Re Post - Innovating Across Silos - Moving From Sick Care to Health Care with Daniel Kraft

[00:00:04] [SPEAKER_01]: Welcome to Think Oral, where we connect you and connected between oral and physical health.

[00:00:10] [SPEAKER_02]: I'm your host, Dr. Jonathan Levine, and I'm your host, Maria Filipova.

[00:00:15] [SPEAKER_02]: Let's get at it.

[00:00:23] [SPEAKER_00]: Hi everyone, Maria Filipova here, and I am very excited to be joined by Jonathan Levine.

[00:00:29] [SPEAKER_00]: And we have a very special episode today for you.

[00:00:32] [SPEAKER_00]: This episode is very special because of our guest, a close friend of mine, but also because

[00:00:37] [SPEAKER_00]: of the topic.

[00:00:38] [SPEAKER_00]: We are talking about innovation today, innovation at scale, innovation in health care and innovation

[00:00:46] [SPEAKER_00]: in oral health.

[00:00:48] [SPEAKER_00]: Fun fact, do you know when was the last large-scale innovation that was adopted in oral health?

[00:00:58] [SPEAKER_00]: My personal answer to that question is that it has been 77 years since the last transformative

[00:01:05] [SPEAKER_00]: innovation in oral health care.

[00:01:08] [SPEAKER_00]: In 1945, fluoride was discovered and added to the drinking water in Michigan.

[00:01:15] [SPEAKER_00]: Since then it has had a profound impact on a large set of patients and communities irrespective

[00:01:21] [SPEAKER_00]: of their zip code, the social status education or medical background.

[00:01:26] [SPEAKER_03]: I love that analogy and it's a really perfect one because it had such a huge impact

[00:01:31] [SPEAKER_03]: on the decay rates for the children and in fact it was a 65 percent decrease, which was

[00:01:37] [SPEAKER_03]: quite incredible keeping children in schools, keeping them out of pain and a huge impact.

[00:01:42] [SPEAKER_03]: But it was the democratization of the impact.

[00:01:46] [SPEAKER_03]: It wasn't just for the few, the two percenters of the people who had access to super

[00:01:51] [SPEAKER_03]: high-end technology.

[00:01:52] [SPEAKER_03]: This was something that got into the drinking water and had a huge profound effect in

[00:01:57] [SPEAKER_03]: the United States.

[00:01:58] [SPEAKER_03]: And this can be really a very important question to ask our innovative colleagues what they're

[00:02:05] [SPEAKER_03]: building, can it flow to the greater mass of the people who do have the access to care,

[00:02:13] [SPEAKER_03]: but also for people who there is a high level of inequality and don't have access to care?

[00:02:19] [SPEAKER_00]: That's right.

[00:02:20] [SPEAKER_00]: I love this example as well because it doesn't require high tech.

[00:02:24] [SPEAKER_00]: It's not quantum computing and AI and neural nets solving a problem.

[00:02:32] [SPEAKER_00]: It's policy, clinical science coming together and doing something very foundational yet highly

[00:02:40] [SPEAKER_00]: impactful.

[00:02:41] [SPEAKER_00]: And that really sets the tone and the ethos for the innovation that we want to uncover,

[00:02:47] [SPEAKER_00]: validate and scale through our conversations.

[00:02:51] [SPEAKER_00]: That's truly the bar.

[00:02:52] [SPEAKER_00]: How many people could we impact with the simplest, most elegant solution to improve,

[00:02:59] [SPEAKER_00]: meaningfully improve access to care, improve equity and quality of care as well?

[00:03:06] [SPEAKER_03]: That's exactly right.

[00:03:07] [SPEAKER_03]: The word equality is so critical there because people who don't have access to care think

[00:03:13] [SPEAKER_03]: that walking around in pain is normal and losing teeth and extracting teeth is something

[00:03:20] [SPEAKER_03]: normal. And it's not until that people can reach out, foundations reach out and start

[00:03:27] [SPEAKER_03]: developing a level playing field to move these people more into an area where they

[00:03:32] [SPEAKER_03]: do have access to care.

[00:03:34] [SPEAKER_03]: Do you see this incredible change, this transformation change for these people?

[00:03:39] [SPEAKER_00]: And with that in mind, I want to introduce our guests for today.

[00:03:44] [SPEAKER_00]: I'm very excited that we are joined by the Stanford and Harvard trained physician

[00:03:50] [SPEAKER_00]: scientist, innovator and investor with over 25 years of clinical research,

[00:03:57] [SPEAKER_00]: biotech and entrepreneurial experience.

[00:04:00] [SPEAKER_00]: Dr. Daniel Kraft is joining us today from the West Coast.

[00:04:05] [SPEAKER_00]: He serves as the chair of medicine and singularity university.

[00:04:09] [SPEAKER_00]: He's also founder and chair of exponential medicine.

[00:04:13] [SPEAKER_00]: Now next med will speak to him about that and will speak to him about his

[00:04:18] [SPEAKER_00]: current entrepreneurial venture around digitizing medical solutions or digital

[00:04:26] [SPEAKER_00]: tools, digital therapeutics for all kinds of clinical applications.

[00:04:31] [SPEAKER_00]: And we'll speak to him specifically about how the lessons learned from

[00:04:36] [SPEAKER_00]: adopting innovation in medical community we could apply on the dental side.

[00:04:41] [SPEAKER_00]: Daniel, welcome to the podcast.

[00:04:43] [SPEAKER_00]: We're very excited to have you.

[00:04:45] [SPEAKER_00]: We are really looking forward to having a very pragmatic and real talk, if you

[00:04:51] [SPEAKER_00]: will, about what we could do to identify impactful and scalable

[00:04:55] [SPEAKER_00]: solutions in oral health.

[00:04:58] [SPEAKER_00]: The reality is that over a third of the US population sees a single provider,

[00:05:03] [SPEAKER_00]: one provider, either a dentist or a physician, but not both.

[00:05:08] [SPEAKER_00]: And so if we have an opportunity to touch a patient once in a year, then to me,

[00:05:15] [SPEAKER_00]: it makes sense to make the most out of that visit and that touch point.

[00:05:18] [SPEAKER_00]: And I share this openly that for me, the future of integrated health is when

[00:05:23] [SPEAKER_00]: your primary care physician talks to you about period on all health

[00:05:27] [SPEAKER_00]: and your oral health and your dentist talks to you about A1C levels

[00:05:32] [SPEAKER_00]: and managing your diabetes.

[00:05:35] [SPEAKER_00]: So without framing in mind, Daniel, what do you see as the most promising

[00:05:40] [SPEAKER_00]: opportunities for that future?

[00:05:42] [SPEAKER_00]: And do you think this is a reality to be a soon to be a reality?

[00:05:46] [SPEAKER_00]: Or do you really think this is more of an aspiration?

[00:05:49] [SPEAKER_04]: The future is coming faster than we think, hopefully, and including

[00:05:53] [SPEAKER_04]: it, oral care and health care and public health.

[00:05:55] [SPEAKER_04]: It's more about getting to a world of integrated health, right?

[00:05:59] [SPEAKER_04]: Where we're not so siloed in body parts and where we connect our oral

[00:06:04] [SPEAKER_04]: hygiene to our public health and our cardiovascular health and our brain health.

[00:06:09] [SPEAKER_04]: I don't think it's very far off in some parts of the world or much

[00:06:12] [SPEAKER_04]: more integrated in some systems even in the US.

[00:06:14] [SPEAKER_04]: So I think it's a real time where we have the opportunity now

[00:06:17] [SPEAKER_04]: to not think in such traditional silos, but recognize that, yes,

[00:06:21] [SPEAKER_04]: while you're in a dentist chair, you could have your blood pressure

[00:06:23] [SPEAKER_04]: ejector.

[00:06:24] [SPEAKER_04]: You could go in A1C and while you're at the primary care office,

[00:06:27] [SPEAKER_04]: they could be doing some elements of oral care that tied to other health

[00:06:31] [SPEAKER_04]: systems in the body beyond.

[00:06:33] [SPEAKER_04]: So I guess it's a time to connect the dots in technology and new

[00:06:36] [SPEAKER_04]: mindsets as we enter the era of 2023.

[00:06:40] [SPEAKER_00]: But it's easier said than done.

[00:06:41] [SPEAKER_00]: And technology is unfortunately not the limiting factor here, right?

[00:06:46] [SPEAKER_00]: So what are some of the real barriers to that future to making

[00:06:49] [SPEAKER_00]: that happen? And we've got, we're privileged.

[00:06:52] [SPEAKER_00]: We have a dentist.

[00:06:53] [SPEAKER_00]: We have a physician here on the podcast today.

[00:06:56] [SPEAKER_00]: So let's put some of these barriers out on the table.

[00:06:59] [SPEAKER_04]: Well, number one, just to be clear, I did get my annual cleaning done

[00:07:03] [SPEAKER_04]: about three weeks ago.

[00:07:04] [SPEAKER_00]: Maybe though, one step at a time.

[00:07:07] [SPEAKER_00]: That's right.

[00:07:07] [SPEAKER_04]: And the oral hygienist was awesome.

[00:07:09] [SPEAKER_04]: And of course she'd guilted it in me a little bit about not flossing very often.

[00:07:12] [SPEAKER_04]: So I just want to put that on the table.

[00:07:13] [SPEAKER_04]: But I did also get now a new connected toothbrush with an app that gamifies it.

[00:07:18] [SPEAKER_04]: So I'm doing a much better job at my brushing and my flossing.

[00:07:20] [SPEAKER_04]: Just put that out there.

[00:07:22] [SPEAKER_04]: So some of the barriers are behavioral.

[00:07:24] [SPEAKER_04]: Just highways remind my kids to brush your teeth in the morning and the afternoon.

[00:07:27] [SPEAKER_04]: I was not always the best brush.

[00:07:28] [SPEAKER_04]: And in fact, some of the barriers are again, are how we get integrated

[00:07:32] [SPEAKER_04]: thinking about oral care and our general health.

