Designing the digital patient

January 31, 2024

How do we best capture patients’ data digitally, use it for treatment planning, and get the final result we want? Practice owner and restorative dentist Elaine Halley does it with ChairsideCAD, Smile Creator and other cutting-edge digital tools. Elaine will join us in Mallorca for Insights 2024, where she’ll detail her approach to smile design and explain how to merge the clinical and technical worlds into one powerful, patient-pleasing workflow.

Q: What led you to a career in dentistry?

A: I graduated from the University of Edinburgh Dental School in 1992. I had started studying biology at university but then met some dental students who were in their second year and realized that, in our country, it was a Bachelor of Dental Surgery and was more than just drilling and filling teeth. I did some work experience, applied to transfer, and that was that. My first few years in dentistry, I worked in England but quickly realized that I wanted to open my own practice. So I did that back home in Perth, Scotland in 1995, and I've had the practice ever since. I opened a second practice in Edinburgh in 2010, and I've sold that into a small group of practices but have stayed on as clinical director. I split my time between my own practice, mentoring associates across 14 practices, and teaching as well.

Q: How did you first discover exocad?

A: The dental technicians that I've worked with for many years do a lot of smile design and full-mouth rehab cases with exocad. As the cases developed, we began using dentalshare to share cases and discuss margin placement and design. When exocad became part of the Align technology family, that was an interesting joining of ways for me since I lecture for Invisalign and iTero. When Invisalign’s Smile Architect was announced, the ability to export directly from Smile Architect into exocad software led me to become connected with learning more about exocad’s ChairsideCAD. All the paths came together.

“Digital lets us use visuals in a way that patients can relate to and understand.” 

Q: How do you see digital workflows impacting the patient’s experience?

A: Digital lets us use visuals in a way that patients can relate to and understand, which is very hard to do with words. Patients can see their mouths as they've never seen them before. We can guide them through the intraoral scan of their mouths and give them a reference point. What does a normal tooth and a worn tooth look like? Is this normal for their age? The diagnostics that digital gives us help us to let patients see what we see and offer them an insight into the treatment plan, making sure that teeth can function and the occlusion works. You allow patients to visualize what they've asked for and see some of the concerns or challenges. Here are the things we maybe can't change or can't control, and here are the different options with pros and cons. There's a marketing piece around patients seeing it and understanding it, but you also give patients the agency and autonomy to make good decisions. It's not that all patients are going to be able to choose the ultimate treatment plan, but at least with digital, we can educate and motivate them so that they can understand the consequences of whatever decision they make. I think it helps patients to feel involved, to feel in control, and that's a good place for adults to be able to make decisions.

Q: How has ChairsideCAD impacted the way that you work?

A: The big “aha” moment for me was with Invisalign Smile Architect, being able to almost play with the treatment plan options. If we move the teeth, what does that do for us? If we don't move the teeth, what does that do for us? Then being able to export into exocad and refine and try out different options from a restorative point of view. That's been huge. It’s a big help on the diagnostic side to have more direct access to the restoration design, while I'm still deciding what I want to present to the patient as the ultimate treatment plan options, which has sped up the process. If I want to do a try-in smile, I can get the digital file from my technician and print the model locally.  We're not reliant on waiting for the post. That helps me turn around case acceptance much more quickly.

Q: Have any of your team members learned how to use ChairsideCAD?

A: We're in the process of doing that with my treatment coordinators who are both qualified dental assistants. They're really good smile designers. That’s why we're figuring out what's the best way to integrate them with the system, and with my dental assistants, I’m thinking about renaming them “digital dental assistants” because they're so involved in the digital workflow.

Q: What types of training have you and your team taken part in?

A: We've had some great online training from exocad. My dental technician has been working with exocad for many years, so he's a real help too. We've looked at various in-person options, but so far there's so much online that we found to be adequate.

Q: We’re really happy you’re joining us as a speaker at Insights 2024 in Mallorca. Can you give us a sneak peek of some of the topics you'll be covering?

