Cover / Editorial / Content / Eating disorders and dentistry: Identifying early signs in the dental office / Study indicates denture wearers may be more at risk of nutritional deficiencies / World News / An Interview with Desmond Chong, the President of Malaysia Dental Industry Association (MDIA) / Business / ADVERTISER INDEX
Cover
1 - 1 viewEditorial
3 - 3 viewContent
4 - 4 viewEating disorders and dentistry: Identifying early signs in the dental office
6 - 6 viewStudy indicates denture wearers may be more at risk of nutritional deficiencies
7 - 7 viewWorld News
8 - 11 viewAn Interview with Desmond Chong, the President of Malaysia Dental Industry Association (MDIA)
12 - 15 viewBusiness
16 - 24 viewADVERTISER INDEX
26 - 26 viewArray
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[1] =>
Vol. 1. No. 4, Jul-Sept 2022
Eating disorders and
dentistry: Identifying early
signs in the dental office
Study analyses tooth
survival after root canal
therapy in US population
Image source: Freepik
Dental sales a mixed bag as
war and supply difficulties
bog down pandemic
recovery
In The Hot Seat
An Interview with Desmond Chong, the
President of Malaysia Dental Industry
Association (MDIA)
[2] =>
[3] =>
Dental Tribune ASEAN
EDITOR’S MESSAGE
I
Publisher
FBI Publications (M) Sdn. Bhd.
t’s the month of July! We are
grateful for your ongoing support
for Dental Tribune ASEAN. As we
are approaching the middle of the
year, we’ve seen a few major events
happening across the globe. On Jun 23,
the World Health Organization declared
the outbreak of monkeypox as a Public
Health Emergency of International
Concern due to the increasing number
of cases which exceeds 17,000 in 75
countries.
Consumer Association of Penang
(CAP) stated that stern action should
be taken against fake dentists and
inspections should be done by the
authorities at dental clinics every six
months. The unhygienic procedure
performed by fake dentists is dangerous
as many of them claim to have learned
their skills from YouTube and such.
It’s also believed that they acquire the
tools needed from hardware stores or
suppliers from other countries that are
deemed not intended for medical use.
On a side note, do check out our firstever interview with Desmond Chong,
the President of the Malaysia Dental
Industry Association where we talked
about how MDIA started its journey,
milestones, and vision. MDIA also
shared their outlook on Malaysia’s
Marketing Communication
Nur Izyan binti Dzulkifli
izyandzul@fireworksbi.com
Publication Manager
Vanny Lim
vanny@fireworksbi.com
Assistant Editor
Atthira Zawana
atthirah@fireworksbi.com
Susan Tricia
Editor
dental industry post-pandemic and
matching grant worth RM10 million
to develop the medical device
industry to encourage investment
and export market.
Dental Tribune ASEAN will be
circulated in dental exhibitions,
seminars, and even webinars across
ASEAN
providing
additional
mileage for advertisers of the
magazine and reaching out to new
subscribers. Visit our website at
asean.dental-tribune.com for more
updates. Let’s do our part and get
vaccinated.
Malaysia Publishing Partner
FBI Publications (M) Sdn Bhd
Add: 9-3, Jalan PJU 5/6, Dataran Sunway, 47810, Petaling Jaya,
Selangor
Tel: +603-6151 9178
Email: my@fireworksbi.com
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Publisher and Chief Executive Officer
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Dental Tribune International GmbH
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asean.dental-tribune.com
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www.dental-tribune.com
Creative Designer
Muhammad Fadzil
design@fireworksbi.com
Board of Directors
Kenny Yong
Susan Tricia
Official Magazine of
Disclaimer
Material from Dental Tribune International GmbH that has been reprinted or translated
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Information in this magazine should not be substituted for the individual judgment brought
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Dental Tribune International GmbH and FBI Publications (M) Sdn Bhd does not necessarily
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Publications (M) Sdn Bhd does not offer any guarantee with respect to the accuracy of any
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Dental Tribune International GmbH and FBI Publications (M) Sdn Bhd does not, via
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individual patients and methods of practice are personal decisions, and the responsibility
for these decisions rests upon the shoulders of the attending dental practitioner.
