A 78-year-old Florida patient allegedly smashed his orthopedic surgeon’s Tesla with a hammer after two canceled operations, including one he said was canceled because he drank water. The vandalism is indefensible. But the story raises an important clinical question for dentists providing sedation: Are we still fasting some patients longer than necessary? Modern anesthesia guidance has moved well beyond the blanket “nothing after midnight” rule. For most healthy adults undergoing elective anesthesia or sedation, current recommendations generally support: Clear liquids until 2 hours before anesthesia or sedation. Solid food for at least 6 hours, and longer after fatty meals. Individualized assessment when gastric emptying may be delayed. That last point matters more than ever because of GLP-1 medications such as Ozempic, Wegovy, Mounjaro and Zepbound. These drugs can slow gastric emptying, but current guidance has moved away from automatically stopping them or canceling procedures. Most patients can continue GLP-1 therapy, while higher-risk patients may require additional precautions based on dose escalation, gastrointestinal symptoms, medical history and the planned anesthesia. The lesson for dentistry is not that fasting rules are unnecessary. Pulmonary aspiration is rare but potentially catastrophic. The lesson is that vague instructions are increasingly outdated. Dental practices providing moderate sedation, deep sedation or general anesthesia should give patients precise written instructions, clearly define what counts as a clear liquid, ask specifically about GLP-1 drugs and gastrointestinal symptoms, and document the discussion. Clinical safety and patient experience are not opposing goals. If your office still tells every sedation patient, regardless of procedure time or medical history, “Nothing after midnight,” it may be time to take another look at the evidence. #Dentistry #DentalAnesthesia #PatientSafety #GLP1 #SedationDentistry

Wally Health Raises $25 Million: Can a $249 Dental Membership Disrupt Dental Insurance and the DSO Model? Wally Health is one of the more interesting dental startups to watch. The company recently raised a $25 million Series A and says it now has more than 50,000 members across 15 locations, with plans to reach 100 by the end of 2027. Its model is simple: $249 per year for unlimited preventive cleanings, exams, X rays, 3D scans and whitening, without traditional dental insurance. Wally generally refers out major restorative treatment while generating additional revenue from services such as periodontal therapy, Curodont, clear aligners, retainers and nightguards. That makes Wally less like a traditional DSO and more like a technology-enabled preventive dental platform trying to own the patient relationship before restorative disease develops. The economics are fascinating. If 50,000 active members each pay $249, that equals about $12.45 million in annual membership revenue. If members average three visits per year, that works out to roughly $83 in membership revenue per visit before additional services. Can that work after paying hygienists, dentists, rent, equipment, supplies, technology, marketing and corporate overhead? Maybe. Wally’s strategy depends on efficient workflows, smaller clinic footprints, strong renewals and additional revenue beyond the membership. Its use of EMS AIRFLOW and Guided Biofilm Therapy is supported by legitimate clinical evidence showing improved comfort and shorter treatment times, although claims such as “pain-free” or dramatically faster cleanings should still be viewed as marketing rather than universal clinical facts. Wally also promotes Curodont for selected early, noncavitated carious lesions. The science is promising, but “reversing early caries” is very different from saying dentistry no longer needs the bur. The real test is scale. Going from 15 locations to 100 in little more than a year is an enormous operational challenge in healthcare. Wally may be proving that preventive dentistry can be unbundled from the traditional dental office and rebuilt as a consumer subscription business. The question is not whether patients like $249 dental care. The question is whether the economics, clinical quality and customer experience still work when 15 locations become 100. Should traditional dental practices copy Wally, compete with it, or partner with it? #Dentistry #DentalBusiness #DSO #DentalInnovation #DentalAI @tytyburnett

