Latest / StartUp Health NOW Podcast / Building the referral bridge dental care has been missing | Brant Herman of Dentistry.One & MouthWatch

Transcript

Building the referral bridge dental care has been missing | Brant Herman of Dentistry.One & MouthWatch · StartUp Health NOW Podcast

• 0:00
  [chime] We think when you look at 50% of Americans who don't go see the dentist every year, those are populations that we really want to engage more actively and get them a starting point.
• 0:16
  Because when you engage patients and you get them on a preventive track for dental care rather than a reactive surgical reaction, you save a ton of money, and I think more and more research, it's proven it's effective.
• 0:29
  It really does improve their healthcare outcomes across over 60 chronic conditions and systemic health conditions. So we see teledentistry as that really simple touch point.
• 0:41
  [upbeat music] Brent Herman, CEO and founder of MouthWatch and Dentistry One, thank you for being with me today. Yeah, great to be here.
• 0:55
  We have had many chances to talk about the work that you're doing in teledentistry, and really kind of being on the bleeding edge of innovation in oral health.
• 1:04
  But I wanna get a sense of where you're at, where the company's at in 2026. What are some of your prime focus areas? Yeah. Well, MouthWatch has been a member of StartUp Health for quite some time.
• 1:16
  We do a lot with dental imaging and helping with intraoral cameras, which help a dentist chairside show a patient what's going on in their mouth. It's also great as a tool that can be used in non-dental settings.
• 1:31
  So nurse practitioners or pediatricians or school nurses, they can capture images that come from a patient, but they may not need to be in a dental chair per se.
• 1:42
  And that really ties into where we're heading and have spent a lot of time, which is Dentistry One, which is a virtual-first teledentistry network- Mm-hmm...
• 1:53
  where we really see the ability to bring patients into the oral healthcare journey, not only from the comfort of their home or their couch, but from any healthcare touch point where they might find themselves. Okay.
• 2:06
  Who's an ideal patient for teledentistry? Is this for any routine checkup, or is this for extreme cases, or what? Yeah.
• 2:13
  Well, I think when patients have a dental home and regularly go for preventive care to an office, teledentistry then becomes more of a, a cosmetic consultation tool or an emergency treatment triage tool.
• 2:29
  We think when you look at 50% of Americans who don't go see the dentist every year, those are populations that we really want to engage more actively and get them a starting point.
• 2:41
  Because when you engage patients and you get them on a preventive track for dental care rather than a reactive surgical reaction, you save a ton of money, and I think more and more research, it's proven it's effective.
• 2:54
  It really does improve their healthcare outcomes across over 60 chronic conditions and systemic health conditions.
• 3:03
  So we see teledentistry as that really simple touch point as a way to turn a pediatrician visit into a dental screening, to turn an OBGYN screening or visit into a dental connection.
• 3:16
  So that's where we love technology really eliminates that travel or transport or scheduling to get in for the cleaning. We can be that first touch point that makes it all really easy.
• 3:29
  L- let me just dig in a little bit on those two examples you gave. You said a pediatrician visit and an OB visit, 'cause I wanna give people a picture of what teledentistry really is.
• 3:38
  So you bring a child into the pediatrician. G- give me a case example of how it might play out that they then end up tapping into Dentistry One. Yeah.
• 3:47
  So I think there's a known value in earlier prevention for children, and we know that more kids are seeing a pediatrician for well visits than they are for a dental visit.
• 3:59
  So dental visits are recommended at year one, and then regularly following that, but that doesn't really happen as frequently.
• 4:06
  So what we wanna be able to do is from that point, which might just be educational, it might be a consultation with parents about best practices and what foods and leaving a baby with a bottle as they fall asleep.
• 4:19
  These little things that can really change the trajectory of a kid's oral health with their primary teeth so that they have the habits in place to stay healthy with their permanent teeth.
• 4:31
  But we see the referral process is a little bit more effective. I think everyone knows referrals aren't ideal even in kind of the confines of a medical system, but dental then lives outside of that.
• 4:45
  And so the referral process to go from that pediatric visit to say, "Do you have a dentist?" "No." "Let me connect you with a consult." And then a key part of what we do is we coordinate care to in-person visits. Right.
• 4:59
  So then we're helping that mom or dad book the appointment, find a dental home.