[00:07:35] [SPEAKER_04]: And I think we're entering an era now when folks are eating into this

[00:07:38] [SPEAKER_04]: era of more self-care.

[00:07:39] [SPEAKER_04]: And I just healthcare with a more engaged with their own health.

[00:07:42] [SPEAKER_04]: They can see some of their data, whether it's from their wearables

[00:07:45] [SPEAKER_04]: and other bowls giving the inside of their sleep and their activity

[00:07:48] [SPEAKER_04]: and their cardiovascular health and their mental health

[00:07:51] [SPEAKER_04]: and potentially tie that to other elements.

[00:07:53] [SPEAKER_04]: So some of the barriers are behavioral, some of them are societal,

[00:07:56] [SPEAKER_04]: but the big one, of course, in clinical health care are the culture of care.

[00:07:59] [SPEAKER_04]: It might be the culture of a clinician of any sort of physician, nurse,

[00:08:02] [SPEAKER_04]: dentist, pharmacist, how they see their workflow and their incentive models.

[00:08:08] [SPEAKER_04]: You can have the best telemedical visit or tell a dental visit

[00:08:12] [SPEAKER_04]: with a paid for the incentives are aligned.

[00:08:15] [SPEAKER_04]: It may not happen.

[00:08:16] [SPEAKER_04]: So a lot of it still drives from the incentive elements.

[00:08:19] [SPEAKER_04]: Now we get paid for care.

[00:08:20] [SPEAKER_04]: It's still a bit nutty that I have to get a separate health insurance plan

[00:08:23] [SPEAKER_04]: and pick a dental plan that's still optional, right?

[00:08:26] [SPEAKER_04]: That should be actually integrated together.

[00:08:28] [SPEAKER_04]: And of course, some of it is not just having the technology

[00:08:31] [SPEAKER_04]: but connecting the dots, whether it's the data from my connected toothbrush

[00:08:35] [SPEAKER_04]: or what does my dentist do with my oral microbiome if they have access to that?

[00:08:39] [SPEAKER_04]: Or how could the 3D printing in the clinic or AI

[00:08:43] [SPEAKER_04]: to better read imaging exams that would improve their efficiencies

[00:08:47] [SPEAKER_04]: but also improve their time face to face with their patients?

[00:08:50] [SPEAKER_04]: So lots of opportunities.

[00:08:52] [SPEAKER_04]: And again, a lot of it, as you mentioned, isn't about the technology.

[00:08:54] [SPEAKER_03]: That's right.

[00:08:55] [SPEAKER_03]: If you look at the facts, one or two adult Americans have periodological disease.

[00:08:59] [SPEAKER_03]: That's chronic inflammatory disease over the age of 65, 70 percent

[00:09:03] [SPEAKER_03]: chronic inflammatory disease.

[00:09:05] [SPEAKER_03]: And there's 58 systemic inflammatory disease

[00:09:07] [SPEAKER_03]: that now connects to inflammation, chronic inflammation in the mouth.

[00:09:12] [SPEAKER_03]: So when we think about these data points deeply

[00:09:15] [SPEAKER_03]: and what we think about in dentistry is that the hygiene room

[00:09:20] [SPEAKER_03]: because of some new innovation that's living in dentistry

[00:09:23] [SPEAKER_03]: becomes the innovation center connecting the dots of dentistry and medicine

[00:09:27] [SPEAKER_03]: through sensors, through genomics.

[00:09:30] [SPEAKER_03]: There's some very exciting young companies coming up

[00:09:33] [SPEAKER_03]: that are using all of the health care innovation

[00:09:36] [SPEAKER_03]: research and science and all of the great

[00:09:39] [SPEAKER_03]: genomics that's happening with our understanding and moving it into dentistry.

[00:09:44] [SPEAKER_03]: And because we know how long adoption takes in medicine, right?

[00:09:48] [SPEAKER_03]: Over 17 years, well, it's worse than dentistry

[00:09:49] [SPEAKER_03]: because it is still a fragmented industry.

[00:09:53] [SPEAKER_03]: The DSO is a coming organizing dentistry,

[00:09:55] [SPEAKER_03]: but they're still only about 18 to 20 percent, which is pretty good growth.

[00:10:00] [SPEAKER_03]: But still we're dealing with fragmented dental business models

[00:10:04] [SPEAKER_03]: of the dentist being the leader.

[00:10:06] [SPEAKER_03]: And it's difficult for them to get out of their same old way

[00:10:11] [SPEAKER_03]: and adopting these new innovations, not dissimilar to the cardiologists

[00:10:16] [SPEAKER_03]: in the United States that are still using the Framingham study

[00:10:18] [SPEAKER_03]: as a basis for their knowledge of cardiology.

[00:10:21] [SPEAKER_03]: Right? So it's these biases that everybody has.

[00:10:25] [SPEAKER_03]: We have to break down those walls between dentistry and medicine

[00:10:28] [SPEAKER_03]: and start really shaking it up a little bit.

[00:10:30] [SPEAKER_03]: And people like yourself, Daniel, please comment on that

[00:10:33] [SPEAKER_03]: because that's exactly what you folks are doing there

[00:10:35] [SPEAKER_03]: at X-Ban actual.

[00:10:36] [SPEAKER_04]: X-Ban actual is a known X-Ban health.

[00:10:38] [SPEAKER_04]: It's a bit about reshaping our perspective

[00:10:40] [SPEAKER_04]: then looking at when the X-Ban actual data

[00:10:42] [SPEAKER_04]: might be data back your mouth and your microbiome

[00:10:45] [SPEAKER_04]: to the size of your teeth to voices of biomarker.

[00:10:48] [SPEAKER_04]: But as you mentioned, the Framingham trial is a great example.

[00:10:50] [SPEAKER_04]: It was still not going trial,

[00:10:52] [SPEAKER_04]: but based on mostly a Caucasian population in Western Massachusetts,

[00:10:55] [SPEAKER_04]: I think most of them were nurses at the start.

[00:10:56] [SPEAKER_04]: That's not representative of our population in the US around the world.

[00:11:01] [SPEAKER_04]: The National Institute of Health and others

[00:11:03] [SPEAKER_04]: have now run this are ongoing with this all of us trial,

[00:11:06] [SPEAKER_04]: which you can still join as a data donor.

[00:11:08] [SPEAKER_04]: I that will help drive the insights

[00:11:10] [SPEAKER_04]: build different precision personalized guidelines for you

[00:11:12] [SPEAKER_04]: rather than the person who grew up in framing

[00:11:15] [SPEAKER_04]: certain social and physical construct.

[00:11:17] [SPEAKER_04]: I think going back to the oral health care space,

[00:11:20] [SPEAKER_04]: not all mouse and risk factors are the same.

[00:11:23] [SPEAKER_04]: I'm lucky to have maybe had one carry in my entire life.

[00:11:26] [SPEAKER_04]: Might have been help from my genetics with fact that my mom

[00:11:28] [SPEAKER_04]: tells me she took a fluoride tablet

[00:11:31] [SPEAKER_04]: when I was in utero in London.

[00:11:32] [SPEAKER_04]: So many factors involved and the rest of the medicine and health care.

[00:11:35] [SPEAKER_04]: It shouldn't be one science fits all in terms of prevention,

[00:11:38] [SPEAKER_04]: diagnostics and therapy.

[00:11:39] [SPEAKER_00]: Yeah, we like that example about a fluoride in the drinking water a lot

[00:11:43] [SPEAKER_00]: because it's a great way to show that you don't need tech

[00:11:46] [SPEAKER_00]: innovation to impact the lives of many.

[00:11:49] [SPEAKER_03]: But also the concept of access to care

[00:11:52] [SPEAKER_03]: that we're dancing around here

[00:11:54] [SPEAKER_03]: because fluoride did have this huge impact on the general population.

[00:11:58] [SPEAKER_03]: And I think some of the challenge that we have is how do we take

[00:12:03] [SPEAKER_03]: some of this new innovation, new science, new research,

[00:12:05] [SPEAKER_03]: whether it's genomics, whether it's airway and understanding

[00:12:10] [SPEAKER_03]: deep sleep and sleep and the impact on our systemic health?

[00:12:14] [SPEAKER_03]: How do we democratize that?

[00:12:15] [SPEAKER_03]: How do we bring that out?

[00:12:16] [SPEAKER_03]: And sleep is an airways is huge issue.

[00:12:19] [SPEAKER_03]: Not issue, but a fantastic diagnostics that the dentist

[00:12:23] [SPEAKER_03]: and the physicians have to work closely together

[00:12:26] [SPEAKER_03]: to get the proper solutions past some of the new

[00:12:30] [SPEAKER_03]: the existing solutions that aren't so wonderful

[00:12:32] [SPEAKER_03]: being driven by insurance companies.

[00:12:34] [SPEAKER_03]: These are the type of things that by working together

[00:12:36] [SPEAKER_03]: we can democratize what we do in health care

[00:12:38] [SPEAKER_03]: because of the opportunity for people who go to the dentist

[00:12:42] [SPEAKER_03]: more than they go to physicians.

[00:12:44] [SPEAKER_03]: So the hygiene room can become an innovation center

[00:12:47] [SPEAKER_03]: that connects information and data and real usable data

[00:12:52] [SPEAKER_03]: that's being shown by sensors and trackers in going up to areas

[00:12:56] [SPEAKER_03]: where we can communicate to the physicians and back to the dentist.

[00:13:00] [SPEAKER_00]: What do you think, Daniel?

[00:13:01] [SPEAKER_04]: When I do data is great when this data age

[00:13:04] [SPEAKER_04]: and data is in new oil, etc.

[00:13:06] [SPEAKER_04]: But it's not about more data.