Do Clear Aligners Cause Tooth Decay? A provocative headline recently asked whether clear aligners cause more decay than candy. The concern is worth discussing, but the evidence does not support that conclusion. A 2024 study of 203 adolescents treated with clear aligners found that 35.5% developed at least one new white spot lesion during treatment. That sounds alarming, but white spot lesions are early enamel demineralization, not necessarily cavities. Most lesions were mild, and no severe cavitated lesions were reported. The more useful finding was who was at risk. Preexisting white spots, carbonated beverages, more anterior attachments, poor brushing, and inadequate aligner cleaning were associated with greater demineralization. In other words, the problem looks less like “plastic causes decay” and more like the familiar combination of plaque, diet, hygiene, saliva, fluoride, and patient behavior. Fixed orthodontics is not innocent either. A meta-analysis reported new white spot lesions in 45.8% of patients treated with fixed appliances. More recent comparative reviews generally suggest that clear aligners produce less plaque accumulation and may have lower white spot lesion risk than braces, although the evidence is not perfect. Nano-hydroxyapatite is also getting attention. A small 2025 clear-aligner study found improvements with nano-hydroxyapatite, CPP-ACP, and fluoride varnish compared with fluoride toothpaste alone. Nano-hydroxyapatite produced the largest numerical improvement, but the study included only 40 patients, was not randomized, and relied on DIAGNOdent readings rather than actual cavity formation. So nano-hydroxyapatite is promising, but it has not been proven superior to fluoride. A large 2026 network meta-analysis of 70 randomized trials involving 4,634 orthodontic patients found that several newer agents can improve white spot lesions, but fluoride varnish remained one of the strongest options for prevention. The practical message is simple: do not fear the aligner. Manage the biology. Identify high-risk patients before treatment. Control plaque and acidic beverages. Keep aligners clean. Monitor attachment margins. Take baseline photographs. Maintain appropriate fluoride exposure and consider additional remineralizing agents when indicated. Clear aligners are not cavity machines, but they are not invisible force fields protecting enamel either. If we can move teeth predictably with sophisticated digital treatment planning, preserving the enamel covering those teeth should be part of the plan from day one.

Episode #1744 : Dentistry Uncensored with Howard Farran, Dr. Jack Hahn is back for round two — 58 years in dentistry, 54 of them in implants, four implant systems designed, and over 5,000 Dentaltown threads mentioning his name. This time he digs into the stories he didn’t get to the first time: the blade implant oral surgeons secretly swiped brochures for, the Clear Choice deal he was cut out of, the HA coating study that got destroyed, and his blunt take on whether implant dentistry should finally be a recognized specialty. 🎧 Pure, unfiltered wisdom from the GOAT of implant dentistry. #DentistryUncensored #DentalImplants #ImplantDentistry #DentalHistory #Dentaltown #JackHahn

AI Prescribing in Utah and What Autonomous Healthcare Means for Dentistry Utah is becoming a real world laboratory for one of healthcare’s biggest questions: which clinical tasks actually require a licensed human every time? Its Doctronic pilot is testing AI assisted prescription renewals for medications already prescribed by clinicians. The system cannot diagnose new disease, start new medications, change doses, or prescribe controlled substances. Importantly, the program is still in its first phase, so a licensed medical practitioner continues to authorize every renewal. Utah is testing autonomy, not declaring that autonomous medicine has arrived. A newer Nolla Health pilot goes further. AI can assess mild to moderate acne using patient history and photographs, then recommend topical treatment. The program is staged, with physician review built in before greater autonomy is allowed. The significance is not that dermatologists have been replaced. They have not. It is that regulators are creating a pathway where software may eventually move from recommending care to initiating it. Dentistry should pay attention because Utah has already tested a dental version of this idea. In a Dentacor pilot, licensed dental hygienists used AI radiographic analysis for narrowly defined conditions. When the hygienist and AI agreed, that agreement could substitute for direct dentist supervision in specified situations. When they disagreed, the case went to a dentist. That is probably how AI will spread through dentistry. Not with robots placing implants, but through hundreds of smaller decisions: chart review, radiographic screening, perio risk assessment, recall intervals, medical history reconciliation, emergency triage, insurance documentation, treatment planning, and patient communication. The opportunity is substantial, but so is the danger of calling too many things routine. A toothache is routine until swelling, diabetes, pregnancy, anticoagulants, or an unusual lesion changes the picture. Good automation must know when to stop and bring the dentist back into the decision. The safest prediction is not that AI will replace dentists, or that it never will. The stronger evidence is that AI will replace individual tasks long before it replaces an entire profession. The real transformation is happening one workflow at a time. What part of dentistry should AI be allowed to own first?