[4] =>
4Dental Tribune ASEAN
CONTENTS
Clinical news
6
Eating disorders and dentistry: Identifying early
signs in the dental office
7
8
Study indicates denture wearers may be more at
risk of nutritional deficiencies
World news
8
Study analyses tooth survival after root canal
therapy in US population
10
Jönköping University aims to create new dental
programme to address dentist shortage in Sweden
11
12
Parties to the Minamata Convention on Mercury
further strengthen phase-down approach to dental
amalgam
In the hot seat
12
An Interview with Desmond Chong, the President
of Malaysia Dental Industry Association (MDIA)
Business
16
20
Dental sales a mixed bag as war and supply
difficulties bog down pandemic recovery
18
Sales slowdown puts the brakes on Align
Technology’s record run
20
Digitally visualise clear aligner treatment results
with new Align Technology outcome simulator
22
SmileDirectClub slashes net loss, signals major
strategy change for 2022
22
Dental Tribune ASEAN | Jul-Sept 2022
24
Henry Schein to acquire Condor Dental and
expand its operations in Switzerland
[5] =>
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[6] =>
6
CLINICAL NEWS
Eating disorders and dentistry:
Identifying early signs in the dental office
By Iveta Ramonaite, Dental Tribune International
Brooke Sharp, a clinical advice coordinator at Beat, an eating
disorder charity based in the UK, stated that eating disorders
often go undetected for a long time, since it is difficult to identify
the disorder by just looking at a person. However, since there
are physical indicators of an eating disorder that are visible in
the mouth, she believes that dentists may be among the first to
observe these.
According to the Oral Health Foundation, dental teams can play
a crucial role in identifying and acting on early signs of eating
disorders. (Image: Paradise studio/Shutterstock)
According to some eating disorder organisations and charities,
between 1.25 and 3.40 million people in the UK are affected
by an eating disorder. The condition can have a tremendous
effect not only on a person’s mental health and body image but
also on his or her oral health, and a patient’s mouth can thus
serve as a major indicator of disordered eating. In this regard,
the Oral Health Foundation has recently highlighted the role of
dentists, dental hygienists, dental therapists and dental nurses in
recognising the warning signs and symptoms of eating disorders.
According to various studies, eating disorders are among the
deadliest mental illnesses. In the UK, around 275,000 people
have binge eating disorder, 235,000 bulimia and 100,000
anorexia. Purging through vomiting often leads to enamel
erosion, whereas binge eating may increase the risk of dental
caries and tooth loss caused by excessive sugar consumption.
Additionally, people with eating disorders often absorb
insufficient vitamins and other nutrients, and malnourishment
too can be reflected in the mouth. Other dental problems related
to eating disorders include sensitive teeth, dry mouth, halitosis
and enlarged salivary glands.
Dentists have an important role
In light of the National Smile Month campaign aimed at
championing the importance of having good oral health,
the Oral Health Foundation has recently stated that dental
professionals are well placed to identify eating disorders early
during regular dental check-ups.
Dental Tribune ASEAN | Jul-Sept 2022
As noted by Chief Executive of the Oral Health Foundation Dr
Nigel Carter, OBE, it is already the case that dental professionals
examine the hard and soft tissue of the mouth and look for signs
of tooth erosion during routine dental examinations. They also
have the opportunity to spot possible injuries to the mouth from
the insertion of foreign objects to cause the person to vomit.
“The UK needs a far better strategy for
diagnosing eating disorders early”
— Dr Nigel Carter, Oral Health Foundation
Commenting on the issue, Dr Carter said in a press release: “The
UK needs a far better strategy for diagnosing eating disorders
early. The sooner an eating disorder is suspected or recognised,
then the more effective treatment will be.”
Sharp stated that the charity is already taking action to provide
dental professionals with the necessary tools for recognising
eating disorders and advising patients on the next steps: “At
Beat, we are currently working on a webinar series to educate
different health sectors about health, which includes dentists,
dieticians, and pharmacists. The aim of this training will be to
help professionals identify the signs of an eating disorder and
understand how to support their patients.”
However, she noted that, although dental teams may encounter
patients with eating disorders, it is not their responsibility
to treat the condition. Instead, they should direct patients to
professional help: “Whilst it’s important to increase awareness
of eating disorders, it is never the role of dentists to diagnose or
treat the eating disorder, and patients must always be signposted
to specialist support,” she concluded.
[7] =>
CLINICAL NEWS 7
Study indicates denture wearers may be more
at risk of nutritional deficiencies
By Anisha Hall Hoppe, Dental Tribune International
cholesterol. Records for patients who were edentulous in either
the maxillary or mandibular arch indicated decreased BUN and
eGFR as well.
