Podcast (Dental)

InnerView Allows Dentists to Reliably Detect and Diagnose Tooth Damage

April 27, 2022

In this episode of The Art of Dental Finance and Management podcast, Art meets with Dr. Cherilyn Sheets and Robert Hayman to discuss InnerView, a tool currently in the approval phase that helps dentists detect and diagnose structural damage in teeth and implants that can’t be seen in an x-ray or visual exam.

InnerView uses quantitative percussion diagnostics to measure how structurally sound and strong a tooth or implant is. Certain fractures can be almost impossible to detect until they are severe, and patients don’t know something is wrong until they are experiencing pain. It’s important to take action to protect the tooth to avoid further damage and a catastrophic event.


Reach out to Art if you have any questions regarding dental finance and management for your dental practice. More information about the Eide Bailly dental team can be found at www.eidebailly.com/dentist.

Being more strategic in all aspects of your dental practice will lead to increased profitability.


Dr. Cherilyn Sheets

Robert Hayman

Show Notes and Resources:

The Transcript

Art Wiederman, CPA: Hello everyone and welcome to a very special edition of the Art of Dental Finance and Management with Art Wiederman, CPA. I'm your host, my name's Art Wiederman and I'm a dental division director for the CPA firm of Eide Bailly. We work with about 1000 dentists in our firm, about 300 in our office in Tustin, California. I'm sitting here on a beautiful April afternoon here in Orange County, and I have a real treat for you today.

One of the pleasures I've had in doing this podcast for the last three and a half years is I've gotten to talk to a lot of my friends and colleagues and dentists about the business of dentistry, financial management, and every once in a while, I get a privilege and an honor to talk to some very, very prominent people in the business, and that's what we have today. And to introduce you to what appears to me to be a very revolutionary product that could very well become the standard of care in your dental office, and you're actually going to get an opportunity to if you want to take a look at it now and try it out now, I'm not getting anything for this podcast. I am bringing this on to bring information to you that I believe will ultimately help you in your dental practice.

And my guests today are Robert Hayman, who is the founder of what was Discus Dental. And I'll tell you a little bit about Robert in a minute. And Dr. Cherilyn Sheets, who is, if you don't know, Dr. Sheets. She's one of the most prominent dentists in the world, just plain and simple. And we're going to talk to you today about this new technology called InnerView, which is just incredible. So we'll get to Dr. Sheets and Mr. Hayman in a moment.

First thing I want to do is I want to remind you to go to our partner Decisions in Dentistry magazine. Unbelievable clinical content. You can buy 140 continuing education courses for a very, very reasonable price from them. Go to www.DecisionsinDentistry.com.

If you're looking for a dental specific CPA, it's right after April 15. So we seem to get a lot of our clients from dentists who get big surprises on April 13th. So if you got a big surprise and you don't want surprises, we don't do surprises. And in our office you can give us a call. I'm at six five seven two seven nine three two four three or awiederman@EideBailly.com.

We also have my mothership, the Academy of Dental CPAs www.ADCPA.org. I just want to remind everybody we're past the deadline for the HHS Provider Relief Fund filings, but if you received money in the first quarter, I'm sorry. In the between January one and June 30th of 2021 from this fund, put a note on your calendar that you're going to have to report on the HHS portal between July one and September 30th. And again, by the time you guys hear this podcast, it'll be close to May. So put that on your calendar.

And if you haven't applied for the employee retention tax credit, the ERTC, if you had significant reductions in your in your gross receipts 50 percent in 2020 or 20 percent in the first three quarters of 2021 versus 2019, we've done this for over 100 dental practices and have gotten well over $4 million in tax credits. So give us a call on that.

So what I want to do is I want to set the table here with Robert and Dr. Sheets, and I've known Dr. Cherilyn Sheets for 38 years. Dr. Sheets is a client of our CPA practice. She is one of the most prominent dentists in the world. Cherilyn and her husband, Mark, have taught me a lot about charity, and giving one of my favorite stories about Dr. Sheets is Dr. Sheets' father JB was a dentist and had a practice in Inglewood many, many years ago, and through a bunch of iterations, Dr. Sheets took her dad's dental office and turned it into something called the Children's Dental Center. And the Children's Dental Center in Inglewood on Buckthorn Street has provided thousands and thousands of young people quality dental care that they never would have had access to.

And one of the greatest honors I've had in my professional life was I got to put on a golf tournament for the Children's Dental Center, a black gold in Yorba Linda, oh gosh, 10, 15 years ago. And it was one of the one of the most amazing things in my life to be able to hand a check. We were able to raise $20,000 that day for the Children's Dental Center.

And again, you know, Cherilyn and Mark have taught me a ton about charity and giving and helping people, and I am honored and thrilled to have them on this podcast to talk about this product, which is called InnerView and InnerView, is basically a product that I truly believe is going to revolutionize dentistry, where dentists are going to be able to reliably detect and diagnose damage in teeth. And that's what we're going to talk about today.

So let me first tell you a little bit about Dr. Sheets and Robert Hayman, who is a name that many of you also know. So Robert was the he's the CEO and chairman of Perimetrics, which is the company that is working with InnerView, if you will. He is a seasoned entrepreneur, leader and operator with over 30 years of experience in the global commercialization of professional consumer dental products. He was the CEO and founder of Discus Dental, the world's leading manufacturer and distributor of tooth whitening, oral hygiene and esthetic dental products. His company created products that you might have heard of. I'm being facetious. Night White, Day White, Zoom, Bright Smile, Breath Rx.