Contradictions do not exist. Whenever you think that you are facing a contradiction, check your premises. You will find that one of them is wrong. -Francisco d'Anconia

Vishing Scams in Dentistry: How Dental Practices Can Stop Social Engineering A dental office receives what looks like a routine referral email. Another dentist is asking about X rays. The name looks legitimate. The signature looks professional. Then someone calls the number. A convincing voice answers, discusses the “patient,” and offers to resend the records through a “secure” or “HIPAA compliant” link. By then, the phone conversation has created trust, and the link feels safer than it really is. That is social engineering. The FBI warns that criminals use spoofed emails, phone numbers, websites, and caller ID to impersonate people and organizations we already trust. In healthcare, that can lead to stolen credentials, exposed PHI, remote access, malware, or ransomware. Dentistry is especially vulnerable because referrals, radiographs, insurance requests, lab cases, and technology support are part of everyday workflow. The safest rule is simple: never authenticate a suspicious communication using information supplied inside that same communication. If an email gives you a phone number, verify the sender using a number or secure portal you already trust. And remember, cybersecurity is bigger than staff training. Multifactor authentication, software updates, restricted remote access, strong access controls, tested backups, and a clear incident response plan all matter. The goal is not to create a perfect employee who never makes a mistake. It is to build a practice where one mistake does not become a disaster. An email does not authenticate a phone call. A phone call does not authenticate a link. A familiar logo does not authenticate an insurer. If a convincing stranger called your front desk today, would your team know exactly what not to do? #Dentistry #Cybersecurity #Vishing #Phishing #DentalPractice

Biological Dentistry Under the Microscope: What Does the Evidence Actually Say? Few subjects divide dentists faster than “biological dentistry.” Supporters see whole-patient thinking. Critics see a collection of treatments ranging from reasonable to unproven. The better question is not whether biological dentistry is right or wrong. It is whether a specific diagnosis or treatment produces better patient outcomes than the alternatives. That standard produces some interesting answers. Fluoride is more complicated than either side admits. Cochrane found that water fluoridation historically reduced childhood caries, but its additional benefit appears smaller and less certain in modern populations already using fluoride toothpaste. The National Toxicology Program found an association between higher fluoride exposure and lower childhood IQ, but says evidence is insufficient to determine whether the U.S. fluoridation level of about 0.7 mg/L has that effect. Amalgam really does contain about 50% elemental mercury and releases mercury vapor. The FDA recommends additional caution for certain vulnerable patients, yet current evidence does not establish that sound amalgams cause systemic disease in the general population. The FDA specifically advises against routinely removing intact restorations simply because they contain mercury. Root canals present another distinction between fact and inference. Persistent apical periodontitis and endodontic failures are real. But evidence that some treated teeth retain disease does not establish that root canal treated teeth as a category cause systemic illness, or that extracting an otherwise maintainable tooth improves systemic health. Jawbone cavitations, NICO and FDOJ raise similar questions. CBCT can reveal abnormalities missed on conventional radiographs, but finding something does not automatically establish what it is. A radiographic finding is an observation. A diagnosis is an interpretation. Surgery requires another evidentiary step. PRF provides an important counterexample. It sounds thoroughly “biological,” but its credibility increasingly comes from randomized controlled trials and systematic reviews showing benefits after third molar surgery, including reductions in pain, swelling, trismus and dry socket. Ozone is earlier on the evidence curve. It has a plausible antimicrobial mechanism and encouraging clinical research, but the evidence remains limited and heterogeneous. And tooth regeneration may eventually make today’s arguments look small. Scientists are investigating anti-USAG-1 therapy to stimulate development of missing teeth. Animal results are fascinating and human development is underway, but predictable regeneration of functional human teeth has not yet been established. The lesson is bigger than biological dentistry. Professional consensus can change. Unconventional ideas can eventually become mainstream. But neither fact lowers the burden of proof. Calling someone a quack is not a rebuttal. Calling critics closed minded is not evidence. New ideas should never be rejected simply because they challenge conventional dentistry, but neither should they be accepted simply because they challenge it. Be radically open to questions and radically demanding about answers. What evidence would change your mind?