[00:13:08] [SPEAKER_04]: In fact, many clinicians don't want the data or don't want to log

[00:13:10] [SPEAKER_04]: into your or ring or Fitbit or 23 me data or EMR of different siloed

[00:13:16] [SPEAKER_04]: segment. I think an opportunity for there to the dentist chair,

[00:13:19] [SPEAKER_04]: which some people try to avoid, is that could become a bit of a check

[00:13:24] [SPEAKER_04]: in for all sorts of health.

[00:13:25] [SPEAKER_04]: You may have heard in the African American population,

[00:13:27] [SPEAKER_04]: the barbershop study where they use the barbershop

[00:13:30] [SPEAKER_04]: where everyone goes every month or so for their cut as a place

[00:13:33] [SPEAKER_04]: to screen African American men for hypertension and identify

[00:13:36] [SPEAKER_04]: folks early and then be preventative of heart attacks, strokes,

[00:13:39] [SPEAKER_04]: renal disease.

[00:13:40] [SPEAKER_04]: Why not use the dental chairs?

[00:13:41] [SPEAKER_04]: A similar check in now that you can put on maybe a fancy

[00:13:44] [SPEAKER_04]: version of a wearable that can do a screen of everything

[00:13:47] [SPEAKER_04]: from blood pressure to a rhythm as maybe other point of care.

[00:13:52] [SPEAKER_04]: Lab elements could be done there, whether it's even globally

[00:13:54] [SPEAKER_04]: when you see your cholesterol.

[00:13:56] [SPEAKER_04]: In part of that, maybe we're going to move to this more

[00:13:59] [SPEAKER_04]: things called omnichannel care, right?

[00:14:01] [SPEAKER_04]: Where your care is integrated with your pharmacist and your

[00:14:04] [SPEAKER_04]: payer and your dentist and your primary care, your specialist.

[00:14:07] [SPEAKER_04]: So that the data can flow and be made actionable.

[00:14:11] [SPEAKER_04]: And this idea of crowdsourcing that knowledge, kind of building

[00:14:14] [SPEAKER_04]: I always call it the Google Maps or Ways at Health,

[00:14:16] [SPEAKER_04]: where the information applied to you or your patient is really

[00:14:20] [SPEAKER_04]: representative of where they are on their healthcare journey

[00:14:23] [SPEAKER_04]: and not just built on the one size fits all guidelines of

[00:14:26] [SPEAKER_04]: framing him or others.

[00:14:28] [SPEAKER_03]: So our listeners, that is such an important point.

[00:14:31] [SPEAKER_03]: And we got to where we needed to get to, which is actionable

[00:14:34] [SPEAKER_03]: data that the industries in its really transdisciplinary

[00:14:39] [SPEAKER_03]: is physician and stead is working together to improve

[00:14:42] [SPEAKER_03]: the lives of people, whether it's the microbiome of the

[00:14:45] [SPEAKER_03]: mouth that's causing inflammation and systemic

[00:14:48] [SPEAKER_03]: and flamm diseases, whether it's the ability to get into

[00:14:51] [SPEAKER_03]: deep sleep and airway and understanding those conversations

[00:14:53] [SPEAKER_03]: that all of the new research that's emerging.

[00:14:56] [SPEAKER_03]: So that is a great point.

[00:14:58] [SPEAKER_04]: One point that connects the dots there.

[00:15:00] [SPEAKER_04]: You mentioned the oral microbiome.

[00:15:01] [SPEAKER_04]: I tried at the Bristol platform and my oral microbiome

[00:15:04] [SPEAKER_04]: wasn't great.

[00:15:04] [SPEAKER_04]: I've done it once.

[00:15:05] [SPEAKER_04]: I now do see that I've got my teeth cleaned in my

[00:15:07] [SPEAKER_04]: better oral hygiene with that improved.

[00:15:10] [SPEAKER_04]: But to make sure folks are aware, it's also a health

[00:15:12] [SPEAKER_04]: care education that when you have information in your

[00:15:14] [SPEAKER_04]: mouth and gingival disease, et cetera, it gives you a

[00:15:17] [SPEAKER_04]: significantly higher risk for cardiovascular disease or

[00:15:19] [SPEAKER_04]: now the connection between was it P.

[00:15:21] [SPEAKER_04]: Ginger Valley and the neurologic issues.

[00:15:24] [SPEAKER_04]: And maybe there's even opportunities to making this

[00:15:26] [SPEAKER_04]: off reboot the mouth microbiome.

[00:15:28] [SPEAKER_04]: We've had now in the era of fecal transplants for

[00:15:30] [SPEAKER_04]: things like C.

[00:15:31] [SPEAKER_04]: difficile infections or potentially rebooting the

[00:15:33] [SPEAKER_04]: gut microbiome first things like C.

[00:15:35] [SPEAKER_04]: diff and obesity.

[00:15:36] [SPEAKER_04]: But could there be an oral microbiome preventative

[00:15:40] [SPEAKER_04]: or therapeutic platform too?

[00:15:41] [SPEAKER_04]: And then back to the early proviso, how do you

[00:15:44] [SPEAKER_04]: align the incentives?

[00:15:45] [SPEAKER_04]: Because most of medical care and dental care is driven

[00:15:47] [SPEAKER_04]: by fee for service and doing more to the

[00:15:50] [SPEAKER_04]: interactions or procedures and not being paid to

[00:15:51] [SPEAKER_04]: keep people proactively healthy.

[00:15:53] [SPEAKER_03]: That's exactly right.

[00:15:54] [SPEAKER_03]: But the science and the research now that we

[00:15:56] [SPEAKER_03]: understand that the mouth actually seeds the gut

[00:16:00] [SPEAKER_03]: and those microbiome, the organisms aren't killed

[00:16:04] [SPEAKER_03]: it in the stomach and one out of three hit the

[00:16:06] [SPEAKER_03]: gut and there's a connection between the inflammation

[00:16:08] [SPEAKER_03]: in the mouth and leaky gut.

[00:16:10] [SPEAKER_03]: Finishing up a book on oral systemic medicine and

[00:16:12] [SPEAKER_03]: it's really this leaky mouth that imposes on these

[00:16:16] [SPEAKER_03]: other areas started with 20 years ago with Moisey

[00:16:19] [SPEAKER_03]: Devereaux studies on the crowded artery and

[00:16:21] [SPEAKER_03]: P.

[00:16:21] [SPEAKER_03]: gingivalis to your point.

[00:16:23] [SPEAKER_03]: But by work, by working together and I thought

[00:16:26] [SPEAKER_03]: you made it makes such a great point as basic

[00:16:28] [SPEAKER_03]: as A1C for diabetes and hypertension and

[00:16:31] [SPEAKER_03]: blood pressure, the dental office in the

[00:16:34] [SPEAKER_03]: hygiene room starts connecting.

[00:16:36] [SPEAKER_03]: And then it's just technology that allows

[00:16:38] [SPEAKER_03]: these connected this connected information to

[00:16:41] [SPEAKER_03]: be actionable to your point.

[00:16:43] [SPEAKER_03]: If we started there and we can get more

[00:16:46] [SPEAKER_03]: preventative and can you just talk a little

[00:16:48] [SPEAKER_03]: bit about the wellness model versus this

[00:16:50] [SPEAKER_03]: reactive model of medicine that puts our

[00:16:54] [SPEAKER_03]: health care at almost 20 percent of our GDP.

[00:16:57] [SPEAKER_03]: Is there a way that we can be more efficient

[00:16:59] [SPEAKER_03]: as a business model by working?

[00:17:02] [SPEAKER_04]: I think as they all know, our trajectory

[00:17:04] [SPEAKER_04]: of healthcare spending in the US and

[00:17:05] [SPEAKER_04]: most Western countries is getting unsustainable.

[00:17:07] [SPEAKER_04]: We're at 18, 19 plus percent of our GDP.

[00:17:10] [SPEAKER_04]: Covid certainly impacted that was lots of long

[00:17:12] [SPEAKER_04]: covid elements as well.

[00:17:13] [SPEAKER_04]: But we know that if you spend more time

[00:17:15] [SPEAKER_04]: money on proactive prevention that will

[00:17:17] [SPEAKER_04]: ever great.

[00:17:18] [SPEAKER_04]: Our tax strokes, cancers, mental health

[00:17:20] [SPEAKER_04]: elements, etc.

[00:17:21] [SPEAKER_04]: Oral disease.

[00:17:22] [SPEAKER_04]: So I think there's a picture opportunity

[00:17:24] [SPEAKER_04]: with technology and beyond to look at the

[00:17:27] [SPEAKER_04]: proactive preventative side precision

[00:17:29] [SPEAKER_04]: wellness and attendance.

[00:17:30] [SPEAKER_04]: We'll have it next mid health this

[00:17:32] [SPEAKER_04]: March.

[00:17:32] [SPEAKER_04]: Lee Roy Hood is a real father of

[00:17:35] [SPEAKER_04]: omics, but also this idea of precision

[00:17:37] [SPEAKER_04]: wellness and other collect phenomics.

[00:17:39] [SPEAKER_04]: Right.

[00:17:39] [SPEAKER_04]: There's no one day to feed that's the only

[00:17:40] [SPEAKER_04]: important piece your genome or your labs,

[00:17:43] [SPEAKER_04]: your blood pressure.

[00:17:43] [SPEAKER_04]: And it's also your social constructs

[00:17:45] [SPEAKER_04]: and your financial health and your

[00:17:47] [SPEAKER_04]: sexual health and all these other pieces

[00:17:49] [SPEAKER_04]: that are measurable or getting

[00:17:51] [SPEAKER_04]: measurable.

[00:17:51] [SPEAKER_04]: And then we start to create the models

[00:17:53] [SPEAKER_04]: that often call the digital twin to

[00:17:55] [SPEAKER_04]: help optimize your health journey

[00:17:57] [SPEAKER_04]: for preventively better diagnostics

[00:18:00] [SPEAKER_04]: and then tying the right therapy to

[00:18:01] [SPEAKER_04]: the individual, whether that's a

[00:18:02] [SPEAKER_04]: digital therapeutic like an app or a

[00:18:04] [SPEAKER_04]: gene therapy or changing the microbiome

[00:18:07] [SPEAKER_04]: of your mouth or maybe picking the

[00:18:08] [SPEAKER_04]: right toothbrush or platform to

[00:18:10] [SPEAKER_04]: keep you on top and connecting the

[00:18:12] [SPEAKER_04]: dots with all these new digital other

[00:18:14] [SPEAKER_04]: platforms that can integrate care

[00:18:16] [SPEAKER_04]: anytime anywhere.

[00:18:18] [SPEAKER_04]: So in the future.

[00:18:19] [SPEAKER_00]: And if we go back to the point

[00:18:21] [SPEAKER_00]: around key to improving access

[00:18:24] [SPEAKER_00]: to care is actually only channel

[00:18:26] [SPEAKER_00]: care and not only talking about

[00:18:28] [SPEAKER_00]: the difference between the bedside

[00:18:30] [SPEAKER_00]: or the website of care, but

[00:18:33] [SPEAKER_00]: actually taking care outside of

[00:18:35] [SPEAKER_00]: clinical setting, right?

[00:18:36] [SPEAKER_00]: Taking care into the barber shop

[00:18:38] [SPEAKER_00]: or into the community or to the

[00:18:39] [SPEAKER_00]: schools.

[00:18:41] [SPEAKER_00]: And in that sense, we have to think

[00:18:44] [SPEAKER_00]: about that behavior change of care,

[00:18:47] [SPEAKER_00]: not necessarily something that you

[00:18:49] [SPEAKER_00]: get done once a year when you go

[00:18:51] [SPEAKER_00]: to your annual physical, but

[00:18:54] [SPEAKER_00]: self-care that you get done

[00:18:56] [SPEAKER_00]: when you're in school, when

[00:18:59] [SPEAKER_00]: you're shopping because it starts

[00:19:01] [SPEAKER_00]: with the food and the grocery bill

[00:19:03] [SPEAKER_00]: that you get when you go grocery

[00:19:05] [SPEAKER_00]: shopping. It's a lifestyle.

[00:19:07] [SPEAKER_00]: And so when you think about that

[00:19:08] [SPEAKER_00]: integrated view of health

[00:19:11] [SPEAKER_00]: and self-care rather than

[00:19:13] [SPEAKER_00]: health care, then in that

[00:19:15] [SPEAKER_00]: view, what is maybe

[00:19:18] [SPEAKER_00]: to make this a little bit more

[00:19:19] [SPEAKER_00]: pragmatic, right?

[00:19:20] [SPEAKER_00]: Let's make this very real.

[00:19:21] [SPEAKER_00]: What would you like to see

[00:19:23] [SPEAKER_00]: change from a patient side?

[00:19:26] [SPEAKER_00]: Right? What do we want to do

[00:19:28] [SPEAKER_00]: differently in the next one or two

[00:19:30] [SPEAKER_00]: years as patients that would add to

[00:19:33] [SPEAKER_00]: that behavior change over the long

[00:19:36] [SPEAKER_00]: period of time?

[00:19:37] [SPEAKER_00]: And what we might want to do

[00:19:38] [SPEAKER_00]: differently if you are a PCP

[00:19:40] [SPEAKER_00]: or if you're a dentist or

[00:19:43] [SPEAKER_00]: hygienist, or if you're actually

[00:19:44] [SPEAKER_00]: designing a health benefits plan

[00:19:46] [SPEAKER_00]: for your employees as an employer.

[00:19:50] [SPEAKER_00]: So let's just go around a little

[00:19:52] [SPEAKER_00]: bit the different stakeholders

[00:19:53] [SPEAKER_00]: and try and make this real.

[00:19:55] [SPEAKER_00]: In what can we impact in a year

[00:19:57] [SPEAKER_00]: or two?

[00:19:58] [SPEAKER_04]: Part of it goes back to help

[00:20:00] [SPEAKER_04]: education, particularly getting

[00:20:01] [SPEAKER_04]: while they're young.

[00:20:02] [SPEAKER_04]: I trained in pediatrics as well.

[00:20:04] [SPEAKER_04]: And we know that the first few

[00:20:05] [SPEAKER_04]: years of life zero to three.

[00:20:07] [SPEAKER_04]: And maybe when you have your

[00:20:08] [SPEAKER_04]: first teeth and maybe a teenager

[00:20:09] [SPEAKER_04]: plays such a role in let's say

[00:20:11] [SPEAKER_04]: your oral health, but also

[00:20:13] [SPEAKER_04]: all these other elements.

[00:20:14] [SPEAKER_04]: So they come back to

[00:20:16] [SPEAKER_04]: education, whether you're in

[00:20:17] [SPEAKER_04]: the dental chair or your

[00:20:18] [SPEAKER_04]: primary care doc or school

[00:20:20] [SPEAKER_04]: education and getting folks

[00:20:21] [SPEAKER_04]: more engaged.

[00:20:22] [SPEAKER_04]: This idea of the new drug is

[00:20:24] [SPEAKER_04]: the empowered and engaged patient

[00:20:25] [SPEAKER_04]: who might be able to look

[00:20:26] [SPEAKER_04]: at their base genome data

[00:20:28] [SPEAKER_04]: and know the risk for certain

[00:20:30] [SPEAKER_04]: diseases or be able to look at

[00:20:31] [SPEAKER_04]: their inflammation markers,

[00:20:32] [SPEAKER_04]: whether it's C reactive protein

[00:20:34] [SPEAKER_04]: or others, or now use some of

[00:20:36] [SPEAKER_04]: these digital tools to do

[00:20:37] [SPEAKER_04]: their own oral screening or

[00:20:38] [SPEAKER_04]: connect to dental care.

[00:20:40] [SPEAKER_04]: So part of it is the education

[00:20:42] [SPEAKER_04]: but the empowerment and back

[00:20:43] [SPEAKER_04]: to the data piece being able

[00:20:44] [SPEAKER_04]: to see that in an integrated

[00:20:45] [SPEAKER_04]: way that matches you.

[00:20:46] [SPEAKER_04]: This idea of precision

[00:20:47] [SPEAKER_04]: engagement or precision

[00:20:49] [SPEAKER_04]: digital health where it speaks

[00:20:50] [SPEAKER_04]: to you in your language based

[00:20:51] [SPEAKER_04]: on your age, culture, maybe

[00:20:52] [SPEAKER_04]: even religion, educational level

[00:20:54] [SPEAKER_04]: or incentive.

[00:20:55] [SPEAKER_04]: Some people are driven by social

[00:20:57] [SPEAKER_04]: points or application of badges

[00:20:59] [SPEAKER_04]: or they want to get a lower

[00:21:01] [SPEAKER_04]: premium because they've been

[00:21:02] [SPEAKER_04]: brushing and flossing more

[00:21:03] [SPEAKER_04]: regularly. So why should they

[00:21:04] [SPEAKER_04]: pay the higher premium?

[00:21:05] [SPEAKER_04]: So there's so many dots to

[00:21:07] [SPEAKER_04]: connect, but it comes

[00:21:08] [SPEAKER_04]: back to behavior and

[00:21:10] [SPEAKER_04]: culture shifts within the

[00:21:12] [SPEAKER_04]: individual and family unit

[00:21:13] [SPEAKER_04]: as well as in the clinical

[00:21:14] [SPEAKER_04]: realm where putting on the

[00:21:16] [SPEAKER_04]: MD hat, we don't get much

[00:21:17] [SPEAKER_04]: education in the medical realm

[00:21:19] [SPEAKER_04]: I don't recall.

[00:21:20] [SPEAKER_04]: And why should that not be

[00:21:21] [SPEAKER_04]: part of your more part

[00:21:23] [SPEAKER_04]: of your physical exam

[00:21:24] [SPEAKER_04]: or thinking about sleep

[00:21:25] [SPEAKER_04]: at me and the oral pathways

[00:21:29] [SPEAKER_04]: where you're your dentist

[00:21:29] [SPEAKER_04]: or an MD or an practitioner

[00:21:32] [SPEAKER_04]: or a pharmacist

[00:21:33] [SPEAKER_04]: and then potentially thinking

[00:21:35] [SPEAKER_04]: about these new digital layers

[00:21:36] [SPEAKER_04]: to connect and improve care.

[00:21:38] [SPEAKER_04]: I recently launched a

[00:21:39] [SPEAKER_04]: platform called digital.

[00:21:40] [SPEAKER_04]: It's easier to remember

[00:21:41] [SPEAKER_04]: digital.

[00:21:42] [SPEAKER_04]: And I'm looking at the database

[00:21:43] [SPEAKER_04]: now there's a whole bunch

[00:21:44] [SPEAKER_04]: of dental related applications

[00:21:45] [SPEAKER_04]: from tele-dentistry

[00:21:46] [SPEAKER_04]: to mouth watch

[00:21:48] [SPEAKER_04]: intraoral camera AI platforms

[00:21:50] [SPEAKER_04]: that will help the dentist

[00:21:51] [SPEAKER_04]: look at your your

[00:21:52] [SPEAKER_04]: and not miss a carry to

[00:21:53] [SPEAKER_04]: health management platforms.

[00:21:56] [SPEAKER_04]: Tons of stuff is coming in

[00:21:57] [SPEAKER_04]: space.

[00:21:57] [SPEAKER_04]: The trick is finding them

[00:21:59] [SPEAKER_04]: and as a clinician,

[00:22:00] [SPEAKER_04]: being able to maybe even

[00:22:01] [SPEAKER_04]: prescribe them to your patients.

[00:22:03] [SPEAKER_04]: So if you're a benefits manager,

[00:22:04] [SPEAKER_04]: should you make some of these

[00:22:06] [SPEAKER_04]: virtual care platforms

[00:22:07] [SPEAKER_04]: home, dentistry, kids,

[00:22:08] [SPEAKER_04]: telehealth elements paid for

[00:22:10] [SPEAKER_04]: and again align the incentives

[00:22:11] [SPEAKER_04]: for the care continuum?

[00:22:13] [SPEAKER_00]: I do want to make a highlight

[00:22:15] [SPEAKER_00]: where you just said

[00:22:15] [SPEAKER_00]: because there's a myth out there

[00:22:17] [SPEAKER_00]: that in order for us

[00:22:18] [SPEAKER_00]: to integrate care better

[00:22:20] [SPEAKER_00]: we need more data.

[00:22:21] [SPEAKER_00]: We may need petabytes of data.

[00:22:24] [SPEAKER_00]: And the reality is that more data

[00:22:25] [SPEAKER_00]: is not always a good thing.

[00:22:27] [SPEAKER_00]: It's not always the answer.

[00:22:28] [SPEAKER_00]: We need more contextualized

[00:22:30] [SPEAKER_00]: data in context,

[00:22:32] [SPEAKER_00]: data that could be actioned

[00:22:33] [SPEAKER_00]: into insights and data

[00:22:35] [SPEAKER_00]: that could move forward

[00:22:36] [SPEAKER_00]: the treatment or the access

[00:22:38] [SPEAKER_00]: of the care.

[00:22:39] [SPEAKER_00]: It's the difference

[00:22:39] [SPEAKER_00]: and there's no shortage

[00:22:40] [SPEAKER_00]: of data and that no shortage

[00:22:42] [SPEAKER_00]: of tools as digital health

[00:22:44] [SPEAKER_00]: could summarize these

[00:22:45] [SPEAKER_00]: and you did list quite a few

[00:22:47] [SPEAKER_00]: of those vetted,

[00:22:49] [SPEAKER_00]: validated technologies

[00:22:50] [SPEAKER_00]: that are already being used

[00:22:52] [SPEAKER_00]: in the dental space.

[00:22:54] [SPEAKER_00]: So myth number one,

[00:22:55] [SPEAKER_00]: let's make sure we're dispersing

[00:22:56] [SPEAKER_00]: that there's no shortage of tools.

[00:22:58] [SPEAKER_00]: There's no shortage of data.

[00:22:59] [SPEAKER_00]: There is gap in the clinician

[00:23:03] [SPEAKER_00]: in the hygienist or the dentist's

[00:23:05] [SPEAKER_00]: ability and the hours of the day

[00:23:07] [SPEAKER_00]: for them to stay on top of it

[00:23:08] [SPEAKER_00]: and to be able to coordinate

[00:23:10] [SPEAKER_00]: the workflows and the integration

[00:23:12] [SPEAKER_00]: across different systems

[00:23:13] [SPEAKER_00]: to talk to each other.

[00:23:15] [SPEAKER_03]: Maria, let me jump in one thing

[00:23:17] [SPEAKER_03]: but I want one thing

[00:23:18] [SPEAKER_03]: that I would add to what Daniel

[00:23:19] [SPEAKER_03]: was talking about is the

[00:23:20] [SPEAKER_03]: necessary roadways for communication.

[00:23:23] [SPEAKER_03]: So if we're really looking

[00:23:24] [SPEAKER_03]: at actionable data

[00:23:26] [SPEAKER_03]: as Daniel was talking about,

[00:23:28] [SPEAKER_03]: how do we take that data

[00:23:29] [SPEAKER_03]: and then put it in a place

[00:23:31] [SPEAKER_03]: like the cloud

[00:23:32] [SPEAKER_03]: and share it with our medical colleagues

[00:23:34] [SPEAKER_03]: and just the most basic thing

[00:23:36] [SPEAKER_03]: whether it was inflammatory

[00:23:37] [SPEAKER_03]: mercury, reactive protein

[00:23:38] [SPEAKER_03]: into lube,

[00:23:39] [SPEAKER_03]: which whichever ones

[00:23:40] [SPEAKER_03]: that could pre eat

[00:23:41] [SPEAKER_03]: and say there's potentially

[00:23:43] [SPEAKER_03]: cardiovascular event

[00:23:44] [SPEAKER_03]: coming down the road.

[00:23:45] [SPEAKER_03]: Just what's happening

[00:23:46] [SPEAKER_03]: with these other new technologies

[00:23:48] [SPEAKER_03]: that's looking at retinal scans

[00:23:49] [SPEAKER_03]: and all these other data points

[00:23:51] [SPEAKER_03]: that are coming in

[00:23:52] [SPEAKER_03]: from our breakthrough technologies.

[00:23:55] [SPEAKER_03]: saliva, we believe

[00:23:56] [SPEAKER_03]: is really the new blood diagnostics

[00:23:58] [SPEAKER_03]: and we know it's very well

[00:23:59] [SPEAKER_03]: from COVID-19.

[00:24:01] [SPEAKER_03]: We know that people with

[00:24:02] [SPEAKER_03]: periodontal disease

[00:24:02] [SPEAKER_03]: had three times greater chance

[00:24:04] [SPEAKER_03]: of ending up on a ventilator

[00:24:06] [SPEAKER_03]: and because of course

[00:24:07] [SPEAKER_03]: the cytokine storm.

[00:24:08] [SPEAKER_03]: So the importance

[00:24:09] [SPEAKER_03]: of what's possible

[00:24:11] [SPEAKER_03]: with some of this data,

[00:24:13] [SPEAKER_03]: Maria, to your point

[00:24:14] [SPEAKER_03]: and what are we doing with it?

[00:24:16] [SPEAKER_03]: There's a universal health record

[00:24:17] [SPEAKER_03]: in medicine

[00:24:18] [SPEAKER_03]: and because of Apple watches

[00:24:20] [SPEAKER_03]: and working with health care systems.

[00:24:22] [SPEAKER_03]: Let's bring the dental teams in on that.

[00:24:24] [SPEAKER_00]: Yeah, I wouldn't go as far

[00:24:24] [SPEAKER_00]: as we've achieved

[00:24:25] [SPEAKER_00]: the universal health record

[00:24:27] [SPEAKER_00]: in medicine just yet.

[00:24:28] [SPEAKER_00]: I think there's a bit of inspiration

[00:24:30] [SPEAKER_00]: there rather than the cottage industry

[00:24:32] [SPEAKER_00]: of different electronic records

[00:24:34] [SPEAKER_00]: and each DSO in the dental space.

[00:24:37] [SPEAKER_00]: Daniel, you just came back from Israel

[00:24:39] [SPEAKER_00]: and you had a great visit

[00:24:40] [SPEAKER_00]: with Khaled and Ron Ballasio

[00:24:43] [SPEAKER_00]: the chief innovation officer

[00:24:44] [SPEAKER_00]: of Israel's largest health care organization.

[00:24:47] [SPEAKER_00]: Anything we could learn

[00:24:49] [SPEAKER_00]: from other countries

[00:24:51] [SPEAKER_00]: who have probably

[00:24:52] [SPEAKER_00]: were a little bit further advanced

[00:24:54] [SPEAKER_00]: in integrated care

[00:24:55] [SPEAKER_00]: and other systems,

[00:24:56] [SPEAKER_00]: obviously with the limitations

[00:24:57] [SPEAKER_00]: and the differences

[00:25:00] [SPEAKER_00]: of incentive structures, right?

[00:25:01] [SPEAKER_00]: If you have a national health system,

[00:25:04] [SPEAKER_00]: be it the NHS

[00:25:04] [SPEAKER_00]: or as I said,

[00:25:05] [SPEAKER_00]: lessons from other countries.

[00:25:07] [SPEAKER_00]: What comes to mind?

[00:25:08] [SPEAKER_04]: I was visiting in Tel Aviv,

[00:25:10] [SPEAKER_04]: Ron Ballasio

[00:25:10] [SPEAKER_04]: who is the head of innovation for Khaled,

[00:25:12] [SPEAKER_04]: the largest sort of healthcare system

[00:25:13] [SPEAKER_04]: in Israel.

[00:25:15] [SPEAKER_04]: And they have a tremendous amount of data

[00:25:16] [SPEAKER_04]: and they were able to leverage that network

[00:25:18] [SPEAKER_04]: really importantly

[00:25:18] [SPEAKER_04]: to look at the rollout of

[00:25:21] [SPEAKER_04]: the Pfizer mRNA vaccine

[00:25:22] [SPEAKER_04]: and demonstrates efficacy

[00:25:24] [SPEAKER_04]: and safety and boosters

[00:25:25] [SPEAKER_04]: and that drove

[00:25:26] [SPEAKER_04]: not just vaccines in Israel

[00:25:27] [SPEAKER_04]: but the evidence base

[00:25:29] [SPEAKER_04]: to roll those out around the world.

[00:25:31] [SPEAKER_04]: So sometimes having a nimble

[00:25:33] [SPEAKER_04]: data rich platform

[00:25:35] [SPEAKER_04]: with an engaged population

[00:25:36] [SPEAKER_04]: is super powerful.

[00:25:37] [SPEAKER_04]: It's something that often doesn't have

[00:25:38] [SPEAKER_04]: in the US with many

[00:25:39] [SPEAKER_04]: scattered quote unquote health care systems

[00:25:41] [SPEAKER_04]: and data that siloed

[00:25:42] [SPEAKER_04]: and very challenging to move around.

[00:25:44] [SPEAKER_04]: So there's just lessons to learn

[00:25:46] [SPEAKER_04]: from startup nation and beyond.

[00:25:48] [SPEAKER_04]: I think it is back to this idea

[00:25:50] [SPEAKER_04]: of often the four P's

[00:25:51] [SPEAKER_04]: proactive, preventative, participatory

[00:25:53] [SPEAKER_04]: what's the other B?

[00:25:54] [SPEAKER_00]: Personalized.

[00:25:55] [SPEAKER_04]: Personalized, right?

[00:25:56] [SPEAKER_04]: That is what Clal-E

[00:25:57] [SPEAKER_04]: and some other systems

[00:25:58] [SPEAKER_04]: are trying to really bring to reality

[00:26:00] [SPEAKER_04]: and it ties often back

[00:26:02] [SPEAKER_04]: to the word we've heard a couple times here

[00:26:03] [SPEAKER_04]: which is workload.

[00:26:04] [SPEAKER_04]: For many clinicians

[00:26:05] [SPEAKER_04]: we are still working with

[00:26:07] [SPEAKER_04]: Epic fail, pun intended EMR systems.

[00:26:09] [SPEAKER_04]: I'm not sure about the dental EMRs

[00:26:11] [SPEAKER_04]: but they don't often seem

[00:26:12] [SPEAKER_04]: that much more user friendly.

[00:26:14] [SPEAKER_04]: Even when I had my oral hygiene cleaning

[00:26:17] [SPEAKER_04]: a month ago in Silicon Valley

[00:26:19] [SPEAKER_04]: it was a mix of phone calls

[00:26:20] [SPEAKER_04]: and finally I got into tech system

[00:26:22] [SPEAKER_04]: and actually this type of integrated

[00:26:24] [SPEAKER_04]: in my Google calendar.

[00:26:26] [SPEAKER_04]: Like wow, this is much better

[00:26:27] [SPEAKER_04]: than used to be playing voicemail tag.

[00:26:29] [SPEAKER_04]: So I think there's the potential

[00:26:31] [SPEAKER_04]: to learn from other systems

[00:26:32] [SPEAKER_04]: particularly maybe the importance of

[00:26:34] [SPEAKER_04]: in some socialized systems

[00:26:35] [SPEAKER_04]: about rewarding and paying for oil care

[00:26:37] [SPEAKER_04]: which again downstream

[00:26:39] [SPEAKER_04]: aligns the incentives.

[00:26:41] [SPEAKER_04]: In the US many healthcare plans

[00:26:43] [SPEAKER_04]: don't really care about

[00:26:44] [SPEAKER_04]: how your health is 20 years later

[00:26:45] [SPEAKER_04]: so they're not going to invest in it

[00:26:46] [SPEAKER_04]: because they figure you're going to change

[00:26:48] [SPEAKER_04]: insurance companies every

[00:26:48] [SPEAKER_04]: nine months to three years.

[00:26:51] [SPEAKER_04]: So we need to realize that all boats

[00:26:52] [SPEAKER_04]: float up and

[00:26:54] [SPEAKER_04]: include oral care with our healthcare

[00:26:57] [SPEAKER_04]: and connect some of those data dots

[00:26:58] [SPEAKER_04]: and workflow so that

[00:27:00] [SPEAKER_04]: when you show up in the primary care visit

[00:27:01] [SPEAKER_04]: or your dental visit

[00:27:02] [SPEAKER_04]: maybe some of those

[00:27:03] [SPEAKER_04]: dots connect between your medical record

[00:27:05] [SPEAKER_04]: and your dental

[00:27:06] [SPEAKER_04]: that your clinician of any sort can

[00:27:08] [SPEAKER_04]: cross fertilizing,

[00:27:09] [SPEAKER_04]: coordinate,

[00:27:10] [SPEAKER_04]: unscreening for sleep apnea

[00:27:11] [SPEAKER_04]: or taking a look at the microbiome

[00:27:13] [SPEAKER_04]: of your mouth or gut

[00:27:14] [SPEAKER_04]: or bring those together

[00:27:15] [SPEAKER_04]: as we build this era

[00:27:16] [SPEAKER_04]: of the proactive

[00:27:17] [SPEAKER_04]: crowdsourced digital twin.

[00:27:19] [SPEAKER_03]: Marie, you heard him say Maria

[00:27:21] [SPEAKER_03]: Yeah, you say it

[00:27:22] [SPEAKER_03]: oral care is part of the solution

[00:27:23] [SPEAKER_03]: and part of the healthcare solution.

[00:27:25] [SPEAKER_03]: Daniel, I've heard you say it.

[00:27:28] [SPEAKER_03]: Listen, this guy just said

[00:27:30] [SPEAKER_03]: the biggest thought later

[00:27:32] [SPEAKER_03]: amazing

[00:27:33] [SPEAKER_03]: and I'm just noting it

[00:27:34] [SPEAKER_03]: with a couple of asterisks.

[00:27:36] [SPEAKER_00]: That's right.

[00:27:36] [SPEAKER_00]: Do you want to connect with Jonathan,

[00:27:39] [SPEAKER_00]: your saying and Daniel

[00:27:40] [SPEAKER_00]: and answer the question I started with

[00:27:42] [SPEAKER_00]: if I'm a patient,

[00:27:44] [SPEAKER_00]: what do we suggest a patient do differently?

[00:27:46] [SPEAKER_00]: And I think what I

[00:27:47] [SPEAKER_00]: what we're all saying is

[00:27:49] [SPEAKER_00]: next time Daniel,

[00:27:50] [SPEAKER_00]: you go to your dentist

[00:27:51] [SPEAKER_00]: for your hygienist cleaning

[00:27:53] [SPEAKER_00]: ask them, talk to them about your sleep.

[00:27:56] [SPEAKER_00]: Talk to them about your stress levels

[00:27:59] [SPEAKER_00]: and your fatigue

[00:28:00] [SPEAKER_00]: and how you're feeling during the day

[00:28:02] [SPEAKER_00]: and see what the dentist could do

[00:28:04] [SPEAKER_00]: in diagnosing and treating

[00:28:06] [SPEAKER_00]: abstractive sleep apnea.

[00:28:07] [SPEAKER_00]: That's the first piece, right?

[00:28:09] [SPEAKER_00]: Engage in a conversation with your dentist

[00:28:11] [SPEAKER_00]: that goes beyond how white your teeth are

[00:28:14] [SPEAKER_00]: or your chipped tooth specifically.

[00:28:17] [SPEAKER_00]: So think about your dentist differently.

[00:28:19] [SPEAKER_00]: Think about them and the hygienist

[00:28:21] [SPEAKER_00]: and the dental team as core part

[00:28:23] [SPEAKER_00]: of your overall care team.

[00:28:25] [SPEAKER_00]: And that's self care,

[00:28:27] [SPEAKER_00]: not self healthcare to be clear.

[00:28:30] [SPEAKER_00]: And I and on the other piece

[00:28:31] [SPEAKER_00]: what I'm hearing is

[00:28:33] [SPEAKER_00]: I do want to underline

[00:28:34] [SPEAKER_00]: this opportunity for benefit leaders

[00:28:37] [SPEAKER_00]: for those who are in decision making roles,

[00:28:40] [SPEAKER_00]: taking care of these

[00:28:41] [SPEAKER_00]: or community of people.

[00:28:43] [SPEAKER_00]: We need to understand

[00:28:44] [SPEAKER_00]: that managing somebody's health

[00:28:47] [SPEAKER_00]: and their productivity,

[00:28:49] [SPEAKER_00]: their wellbeing and wellness

[00:28:51] [SPEAKER_00]: is requires thinking about their oral health

[00:28:54] [SPEAKER_00]: and their overall clinical health,

[00:28:56] [SPEAKER_00]: systemic health

[00:28:57] [SPEAKER_00]: as well as their financial wellbeing

[00:28:58] [SPEAKER_00]: as well as their safety

[00:28:59] [SPEAKER_00]: as well as social drivers of health.

[00:29:02] [SPEAKER_00]: Health is a complex interconnected system.

[00:29:04] [SPEAKER_00]: So the next conversation

[00:29:06] [SPEAKER_00]: about wellbeing and productivity of employees

[00:29:09] [SPEAKER_00]: ask the question of how oral health

[00:29:12] [SPEAKER_00]: is contributing or distracting

[00:29:14] [SPEAKER_00]: from the productivity

[00:29:15] [SPEAKER_00]: and the wellbeing of your employees.

[00:29:17] [SPEAKER_00]: And you might be surprised

[00:29:18] [SPEAKER_00]: that the answer will come from that question.

[00:29:21] [SPEAKER_04]: I wonder how many,

[00:29:22] [SPEAKER_04]: one of what sick days

[00:29:22] [SPEAKER_04]: are when you need to have that root canal

[00:29:24] [SPEAKER_04]: or have that not so pleasant dental visit

[00:29:27] [SPEAKER_04]: or the downstream costs

[00:29:29] [SPEAKER_04]: of cardiovascular events

[00:29:31] [SPEAKER_04]: that could be tied to improving oral care.

[00:29:33] [SPEAKER_04]: That might mean maybe your pair

[00:29:35] [SPEAKER_04]: is going to cover the medical selfie

[00:29:37] [SPEAKER_04]: and the camera,

[00:29:37] [SPEAKER_04]: the exponential power of our cameras

[00:29:39] [SPEAKER_04]: and our smartphones

[00:29:39] [SPEAKER_04]: can help you do your analysis.

[00:29:41] [SPEAKER_04]: Why not take a picture of your mouth

[00:29:42] [SPEAKER_04]: and your teeth and your gums

[00:29:43] [SPEAKER_04]: and give you,

[00:29:44] [SPEAKER_04]: oh, it looks like you're getting gingivitis.

[00:29:45] [SPEAKER_04]: You might need this particular new rinse

[00:29:48] [SPEAKER_04]: or new toothbrush

[00:29:49] [SPEAKER_04]: or get scheduled for your visit.

[00:29:51] [SPEAKER_04]: Maybe that comes through different interfaces

[00:29:52] [SPEAKER_04]: like your Google Home or Amazon Alexa.

[00:29:55] [SPEAKER_04]: Maybe we're now in this world of GPT-3

[00:29:57] [SPEAKER_04]: and generative AI

[00:29:58] [SPEAKER_04]: that they can now write you notes

[00:30:00] [SPEAKER_04]: that are going to talk to you,

[00:30:02] [SPEAKER_04]: Maria, in your native language of Bulgaria

[00:30:03] [SPEAKER_04]: that'll make you take action

[00:30:04] [SPEAKER_04]: that wouldn't make me take action.