Robert's business partner, Dr. Bill Dorfman, who was the extreme makeover dentist, very famous dentist in Beverly Hills. They brought a whole new category of innovative products and sophisticated consumer style marketing. He took it to from a startup company to a company that was doing upwards of $200 million. And Robert is now focusing his efforts here on inner on this product and working with Dr. Sheets.

Dr. Cherilyn Sheets is the chief dental officer and co-founder of Perimetrics. She oversees all clinical and diagnostic development for the company and maintains a full time private practice in Newport Beach, California, for esthetic rehabilitative dentistry. I was in there with my partner, Don Watson, and Dr. Sheets actually demonstrated this product on Don. I mean, my eyes were open. I mean, it was unbelievable. I am so excited for everybody, for you to hear about what this is going to do. Cherilyn is a graduate of the USC Dental School, an international educator, clinician, author and researcher. She has won the Gordon Christiansen Award for Excellence in Lecturing the USC School of Dentistry alumnus of the Year. She got the Section Honor award from the California Section of the Pierre Harshad International Honored Dental Academy. The Lucy Hobbs Taylor Award. She's probably won a Heisman Trophy. She's won a whole lot of stuff. But anyway, Dr. Cherilyn Sheets and Robert Hayman, welcome to the Art of Dental Finance.

Robert Hayman: Thank you.

Art Wiederman, CPA: It's great to have you on here, and I'm very excited to talk about this product. And again, the good news, folks, is that I'm going to. This is about as far into clinical dentistry as I'm going to get, but I have two of the smartest people in the dental profession and one of the top clinicians in the world to if I if I say something dumb, you'll please correct me. But Cherilyn, let's get into the conversation. You and I have talked about this over the years in the 38 years that I've known you. Is that, you know, you've always talked about how current dentists currently detect and diagnose damage in teeth and that and that damage in teeth is really undetected. So what are dentists doing now? How do they generally detect you tooth damage? What are they doing now?

Dr. Cherilyn Sheets: Well, I think probably the first thing, Art, thank you so much for having Robert and me on your program. We really greatly appreciate this opportunity to kind of talk with you about this because it is exciting for us to be involved with a kind of a breakthrough technology. But first of all, I think is, you know, what do we mean by damage? And what we mean by damage is that kind of undetectable structural damage that happens in teeth or implants that doesn't really show up on X-rays or from a visual examination.

And when I started working with Jim Earthman professor Jim Earthman at UCI and he developed this quantitative percussion diagnostics. We realized that it was the percussion which is more of an engineering test that lets you know how structurally sound a tooth or an implant is. So that's really what InnerView is all about. It's a way of applying an engineering, a mechanical test to teeth and implants to let us know how strong they are. And there are different things that can weaken a tooth or an implant through a tooth. You know, it could be a fracture, you know, within the tooth, which is almost impossible to detect unless it's severe or catastrophic. You know where the piece falls off.

But it's often that patients will come in and say, You know, I have this vague pain, and when I bite down every once in a while and I get a sharp shooting pain, those are all the in stages typically of a crack in a tooth. So what we want to do is we want to be able to pick these problems up, the structural problems up before we're starting to get symptoms. And you know, Robert has a way of saying that oftentimes we in dentistry are flying blind, right, Robert?

Robert Hayman: Absolutely. It's the number one indication for damage right now is pain.

Art Wiederman, CPA: Right, yeah, that's what you guys were telling me, so you're saying that the dentists don't have the tools that they need to really do a comprehensive job of detecting damage in teeth? So what tools do they use now?

Dr. Cherilyn Sheets: Well, for me, you know, I mean, certainly, we use visual examination. We use patient's symptoms. We use X-rays. And now with CBCTs, you know, that allows us a more sophisticated X-ray to be able to look for these things. But once again on an X-ray, if the crack is parallel to the angle, you know that the dental rays are coming in, the X-rays are coming in and it's wide enough separated. You know, you might be able to pick something up on an X-ray or CBCT in the cracks that are really more advanced, but cracks start off as just microns. And it's if you think in terms of a windshield on a car, you know, when a storm hits that windshield and you get that the initial little crack, if you don't do something about it, you know the whole windshield is going to eventually shatter, right? And that's the catastrophic fracture.

So teeth have those same kind of initiating events that if you can do something to protect it, you're going to hold it. But if you don't, it's just going to keep on propagating and getting worse. And we've certainly seen this in the fatigue failure studies that have been done at the University of California at Irvine by Dr. Earthman and his team over there. And it's so amazing Art because they all have a tooth and you'll have a pressure point on it and it'll cycle 140,000 times with nothing happening. And then after that, you'll see this little uptick and we are measuring it with InnerView to see. And so nothing happens, and all of a sudden you can see it starting to move up and then the same pressure, same amount of time every point from that initial crack on. You can see it getting worse and worse and worse and worse until it ultimately fractures completely.