• 5:04
  And when you start looking at CHIP or Medicaid populations, this becomes a key challenge of just finding who is a provider that can support that patient base, and then really helping get them in and assign them a dental home, and get them some treatment.
• 5:18
  So just so I'm clear, the differentiation here from the old way is that instead of it being totally siloed, "Hey, you should go see a dentist," the pediatrician is dialed in and may be a member of Dentistry One and has a way to immediately make the handoff?
• 5:33
  Yeah. So I would say the old way was we would hope and pray that the pediatrician would even bring up oral health.
• 5:41
  Now, we think that's happening more, and there's a lot that a pediatrician can do that we're starting to see more on federally qualified health centers and clinics of they could do fluoride varnish application.
• 5:54
  They can do silver diamine fluoride, which is an amazing medicine that stops decay from progressing. Hmm. So there are these tools and technologies now that are available for medical settings.
• 6:06
  Some of those programs, we act like a dental mentor, that we help a nurse practitioner or a PA know how to apply these things- So that they can start seeing more patients, because I don't think we're gonna immediately solve the access to care shortage of providers unless we start looping in medical providers to deliver some of these services.
• 6:30
  But for us, all they need is a QR code or a URL or a referral card, and now that patient's on their smartphone, they're talking to a dentist, they're getting care coordination into an office, and you've now made it so that it's not up to the patient to remember.
• 6:46
  It's more integrated into that well visit to really get a streamlined referral into a dental home and get that patient on a good track of prevention. You mentioned the lack of...
• 7:00
  You said 50% of folks aren't seeing a dentist, so on the behavioral side, there's a gap.
• 7:05
  On the provider side, help us understand the potential gaps in terms of rural health, the need for teledentistry in areas with a lack of professional care. Yeah.
• 7:17
  Well, I think the number of provider shortage areas is significant, even more amplified by when you look specifically at dentists. But I think right now the dental care system is at 95% capacity.
• 7:30
  So even within practices and clinics that exist, if you move the needle a tiny bit, you've just overwhelmed the system. Mm. So that's where we see we can help shift certain appointments to virtual only.
• 7:45
  They can be consultative. We even have a program where we're fulfilling fluoride varnish direct to patients, and then we supervise it.
• 7:53
  So now you've saved a lot of time and effort and appointments from a clinic where they can focus on more critical acute issues that need in-person treatment and balance their schedule out a little bit more.
• 8:06
  So I think, one, you've got dental deserts where there's no provider within 45 minutes or an hour drive.
• 8:13
  In those cases, teledentistry is great at teeing up the appointment and following up on the appointment so that patient doesn't have to commit three hours, four hours of their day to a consultation or to a follow-up, and then we kind of complement an existing practice and how they deliver care.
• 8:33
  But we also want that idea of a patient who may have avoided the dentist. I know a ton of people where they're like, "I haven't been in four years." Yeah. Well, for us, like, now you're missing the window- Yeah...
• 8:43
  where you could really keep that to be an affordable preventive visit and not have it become a filling or a crown or a more costly expense.
• 8:53
  And there's so much that we start seeing when you look at this broader population of Americans with chronic disease.
• 9:01
  So you start multiplying a rural setting plus chronic disease of cardiac disease or diabetes, and we can bring this cost savings and outcome improvement to that chronic disease patient really just by tapping them into a little more dental care, focusing on prevention.
• 9:20
  And I think this conversation, and I'm thrilled to see it, is shifting away from white smile, straight teeth into let's prevent infection and reduce inflammation. Mm. Yes, you're gonna have a beautiful smile.
• 9:33
  That's still important socially and for employment, and we wanna connect people to that, but the mouth is one of the easiest indicators of inflammatory disease, and controlling inflammation in your mouth is super effective at reducing risk and outcomes for early pregnancies, for diabetes medication requirements and inflammatory markers, cardiac disease, Alzheimer's.
• 9:59
  The number of connections is so established, but I think what's been lacking is this real connection between medical care and healthcare systems, health insurance, compared to dental care delivery systems, let alone dental insurance, which is its own kinda different animal.
• 10:21
  Well, let's talk about ways to connect those dots and bridge that chasm. You made the case for oral health as holistic health, as whole person health. There's all of these indicators that connect it to other things.
