Overcoming opioid crisis in dentistry – Dr. Jason Goodchild shares 2018 trends


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In a recent interview with Becker’s Dental + DSO Review, Jason Goodchild, DMD, director of clinical affairs at Premier Dental, foreshadowed trends for 2018.

Question: What technology and/or devices do you predict to develop or become popular in 2018?

Dr. Jason Goodchild: Two dentistry trends that have been around for a while – metal-free dentistry and digital dentistry – will continue to develop in 2018, as technology evolves and improves.

The dental industry will see an expanding emphasis on metal-free restorations. This goes hand-in-hand with the shift away from amalgam restorations. More and more, as you look in the mouths of dental patients, everything will look tooth-colored, including places where restorations have been placed. In addition to using metal-free materials to restore lost or damaged teeth, dentists are also more often using bioactive restorative materials, with materials that actually facilitate healing or remineralization.

Digital dentistry will also continue to expand and refine dental practice in 2018. Digital tools and techniques have been around for decades, but this year, the cost of entry into digital workflows will continue to come down and become more reasonable and attainable. From crowns to bridges, dentures and even orthodontics, dentists can utilize digital tools to provide better, faster dental care.

Historically, crowns and bridges have been made from metal or metal and porcelain. In a recent Clinicians Report Newsletter a survey of general dentists revealed that 80 percent of respondents used metal-free restorations most often, with only 17 percent reporting that porcelain and metal crowns were used most commonly. These types of restorations, and including bridges, can be fabricated with digital tools such as CAD/CAM devices which are becoming more prevalent as mentioned above (e.g. CEREC, E4D). Not only does the digital workflow involve chairside fabrication of crowns and bridges and same-day dentistry (these previously had to be sent to a dental laboratory), but it also can help with clear-aligner orthodontics (e.g., Invisalign, ClearCorrect). No more gooey impression material in patients’ mouths, now 3D scanning devices can be used to capture the clinical situation and help design the treatment.

Q: What changes can dental professionals expect in 2018?

JG: One of the biggest changes in dentistry going forward will be an increased awareness of the opioid crisis and the role dentists will play in tackling this epidemic.

Opioids are the most prescribed drug category in the U.S. As a result, doctors and dentists have been urged to look at their prescribing practices, assess how they prescribe opioids to patients, and consider altering the criteria for prescribing opioids so that they become a pain killer of last resort.

Dental professionals will see new data and guidelines urging them to minimize the circumstances in which opioids are prescribed, and reduce the amount of medication given to most patients to avoid having leftover medication in homes that might fall into the wrong hands. In a recent column, it was recommended that, when needed, opioid prescriptions should be limited to 12 tablets to minimize diversion, according to General Dentistry.

New best practices will emphasize a larger role for ibuprofen and acetaminophen in pain management for most dental procedures.

Dental professionals will become important players in the campaign to reduce opioid abuse in 2018 and for many years to come.

Q: What three trends will the dental industry experience or move toward this year?

JG: Three trends that will move the industry forward in 2018 are the growth of corporate dentistry, the expansion of the use of mid-level providers, and an ever-greater focus on customer experience for dental patients.

Corporate dentistry is in no way a new phenomenon, but it is still a very hot trend. Dental practices continue to be purchased by large corporations. These corporations own and operate large numbers of offices. Examples include Heartland, Aspen, and Great Expressions. Recent dental school graduates are joining this practice model in large numbers. It is an easy pathway to a busy practice that results in excellent experience, a good starting salary, and no need to deal with the usual management headaches of a private practice. If this trend continues, single-owner offices will become the minority in the dental industry.

Another ongoing trend that will continue to shape the industry in 2018 is the use of mid-level providers in dental practices. Dentistry in 2018 is all about efficiency. Margins are small and services need to be completed quickly and correctly. That’s why many practices continue to employ mid-level providers to do certain tasks and procedures. Mid-level providers are non-dentists who are trained to perform certain procedures. Some examples include expanded function dental assistant (dental assistants that can also place fillings), restorative hygienists (can give local anesthesia, do hygiene procedures, and place fillings), or certified dental assistants (can take impressions, polish teeth, etc.). Regulations about the use of mid-level providers vary state-to-state, so it depends on local regulations as to how pervasive mid-level provider may be in a specific area. But it continues to grow across the country as a way to increase profit and provide more efficient service.

Finally, the last trend impacting the dental industry this year is the focus on providing the best possible customer experience to dental clients. There is a lot of competition in the marketplace and dental clients have lots of options for care. To succeed, a practice must not only provide excellent care, but also excellent customer service and patient experience. This has practices focusing on everything from having the latest equipment, to updating office décor, to employing a pleasant and responsive office staff, and establishing a strong social media presence. When it comes down to it dentistry is still a business. It is not enough to just provide good dentistry; in 2018 it also involves keeping customers satisfied and happy about the entire dental experience – from the first call to walking out the door after a successful procedure. Like it or not, providing both outstanding care and excellent customer service are essential to building a successful practice.

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