Art Wiederman, CPA: So, Cherilyn this is a tool that will help a dentist actually do better in preventing big problems. Because I know you and I have talked about how, you know, if the only thing we really have is an x ray that doesn't get anywhere near where we need to be, and a patient may be calling if they have some pain and maybe they might not. Even they might have a little pain, and they may not even think it's enough to call the dentist. Right, right? You know, so you've told me, you know what 90 percent of patients leave dental exams with undiagnosed tooth damage. I mean, so let's get into this InnerView. You know, first of all, how did you come up with the idea and how does it work? So I'm going to let you go here.

Dr. Cherilyn Sheets: OK. All right. So the way we came up with the idea was really kind of a funny situation. I had discovered something in working with patients that had to do with dental implants and natural teeth. And when they were linked together on a bridge in about three percent of the cases where the patient was a heavy clincher and rupture the tooth didn't like it and it would start moving away from the bridge. So cutting through that whole story, I thought I had come up with an explanation for it. And in fact, I had reversed it, and they were saying in the literature that it was irreversible and it was a mystery. So I thought I knew why it happened.

So Dr. Carl Reader that, as you know, I worked with for many, many years, I've always played on prosthodontics, he said. Well, if you really think you've got something, you know, you should get over to UCI and see what they think. So I went home kind of frustrated, and my husband, who's in finance, as you know, says I have to go to UCI tonight and meet the dean of the engineering school you don't want to go to, you know, I said I will be in the car in five minutes. I'm going.

So I went, I met the dean. I'm drawing pictures, you know, on the tablecloth, just totally being obnoxious. And he went, Oh, this is really interesting. He says, I have a guy I want you to meet. His name is Jim Earthman. I said, OK, great. So we called each other. I told him that I wanted to come see this data. And he came over and looked at all these notebooks and pictures and study caps and everything and went, I have a treasure trove of data here to look at which of course, always makes an engineer happy.

Art Wiederman, CPA: Yeah, that's what they do.

Dr. Cherilyn Sheets: So he got into it and he said, You know what? This is really following basic engineering principles. I think it makes sense. Let's write a paper. And I said, Really, OK, let's do it. So we wrote a paper, and the Journal of Prosthetic Dentistry thought this really was good idea and it was timely. So they fast tracked it and we were out and proud. In three months, which is pretty basic for a journal. So then Jim came to me and he says, you know, we've done something really bad. And I said, Oh my gosh, what's that? And he says, we put out a hypothesis, but we don't have any way to prove it. So I said, OK, let's prove it.

So then he was looking for something that could measure shock absorption in teeth and there wasn't anything on the marketplace. And so ultimately then he took, you know, a unit that was out there but was extremely inconsistent in its readings, you know, invented a new tip, put the information, looked at it differently and then came up with a research version of the periometer, which we patented IND and got FDA approval in 19. I'm sorry, in 2008. So we started, you know, just doing these little science projects and got to a point where we were seeing that this did more and more. So we kept looking. And finally, we got to the point where we realized we could pick up fractures in porcelain. Then we were testing implants and using natural teeth as a control, and we saw that all those teeth had these different energy return grafts that are like fingerprints, structural fingerprints of the teeth. But we weren't really sure what all we were dealing with. So at that point? My husband says to me, Cherilyn, I think we need to draw a line in the sand on your hobby here. This is getting extremely expensive, so what are you going to do? And I said, you know, I'm going to call my friend Robert Hayman and I'm going to say, you know what he thinks about this? And so I called Robert and he came down and we did our dog and pony show about all the things that we had done. And Robert looked at it. And what did you say, Robert?

Robert Hayman: Well, I thought it was fascinating. There was nothing that really could identify the cracks in teeth the way that this could. And there were a lot of other, you know, without dragging everybody into the weeds, there were a lot of other potential uses for it as well. You know, one of them being in the hygiene room, of course. And so we just started the partnership and it's gone since then.

And one of the biggest issues we had, actually, which is funny, is here we had this technology we could all see how promising it was and we had, you know, glimmers of success, glimpses of success, I should say, but we didn't have enough clinical studies. And so we knew that we needed to get a lot more in terms of clinical credibility, really. And Cherilyn and Jim and I and, you know, we started working along with Dr. Nationality Dr. Sushma nationally, who was very helpful on a number of different clinical studies. And today we have 25 different clinical studies. But it took a long time to get those going and proven because we just knew that without clinicals, we weren't going to be taken seriously. And it's been going ever since.

Art Wiederman, CPA: Yeah. Well, again, it's fascinating technology, Cherilyn. Let's get a little into the weeds about how this InnerView works. Again, I remember when you put Don in the chair and you started tapping teeth and I was looking up on the computer and it was the pretty colors. It was really amazing. And so kind of walk through, how would a dentist use this and what kind of data does it generate to help them in their diagnosis and treatment?

Dr. Cherilyn Sheets: Sure. So there's a handpiece that now is all electronically connected. You know, in with our computer program and the hand pieces, I held parallel to the ground and close up and just lightly rests on the cusp of the tooth and the facial buckles surface of the tooth. And then with the right amount of light pressure it, it triggers five light, percussive taps against the tooth. And what's amazing is in that microsecond that the rod is just tapping the tooth, it not only generates this percussive force into the tooth, but it also picks up the response back on how that tooth or implant handled that energy and that creates this energy return graph.

