|Year : 2020 | Volume
| Issue : 1 | Page : 28-30
The Center for Research and Education in Technology (CRET), Inc: Promoting a Partnership Between the Dental Industry and Dental Schools
Edward F Rossomando
University of Connecticut School of Dental Medicine, Farmington, CT, USA
|Date of Submission||29-Feb-2020|
|Date of Decision||29-Feb-2020|
|Date of Acceptance||29-Feb-2020|
|Date of Web Publication||11-Apr-2020|
DDS, PhD, Professor Emeritus Edward F Rossomando
University of Connecticut School of Dental Medicine, Farmington, CT 06030
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rossomando EF. The Center for Research and Education in Technology (CRET), Inc: Promoting a Partnership Between the Dental Industry and Dental Schools. Dent Hypotheses 2020;11:28-30
|How to cite this URL:|
Rossomando EF. The Center for Research and Education in Technology (CRET), Inc: Promoting a Partnership Between the Dental Industry and Dental Schools. Dent Hypotheses [serial online] 2020 [cited 2022 May 21];11:28-30. Available from: http://www.dentalhypotheses.com/text.asp?2020/11/1/28/282245
| Introduction and Overview|| |
I am pleased to have this opportunity to speak with you about the Center for Research and Education in Technology (CRET). CRET was founded 16 years ago in 2004. In 2020 we have 26 member companies.
CRET is a not-for-profit company and is the first ever partnership between the dental industry and dental schools to introduce the latest in digital technology and innovative products into dental schools. The partnership eliminates outdated equipment usually found in dental schools and replaces it with the latest in equipment and products facilitating a smoother transition by dental students into private practice. The cornerstone of CRET’s program is its Innovation Center, a unique beta-site within the dental school that promotes access for CRET member company products to dental students and faculty. I would like to tell you how CRET got started, some details about an Innovation Center, how CRET member companies benefit from membership and how treating patients in an Innovation Centers produces graduates better prepared for private practice.
I would like to conclude with a look to the future and how CRET hopes to work with the dental industry to deal with the threat of corporate dentistry and plans for using digital technology to assist in designing private dental practices to deliver cost-effective dental care.
| CRET’s Origin Story|| |
But let me start from the beginning − what Hollywood would call CRET’s origin story. Let me take you back to the year 2000–when digital technology − equipment like CADCAM and digital x-rays − was new to the marketplace but entering dental practice at a surprisingly rapid rate. Unfortunately, this equipment was not entering the dental schools as fast. To make the point I would like to tell you a story told to me by the CEO of a major equipment manufacturer.
Once upon a time there was a CEO of a major dental manufacturing company. He had been trying to sell CADCAM equipment to dental schools with no luck. His frustration led him to seek out the dean of a well-known dental school and offer the following deal. “I will donate a CADCAM machine to the school. Use it and I will be back in a year and you tell me what you think”. The Dean accepted and the equipment shipped. Fast forward one year. The CEO returns to ask about the equipment. But neither the Dean nor any faculty can recall receiving it nor can they locate it. Finally, a custodian was called, and he guides them to a closet − and there is the CADCAM still in the crate. It was never unpacked, never plugged in, and never used.
I heard that story in early 2001 and by 2002 I heard similar stories from many other CEOs including Carl Bretko, then President of the DentalEz company. At a meeting with me to discuss the problem, he offered to organize a meeting of high-level and senior dental industry leaders to discuss the problem and hopefully find a solution. This meeting took place in 2004 at the Yankee Dental Congress in Boston, Massachusetts.
| The Innovation Center|| |
At the meeting the group agreed: gifting equipment to the schools was out of the question. The equipment would probably end up in the closet.
The plan proposed included forming an organization to be called The Center for Research and Education in Technology, CRET. CRET would partner with a dental school to build an Innovation Center (IC). The school would provide space and funds for renovation, and CRET would provide all the equipment and products needed for students to treat patients.
CRET stipulated the IC would be designed to look like a private dental office. It would have a reception area, six operatories (with each operatory equipped by a different CRET member), sterilization and radiographic areas, and a dental lab and conference room.
CRET also stipulated all seniors would spend a minimum of two weeks treating patients in the IC. CRET would provide all training to ensure equipment and products were used properly by students and faculty.
| The Advisory Committee|| |
To ensure equipment did not end up in a closet, CRET set up an Advisory Committee (AC) for each IC they supported. Each AC was composed of a minimum of three CRET members and three faculty members from the school. Also included was the Director of the IC. The AC was to meet at least once per year at the school. At these meetings the IC director reports on the dental procedures performed by students and CRET members can ask about the use of CRET products and get both positive and negative reports from students and faculty on their use and acceptance by patients.
| The Student Forum|| |
At each AC meeting the CRET members host a student forum, an informal gathering of fourth year students all of whom have treated patients in the IC. Participation in this Forum is for CRET members only − faculty are neither invited nor included − to discuss anything and everything the students want to talk about. This includes CRET member products as well as comments about faculty and suggestions on how to improve operations at the IC. The absence of faculty and the fact that the discussion at this gathering is anonymous is important as it encourages a discussion that can move in unexpected directions.
| Other Features of the Advisory Committee|| |
The formation of an Advisory Comm was important to the CRET founders and to the success of CRET’s program. No longer do companies donate and hope for the best. Now when a company donates to the IC, the fate of the donation can be monitored.