Did you know there is an actual castle built into Camelback Mountain? The story behind it is almost unbelievable. In 1967, Phoenix orthodontist Dr. Mort Copenhaver purchased a rugged, rocky piece of Camelback Mountain. The mountainside was so steep that there wasn’t even a proper road to reach it. But Copenhaver wasn’t taking no for an answer. Construction was anything but easy. A runaway boulder reportedly crashed into a neighbor’s fireplace, and Copenhaver himself suffered burns in a tractor fire. Yet he kept building. After roughly 12 years, his dream had become a nearly 8,000-square-foot fortress built directly into the mountainside, overlooking the Valley of the Sun. This was no ordinary Phoenix mansion. The castle reportedly featured 20 rooms spread across eight levels, along with towers, hidden passageways, a dungeon, an indoor waterfall, massive fireplaces, stained glass, and a giant spa beneath a retractable roof where guests could watch the stars. By the late 1970s, the castle had become a legendary gathering place. Lavish parties, wealthy socialites, and extravagant nights high above Phoenix became part of its reputation. Copenhaver’s parties grew so famous that the castle was sometimes compared to the Playboy Mansion. Esquire even recognized him as one of America’s eligible wealthy bachelors. But behind the castle walls, financial problems were growing. By the 1980s, Copenhaver’s business empire was unraveling, and the dream home was becoming a financial burden. In 1988, bankruptcy forced him to surrender the fortress he had spent more than a decade creating. The man who built his dream castle could no longer call it home. The property passed through several owners over the following decades. Eventually, a new owner began restoring it. In an extraordinary twist, Copenhaver himself returned to help repair and restore the home he had once built. Today, a project like this would be extraordinarily difficult to reproduce under modern hillside development restrictions. The castle remains a monument to a very different era in Phoenix. A childhood dream. Twelve years of construction. Lavish parties. Financial ruin. And one of the most unusual homes in Arizona, hidden in plain sight on Camelback Mountain. @RickKushner1

Uncovering Hidden Sugars with Grandpa Howie and his grandchildren youtu.be/tcQwbIJG91Y?is=NGva…

Arizona Man Accused of Killing Dentist Dr. Amed de Jesús Preciado Hernández After Dental Dispute: What Dentists Should Know About Patient Aggression A dental dispute in Nogales, Sonora, ended with two people dead and two police officers wounded. On October 15, 2026, dentist Dr. Amed de Jesús Preciado Hernández, 42, was shot and killed outside his clinic. Mexican investigators identified a 30 year old American, reported by Arizona media as Ernesto Rascón, as the suspect. Two days later, police located him in Agua Prieta. Authorities say he opened fire during the attempted arrest. Police returned fire and killed him. Two officers were wounded and survived. The headline quickly became, patient kills dentist over a loose tooth. That may be broadly consistent with investigators’ theory, but the motive was never tested in court. Sonora authorities initially described the dispute as a disagreement related to dental treatment and later said the suspect blamed the dentist for leaving a tooth or restoration loose. What appears more important for dental practices is the behavior leading up to the attack. Reports describe an agitated patient who arrived demanding treatment without an appointment, became angry when he could not be seen, waited outside, and later approached the dentist at his vehicle. Surveillance footage reportedly captured the attack. The danger was not the loose tooth. The danger was escalating behavior. Dentistry creates unusual pressure points. Patients may be anxious, in pain, financially stressed, or disappointed by a complication they did not expect. A dentist may see postoperative sensitivity, a failed restoration, or a biological complication. The patient may see incompetence, betrayal, or a bill for something that “didn’t work.” Most of these situations are resolved with communication. Some become hostile. Rarely, they become dangerous. The ADA reported in 2024 that more than half of surveyed dentists sometimes or often encounter aggressive patients, and about 30 percent said they had felt their safety threatened by a patient. That does not mean lethal violence is common. It is not. But patient aggression is common enough that every dental office should have a plan. Warning signs can include rising voices, clenched fists, pacing, profanity, hostile sarcasm, slamming objects, abrupt movements, or increasingly irrational behavior. Front office staff may see the pattern before the dentist does. The first response is often simple. Listen. Let the patient explain the problem before defending the dentistry. Acknowledging frustration is not the same as admitting fault. Clear informed consent, realistic expectations, and well defined remake, refund, and financial policies can also prevent many disputes from escalating. But there is a line where customer service ends and safety begins. Every practice should know who calls 911, how staff summon help, where employees and patients move during an escalating confrontation, how incidents are documented, and when a threatening patient relationship should be terminated. Panic buttons, exits, room layout, and staff role playing deserve the same kind of preparation as medical emergencies. The lesson from Nogales is not that every angry patient is dangerous. Most are not. The lesson is that aggressive behavior should not be normalized until it becomes threatening. Does your team know exactly where that line is, and what to do when someone crosses it?

Dental PPO Network Leasing: Who Really Controls Your Contracted Fees? Most dentists think they know which insurance companies they participate with. Then an EOB arrives from a payer they don’t remember joining, with a contractual write-off they weren’t expecting. “I never signed with them.” The payer may be right anyway. Welcome to dental network leasing. A dentist can contract with one network at negotiated fees, and that network may provide other insurers or benefit administrators access to those contracted rates. It is legitimate infrastructure that can expand patient access, reduce duplicated credentialing and help smaller insurers compete without building nationwide networks from scratch. But it creates an important question: What contract gives this payer the right to my discount? The same dentist can sometimes be accessible to a payer through multiple networks, potentially carrying different fee schedules. That doesn’t prove insurers always select the lowest fee. The evidence does not support that universal claim. But which contractual pathway controls a claim can materially affect reimbursement. The biggest financial issue may be even simpler. Suppose you accept a 25% PPO discount and receive 200 genuinely new patients. That discount may be an excellent customer acquisition cost. Now suppose the same 25% discount suddenly applies to 200 patients already in your practice because their insurer gained access through a leased network. Same discount. Completely different economics. You didn’t acquire 200 patients. You repriced 200 existing patients. That is why PPO participation should be treated as a business strategy, not merely a credentialing function. For every major payer, your practice should know: Who holds the underlying contract? Which network connects the payer to each dentist? What fee schedule actually governs the claim? Are there competing pathways? Can you change or terminate an unfavorable relationship? Regulators are increasingly asking the same questions. The policy fight has evolved from whether network leasing should exist to whether dentists should have greater transparency and control over where their negotiated discounts travel. At its core, the debate comes down to two words: Opt in or opt out? Network leasing itself isn’t necessarily the problem. Opacity is. If another company can use the fee schedule you negotiated, shouldn’t you know exactly who has your discount and why?

Did This Happen to Your Dental School Classmates? 😂 Twenty years later, which one did you become?

“Life moves pretty fast. If you don’t stop and look around once in a while, you could miss it.” — Ferris Bueller’s Day Off (1986)

GERD and Dental Erosion: What Dentists Need to Know Before Rebuilding a Severely Worn Dentition When a severely eroded dentition walks through the door, the temptation is to immediately ask: composite or ceramic, crowns or additive dentistry, how much should I open the bite? But the first question should be: What destroyed these teeth, and is it still happening? GERD is strongly associated with dental erosion. A 2022 meta-analysis of 28 studies involving 4,379 adults found erosion in about 52% of patients with GERD versus 21% of controls. But erosion is not a diagnosis of GERD. Reflux, vomiting, dietary acids, carbonated beverages, acidic supplements, xerostomia and mechanical wear can overlap. GERD and bruxism can coexist. Dentists can be sentinels for unrecognized reflux without pretending to be gastroenterologists. Document the wear, investigate the history, establish whether it is progressing and refer when appropriate. Control the acid before rebuilding the damage. Then comes the restorative question. Modern evidence increasingly favors preservation. Direct composite may require more maintenance but can conserve tooth structure and is readily repairable. Indirect ceramics generally show lower failure rates and can provide excellent durability, but may require more intervention. Increasing occlusal vertical dimension can sometimes create restorative space instead of drilling it away. Ferrule matters too, particularly in endodontically treated teeth. But evidence supporting ferrule does not automatically mean every compromised tooth needs crown lengthening. Natural dentin is valuable, and obtaining more exposed tooth structure can carry its own biological cost. The goal is not to join Team Composite or Team Ceramic. It is to preserve as much natural tooth as possible while balancing durability, repairability, function, esthetics and the patient’s lifetime restorative needs. The sequence is simple: Recognize the wear. Investigate the cause. Control the disease. Determine whether it is still active. Preserve what remains. Then restore what needs restoring. A spectacular before-and-after photograph gets attention. The photograph five or ten years later tells us whether we really understood the disease. When treating severe erosive tooth wear, are we planning for delivery day, or for the rest of the patient’s life? #Dentistry #GERD #DentalErosion #RestorativeDentistry #Prosthodontics

Can a Tooth Infection Actually Kill Someone? Yes, but fortunately it is rare. Dental decay itself almost never kills. The danger begins when infection reaches the pulp, escapes the tooth, and spreads into deep tissues, the bloodstream, the chest, or the brain. A 2026 JADA study found nearly 9,000 U.S. hospitalizations per year in which periapical abscess was the primary diagnosis. Among those patients, about eight died per year. An earlier national study found a similar number, about seven deaths annually. That does not mean only seven or eight Americans die each year from dental infections. Once infection spreads, the final diagnosis may be sepsis, brain abscess, mediastinitis, pneumonia, or airway obstruction, so the original dental source can disappear from the mortality coding. The true number is unknown. The real clinical issue is recognizing when a routine dental infection is no longer routine. Warning signs such as facial or submandibular swelling, fever, dysphagia, drooling, trismus, tongue elevation, muffled speech, difficulty handling secretions, respiratory distress, or inability to lie comfortably supine may signal deep space infection or impending airway compromise. The real world cases are sobering. Former NFL player Mike Williams died at 36 from bacterial sepsis with cerebral abscesses and necrotizing pneumonia due to multiple dental caries and retained roots. Twelve year old Deamonte Driver died after an abscessed tooth spread infection to his brain. The lesson for dentists is simple. Treat the source, not just the symptoms. Antibiotics may suppress infection, but they do not eliminate the source. Explain that less pain does not always mean the infection is gone. Escalate quickly when deep space spread or airway compromise is suspected. Dental caries is the most common health condition in the world. Fatal odontogenic infection is rare. Both statements are true. Are we communicating the urgency of definitive treatment clearly enough? #Dentistry #DentalInfection #Endodontics #OralHealth #Dentaltown

Is Dentistry Becoming Medicine? What the Collapse of Physician Ownership Should Teach Every Dentist American medicine offers dentistry a warning. In 2012, 60.1% of physicians worked in private practice. By 2024, that had fallen to 42.2%. Medicine did not get there because physicians suddenly stopped valuing independence. One rational decision followed another. Older doctors sold. Younger doctors accepted employment. Hospitals acquired practices. Insurers negotiated aggressively. Eventually, employment became the norm. Is dentistry next? Not yet. About 73% of dentists were practice owners in 2023, although that was down from 85% in 2005. DSO affiliation reached 16% in 2024 and 27% among dentists less than 10 years out of school. But the ADA data reveal something important. Younger dentists may be delaying ownership rather than abandoning it. Among dentists graduating from 2006 through 2010, ownership eventually reached 81% by 15 to 19 years after dental school. That distinction matters. A dentist working for a DSO at 30 and buying a practice at 40 represents a changing career path. A dentist working for a DSO at 30 and remaining an employee at 50 represents a changing profession. The real warning sign may be economics. Dental practice expenses are rising faster than revenue, while the capital, staffing and administrative burden of ownership keeps increasing. If employment offers attractive compensation without the debt, risk and headaches of ownership, employment becomes a rational choice. No motivational speech about entrepreneurship can repeal arithmetic. Dentistry still has an enormous advantage over much of medicine. Dentists can own the practice, equipment, goodwill and real estate while controlling the patient experience and building equity in the business. But preserving independent dentistry does not mean preserving the solo practice of 1985. The future may belong to dentist-owned groups that share purchasing, HR, billing, marketing, cybersecurity, technology and AI. The goal should be to capture the economies of scale of corporate dentistry without surrendering meaningful dentist ownership and clinical control. DSOs are not inherently the enemy. For many dentists, employment is an excellent choice. The goal should be preserving the choice. Medicine teaches us that professional independence can disappear one perfectly rational transaction at a time. If dentistry wants owners, dentistry has to make ownership worth owning. Will the dentists graduating today still own dentistry 20 years from now? #Dentistry #DentalPractice #PracticeOwnership #DSO #DentalBusiness