[00:30:06] [SPEAKER_04]: And can we get...

[00:30:07] [SPEAKER_00]: That would be the Christmas gift

[00:30:08] [SPEAKER_00]: for my parents then next year.

[00:30:10] [SPEAKER_00]: That really could make that happen.

[00:30:12] [SPEAKER_00]: And more importantly,

[00:30:13] [SPEAKER_00]: I want to take a medical selfie of my smile

[00:30:17] [SPEAKER_00]: and then see the connection

[00:30:19] [SPEAKER_00]: over in the next 10 years

[00:30:21] [SPEAKER_00]: if I don't take care of my gingivitis

[00:30:22] [SPEAKER_00]: or the inflammation in my mouth

[00:30:24] [SPEAKER_00]: to see the implications of my cognitive health

[00:30:28] [SPEAKER_00]: and the cognitive decline

[00:30:29] [SPEAKER_00]: because we know there are clinical studies

[00:30:31] [SPEAKER_00]: that are connecting prevalence of Alzheimer's

[00:30:35] [SPEAKER_00]: and put me at the higher risk of Alzheimer's

[00:30:37] [SPEAKER_00]: if I have untreated periodontal disease.

[00:30:39] [SPEAKER_00]: So these are the connections

[00:30:41] [SPEAKER_00]: that we want to make sure that people are seeing.

[00:30:44] [SPEAKER_00]: So we talk about digital twins and medical selfies.

[00:30:47] [SPEAKER_00]: That's what we want to see as patients,

[00:30:49] [SPEAKER_00]: making things real.

[00:30:50] [SPEAKER_04]: And I remember as a kid having those...

[00:30:53] [SPEAKER_04]: The dentist tried to scare you

[00:30:54] [SPEAKER_04]: and show you pictures of what would happen

[00:30:56] [SPEAKER_04]: to bad cases of people

[00:30:58] [SPEAKER_04]: who hadn't brushed their teeth for months or years.

[00:31:00] [SPEAKER_04]: And you mentioned the study of the medical selfie,

[00:31:02] [SPEAKER_04]: but we can look in the mirror and see are you of the day.

[00:31:04] [SPEAKER_04]: But what if you could see you of tomorrow,

[00:31:06] [SPEAKER_04]: whether that was your oral mouth situation

[00:31:08] [SPEAKER_04]: or how that ties to cardiovascular mental health

[00:31:11] [SPEAKER_04]: or neurologic health?

[00:31:13] [SPEAKER_04]: Now you can personalize that.

[00:31:14] [SPEAKER_04]: You can have the...

[00:31:15] [SPEAKER_04]: Use the snapshot version of a filter

[00:31:16] [SPEAKER_04]: and make you older or healthier

[00:31:19] [SPEAKER_04]: and dial this up if you take care of X, Y, and Z,

[00:31:22] [SPEAKER_04]: working out, eating better oral care.

[00:31:24] [SPEAKER_04]: You'll look vibrant and ex at age 60 or 70

[00:31:27] [SPEAKER_04]: versus this might well look like

[00:31:28] [SPEAKER_04]: if you are your current trajectory.

[00:31:30] [SPEAKER_04]: So I call it kind of looking at your future self

[00:31:32] [SPEAKER_04]: and now augmented virtual reality can play a role

[00:31:35] [SPEAKER_04]: that even in the side, in the dental chair,

[00:31:38] [SPEAKER_04]: some people certainly don't like to have procedures done.

[00:31:40] [SPEAKER_04]: Now you can kick a low-cost, calculus quest

[00:31:42] [SPEAKER_04]: and put it on in the dental chair and be at the beach

[00:31:44] [SPEAKER_04]: and some folks might relax

[00:31:46] [SPEAKER_04]: and be more likely to go visit their dentist

[00:31:49] [SPEAKER_04]: when they might have some aversions otherwise.

[00:31:52] [SPEAKER_03]: And also when you think about where do you start?

[00:31:54] [SPEAKER_03]: I could tell you myself, I'm still practicing.

[00:31:56] [SPEAKER_03]: I'm a prostatoneous, credit bridge dentist

[00:31:58] [SPEAKER_03]: or a multi-special sleep team.

[00:32:00] [SPEAKER_03]: We establish in the hygiene room a healthy mouth baseline.

[00:32:03] [SPEAKER_03]: So we really try to get everybody

[00:32:05] [SPEAKER_03]: to get some basic microbiome testing, CBCT.

[00:32:08] [SPEAKER_03]: We're always looking at airway

[00:32:09] [SPEAKER_03]: and we start asking proactive questions

[00:32:12] [SPEAKER_03]: to see are there sleep disorders?

[00:32:14] [SPEAKER_03]: And I just make this as an example

[00:32:16] [SPEAKER_03]: that the dental profession needs to get elevated.

[00:32:19] [SPEAKER_03]: The medical profession needs to get elevated

[00:32:21] [SPEAKER_03]: and come together

[00:32:22] [SPEAKER_03]: in kind of this good communication pathway to start.

[00:32:26] [SPEAKER_03]: So we have a place to start.

[00:32:27] [SPEAKER_03]: I love the idea of having a sort of oral health baseline

[00:32:30] [SPEAKER_04]: because now there's all these new forms of data

[00:32:32] [SPEAKER_04]: but almost needs to be synthesized into,

[00:32:34] [SPEAKER_04]: I don't know if it's a single score.

[00:32:36] [SPEAKER_04]: Like we have a FICO score for our financial health

[00:32:39] [SPEAKER_04]: and I imagine not being a dental professional

[00:32:41] [SPEAKER_04]: that there could be an integrative score

[00:32:43] [SPEAKER_04]: around everything from your gums

[00:32:45] [SPEAKER_04]: to the health of your enamel to your quality of your breath.

[00:32:49] [SPEAKER_04]: There's now obviously voice as a biomarker

[00:32:51] [SPEAKER_04]: but there's also breath as a biomarker

[00:32:54] [SPEAKER_04]: where you can look at the molecules in your breath

[00:32:55] [SPEAKER_04]: that might be something else that could be screened

[00:32:57] [SPEAKER_04]: in the dental office to look at signs

[00:32:58] [SPEAKER_04]: as creeper lung cancer to metabolic disease.

[00:33:01] [SPEAKER_04]: Again, other things that can be done

[00:33:02] [SPEAKER_04]: from the oral cavity

[00:33:03] [SPEAKER_04]: including the respiratory pathway

[00:33:06] [SPEAKER_04]: that could be integrated into that overall score.

[00:33:08] [SPEAKER_04]: And when you have a score you can gamify

[00:33:10] [SPEAKER_04]: and try and I'm gonna get my tooth brushing score

[00:33:13] [SPEAKER_04]: from an eight to a nine.

[00:33:14] [SPEAKER_04]: And again, maybe that might align

[00:33:15] [SPEAKER_04]: with certain incentives financial

[00:33:17] [SPEAKER_04]: or otherwise depending on who your payer is

[00:33:19] [SPEAKER_04]: and how it's designed.

[00:33:20] [SPEAKER_03]: Yeah, because it drives behavior

[00:33:21] [SPEAKER_03]: just like that oral rate you're wearing,

[00:33:23] [SPEAKER_03]: I wear one also.

[00:33:24] [SPEAKER_03]: And when I see that sleep score again,

[00:33:26] [SPEAKER_03]: the little low I go, oh boy,

[00:33:28] [SPEAKER_03]: and it starts changing the behavior

[00:33:30] [SPEAKER_03]: of when I'm going to sleep or all of the things

[00:33:32] [SPEAKER_03]: that we do to get a good sleep.

[00:33:35] [SPEAKER_04]: I just have this idea like the ordering

[00:33:37] [SPEAKER_04]: I when I wake up in the morning,

[00:33:38] [SPEAKER_04]: now I look at, I'm addicted to looking

[00:33:40] [SPEAKER_04]: at my sleep score and my readiness score.

[00:33:42] [SPEAKER_04]: Readiness score comes from a bunch of things

[00:33:44] [SPEAKER_04]: from your temperature to your resting heart rate

[00:33:46] [SPEAKER_04]: to your sleep score to your exercise the day before.

[00:33:48] [SPEAKER_04]: What if your readiness score was tied

[00:33:50] [SPEAKER_04]: to your connected toothbrush

[00:33:51] [SPEAKER_04]: and it could tell you,

[00:33:53] [SPEAKER_00]: rush that morning and for how long

[00:33:57] [SPEAKER_04]: why not integrate with health kit

[00:33:59] [SPEAKER_04]: and these other platforms?

[00:34:00] [SPEAKER_04]: There's also an on Android platforms,

[00:34:02] [SPEAKER_04]: common health ways to again make this really actionable

[00:34:04] [SPEAKER_04]: and again, not design it as one size fits all.

[00:34:07] [SPEAKER_00]: And I'm very excited for not only

[00:34:09] [SPEAKER_00]: for that segment of our listeners

[00:34:11] [SPEAKER_00]: who are data geeks and get excited about data

[00:34:14] [SPEAKER_00]: like Jonathan, you're Daniel here,

[00:34:16] [SPEAKER_00]: but for those of us who just like

[00:34:18] [SPEAKER_00]: to feel good and feel better

[00:34:20] [SPEAKER_00]: and like to connect the dots.

[00:34:22] [SPEAKER_00]: And from that perspective, I think this part

[00:34:24] [SPEAKER_00]: of the conversation that we are entering in

[00:34:26] [SPEAKER_00]: and then we'll probably put a pin for the moment

[00:34:28] [SPEAKER_00]: is the most exciting part, the ideation part

[00:34:30] [SPEAKER_00]: because once you open up your mind

[00:34:32] [SPEAKER_00]: to think about the art of the possible

[00:34:33] [SPEAKER_00]: and what if we didn't think of our dentist

[00:34:36] [SPEAKER_00]: in a silo up to our PCP?