Now, the easy way of thinking about this is if you hit a, you know, or tap up a completely stable piece of composite or granite or tooth or implant that's healthy and there's no movement in it, it's going to come back with pretty much a perfect bell shape curve. But if there's a crack in it or there's something loose that's moving or the whole thing is moving, then you're going to get perturbations or little bumps in the graph. Or you might get a complete repeat of a of a graph so that you have multiple.

So when a patient or the doctor looks at these graphs, the closer it is to a singular bell shaped curve, the healthier that side is, the more bumps you get and the more peaks you get. And the further out in time it goes, the more just damage the tooth is. And that's why we started calling it damage because of structural damage. Now the dentists then will get on their report, and it only takes three seconds for each tooth to test. So you can do the entire mouth and, you know, three to four minutes, and the screen then shows for each tooth. It has the little graph up above, but it also puts a numeric score. So you've got an americ score for the overall mobility of the site that was tested and also for what we call damage, which is movement of a portion of it.

So let's think, what does that mean? Well, probably the simplest. Just think of a non restored tooth that has a crack in it. That's what's going to be moving, and that's what we're going to see in the graph. Or you could have a loose crown and the crown when it's tapped is going to create a little micro movement. And that's what we're going to be seeing reflected in the graph. Or you could have an implant that's starting to lose also integration and instead of a perfect bell shaped curve or close to it that we should get in a fully also integrated implant. We're going to get these perturbations and show that it's actually moving. And that's something that we've seen just over and over. You know, in patient after patient,

Art Wiederman, CPA: I mean, you were talking about you were talking about non-treated teeth. Also from what I understand, Cheryl, and you can have cracks in unrestored dentition. Talk about how cracks are more prevalent in teeth that have had prior dental procedures done.

Dr. Cherilyn Sheets: Well, when you think about it, I guess it makes sense. You know, you've already got a tooth, a tab, some calories or a chip for damage of some sort and then a restoration is placed into it. And those restorations, particularly if their fillings, you know, are just relying upon undercuts within the tooth, but that teeth probably first of all, the filling is going to wear out at a certain point in time. And what you want to do if something's breaking down and starting to micro leak, which can create decay, you want to find that out early in that process, not after. There's all kinds of decay there or other issues that are going to be more difficult to work with and needing maybe root canals or, you know, heaven forbid, an extraction.

So that's the one of the joys of this is that we're picking up problems really early in the damage cycle, which allows us to come in with some preventive services. For instance, if you've got a patient that maybe doesn't have any restorations but you're seeing really high damage scores, then you want to start looking at potential possibilities. You know that the tooth is being overloaded because it's got a high damage score. So you look at the tooth doesn't have any restorations, but it looks like maybe there's some wear forceps on it. So then you start thinking in terms of occlusal overload.

So it allows the dentist to look at the habit patterns. You know, you ask them, Do you chew ice? Oh yeah, I chew ice. Oh, well, that's not a good idea. Let's talk to you. Do you chew gum? Oh yeah, I chew gum every day for hours. Guess what? That's not a good idea. It's overloading your teeth, and it's going to create more cracks and fractures in your teeth. So you can have those basic conversations, you know, like, do you chew on pens? Well, that's probably not a good idea. No, he's chewing on a pen.

Art Wiederman, CPA: Yeah, exactly. So I'm going to remember, I'm a CPA and you know that. But I do know that talking to all the people I talked to, about the links between periodontal disease and heart disease and liver disease and all kinds of afflictions, can this product actually, I mean, can that help find some maybe other problems that a patient might have in their body, or is this strictly limited to teeth?

Dr. Cherilyn Sheets: Well, I mean, teeth don't just sit there by themselves. Teeth are encompassed by the periodontal ligament by bone. You know, it's a whole oral systematic system. So yes, if you've got other problems that are lowering your overall immunity, or if you've got periodontal disease, which is going to be putting pathogens into the bloodstream, you know, those are all things that we want to know. So from a damage standpoint, we're more mechanical, but from the things that can cause damage, there is that biological and mechanical combination. That's why it's bioengineering, basically.

Art Wiederman, CPA: If that's well, my audience knows anything over three syllables, I can't really deal with, and you've said about 30 words that are about 10 syllables, but I'm going to let you go on this one.

Dr. Cherilyn Sheets: I apologize.

Art Wiederman, CPA: Oh, that's OK, Cherilyn. Diagnosing and detecting tooth mobility. I think you mentioned that a little bit. That's also important in all of this, right?

Dr. Cherilyn Sheets: Yes, absolutely. If there's increased mobility on a tooth, you want to know why. Because that has to do with the attachment mechanism with the periodontal ligament in the bone. But if it's an implant and you're seeing increasing mobility, you know you're losing OSU integration. Now, if you know that early on, you can unload it, you know you can do an occlusal adjustment so you can do night guards, you know, to protect patients when they're asleep, you can, you know, do all sorts of preventive things. And then if the prevention doesn't work, then you can go into the more therapeutic options that you have. Restoring a tooth, unloading an implant, allowing it to heal, taking cysts for implants, doing so systemic support, you know, like putting the patient on additional micro minerals. The important thing I guess I want to get across is just that knowledge is always power. So this gives us a whole new area to have knowledge and that we can then, as dentists, make informed decisions that are evidence based as far as the structural strength of the site we're looking at.