A retrospective longitudinal study conducted by the Regenstrief
Institute and the Indiana University School of Dentistry indicates
that full or even partial denture wearers might be at risk of nutritional
deficiencies. (Image: Shutterstock/Krakenimages.com)
Although prosthodontic treatment is the primary means of
helping either completely or partially edentulous patients,
nutritional counselling too might be warranted for patients
who have received dentures, according to a recent retrospective
longitudinal study by Regenstrief Institute in Indianapolis and
the Indiana University School of Dentistry.
The study linked laboratory values of nutritional biomarkers
with dental records. The laboratory tests included complete
blood count, basic metabolic profile, and lipid and thyroid panel
tests. The research team compared the nutritional state of 3,519
study subjects who had received removable partial or complete
conventional or implant- or abutment-retained dentures with
the nutritional state of 6,962 members of a control group who
had not received or required prosthodontic intervention. In
addition to age and sex, the authors considered other factors
available in the electronic records, including race, treatment
history, and insurance status. The study used records spanning
from 1 January 2010 to 31 December 2018 of patients who had
been treated at Indiana University School of Dentistry clinics,
and nutritional markers over the course of two years were
compared.
Noticeable findings included significant decreases in serum
albumin, creatinine and blood urea nitrogen (BUN) in
completely edentulous patients after they had received their
dentures and an increased estimated glomerular filtration
rate (eGFR) in the same group. Those who had dentures also
had decreased serum albumin, protein and serum calcium
compared with controls. For partially edentulous patients, there
was a decrease in thyroid-stimulating hormone, BUN and total
The authors suggested that lowered levels of serum albumin in
denture wearers could have a connection to older patients having
problems with chewing and swallowing and in patients who
already struggle with chronic inflammation and malnutrition.
Generally, serum albumin and prealbumin decrease only in
patients who experience severe malnutrition, and the study
authors recommended further studies to explore the connection
between albumin levels and prosthodontic intervention.
Senior author Dr Thankam Thyvalikakath, a research scientist
at Regenstrief Institute and director of the dental informatics
core at the Indiana University School of Dentistry, shared
her perspective in a press release. She said: “Dentures are a
significant change for a person. They do not provide the same
chewing efficiency, which may alter eating habits. Dentists need
to be aware of this and provide advice or a referral for nutrition
counselling. These patients need support during the transition
and possible continued monitoring.”
The study authors concluded that serological testing could
help with monitoring the health and nutritional state of
denture wearers and that patients should be offered nutritional
counselling when receiving their prosthodontic treatment.
Although serum albumin, calcium, protein and creatinine
decreased in denture wearers, the mean values of haematological
markers remained within normal ranges, excluding triglyceride,
low-density lipoprotein and total cholesterol. Weight and body
mass index were above the normal range. The study authors
noted that the latter values indicated overweight patients in
both the control and study groups and were consistent with the
local population in Indiana.
The risk of undernutrition is not a new consideration, but the
use of electronic records enabled a much more feasible approach
to evaluating the health and progress of a larger selection of
patients.
The study, titled “Nutritional assessment of denture wearers
using matched electronic dental-health record data”, was
published online in the Journal of Prosthodontics on 23
March 2022, ahead of inclusion in an issue.
Dental Tribune ASEAN | Jul-Sept 2022
[8] =>
8
WORLD NEWS
A new US study has found that the overall median survival time for teeth after undergoing root canal therapy is 11.1 years.
(Image: VanoVasaio/Shutterstock)
Study analyses tooth survival after root
canal therapy in US population
By Brendan Day, Dental Tribune International
Though there have been many studies on the survival rate of
endodontically treated teeth, only a relatively small proportion
of these have analysed these outcomes outside of an academic
clinical setting. Using data from a large group of general dental
practices across the US, researchers have been able to glean a
deeper insight into just how long teeth tend to survive after
undergoing root canal therapy and predictors of that survival
time.
The study was conducted by a team led by Dr Thankam
Thyvalikakath, a research scientist at Regenstrief Institute and
director of the dental informatics core at the Indiana University
School of Dentistry, both in Indianapolis. The team used deidentified data of 46,702 patients who had received root canal
therapy from members of the National Dental Practice-Based
Research Network, a consortium of dental practices and
organisations throughout the US. According to the researchers,
this study is the first of its kind in the US to analyse such records
from patients at community dental practices.