If CRET member Products are favorably received, they may be purchased from CRET members by the school.
Only products from CRET members can enter the IC and all items that go into the IC are either provided by CRET members or requested by the school. The IC is a − privileged space − very much like a beta testing site.
| The Threat of Corporate Dentistry to the Dental Industry|| |
The CRET leadership had another goal in mind when creating Innovation Centers. Specifically, they wanted to deal with what was perceived as an emerging threat − the decision by the younger generation of dental graduates in the US − millennials and generation Zers − to practice in a corporate dentistry setting. Why is this a threat? Because dentists in corporate setting don’t make purchasing decisions. And because in the US the number of yearly graduates is equal to or less than the number of retirees, the net number of practicing dentists is in decline and this means a decline in the number of decision makers and decision makers are customers. With graduates signing up for corporate dentistry, the number of customers declines further.
But why are millennials and generation Zers opting for corporate dentistry? One explanation that has been stated many times is the extensive debt of those in these generations.
While this debt might be a factor, I’m not sure it the only factor. Those in this age group have had experiences very different from those older. For example, those in this group have grown up with social media and the 24-hour news cycle. And what do they hear and see over and over. Fires, terrorists, shootings. For this group the world is a risky and frightening place. Because of this I would like to suggest that those in this age group become risk averse. As a result, when graduation looms, some in this age group realize feel unprepared to open a private practice − it presents too great a risk. Signing up to practice in a cooperate dentistry setting represents an alternative with significantly less risk.
But risk-averse dentists are the opposite of what the dental industry needs. You need early adopters. Those who will take a chance on an industry device.
So how do we counter the media and teach that it is ok to take a risk? Working in the CRET IC, dental students experience first-hand the risks involved in private practice but they also see that while there are risks, these risks can be managed. In the IC students are exposed to a curriculum that includes the principles of entrepreneurship and experience the positive aspects of owning a private practice. Experiencing a supervised program in entrepreneurship can reduce risk aversive concerns and hopefully encourage graduates to enter private practice.
| CRET and The “Smart Dental Office”|| |
To date CRET has opened ICs at four dental schools: Loma Linda University, University of Missouri at Kansas City, West Virginia University, and the University of Mississippi. All four are similar in floor plan and interior design. With each, the focus was on providing students with digital equipment introduced to enhance fabrications such as optical scanners, CAD and 3D printers. The goal was to provide seniors with experience with this equipment to facilitate their entry into private practice after graduation.
In the last few years, however, a new category of digital equipment has entered the market. Technology pioneered by the auto industry for driverless cars, including sensors, radar, and video cameras, when combined with artificial intelligence (AI) software and high-speed computers, can track the motion of personnel and equipment within the office. The shift, from focusing on optimizing workflow for manufacturing to optimizing the movements of patients, office staff, the dentists, and equipment within the dental office opens the possibility of maximizing efficiency of delivering care and of lowering overhead costs.
Every time CRET builds a new IC there is an opportunity to redesign the dental office with these goals in mind. Most − if not all − these redesigns have focused on the floor plan, the interior décor and the arrangement of equipment to maximize workflow.
In envisioning the dental office of the future, CRET is changing the focus from the floor plan and the arrangement of equipment to the motion of the people in the office − the collective motion of all people of all in the dental office − what CRET calls the chorography of the dental office.
There are many people in the modern dental office − the office staff, the operatory assistants, the radiologist, the hygienist and of course the patients. All these people move through the office in a dance directed by the dentist. But until now it was almost impossible to determine a floor plan that would provide the optimal arrangement that will maximize personnel motion within the office and workflow through the office.
To determine this optimal arrangement would require studying the movement of all these people in the office as well as monitoring equipment and inventory. Until today this task was beyond our technology.
Today we have new technology − we have sensors, video cameras, and ways to tag people and equipment and instruments. By tagging all office personnel and patients and equipment and instruments, it is possible to capture the motion of all in the dental office. These data, coupled with algorithms and high-speed computers to process all these data, will allow for the first time an evaluation of the “dance” in the dental office and decide which routine is best for each dental office. This research is needed as the dental office arrangement has not been changed since the 1800s when the dental office was in the back of the barber shop.
This approach is already in use at a new dental clinic at Columbia dental school.
Also, one dental school is taking this idea one step further. Recently CRET visited a dental school where the dean wanted to study the best way to configure the operatories. But how could he study operatory arrangement? He looked into designing a new clinic with movable operatory walls. He planned to use the movable walls to evaluate various operatory and office configurations and tagging to track the motion of personal within the various office configurations.
He reasoned that by optimizing personnel motion, students could be better educated, and they could provide better oral health care and at lower cost.
We invite you to join CRET as we create a new science, dental office design, and design the next generation of “Smart Innovation Centers” for our dental schools. These Smart Centers could well become prototypes for the design of dental offices of the next half century.
| Conclusions|| |
In this talk I have tried to present a picture of how and why CRET was started, a description of the Innovation Center. In addition, I described how CRET members gain access to dental students and faculty, how the IC promotes private practice and finally how new technology enables us to envision using digital technology to design a Smart Dental Office.
I would like to conclude by thanking all the CRET members that, since 2004, have provided support for CRET programs and continue to share CRET’s goal of improving dental education one school at a time.
The paper is adapted from a talk presented at a meeting of the Dental Trade Alliance on February 19th, 2020 in Chicago Il, USA.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest