Dr. Lorne Lavine, the Digital Dentist and cyber security expert is interviewed by Alex Nottingham, JD, MBA on Dental All-Stars. They delve into the topic of artificial intelligence (AI) and its implications in dentistry. Dr. Lavine explains that while AI has been present in dentistry for some time, it is now being used in non-clinical areas as well. They discuss the benefits of AI, such as improved diagnosis, decision-making, and treatment planning. However, they also highlight the potential issues with AI, including the possibility of misdiagnosis and concerns about data security and access to AI technology. Overall, the conversation sheds light on the advancements and challenges associated with AI in dentistry.
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About Dr. Lorne Lavine
Dr. Lavine is the Digital Dentist. A former periodontist turned cybersecurity, IT, and HIPPA expert for dental offices, Dr. Lavine lectures and educates globally to keep dentistry safe from all the various cyber threats.
About Alex Nottingham, JD, MBA
Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.
Transcript performed by A.I. Please excuse the typos.
This is Dental All-Stars, where we bring you the best in dentistry on marketing, management and training. Here’s your host, Alex Nottingham.
Welcome to Dental All-Stars. The title of this podcast is The Age of AI and How to Protect Yourself. Our guest is Dr. Lauren Lavine, and he’s a digital dentist. A former periodontist turned cybersecurity, IT and HIPAA expert for dental offices, Dr. Lavine lectures and educates globally to keep dentistry safe from all the various cyber threats. Please welcome Dr. Lavine. Thank you, Alex. Pleasure to be.
back here. I’m looking forward to the president. I want to make sure we start this off on the right foot today. I was playing tennis on Saturday and I tore my calf muscle. This is probably one of the few times in your life that you may be able to beat me in tennis. So I thought if you want to fly out here for money, this would be a good chance for you. I can really only walk on one leg. So you tore your calf muscle? Yeah, torn the middle head of my gastro third time actually that I’ve done it. So Wow.
Okay. I don’t know if you knew that, but it is. Well, I have a story once when I was in high school. I lost the match against a buddy of mine and I threw the racket at the net. I missed the net. I hit him in the knees. So contact it can be because I know you’re Canadian. So, you know, you have to make a sport contact. Yeah. Listen, it’s the oldest sport in the world.
Very nice, very nice. Well, thank you. Thank you. We’ll set up a match. We’ll both play with one leg, one calf. We could do it. So AI, you’re the digital dentist and I really was looking forward to talking about this subject, artificial intelligence. So it’s wrapping up very fast. And there’s some really exciting things about it and some scary things about it. And I’d like to talk to you about AI. So
Starting with the benefits, what are some of the benefits with artificial intelligence? And even before that, define for us what AI is and what the benefits may or could be. Yeah, I mean, what’s interesting to me is I don’t know what has triggered this, quote unquote, rapid growth. AI in dentistry has been around for a long time. I mean, one of my friends, Doug Yoon, who runs XDR, digital radiography.
He was instrumental in developing the logic on carries detector, which was back in the mid nineties. So we’ve actually had AI, you know, for quite some time. What we’re starting to see now is more and more kind of non clinical, non traditional use of AI. I mean, there’s a lot of different definitions of AI. I think machine learning is another way it’s basically using something like computers to
a human normally had to do in the past. So people use those terms like machine learning, AI interchangeably, but that’s kind of my definition of it is usually it’s software systems that are trained to function as a human would. So they’re replacing what we as humans typically have had to do ourselves.
Okay. So AI has always been been around or always, but it’s been around for more than we may be aware of. I mean, there’s chat, G B chat G what PT, what is it? Chat GPT, GBT and the you’re saying like, I wonder even if Google search is a form of AI or has been right. Is that considered AI? Yeah. I mean, the things that you can find on chat GPT are typically have been part of Google for quite some time. I mean,
You know, Google, when you, and Amazon, any shopping site, you know, they look at your past history, you know, Google will look at your past searches, other sites that you’ve been to, and it tailors the things that you see, it tailors the ads that you see, all of that is part of it, it’s learning what you’re doing. Of course, you know, the ones that are absolutely far and away the best at it, which is not necessarily a good thing, are social media companies. I mean, they are amazing at being able to
especially when it comes to teenagers being able to tailor what they see and how they see it. And, uh, you know, it’s, you know, they, that’s the whole point I think of social media is what’s, what they’re there for is to, to target, uh, you know, what I consider to be somewhat vulnerable population, younger people. So, uh, yeah, it’s been around for, for quite some time and people don’t necessarily use the term AI, but it’s absolutely part of, of a lot of industries. Yeah. I think that puts me at ease because
I use some of these programs, not chat, GBT, but an offshoot. There’s so many of them and I had them write articles and, and it was pretty impressive what I was able to do. At first I was kind of like scared, like, Oh my goodness, look what it’s doing. And afterwards, as I, from my experience is it was, it was kind of generic and they didn’t hit the exact mark, but it was helpful in starting the conversation. And you said you, you don’t
put out, I know you write a lot and you never put out content full AI, but you said occasionally you use a tool for brainstorming. Tell me about that where it might be useful. For a perfect example, I write a regular monthly column for DPR, a general product report, and that’s always fresh content, always. Occasionally I’ll have other companies that contact me to say, Hey, you know, we want an article from you.