Analysis of the data found that the overall median survival time
for teeth after undergoing root canal therapy was 11.1 years and
that 26% survived for more than 20 years. The researchers also
demonstrated that these survival times differed depending on
Dental Tribune ASEAN | Jul-Sept 2022
follow-up treatments and other factors. Teeth that received root
canal therapy along with a subsequent filling and crown had a
median survival time of 20.1 years, whereas those that received
no additional restorative work after the therapy survived for an
average of just 6.5 years.
Another significant predictor of tooth survival time after root
canal therapy was the presence of dental insurance at any point
during dental care. In a press release, Dr Thyvalikakath noted
that these findings could “inform dental insurance coverage by
demonstrating the value of crowns and permanent restoration
options”.
“Oral health is a public health issue that significantly affects
people’s overall health. Leveraging dental records can help us
better understand ways to improve treatment, identify causal
relationships and maintain the health of teeth and gums,” she
added.
The study, titled “Root canal treatment survival analysis in
National Dental PBRN practices”, was published online in
the Journal of Dental Research on 12 May 2022, ahead of
inclusion in an issue.
[9] =>
[10] =>
10 WORLD NEWS
Jönköping University aims to create
new dental programme to address
dentist shortage in Sweden
By Anisha Hall Hoppe, Dental Tribune International
Jönköping University in Sweden has announced that it has applied to the federal government for permission to launch the first
new dental programme in half a century and that it has the support of local governments and other universities in its efforts.
(Image: Shutterstock/Frame Stock Footage)
Sweden has too few dentists in 18 of its 21 regions, and this
is expected to continue until at least 2035. To close this gap,
Jönköping University has submitted an application to create
a new dental programme in conjunction with Linköping
University and Jönköping county regional council. Once in full
swing, the programme will provide 30 new study places each
semester.
The new programme is modelled after a similar successful
initiative undertaken in Norway and will also utilise national
dental service clinics to provide the clinical hours for the dentists
in training. Technology is the core of the new programme, and
dental simulators will be used for manual skill practice before
working on real patients. A new centre for odontology and oral
health science is in the works as well.
Prof. Agneta Marell, president of Jönköping University,
commented on the importance of the initiative: “Together, we
will contribute to strengthening both the quality and relevance
of education, research and technological innovation. This will
also facilitate the clinical research that is conducted at the
participating clinics, at the same time as providing more career
paths in the field of dentistry.”
Dental Tribune ASEAN | Jul-Sept 2022
The new dental students will spend their first two years studying
medicine through Linköping University, with the aim that the
foundation in medicine will better prepare them for holistic
treatment planning. The dental department at Jönköping county
regional council will provide additional support and teaching
and research staff for the new programme.
The first new dental programme in more than 50 years,
Jönköping University’s proposed programme will benefit from
the cooperation of more than half of Sweden’s other regions.
Though it is still awaiting approval from the Swedish Higher
Education Authority, with the rise of urbanisation in Sweden,
the need for dentists, particularly in less densely populated areas
is pressing. Remarking on the value of the new programme, Prof.
Marell said, “In this way we can address the shortage of dentists,
increase the availability of good dental care and contribute to a
more equal distribution of dental care throughout the country.”
[11] =>
WORLD NEWS 11
Parties to the Minamata
Convention on Mercury further
strengthen phase-down approach
to dental amalgam
By Dental Tribune International
Although mercury-free alternatives exist, clinically, economically
and practically, they are still less than optimal. Therefore,
continued investment is needed to accelerate the development
of innovative restorative materials, to increase their durability
and affordability and to move them from the laboratory to the
market. If this is not done, dental practitioners will witness
a negative impact on the provision of quality treatment for
dental caries and an increase in tooth extractions, threatening
to widen oral healthcare inequalities. Evidence on the health
and environmental impact of new restorative materials is also
needed.
Parties to the Minamata Convention on Mercury recently
approved limitations for the use of mercury in dental settings.
(Image: Shutterstock/Goffi)
To date, more than 100 countries have ratified the Minamata
Convention on Mercury, a global treaty to curb the effects of
mercury on the environment and human health. Parties to the
convention recently rejected a controversial proposal from the
Africa region’s delegation for an all-out ban on dental amalgam
and instead approved two new provisions that add limitations to
the use of mercury in a phase-down approach.
It was during the second segment of the meeting of the Conference
of the Parties to the Minamata Convention on Mercury in late
March that limitations were approved on the use of mercury in
bulk form by dental practitioners and in patients under the age
of 15 as well as in pregnant or breastfeeding women, instead of
supporting an overarching ban on dental amalgam.
As there is no solution to every situation faced by the parties
as they implement a phase-down approach, organisations such
as FDI World Dental Federation emphasise the importance of
adapting strategies to national contexts and in line with Part II
of Annex A of the convention. The section referred to stipulates
that any efforts to phase down the use of dental amalgam
should consider relevant international guidance and domestic
circumstances and that parties must adopt at least two of the
nine measures. The measures include promoting insurance
policies that favour amalgam alternatives, encouraging research
and development of quality mercury-free restorative materials
for dentistry and establishing national objectives for oral health
promotion.
In order to be well prepared for the next meeting of the parties in
Geneva in Switzerland in 2023, it is recommended that parties
should work together with their ministries of environment,
ministries of health, national dental associations and chief
dental officers to understand the challenges and the feasibility of
any recommended approaches. The World Health Organization
states that setting up a national coordination committee under
the leadership of the respective ministry of environment and
ministry of health could create an environment conducive to
consensus building for the healthcare sector.
Dental Tribune ASEAN | Jul-Sept 2022
[12] =>
12 IN THE HOT SEAT
An Interview with
Desmond Chong, the
President of Malaysia
Dental Industry
Association (MDIA)
Dental Tribune ASEAN | Jul-Sept 2022
[13] =>
1. Malaysia Dental Industry Association (MDIA)
gathers all Malaysia’s dental dealers from the
dental industry. Briefly share with us MDIA’s
history and milestones.
MDIA (formerly known as MDDA) is officially registered with
the Registrar of Society (ROS) on 2 September 2015 by a group
of dental dealers who are markedly passionate about the future
of the dental industry, growing to a total of 88 members in 2021.
MDIA is the sole national association representing suppliers of
dental products & devices in both industries (For dental clinics,
laboratories & hospitals used) and consumers (For individual
use such as toothpaste, etc) in Malaysia’s dental industry.
MDIA started Malaysia International Dental Show (MIDS)
on 23-25 September 2016, being the 5th edition in 2022, is the
leading international show of its kind to be held in Malaysia and
the region, this time organized by both the dental school of the
university together with the trade association, namely MAHSA
University and MDIA.
Our member companies also play a vital & important role in
providing oral healthcare professionals with essential education
and training to ensure the safe and effective use of modern
technology of the dental device.
MDIA’s Vision
To bring professionalism, respect, and ethics to the dental
industry in Malaysia.
MDIA’s Mission
To ensure the benefits of modern, innovative technology and
reliable dental materials & devices, and services are delivered
effectively and ethically to provide and improve better oral
health outcomes for the Malaysian community at large.
6 Objectives
(1) To unite all members of the dental industry in a common
endeavor to develop the dental industry in Malaysia for the
benefit of the members.
(2) To assist and uphold the member benefits and rights in
terms of industrial, business relationships, disputes, social
economy, legal and regulatory matters.
(3) To conduct and coordinate training and education for the
dental industry.
(4) To represent, communicate and collaborate with the relevant
ministries and various associations on all matters related to
the dental industry.
(5) To organize conferences, seminars, workshops, and trade
exhibitions related to the dental industry and obtain the
approval of CPD points from the relevant authorities.
(6) To represent and promote Malaysia’s dental industry and the
association regionally and internationally.
(7) To assist members to obtain funds and grants for business
operation and expansion.
(8) To provide and organize voluntary activities, charitable
work, and community welfare.
Dental Tribune ASEAN | Jul-Sept 2022
[14] =>
14 IN THE HOT SEAT
2. Do share with us MDIA’s overview and outlook
of Malaysia’s dental industry as we exit the
pandemic.
The dental industry has been doing fairly well even during the
pandemic as we are one of the industries that are allowed to
operate. Overall, our members grow even during the pandemic.
However, those under the government project had some
reduction because of the budget limitation and as the government
may fund different areas. So, those doing government projects
may have slowed down during the period, and some of them
had switched to private. The growth is there and currently, we
have almost 1000 graduates. Imagine the numbers after they
have completed their study in the government, they will come
up either for the private or set up their clinic. Thus, we can see
the growth of clinics in the past two years. The classic example
is in Taiwan, where the number of the clinic is increasing. The
government has also been allowing licenses for dental schools.