A: The area I’m most excited about is how we systematically capture all our patient data digitally, utilize that for treatment planning and then present it back to patients in a way they can understand. I want to show how to best utilize the digital workflow for diagnosis and treatment planning, then once the patient has agreed on the treatment planning, being able to use that to quality control the clinical end result so that it’s predictable. I think that's where a lot of the stress comes into dentistry—when we've either missed something in the diagnosis or we do this beautiful plan, but then we look at the result and we’re disappointed. That's where digital comes into its own. We can capture each stage and check if we’ve moved the teeth where we want them to be. Do we have the occlusion we want? Are we able to design the restorations as an exact copy of what our design was?  At Insights, I want to share that workflow and describe how I systematize it in my practice because I find often in dentistry, we gather a lot of information, but it's not clear how we should organize it. Digital helps us, but it only helps us if we're organized with how we utilize all the available elements.

“Clinicians and technicians tend to get split off into two separate learning tracks. For me, a huge reason to come to Insights is that the conference brings everyone together.”

Q: What would you say to someone debating whether to attend Insights?

A: We’re at this cusp in dentistry where there's so much being talked about when it comes to digital dentistry. I think clinicians who may previously not have thought about going to an exocad Insights conference, thinking it was just for dental technicians, should see that the crossover is happening. We're just on that tipping point of joining these worlds together. There's so much that we can learn from the world of exocad and our dental technician colleagues who are so experienced. Clinicians and technicians tend to get split off into two separate learning tracks. For me, a huge reason to come to Insights is that the conference brings everyone together. We’ll see what the next five to ten years will bring. I think exocad Insights is at the forefront of that prediction of the future and figuring out how we all collaborate with companies like exocad and with each other.

Q: Now for some light questions. Do you have a favorite song at the moment?

A: I've got a 16-year-old daughter and a 17-year-old Ukrainian boy living with me at the moment. So they dominate what I listen to in the car when I'm taking them to the bus. We hear a lot of Harry Styles.

Q: What's your favorite tooth?

A: I think my favorite tooth is the upper lateral incisor because they don't have to conform 100 percent. They can be a little bit quirky. You can give a uniform, boring smile a bit of interest by playing with the lateral.

Q: If you could give advice to your younger self, what would you say?

A: I was young when I started my own practice, so I would tell myself to just relax, keep learning, work on communication skills, do the best that I can and enjoy the life that dentistry can give.

Q: One word for exocad?

A: Sophisticated.

Image exoBloG Elaine Halley

Dr. Elaine Halley graduated from the University of Edinburgh in 1992 and achieved membership of the Royal College of General Dental Practitioners in 1995. She is a founder and past president of the British Academy of Cosmetic Dentistry and an accredited member of the International College of Dentists. She has a Master of Science degree in Restorative and Aesthetic Dentistry with distinction from the University of Manchester. She is a Digital Smile Design master accredited by Christian Coachman and is an official DSD instructor. She teaches Digital Smile Design on the Tipton Training Level 7 Post-graduate certificate for dentists who wish to further their skills in dentistry in Watford, Manchester and Dubai. She is a member of Align Technology’s Global Faculty and teaches the Comprehensive Invisalign certification courses throughout the UK. She is an Opinion Leader for many dental companies, including DMG, Ivoclar, Optident and Align Technology (Invisalign) and lectures throughout the UK, Europe and the United States. She has authored numerous articles on clinical dentistry, smile design, treatment planning, digital dentistry and the business of dentistry. She serves on the board of the Digital Dental Society UK. Elaine opened Cherrybank Dental Spa in Perth in 1995, and she opened a second practice in 2010 in Edinburgh, which she has since sold into the Pain Free Dentistry Group. She is Clinical Director for the Pain Free Dental Group, a group of practices across Scotland, which involves mentoring the associates who work there. She is the author of “Smile Analysis,” published by Edra Publishing in February 2022. This is a textbook for dentists which gives a pathway for progression from single-tooth treatment to comprehensive diagnosis and treatment planning.

by Caitlan Reeg
Writer at exocad

Caitlan Reeg spends her days telling the world about the innovations her colleagues create. She’s passionate about healthcare, technology, and the ways the two interact to improve our lives. A former journalist, Caitlan has worked on staff at Dow Jones Newswires in Frankfurt and at the national public radio program Marketplace in Los Angeles.