Art Wiederman, CPA: So to my listeners again, my podcasts are a call to action, and this is an opportunity, I believe, and that's the reason I brought it to my audience to help you in your dental practice. So, Robert, I want to ask you a couple of questions. Number one, where are you guys with this? I mean, it's not available to the general dental public yet, but where are you as far as I know you're working with the FDA, where is the product? When would it be potentially available for dentists to acquire and how would that work?

Robert Hayman: Well, right now we are shifting from research and development more towards field testing and data acquisition. Because we use artificial intelligence, we need data. We gather data in different ways. One is actually through what's called finite element analysis modeling, which is a supercomputer model, but that's great for a number of different things. But right now we're working with new practices that are doing field testing and data acquisition. We're also working on FDA approval. We've already got FDA approval for the research version, we'll soon get it for the launch version called the InnerView. And then ultimately, we're working on our De Novo right now that we're going to be submitting very soon. And it won't take long until we have approval for the detection of damage cracks really.

FDA likes to be more specific. So in this case, we can't use a catchall phrase. It's really cracks. And we'll be able to deal with this, at least in the beginning, is be able to see that or detect that there's a probability of the existence of a crack and the severity of that crack as well. And I think that what'll happen long term is we our plan is to use artificial intelligence and use that section of the FDA to continuously self-certify and widen the diagnostic capabilities of the technology. So with additional data, with finite element analysis, supercomputer modeling and you know, with the, you know, continued enhancements to the algorithms as well as, you know, the technology, we're going to be able to identify more and more. We're already on the verge of being able to and we're not going to be able to get FDA approval for this right away just because we can only get so much at a time, but we're on the verge of. We believe getting vertical cracks as well as accessible cracks, but we'll ultimately it's exciting to think about what we're going to be able to long term be able to identify it.

Art Wiederman, CPA: So, Robert, and we've talked about this. The three of us have talked about the fact that you guys are in the process of having, you know, doing a bunch more clinical trials. That's right. Correct. So one of the things and one of the reasons I wanted to bring you on is to introduce this to my audience. And I guess there's an opportunity for dentists out there to participate in these trials and maybe learn more about this. How would that work? And if there's information you want to give out, I feel free because I just think this is absolutely fantastic. And again, I believe so much in Rob. And Dr. Sheets that I just think that I would love dentists to take a look and help them get this to market because I think it's going to revolutionize the profession.

Robert Hayman: Thank you. Thank you. The thing that we we'd like to do is before we bring people on board to do field testing or data acquisition for us. We'd like them to learn more about the technology itself. And so we do have various seminars that we hold from time to time to do exactly that because before you commit to something, you should know what you're getting into. Now, you know, it's taken a lot of time, it's taken a lot of technology and a lot of research and development to take a very sophisticated technology, believe it or not, with multiple disciplines and make it simple to use.

But even though it's simple, we still need to get this thing off the ground. We need to resolve a number of different, you know, potential issues that we're, you know, we're always looking at. And so we have a couple of seminars that are coming up within the next week or two that we're going to announce shortly. And if you want to get in touch with us to sign up for those seminars, we're only going to take about 20 25 people per seminar because we do like to feature a very robust question and answer Q&A session on each one of them because there are a number of good questions that get asked and need to be answered. And people do have questions when they're getting involved in something. So if you want to get in touch with us, please do. I can give you my, my email address or my cell phone. You can text me or email me. Is that OK, too?

Art Wiederman, CPA: Yeah, that's exactly what I want you to do. And also, I'll make sure that when we when we put this out in social media for the podcast and through Eide Bailly that that's in there too. But go ahead. Yes. If you are interested in attending one of these webinars to learn more about InnerView, Robert, what's the best way to get ahold of you?

Robert Hayman: You know, and again, they're limited. So you know, it's on a first, first come, first serve basis. But get try my email. Well, let me get my text message, my text, my cell phone first, which is area code three one zero seven six six four five one nine. Area Code three one zero seven six six four five one nine or just email me at rhayman@perimetrics.ai as in Robert Hayman at Perimetrics dot A.I. as an artificial intelligence.

Art Wiederman, CPA: And if you have any trouble, I give you guys have my email and my number just get a hold of me and I'll get the information to Robert. If for some reason you have trouble connecting. Now, the thing that I care about, I'm not that I don't care about this. This is fabulous and fascinating to me is I'm a numbers guy, Robert, and you're a numbers guy. How do we make? How do dentists, if they, you know, ultimately this is going to come to market, right? I mean, this product will come to market and tell me how we can make more money as a dental, as a dentist, how do we diagnose more procedures? How does that work? Give us some idea of what if a dentist does put this into operation in their practice? How do they make more money in their practice? Grow the revenue? So that's what I'm always looking for.

Robert Hayman: Clinicians are identified are able to identify issues long before they get to a catastrophic phase. So for the first time ever, we're able to essentially identify when we're going to intervene. It's really a collaboration between the patient and the clinician. With the, you know, there are a number of procedures again walking out the door that will ultimately become catastrophic if they're not dealt with right now and they should be dealt with. Some are preventive, such as abrasions and mouth guards, and others are just restorative procedures that need to be taken care of. It may be a restoration that's existing that needs to be replaced, or maybe a crack that needs to have a crown or another procedure on it so that it doesn't get to a catastrophic phase.