• 10:34
  Just a couple weeks ago, we had an investor roundtable with Lisa Suennen from the AHA Vend- Ventures, and she said that one of her top interest areas was understanding the connection between oral health and the rest of healthcare, and yet there is a siloing going on.
• 10:50
  There is a challenge there. So, like, what do you think needs to happen for tools like Dentistry One, oral health tools to be more embedded in health innovation writ large?
• 11:03
  Yeah, I think some are just fundamental systemic changes in seeing there are...
• 11:11
  And this really hits home for me and as a technology company is we have found the shortcut or the access road or the sky bridge between the siloed institutions, and that sky bridge looks like digital connectivity through virtual care.
• 11:31
  There's a long change that's coming, and I think it's in underway, but getting a hygienist into an oncology ward or getting a hygienist into an OB clinic, those things take a lot of time and a lot of forward thinking and connection.
• 11:47
  But we wanna see that at least this bridge can happen with a referral, that if you have an integrated, streamlined referral from these medical care settings, now you can really start driving the right kind of patients who are gonna benefit the most from that one silo into a dental system that wants to see them, that wants [chuckles] to treat them, I think can really kind of help improve those better outcomes and results.
• 12:17
  Something that occurs to me is that there's a lot of different stakeholders whose behavior you're trying to change.
• 12:22
  If you could shift the thinking of one stakeholder, and I'm thinking of patients who are coming to the dentist, or actual dentists expanding their toolkit with MouthWatch, an insurance payer thinking differently about how they reimburse, a clinic, like a pediatric clinic that incorporates dental care.
• 12:43
  Like, what zone are you most passionate about right now or you feel like has the highest impact? We love programs that we're doing some initial successful projects with, where in a maternal health clinic
• 12:58
  right now, they're trying to boost the number of Medicaid members who are covered for maternal healthcare and increase the number of those patients who are seeing a dentist.
• 13:10
  So right now, that looks like every encounter with pregnant moms is leading to a referral to a dental consultation, and then we're helping that patient and then getting them connected into a preventive visit.
• 13:24
  So that's one really good example that from the waiting room or from the operatory during this, just a pregnancy well visit, we're helping support that.
• 13:32
  Same thing goes with pediatricians' visits, where in clinics, FQHCs that may not have dental, this is becoming a really effective referral.
• 13:42
  And I think the same thing that's valuable in, let's say, a Medicaid audience is effective in a commercial audience, but more on convenience, right? Yeah.
• 13:52
  The convenience is the win, that as long as my doctor recommends it and suggests it, and makes it so that I get a text message an hour after I leave the appointment that says, "Hey, here's some information about oral health, and we're here to help you book an appointment if that's what you need," there's a lot of things that we can do there.
• 14:12
  So I think that's the place where when plans are looking and they're paying out of their medical budget because of untreated inflammation and lack of prevention on dental, I think there's a huge win there.
• 14:25
  That might look like commercial payers that manage both medical and dental, or it looks like Medicaid- Yeah... where it's coming out of the same pot, but you can connect more patients in.
• 14:35
  And I think that's a real primary use case for us, is being that simple bridge from whether it's from an EHR or it's from a table tent in the lobby waiting room, that we become that easy bridge, as opposed to no one wants to think about making another appointment.
• 14:54
  Yeah. I think when we can streamline that and also help patients start to see more and more... There was a recent study, I think Delta Dental did it.
• 15:02
  It's a significant majority of people who understand that oral health and systemic health are connected, but I think the tangible way of making that connection happen is still really challenging.
• 15:15
  And that's where I think virtual care and teledentistry does a great job of saying like, "We're gonna make it so simple for you to reveal it," just like when you go to the doctor and they make a referral for imaging.
• 15:27
  That is a streamlined process from my primary care- It's-... to an MRI or to an X-ray. We just wanna make that happen for a referral to dental. It seems so obvious when you say it that way.
• 15:38
  It seems almost silly that it's been so siloed up until this point. I think you mentioned that people have an innate understanding of the connection between their dental health and their holistic health.
• 15:48
  How much work has been done in terms of trying to quantify the cost savings? You know, we say that, you know, an ounce of prevention is worth a pound of cure, and it's nice to try to connect the dots.
• 15:59
  A dollar spent on dental care is worth how much down the road? Is there any sense of what that looks like?