And I don’t want to just regurgitate something that I did in DPR, besides the fact that I think it might be copyrighted. So I don’t, but I, but I also don’t necessarily want to sit there and spend two or three hours writing a whole new article. So I did this a couple of times. I’ve gone into chat GPT and said, you know, write an article on this for 1500 words, uh, similar to the style of me, because I have so much of my content out there.
And within about 30 seconds, there’s a 1500 word article on whatever topic I wanted. I went, you know, I had to go back and tweak it a bit and change some things around and, you know, put my own spin on it. But I’d say 90 to 95% of the content of that is exactly what I would have put. And it was written in my style. It’s scary. I mean, anyone, you know, that’s, that’s the downside is someone can say, this is an article for me, I wrote this and it would.
You know, to me, unless, of course, I know which articles I’ve written, but if I looked at something and someone said, hey, you wrote this five years ago, does this look familiar? I would look at it and say, yeah, that sounds like me, even if I didn’t necessarily remember writing it. So it’s pretty scary what it can do. I use it as science, like my son’s into IT as well. So if we want to write a program in a certain language, like C++ or something similar,
We could go to chat GPT and say, write a program in this language that can accomplish this. And, you know, really in seconds, you have a program. I mean, that’s, you know, that you would need years of programming know how to be able to write. It can do it for you on the fly. So it’s, it’s pretty impressive. We’re seeing a, and I like to get to the issues in a moment of AI because all right off the bat, we’re identifying that.
some content creation and those that provide that can be not obsolete but minimized some of that, the job force and even the programming there. Now in dentistry specifically, where do you see AI being used? You touched on it earlier, but what are some areas that you see AI being used in dentistry? Right. So the first which I mentioned was something like a logic con is diagnosis.
being able to evaluate X-rays, cone beam, information, periodontal probing, whatever the case may be, and being able to diagnose. Kind of related to that would be things like decision making. Okay, now we’ve done this diagnosis, how do we then go about deciding what needs to be done? Kind of an offshoot of that would be a treatment plan. We can literally come up with a treatment plan based on AI, based on, okay, if someone’s got
this number of pockets, or this pocket depth, or whatever the case is, this is the treatment that we’re gonna recommend, and we’re gonna do it in this order. That can be completely automated. Things like predicting treatment outcomes can certainly be done with AI as well. On a non-clinical basis, we’re seeing something like scheduling. You could use AI for online scheduling based on the production numbers that you want and how you set it up.
So there’s a lot of things that it can do. The things that I tend to focus on, the things that I’m seeing most as far as the development of AI in dentistry is on the clinical part, on the diagnostic part and the decision-making, treatment planning and treatment outcomes is all kind of related to what the AI is doing. I would put you in the boat where, so I’m an attorney and I also would put a accountant in this realm and I would put you in this realm.
that tend to see the problems, right? Because being an accountant, being an attorney, being the digital dentist in IT, like what can go wrong and being aware of that to help people make sure it doesn’t happen. Right, there’s a lot that can go wrong. Right, and that’s what I like to get to because I know you’re a very nice guy and fun, but, and I wouldn’t say you’re a pessimist, but you see what happens.
And you you’re trying to find the issues before they happen because they’re so catastrophic when you aren’t prepared. So with that in preparation, what are the issues with AI specifically in dentistry? I mean, you can go both like broadly and then in dentistry, what what’s happening with AI and where do we have to be careful and protect ourselves from? Right. So two things that cut the jump out to me in dentistry specifically. The first, of course, is.
If we’re using it as a diagnostic tool, just like with humans, you can misdiagnose. It’s important to understand with AI, what it’s doing is it’s taking data, data that it’s given, and it then incorporates that data. The more data that it has, the more accurate it can be, but it may not, for example, how do you train a software program to replace 20, 30, 40 years of a clinical experience? There’s always nuances in dentistry.
based on the patient. I mean, there may be decisions that need to be made based on their medical history, on their past dental history, on their finances, whatever, that are going to affect that. In IT, we have this old expression, garbage in, garbage out. So the AI is only as good as the data set that it’s been fed in order to make its decision making. And until you’ve been able to put enough information in, there’s always the chance of misdiagnosis, for example.
The other big thing for me, of course, is you’re sharing patient information. We live in an age where data security is a huge issue. HIPAA compliance is a big problem. We have no idea. These AI companies, chat, GPT, what does it do with that information? If we’re giving it confidential information, is it secure? I think it’s new enough that people really don’t know how it’s being used.
and in what capacity. I think more just from a societal standpoint, as with anything, anytime you automate someone’s job functions, you eventually get to a point where you don’t need that person. I mean, you’re potentially looking at loss of jobs. I think the other thing, and this is more from a society standpoint that I look at it anyways would be,
I think one of the goals in dentistry and in healthcare is that we want to increase access to everyone. The fact of the matter is that AI is probably going to be more related to people at a higher socioeconomic level because it’s not going to be available to everyone. So right now, I think we have a big disparity between the haves and the have-nots in society when it comes to healthcare. I think AI potentially could exacerbate that.
that you’re going to have people in good areas, higher socioeconomic levels that have access to this AI, whereas people in lower socioeconomic areas may not have access to it. If we do get to a point where AI is better at humans than in diagnosing and decision making, then those people are at a disadvantage. I think that’s a potential concern as well.
AI and specifically in your realm of privacy, HIPAA, as well as, okay, starting with the first issue you raised in diagnosis, we can’t say, oh, well, the AI diagnosis way, there’s still a standard of care and you’re responsible regardless. I don’t think saying I used machine learning as my diagnostic tool and it was wrong. So you’re saying that still as the dentist, you’re responsible.
for making the final say. Yeah, it’s just a tool. It’s no different than an X-ray or a perioprobe or whatever the case may be, a cone beam image. At the end of the day, the buck stops with you. And it’s the same thing with HIPAA. We’ve always talked about HIPAA. And there’s so much that can go wrong with the practice, whether it’s being hacked or ransomware or their backup fails. There’s a lot of things that can go wrong. And we all, a lot of us tend to use
outside experts for those things to make our practices run. But the buck stops with you. I mean, you’re the covered entity when it comes to HIPAA. You’re the only one that’s at the end of the day responsible for what goes on in your practice. So you’re right. You can’t turn around to AI and say, well, the software misdiagnosed it. You know, from that standpoint, maybe we use AI as a preliminary diagnostic tool, but the dentist maybe should be the one that makes the final decision. You look through all of it before you start
making your final decision. You don’t rely on it. You just use it just like you would other tools in your practice to try to figure out what makes sense. That makes sense. I think about just being careful that we don’t get too lazy and rely on it where we miss something. It almost it’s like it looks like a real boy, but it’s not. Just being being careful. Yeah. Now with respect to viruses, malware, ransomware.
Are they becoming like superbugs now because of AI? I mean, is like virus technology AI in a sense? And is it becoming more of a issue? Yeah, some people may be using AI to develop the ransomware out there. A lot of the ransomware that we’re seeing coming down the pike is what’s called zero day. And that’s basically a fancy way of saying that it’s so brand new that your antivirus software, your firewall doesn’t know what to do with it. I mean, all
antivirus software works the same way, which is use as signatures. Because a lot of these viruses have codes kind of like DNA where there’s a little strip there that the software says, Oh yeah, this is what I saw in these other types of viruses. This must be a virus as well, because it has a similar code. The new ones that are coming out are so new and so unique that your software just doesn’t know what to do with it. And, you know, because of that, we still have.
clients on firewalls, antivirus software, what we’ve been pushing people towards over the last few years is something called application whitelisting, where we basically say if a program tries to run that hasn’t already been pre-approved, it can’t run. We won’t let it run. We can let it through if it is actually a good program, but we’re gonna stop it in its tracks until we do that. So the other thing with ransomware, which is a big concern for me as I see it, we’re now seeing what’s called ransomware as a service.
Where in the past, these different groups had to develop their own ransomware viruses, which obviously is very time consuming. So what’s happening now is you’ve got some major players in the ransomware field that are creating the viruses. They’re then selling it to other companies as a service to say, hey, you can use our ransomware and whatever you collect, we’re going to take 15% of that, 20% of that off the top. So you’ve got all these people now who basically don’t have the skills to develop ransomware.
but they do have the skills to infiltrate networks and they’re saying, okay, well, we’re gonna, you know, we’re gonna license your ransomware code and, you know, we’ll keep 80% of whatever we make. That’s a good deal, you know, no overheads. So it’s really kind of very frightening to me what’s going on. And there’s no doubt that they are using tools like AI to help develop their viruses. Well, now that I’m officially scared and all of us listening are scared, the digital dentist,
How can you help us or what can we do to protect ourselves from? I know you have specific tools in your suite. What are tools that either you provide or that offices need to have to certainly what stands out as the viruses and malware or anything else relating to this AI or machine learning or bugs that are out there? How can we protect ourselves?