So, you know, typically we take a look at, you know, different levels of dentists. And let's just say we get a growing practice. It's a young practice for the cost of, say, $1500 they can acquire the system that would be, you know, one hand piece, let's say, some tips and also a base station for every operatory. And probably over a space of about a year, they should be able to generate between 75 and 90,000 $100,000 worth of additional revenue that year. So the payback on this is really quick and a practice that is a, you know, growing still but has been around for a few years the cost of this will probably be, you know, anywhere between two and three thousand dollars because they'll have a few hand pieces, but base stations again in every operatory. And, you know, they could do anywhere between a hundred and fifty and a hundred seventy five thousand dollars a year if they're using this correctly and if they're trained properly.

And it's not a huge amount of training, by the way. But there is some training involved and then a topnotch practice that is really been around for a while and really knows their stuff. Again, the costs they're going to have more operatories typically, it'll be three to five thousand dollars there. It would be the investment in the capital equipment for this, which again is very, very mild. But the return the new revenues generated for this would probably be in the range of between three hundred and fifty and three hundred seventy five thousand dollars a year. We have numbers at back all this up, the assumptions that we've made. It sounds, you know, like a big number and it is a big number. But again, when you realize what this technology does, the ability to have a health history on every single tooth in the oral cavity and choose when you're going to intervene because you can see the trend lines of each tooth run exceptions analysis and flag issues before they get to a catastrophic phase. Head them off at the pass, so to speak, is huge, and this is a big part of it.

Art Wiederman, CPA: And folks, this is why I brought Robert and Dr. Sheets onto this podcast because when I saw this technology and I learned about it and I've seen lots of technologies, I mean, I talked to dentists and I talked to dental companies all the time when I saw this. It just makes so much sense, and I really wanted you to know about it. Let's get a little more into some of the other questions I have. So this product this InnerView integrates with practice management software like Dietrich's and Eagle Soft. Cherilyn how does that work?

Dr. Cherilyn Sheets: Well, we'll be having bridges ultimately, you know, to the different software companies. Roberts already talked with most, all of the major companies. They were interested in having this once we bring this to market. But right now, I've got it, you know, on each of my computers and I just bring it up so that the patient can see it on the computer and I can explain everything on that. So we have it so that it can be used independently, and all of our information goes up to the cloud so that we can have constant reinforcement and data acquisition that's going on. But eventually, you know, we'll be able to access this through all of the practice management systems.

Robert Hayman: Yeah, that's perfect Cherilyn. In fact, it won't only bridge, it will integrate with all the majors and even the second tier companies as well. They've all expressed a strong desire to work with us.

Art Wiederman, CPA: Yeah, because you've been talking to lots of people in the dental world and what's the reaction been to InnerView what I mean, you've shown them what you're doing, what are you hearing from the people in dentistry?

Dr. Cherilyn Sheets: Well, when I lecture, I mean, Robert can talk about the manufacturers, when I lecture to dentists, always the first question when I finish is when can I have one of these? When can I buy it? So which, of course, is wonderful for us to hear. And Robert, can you give them the manufacturers side?

Robert Hayman: Yeah, we speak with a number of, you know, executives in the dental space in which I've been involved with for decades at this point. Every one of them is keyed in on this, every one of them who we speak to. And we have them sign NDAs beforehand because there's a lot of sensitive and really groundbreaking information that we're working on. But every single one of them are interested in working with us.

Identifying new executive leadership for the company because we will be running a pilot probably in the, you know, fourth quarter of this year in one of the regions is really been one of the easiest things and very, very gratifying to see. And then when it comes to speaking to key opinion leaders, thought leaders in the industry, once again, every single one of them has a strong interest and a fascination with what we're doing because really, for the first time ever, this is probably easily dentistry's number one unmet diagnostic need and maybe number one diagnostic period, once the need is met. So it will potentially change the way dentistry is being done and make it better for everybody, patients, clinicians, everyone.

Art Wiederman, CPA: I would hope you can also get this into the dental school so that the young people that are starting their careers could learn how to use this technology too. I'm sure that's in the works. Just a couple more things I want to touch on and then we can wrap this up. Implants, Cherilyn, you touched on, how does this work in helping dentists with implants?

Dr. Cherilyn Sheets: Well, currently the state of the art is to tap an implant, you know, just turn your mouth there over a tap on the implant. Listen to the auditory sound and then determine whether this is a healthy implant or not. And take an x-ray and probe around it. But really, we depend a lot upon this auditory sound, which is very qualitative. And so when we can put an abutment on it and tap it, we get an actual true representation of what happens and how that implant responds. And the more bone that's on it, the more you're going to get close to the perfect curve and the less bone that's on it, or if you got bone voids on it or it just didn't integrate, it's going to get worse and worse and worse. So that's one thing.

But what's really unique about our system is that the one system or two systems that are on the market pretty much keep it limited to just that surgical placement and before you put, you know, all of the things on top, the abutment and the crown, but with our system, because we can test teeth also, you can test the implant not only at the point when it's delivered, but you can test it throughout its lifetime, just like you can a tooth. So we actually get these trend reports. And that's one of the reasons that Robert and I are so excited about this being a part of the hygiene program.

So the hygienist, you know, have the responsibility for the education and the wellness, you know, of the patient for most of the practices, you know that they're in and they'll do a screening probing at least on every single patient, you know, before they start doing their hygiene. And that's wonderful for the periodontal health. But with this test, because we've got it down now to where it doesn't take very long at all, they can also be the proponent for the structural wellness of the teeth and then provide this reading, which then every time we have patients, every time they come in for their three month cleaning. Because most of our practice is on every three months, they get an InnerView test and we're developing these trend lines. And already I've seen some really dramatic things that I didn't expect to see.

For instance, you'll have a reading on a tooth at one point let's say that it's 40, and three months later, you test it again and it's up to 70. And when that happens, you go, OK, what just happened here? And oftentimes it's just a crown that's on it, and it's losing cement seal and it's getting ready to come off. Now it's much better to be able to tell your patient this is really trending up. I think we have a problem here and they're alerted rather than to have them come and get their teeth cleaned and then leave and a week later, their crown falls off and they're going, Why couldn't you see this when I was there? Well, that's the point. We couldn't see it because it's mechanical and we always say that, you know, this test allows us to see what can't be visually seen by the mechanics of the way it tests.

Art Wiederman, CPA: I mean, you what you're saying is every single time I was going to ask you how hygienist would work with this, but you answered that is so like, you know, people, hygienists and assistants will probe maybe once a year. You're saying in this situation, the hygienist will do this test. I mean, for either three or four or six months, we call every time the patient comes in? Yes, because that only takes three or four minutes, you said, right?

Dr. Cherilyn Sheets: That's right. Yeah. So whatever their recall time period is, that's when they also get checked because we're already just we only started this version. You know that we're field testing now, you know, less than a year ago, I mean, we've been using it for research, but now I've totally integrated it into the office. So every single examination I do, the patient gets InnerViewed every time I'm doing restorative work, we take an InnerView reading on it before I start disassembling the tooth, you know, taking off the crown, the fillings, whatever it is, because it gives me some pre knowledge of what I'm going to find when I go in there. So if I see a really high reading, my radar is already up to look for micro leakage cracks. You know, anything that's destructive in there and you that's just going to say.

And then the other aspect of this is the hygiene monitoring program. We call it a wellness program in order to make sure that structurally, you know, these teeth and implants are well and if not, we want to know about it in advance and let our patient know about it.

Art Wiederman, CPA: And doctors, the whole key that we've talked about on this podcast for three and a half years is you building trust with your patients. I mean, what a cool thing. And again, I just believe that. After seeing this technology, this is like the first technology I've seen that I just kind of did somersaults over and how cool is it to be able to say, you know, Mrs. Smith, you know, we've been we've been monitoring this tooth now for a year. A year ago, we didn't think it was a big problem, but it's trending in the wrong direction. So now we need to do something. But it's ultimately Cherilyn, it's the dentist's decision. What to do with this information, right?

Dr. Cherilyn Sheets: Of course, just like taking an X-ray and the dentist looks at the X-ray and decides what to do given the information that they have from it. And this is the same thing. It's an aid to diagnosis. It gives you information you've never had before.

Art Wiederman, CPA: Now you've had you've had that. You've been using this in your practice with Dr. Paquette, Doctor Woods, as well as with in other practices. What are you hearing about how the patients like this? How are they reacting to this new technology?

Dr. Cherilyn Sheets: Well, it's really been fun because in our practice, we've had, you know, the research version for over 10 years. But now that they see the InnerView, which, you know, looks like an Apple product, you know, it's white. It's all these fun things. And they just go, Oh my gosh, this looks so great. You know, this is advanced. This is wonderful. And I had a patient just today who said it's so wonderful to be a part of something that you feel is going to help you know, other people and help science. And they get very caught up in what their own readings are and when they have, you know, occlusal adjustment or they have a splint, they have a crown placed and then we test it afterwards and they can see the improvement in it. You know, they get they get very excited about it.

So I've been pleased because at first we thought, Oh, you know, they may not like this or they may think that it's, you know, it's too complicated for them to understand or anything. It's just not the case at all. It's been really easy for them, and even the grafts are easy because they'll see a curve good. Not bell shaped curve, bad.

Art Wiederman, CPA: Even CPA Art understands that. I mean, there you go. But and you guys have are going to have some training that goes along to teach the doctors how to use InnerView and how best to get the get the best patient experience?

Dr. Cherilyn Sheets: Absolutely. It's like anything else. If you know, if you know what you're doing and you're trained, their confidence is going to come across. The patient's going to feel comfortable with it, and you're going to get a much better response. So it doesn't take long, you know, to get your training. But like anything you know you want to be handling, you want to be taking the X-ray right at the right angle. You want to be applying the InnerView at the right angle to the tooth and understanding, you know, the basic interpretation of it.

Art Wiederman, CPA: And the last thing we'll touch on is we have lots and lots of specialists that listen to our podcast. How would specialists as opposed to general dentists be using this product?

Dr. Cherilyn Sheets: Well, really, for all of us, no matter what we're doing, you want to know if your foundation is structurally strong. So if you're an idiot honest, you're going to want to know whether that tooth has got cracks in it, you know, is it weak or strong? If you're periodontist, you know, the bone support is going to provide either more strength and less mobility or it's going to be worse. And certainly, price is just kind of like super dentist, you know, so you have to have all of these things. And I mean, I can't think of a specialty in dentistry other than maybe anesthesia, you know, that isn't going to benefit from this. Orthodontist. You know, we talk about how an ankle loose tooth, you know, is really a problem if you don't know it ahead of time. And this way you can be able to identify those problems.

And for me, I had a little Invisalign done. I looked right after it was completed and I thought, Oh my gosh, all my teeth are going to fall out because it was so much mobility and so many destructive grafts. But by the time the bone has reformed around those teeth and everything is in a stable position, you see those grafts improving. And so for an orthodontist, I think it will help them understand that not everybody heals at the same rate, and some people are going to need to be retained much longer than others, you know, who form really tight bone apposition around the moved tooth.

Art Wiederman, CPA: Well, so I'm very excited for you guys and what you're bringing to the profession, Cherilyn and I want to thank you for everything that you both of you, what you've both done for this profession. Robert, with your amazing company Discus Dental and all the thousands and thousands of dentists, not only the United States, but all over the world that you've helped and Cherilyn and just for your faith and trust in me over 38 years and your friendship and your husband and I remember when your daughter, Melissa, was four years old and I was playing hide and go seek in my conference room around the table, and now she's a little older than that and a very successful businesswoman in her own right, and it's just been an honor and a privilege to know you.

And again, you've taught me about giving back. I mean, you will never meet two more charitable people. I don't mean to speak, I don't know you as well, Robert, as I know Cherilyn, but I don't know any two people that are more charitable than Cherilyn Sheets and her husband, Mark. It's just an honor and a privilege to know you.

One more, one more time, Robert. Why don't you talk about there's some ways that people can learn about this? And then if you guys will stay with me as I take the podcast out? That would be great. So, Robert, you're looking for you're going to be doing some webinars here. We're going to be. This is going to go up on the internet on April the 27th. So I don't know when your webinars are, but if you want to give out the information and how people can find out about it or find out about participating these trials or whatever it's going to be to help go right ahead.

Robert Hayman: Yeah, in May, we're going to offer a couple of seminars, webinars essentially via Zoom that will essentially be regarding the technology and the system, how it's used and really get into a little bit of detail in terms of what needs to happen. And those who are attending this are also going to be able to register when the time comes to be field testing offices as well as data acquisition offices and then down the road.

You know, obviously we're very well connected in terms of information technology, the internet and what the technology does. We you can imagine that there are a number of implant companies, composite companies in restorative companies associations where they see the ADA, you know, and what not that are very interested in running various clinical studies or tests. We have the ability to ultimately run what could be the largest real time clinical studies that the industry's ever seen, and we can provide outcomes assessments for the associations as well as clinical studies for, you know, all the various companies that are out there.

So there will be a number of clinicians who will be interested in participating in that as well. But again, we have the two seminars that will be scheduled for May. We don't have them quite scheduled yet. We're working on times. We're starting to get into vacation season there with various people and we should have those up and on our website as well. And we're limited to only 20 to 25 people typically. That's where we're at.

Art Wiederman, CPA: And one more time, Robert, what's your email address or did you give out a phone number before just an email?

Robert Hayman: Yeah, my mobile number is area code three one zero seven six six four five one nine and my email address is rhayman@perimetrics.ai.

Art Wiederman, CPA: Well, guys, this has been fascinating. I'm a numbers guy. I'm not a science guy. I barely passed science classes in high school and college, but I did. So you have done a great job of explaining this, and I think I'm just again. I don't bring products to my podcast, just Helter-Skelter, I believe in what these two guys are doing, and I think it's going to become the standard of care. And I wanted my audience to hear about it. So guys again, stay with me just for a minute as I take podcasts out with a couple of announcements. Again, thank you for the honor and privilege of your time and listening.

We've got some great stuff coming up in the future. Make sure you go to Decisions in Dentistry website www.DecisionsinDentistry.com for great clinical content. A who's who of clinical writers and authors, as well as one hundred and forty continuing education classes that you can get for a very reasonable price. If you're looking for a dental CPA and this is all we do, folks. Give me a call at six five seven two seven nine three two four three or awiederman@eidebailly.com that's Eide Bailly dot com.

And also, if any of you are going to be at the National Academy of General Dentistry meeting in Orlando at the end of July, I will be giving a full day program on numbers of the dental practice and financial planning, so I would love if some of my podcast listeners were to come up and say, Hi. I will be speaking on July the 28th. So if you're going to be in Orlando in July, make sure that you are prepared to sweat. But it's I've talked to the folks at the AGD and it's going to be an absolutely fantastic meeting.

Well with that, folks, thank you again. Please tell your friends about our podcast. We've got thousands of people that listen. This one will come out on April the 27th, and I'm excited to get more of this information out to you. And with that, with that said, I am Art Wiederman, Dental Division Director of the CPA firm of Eide Bailly, signing off for the Art of Dental Finance and Management with Art Wiederman, CPA. Thank you for listening, and we'll see you next time.