[00:34:39] [SPEAKER_00]: What if we could connect digital and tools,

[00:34:43] [SPEAKER_00]: digital tools to analog tools?

[00:34:46] [SPEAKER_00]: And what if we could actually action

[00:34:48] [SPEAKER_00]: some of the clinical connections that we know

[00:34:50] [SPEAKER_00]: from literature that connect our,

[00:34:52] [SPEAKER_00]: look at our health as a system of interconnections

[00:34:55] [SPEAKER_00]: rather than silo disciplines.

[00:34:58] [SPEAKER_00]: And so with that perspective,

[00:34:59] [SPEAKER_00]: maybe in last minute invitation, Daniel,

[00:35:02] [SPEAKER_00]: first of all, we would love to have

[00:35:04] [SPEAKER_00]: to continue the conversation

[00:35:05] [SPEAKER_00]: and for those, for our listeners

[00:35:06] [SPEAKER_00]: who could join you at NextMed in March.

[00:35:09] [SPEAKER_00]: I heard you say extended invitation

[00:35:11] [SPEAKER_00]: to all of those current and future

[00:35:13] [SPEAKER_00]: dental oral health entrepreneurs

[00:35:15] [SPEAKER_00]: that they're welcome to the NextMed community

[00:35:18] [SPEAKER_00]: and to NextMed in March 2023.

[00:35:22] [SPEAKER_00]: Where else could, what are great resources

[00:35:24] [SPEAKER_00]: and what else should those entrepreneurs

[00:35:27] [SPEAKER_00]: be looking at in terms of resources

[00:35:29] [SPEAKER_00]: and friendly audiences where they could brainstorm

[00:35:32] [SPEAKER_00]: some of those art of the possible ideas

[00:35:34] [SPEAKER_00]: or get more insights into how innovation

[00:35:38] [SPEAKER_00]: got scaled and adopted in medical?

[00:35:40] [SPEAKER_04]: I think the magic is,

[00:35:41] [SPEAKER_04]: and what we'll be doing at NextMed Health

[00:35:42] [SPEAKER_04]: websites, NextMed.Health come join us

[00:35:44] [SPEAKER_04]: is that the magic happens at the interface of fields, right?

[00:35:47] [SPEAKER_04]: Where you, where dentist runs into someone

[00:35:50] [SPEAKER_04]: who does 3D printing or AI or VR or blockchain

[00:35:53] [SPEAKER_04]: or nanotech or how Christopher might play a role

[00:35:56] [SPEAKER_04]: or someone who's run a healthcare system in Nairobi

[00:35:58] [SPEAKER_04]: that could apply to anywhere in the world,

[00:36:01] [SPEAKER_04]: cross-portalization.

[00:36:02] [SPEAKER_04]: And that opens up the realm

[00:36:05] [SPEAKER_04]: of the art of the possible as you mentioned.

[00:36:06] [SPEAKER_04]: And also realizing that there's this old quote

[00:36:09] [SPEAKER_04]: shared at a prior NextMed by the head of innovation

[00:36:11] [SPEAKER_04]: of NHS that challenges and often the new ideas

[00:36:15] [SPEAKER_04]: but escaping from the old ones.

[00:36:16] [SPEAKER_04]: And a lot of folks I think in the dental world

[00:36:18] [SPEAKER_04]: are still stuck in these old mindsets

[00:36:20] [SPEAKER_04]: and practices and billing realms.

[00:36:23] [SPEAKER_04]: So the idea is not when we talk about innovation

[00:36:25] [SPEAKER_04]: and disruption, not to just digitize the fax machine

[00:36:27] [SPEAKER_04]: but maybe blend all these new worlds

[00:36:29] [SPEAKER_04]: not just with the technology of 2023

[00:36:31] [SPEAKER_04]: which is already pretty fantastic

[00:36:32] [SPEAKER_04]: but imagine what we're gonna have in 2033

[00:36:34] [SPEAKER_04]: and build and like Wayne Gretzky's

[00:36:36] [SPEAKER_04]: speech where the puck is going to be

[00:36:38] [SPEAKER_04]: and all we'd look for pain points

[00:36:40] [SPEAKER_04]: and how to solve them.

[00:36:41] [SPEAKER_04]: In fact, I have a patent

[00:36:42] [SPEAKER_04]: and I would love some of your audience

[00:36:44] [SPEAKER_04]: to join me to build this company.

[00:36:46] [SPEAKER_04]: I was never a great toothbrusher.

[00:36:47] [SPEAKER_04]: I didn't admit that earlier.

[00:36:48] [SPEAKER_04]: How often did you brush your teeth?

[00:36:49] [SPEAKER_04]: Even if you're doing three minutes or five minutes

[00:36:51] [SPEAKER_04]: in which are you on any one tooth area?

[00:36:53] [SPEAKER_04]: So I designed a digital prototype a few years ago

[00:36:55] [SPEAKER_04]: of a 3D printed sort of mouth washing machine

[00:36:58] [SPEAKER_04]: that would in Dennis would stand your mouth

[00:37:00] [SPEAKER_04]: it would 3D print the sort of structure

[00:37:02] [SPEAKER_04]: that you'd bite into a mouth guard

[00:37:03] [SPEAKER_04]: and be connected to almost like a waterpicked version

[00:37:05] [SPEAKER_04]: then it would do your entire mouth cleaning

[00:37:07] [SPEAKER_04]: with different rinse cycles

[00:37:08] [SPEAKER_04]: depending on what you needed.

[00:37:09] [SPEAKER_04]: I think I've seen other versions come out of that since I...

[00:37:12] [SPEAKER_03]: There are, there's one came and went

[00:37:15] [SPEAKER_03]: one called Amabrush.

[00:37:16] [SPEAKER_03]: There's a new one now

[00:37:17] [SPEAKER_03]: that some technology people came together

[00:37:19] [SPEAKER_03]: that just getting commercialized is exactly right.

[00:37:21] [SPEAKER_03]: It's a waterpick but it's a mouthpiece

[00:37:24] [SPEAKER_03]: that the key is you got to get to the spaces

[00:37:27] [SPEAKER_03]: between the teeth.

[00:37:28] [SPEAKER_03]: Not so much on the front and back.

[00:37:29] [SPEAKER_04]: Yeah, so a good example

[00:37:30] [SPEAKER_04]: I had this great idea

[00:37:31] [SPEAKER_04]: we even prototyped it a few years ago

[00:37:32] [SPEAKER_04]: at Singular University

[00:37:33] [SPEAKER_04]: but you gotta execute on it.

[00:37:34] [SPEAKER_04]: We'll see if mine has some legs

[00:37:35] [SPEAKER_04]: but so for anybody out there

[00:37:37] [SPEAKER_04]: keep a little note

[00:37:37] [SPEAKER_04]: but whether you're a dental student

[00:37:38] [SPEAKER_04]: a medical student, a patient of any sort

[00:37:41] [SPEAKER_04]: find a pain point

[00:37:43] [SPEAKER_04]: think about how what's not working today, right?

[00:37:45] [SPEAKER_04]: Okay, the tooth based tube

[00:37:46] [SPEAKER_04]: is you have to sprinkle,

[00:37:47] [SPEAKER_04]: spread it out.

[00:37:48] [SPEAKER_04]: Couldn't that be designed in some new crazy new way?

[00:37:50] [SPEAKER_04]: Could that be tied to amplification?

[00:37:53] [SPEAKER_04]: Could there be a digital layer?

[00:37:54] [SPEAKER_04]: Could you imagine an era of a

[00:37:56] [SPEAKER_04]: making this up a personalized toothpaste

[00:37:58] [SPEAKER_04]: that has the right microbiome and elements

[00:37:59] [SPEAKER_04]: that matches your oral risk factors

[00:38:01] [SPEAKER_04]: and then dental components?

[00:38:05] [SPEAKER_04]: Could you use a toothbrush as a diagnostic device

[00:38:07] [SPEAKER_04]: because it'll be screening the microbiome

[00:38:08] [SPEAKER_04]: in your mouth and looking at your saliva?

[00:38:10] [SPEAKER_04]: All these ways to think about connecting the dots

[00:38:12] [SPEAKER_04]: and solving pain points

[00:38:13] [SPEAKER_04]: happen at this interface

[00:38:13] [SPEAKER_04]: that people, ideas, mindset and inspiration.

[00:38:17] [SPEAKER_00]: Very exciting.

[00:38:18] [SPEAKER_00]: So excited about the future of care, self-care

[00:38:20] [SPEAKER_00]: and integrated oral and systemic health.

[00:38:24] [SPEAKER_00]: Thank you Daniel for joining us.

[00:38:25] [SPEAKER_00]: We're right at the time

[00:38:26] [SPEAKER_00]: and we'll look forward to continuing the conversation.

[00:38:30] [SPEAKER_04]: Great, thanks for having me, Keith Smiling.

[00:38:32] [SPEAKER_04]: Check out the demo resources on digital.health

[00:38:34] [SPEAKER_04]: and come join us at nextmed.health.

[00:38:36] [SPEAKER_04]: See ya.

[00:38:37] [SPEAKER_01]: Great, see ya.

[00:38:37] [SPEAKER_04]: Looking forward to it.

[00:38:38] [SPEAKER_04]: Thank you Daniel, thank you Maria.

[00:38:40] [SPEAKER_01]: Thank you.

[00:38:40] [SPEAKER_02]: Always fun.

[00:38:45] [SPEAKER_02]: Thanks for listening to the Think Oral Podcast.

[00:38:48] [SPEAKER_01]: For the show notes and resources from today's podcast

[00:38:51] [SPEAKER_02]: visit us at www.outcomesrocket.health.thinkoral

[00:38:58] [SPEAKER_01]: or start a conversation with us on social media.

[00:39:02] [SPEAKER_01]: Until then keep smiling and connecting care.