Primum non nocere. “Anyone can be skeptical; any scientist can be overly empirical. It is the rigor coming from the combination of skepticism and empiricism that’s hard to come by.” —Nassim Nicholas Taleb, The Black Swan

The AI Bubble and Dentistry, What the Crash of 1873 Can Teach Dental Practice Owners Artificial intelligence is already moving into radiology, scheduling, claims, treatment planning, marketing, call conversion, and patient communication. The question is no longer whether AI is real. It clearly is. The harder question is whether dentists will confuse a revolutionary technology with a good investment at any price. Liaquat Ahamed’s new book, 1873: The Rothschilds, the First Great Depression, and the Making of the Modern World, tells the story of the railroad boom of the 1850s and 1860s. Railroads transformed civilization, but investors became so convinced of their future that they financed too many projects with too much debt at valuations future cash flow could not support. The boom collapsed in 1873. Railroads failed, banks broke, credit disappeared, and the U.S. economy entered a contraction that the National Bureau of Economic Research dates at 65 months. The lesson is not that railroads were a mistake. The railroads were real. The technology was revolutionary. The financial excess surrounding them was also real. AI may be following a similar pattern. Alphabet, Amazon, Microsoft, and Meta are expected to spend more than $700 billion in 2026, much of it on AI infrastructure. The Bank for International Settlements estimates that the five largest hyperscalers are committing more than $1 trillion across 2025 and 2026. Yet demand is also real. Google Cloud, Azure, and AWS continue growing rapidly. Amazon says its AI services already have an annualized revenue run rate above $15 billion. So this is not simply another dot com fantasy. But real demand does not guarantee good economics. That is the lesson for dental practice owners. Do not buy AI because competitors are buying it. Do not reject AI because Wall Street may be overexcited about it. Ask a simpler question. Does this specific tool improve this specific workflow enough to justify its cost? Does AI improve diagnostic consistency? Reduce no shows? Convert more calls? Reduce insurance labor? Improve case acceptance? Increase productivity? Save enough staff time to produce a measurable return? A great demo is not ROI. The smartest practices will not necessarily use the most AI. They will use AI where it measurably improves clinical care, workflow, patient communication, or profitability, and ignore it where it does not. The railroad revolution succeeded spectacularly, even though many railroad investors went broke. AI may do the same. Are we using AI to build better dental practices, or simply buying into the biggest technology race of our lifetime?

Episode #1743 : Dentistry Uncensored with Howard Farran, Howard sits down with the leadership behind DOCS Education — Dr. Michael Silverman, co-founder and President, and Dr. Anthony Feck, Dean of Faculty. Between them, they’ve taught over 40,000 dental professionals how to safely implement sedation and treat the high-anxiety patients most practices never reach. Add four decades of clinical experience, advocacy before state dental boards, and a passion for practice building — and this one covers a lot of ground. 🎧 A must-listen on sedation dentistry, patient safety, access to care, and reaching the patients who’ve been avoiding the chair for years. #DentistryUncensored #SedationDentistry #DOCSEducation #DentalAnxiety #DentalCE #PatientSafety