So, and I mentioned a few of them already, the approach that we take is basically a three-pronged approach. Number one, it’s the ounce of prevention is worth a pound of cure. Making sure that you never get hit with these viruses in the first place is way easier and less costly than having to deal with it once it gets in. So, we wanna have…
you know, the approach I take is kind of like a filter, that you know, you’ve got all this stuff, bad stuff coming in, and by the time anything doesn’t get through, you want it to be the very bottom of that filter, very thin little, you know, dribble of stuff that they can get through. Your firewall is the number one way of dealing with malware that’s coming in. We also wanna make sure that all your software, because people always think that, you know, the way that viruses get in is by someone clicking an email.
attachment or some other way, it’s actually probably one of the more common ways that viruses get in is through security holes in your software. All software has security holes in them and these companies are constantly releasing patches. Oftentimes the patches themselves have holes in them. You’re kind of playing this game of whack-a-mole. That’s part of the reason why one of the HIPAA rules, something called patch management, which is that it’s a law, you have to keep your systems current and up to date. As I mentioned…
firewalls, you know, that type of, you know, passionate software, it’s not foolproof. You know, nothing you do is a hundred percent. So stuff will get through. So then you have to deal with it. That’s where, you know, certainly having anti-virus software, anti-ransomware software is gonna be beneficial. And as I mentioned before, that the application whitelisting in my mind is kind of like the final piece of the puzzle. That we’ve been…
installing application white listing for about two and a half years for our clients, we have yet to see a single virus on any computer that has that software, which is not something I could have said beforehand. That being the case, even with all your best efforts, not everything, like I said, is 100%. And you need to have some good way to restore. And that’s where backup, having a good solid backup is, in my mind, critical for any practice.
You know, it’s just basically, you know, it’s just going through that protocol of doing everything you can to prevent it from ever getting in, making sure you’ve got the tools in place to deal with it. And if all else fails, being able to recover. That’s kind of the approach that we would take for any office. It makes sense. And for those that are listening, if we’d like to learn more about you and your services, what will we do? Where would we go?
You can, the easiest way is to go to the website, which is www.thedigitaldentist.com. And there’s a little form there where you can just, you know, yes, you want a consultation, you put in your name, your phone number, your email. It comes to us, my office manager, Candace, will contact you. What we recommend for most offices is what we call it a technical audit or security audit. It’s, you know, the basic kind like that any dentist would understand.
you can’t treat the planet you diagnose first. I’m more than happy to talk to any office if they wanna pick my brain, but for most people they have, they wanna know their specific situation. What do I do? Do I have protection in place? What are things that I need to do for my individual practice to secure it? So we normally charge for it for any of your listeners. If they call, if they go to the website or they call us, they can just mention that they heard the podcast and.
we’ll waive the fee, so it’s free. The process doesn’t take that long. It takes maybe 30 minutes, 40 minutes. We only need you for five or 10 minutes of that just to log us onto the systems. We gather the data, and then I would sit down with you afterwards and say, okay, here’s what we found, and here’s what I recommend, and here are the choices, and here’s what the choices will cost, and here’s what’ll happen if you choose choice A versus choice B. And the goal is to come up with a plan that’s gonna fit.
to what you wanna do in your budget, and then we go from there. But you don’t know what you’ve got in place or what you don’t have in place until you actually look. And that’s the problem is a lot of offices just haven’t looked, so they don’t know what’s going on, and you don’t wanna find out the hard way. So the other option, if you wanted to wanna call us up, we have a toll-free number, which is 866-204-3398.
I think it’s extension 200 from my office manager, Candice, and same deal. She’ll schedule us to call. The other thing that I did is I know that there’s some people out there who are a little bit shy, who may not want to talk right away or want to sort of get a feel for where they might be at. So I set up a separate website. It’s called go.thedigitaldentist.com.
And it’s basically a security predictor checklist. It’s like a six point or I think six or seven point checklist that’s gonna ask you these questions and you’ll get an immediate response as far as this is where you’re at as far as the security in your practice. And if that then triggers you to go to the website or call us that, that’s great. And if not, you’ve got information that you didn’t have five minutes before that. Thank you, Lauren. I appreciate it. I appreciate it so much. And I…
I didn’t mention the beginning. We go back way back since the beginning of all start dental academy. Uh, you’ve been a big supporter and we really are so grateful for you and what you’ve done for dentistry. I mean, you just add a, a sense of security and safety knowing that you’re out there and you’re providing and protecting people, uh, to keep them safe and so they can just do more dentistry without unnecessary headaches. Uh, so thank you so much. And remember.
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