• 16:05
  Yeah, a range of studies show something like cardiac patients who effectively are engaging with preventive dental care, it's about a $1,200 savings if they're being treated for cardiovascular disease.
• 16:17
  Treatment is a 12% reduction in overall health costs for a diabetic patient. That might look like 1,500 to 2,000. So there's a financial sense that really comes up.
• 16:30
  Some of the challenges, and I think if everyone looks at what their dental plan does, you know, it's really tricky to see any connection between my preventive visits, which might be covered at 100% and allow me to kind of use that aspect of my plan, to where you- when you get into restorative, you're coming out of pocket.
• 16:48
  Dental is the second-highest out-of-pocket medical expense. So the whole system benefits, and even consumers benefit when prevention is emphasized. It's integrated into other preventive care touchpoints.
• 17:03
  And as soon as someone's out of that preventive care journey on, let's say, healthcare, and they're diabetic and you're trying to kind of help manage that inflammation, or it's part of their pregnancy and you're doing more than just what can be done within that OBGYN's office, this is where you can start revealing those improvements and cost savings.
• 17:24
  Another challenge is Medicare simply doesn't cover dental except in a few real edge cases of end-stage renal disease or organ transplant patients.
• 17:34
  So I think as that movement starts happening, again, we wanna be that easier bridge, because most dental practices don't accept Medicare.
• 17:43
  But we can kinda help coordinate patients who are covered by those kind of edge cases, which was a huge advancement for dental coverage, get them into a practice that can see them and help them reveal better f- health and outcomes.
• 17:58
  Do you see that regulatory environment shifting, the reimbursement models shifting? I think dental insurance is evolving a little bit more. I don't think Medicare coverage for dental is coming yet.
• 18:11
  I think the current mindset of cost reduction and fraud, waste, and abuse, and focus on innovation, I don't think that's happening. But I think the financial story is there, and it's proven over and over.
• 18:24
  And I've seen states that find a bipartisan solution when they start looking at an adult dental benefit reduces emergency room spends, it reduces overall healthcare costs, and you get to this place that covering preventive services for adults is much cheaper than leaving them to emergency only.
• 18:45
  And what it does, I think it's about $1,500 average for an ED visit- Yeah... a dental concern. Yeah.
• 18:50
  And so much of that can be taken care of virtually, and whether it's just a simple prescription and a referral that's what's happening in emergency room, we can do that for 60 bucks as opposed to it costing 1,500.
• 19:04
  So I think when states- Yeah... start seeing this is how kind of technology can really have this tangible outcome improvement and cost savings. Ex- excellent.
• 19:15
  Last question, anything big we should be looking forward to from you over the next year, something that you're excited about? Yeah. We're rolling out some more approaches with
• 19:24
  kind of what do you have this tool of an AI preventive scan, which is a part of our platform, access to coaches, and then dentists and care coordinators.
• 19:35
  So we're doing a lot more with physical products being available based on a curated selection for someone's specific oral health goals.
• 19:44
  But then also, we're working with retailers and retail products so that we're really seeing how do we put a dental office virtually in the aisle of the drugstore or the retailer where you're overwhelmed with choices.
• 20:00
  Yeah.
• 20:00
  You're hoping you remember what your hygienist said at your last appointment, but we really become this expertise, not only in these medical settings and touchpoints, but wherever you're thinking about an oral health decision, Dentistry One is there to have the right person with the right information to help you stay healthy and get connected to the right care you need.
• 20:23
  Brandon, appreciate you giving me another update. This is something that you've been working on a long time. You've had a fair amount of success at it, and yet it strikes me that it's still a greenfield problem.
• 20:33
  There's still so much to do, so many people who still [laughs] need dental care, so many systems that aren't integrated, so there's a lot of great work for Dentistry One and MouthWatch to continue to do.
• 20:44
  So I'm excited to continue to watch your progress. Yeah, I appreciate that. All right. Take care. Be well. All right. Thanks. Take care. Take care.
• 20:52
  [outro music] And finally, an invitation to all of the extraordinary Health Transformers, whether you are a startup, someone building the future of health, or whether you are an investor, funder, or buyer of the solutions out there in the marketplace, this is an invitation to you to join the StartUp Health member community.
• 21:16
  Learn more at startuphealth.com. Look forward to hopefully seeing you soon. [outro jingle]