Hello future. You're Justin Time! Just in Time to continue delivering smiles to the world. Just in Time to help fill the void when many of us retire. What would we ever have done without you?
To recap: Justin came to America from France.* In the mid-1980s "he" announced, at the annual meeting of the Dental Laboratory Association of New York, his intention to debut what he hoped would be the industry's first CAD/CAM system. His visit created a stir: it was a vision of what our future might look like. After traveling around our country for a number of years, looking for a permanent home, Justin went back to the drawing board in Europe. In 1997, Procera, from Sweden-based Nobel Biocare, became the first usable Just-in-Time system in the U.S., just a couple of years before other "Just-in-Time technologies" arrived. "Justin," of course, is a personification of all "automated milling and printing technologies." So again I ask: where would we be heading now if Justin hadn't arrived in Time?
In the next 10 years, 43% of our industry's owners hope to retire. If the past 10 years are an indication of the next 10 in terms of growth, our research suggests that, as owners retire, new laboratories will spring up at half the retirement rate. (In fact, 15% of our State of the Industry 2010 Survey participants opened within the last five years.)
Let's do the math: including those in doctor's offices, there are currently about 11,200 U.S. laboratories. If 43% retire, we'd lose 4,816 labs; that leaves us with only 6,384. But if about 23% [of the 11,200]--or 2,576--new laboratories emerge during these same 10 years, it raises back the total to 8,960. By the year 2020 we may have only lost a total of about 2,240 laboratories.
Forget for the moment that business has been painfully slow over the last six quarters. We're in recovery now [albeit a slow one]. Before the slump, business was hopping. In time, it will be hopping again. In fact, it will most likely be booming: There are 78 million Baby Boomers moving steadily into their senior years and many of us (yes us, ugh!) will need restorative care and, because of our culture's fixation on youth, we are also a prime target audience for cosmetic dentistry. On top of this, there is a huge underserved segment of our market in need of affordable restorative care and that segment is expanding. That's a lot of dentistry on our horizon!
Keep in mind that dentists will also be retiring at a much higher rate than the influx rate of new dental school graduates. Though "Justin" saves both chairtime and bench time, and gives us a greater ability to meet the restorative needs of a large influx of seniors, will this be enough to avert a crisis in access to care?
I don't think in-operatory milling will have a negative long-term impact on the laboratory community. Dentists will be so busy meeting the needs of this bulging senior population that they will likely be quite happy to farm out--to the trained experts--the "mechanical" restorative work that gets in the way of their billable time.
With some lab owners telling us they won't survive until the end of this year, I am certainly not oblivious or insensitive to current economic pressures. I don't mean for my rosy picture of tomorrow's landscape to minimize or disregard today's distressing realities. We are an industry in transition and this necessarily creates some upheaval.
However, in the long term, I think we're looking at a pretty stable, healthy and highly efficient dental healthcare model that will get stronger as we move through this next decade. And no matter what machines can do, there remains the need for dental technicians, as "scientific artists," to work their magic in making restorations look lifelike. The creative aspects of restorative dentistry, including client-relationship services, will continue to thrive on that personal touch. In addition, the one remaining restorative area not yet affected by automation is complete dentures and, even without Justin, that market is doing well and growing.
All good prospects for the future.
*Dr. Francois Duret presented the first laser scanner prototype to the International Education Congress of Dental Technology attendees in October, 1986; the scanner had been developed over a 15-year period with the help of Hennson International. Though Duret hoped to have units available in the U.S. by the end of 1988, he was never able to make it happen.