, where can our listeners find you online?

[00:25:32] I have a LinkedIn. What do you call it? LinkedIn profile or me on LinkedIn. LinkedIn. And of course, through Overjet, I invite you to go to overjet.ai or overjet.org. And I guess I should, I think it's overjet.ai. But please find me on that. Take a look at our website. Learn about this technology. Think about how it can really advance your work. And as you work to provide the best care for your patients. Yeah. And I'd love to hear from you. So find me on LinkedIn. That's terrific.

[00:26:02] Now, before I forget, did you happen to bring tea with you today? And let me see your mug. I'm actually, as you might guess, this is my University of Florida mug. And this was a gift to me from the faculty. And I really appreciate that. And I brought my Earl Grey tea bag, which is my favorite tea. And I actually am a tea drinker. This is for real. I love my Earl Grey tea. And I really enjoyed the opportunity to be with you today.

[00:26:31] Thank you so much for joining us. We really appreciate you being so generous with your insights and all the work you're doing to forward the industry. Thank you, Grace. And thanks to you folks for joining us too. Check out the High Tea with Grace podcast for more interviews with great guests like Dr. Terry today. Cheers. Cheers. Like a Girl Media is more than a media network. It's a community. We want to meet you and amplify your voice and the voices of outstanding women innovating in healthcare.

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