That is the trend now. It will be good for the supplier because
you’ll have more deliveries visa to supply more things. Overall,
the dental industry perspective is good.
Dental Tribune ASEAN | Jul-Sept 2022
3. In your view, how does the new generation of
dentists view dental as a profession?
There are two ways to become a dentist nowadays; through
government or private universities are more accessible. The new
and young dentists are quite innovative now. They are willing
to invest in technology they’ll buy new machines such as X-ray
machines, intra oral scanners, 3D printers, etc. All of these are
more affordable now. However, it’s a challenge to get ROI in the
initial stage but good to provide better treatment and patient
experience in the longer term.
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4. MDIA recently had an initial meeting on medical
device associations for a matching grant worth
RM10 million to develop the medical device
industry to encourage investment and export
markets. Do share a little bit on this.
Recently we had a meeting between the government and various
medical device associations including dental to support the
development of the industry mainly to encourage investment
and export markets. The dental industry is quite a small
industry compared to the medical. The 10 million will channel
go to medical more as dental players are mostly traders which
means they will need present as a manufacturer. 95% of dental
players are traders or distributors, and very few manufacturers.
The government grant will support more manufacturers. If you
are a trader, it’ll be a little bit difficult because the government
will encourage the local manufacturing products. As for this,
I’m encouraging all the members to go into manufacturing
although it will take time and effort. Malaysia has it’s advantage
in term of operating cost as well as upcoming regional ASEAN
markets.
5. As we’re already started shifting to endemic,
what are the latest trends in the dental
industry that you could share with us?
Some direct-to-patient dental treatments are happening online
such as on Facebook or WhatsApp. The procedure continues
with meeting at the hotel with a low-cost treatment which is
dangerous because they don’t have the proper license, skills,
sanitizing and dental equipment. They usually learn the skills
from YouTube which is quite dangerous. Our members are not
allowed to sell equipment to these individuals/ companies as
we have proper medical device registration with the relevant
authority to provide to dental professionals only. The worse
scenario is they can buy it online easily from unregistered
suppliers from overseas. In my view, this is one of the most
dangerous trends now. The other trend would be the treatment
that de-emphasis the role of doctors, they use the doctors as the
partner to kickstart the treatment. The clinic appointment will
only be for two or three visits, the company will take over the rest
of such by checking through the monitoring in an application.
This will create an issue of who will be fully responsible for the
treatment, whether is the doctor or the company? This trend
will need the government and the industry to monitor and come
out the suitable guidelines to protect the patients.
Dental Tribune ASEAN | Jul-Sept 2022
[16] =>
16 BUSINESS
Dental sales a mixed bag as war and supply
difficulties bog down pandemic recovery
By Jeremy Booth, Dental Tribune International
Dental companies faced a difficult economic environment during the first quarter of this year, driven by supply chain disruptions,
waning consumer confidence and fallout from the war in Ukraine. (Image: mykhailo pavlenko/Shutterstock)
Dental companies may have expected a widespread ebbing
away of the SARS-CoV-2 pandemic to bring them out of the
financial woods. However, the resulting supply chain crisis has
choked the world’s ports, and the war in Ukraine has caused
consumer price indexes and inflation to soar. Owing to these
factors, the first quarter of this year arguably provided a stiffer
operating environment than that of two years ago, and economic
headwinds appear to have finally caught up with clear aligner
therapy.
The first quarter was a challenge for the dental giants Dentsply
Sirona, Align Technology, Envista Holdings and the Straumann
Group—the latter being the strongest performer during the
three-month period ended 31 March.
Sales of clear aligners appeared to be unshakeable at the
beginning of the pandemic, but this idea was contradicted by
minimal—albeit, symbolic—consecutive dips for the world’s
largest clear aligner manufacturer. Align had recorded six
consecutive quarters of sequential revenue growth prior to the
first quarter of this year, when total sales of US$973.2 million
(€914.0 million) represented a 5.6% decline compared with the
prior quarter.
In a webcast call with analysts, Align Technology President and
CEO Joseph Hogan listed three factors that had resulted in a
Dental Tribune ASEAN | Jul-Sept 2022
challenging quarter: the continued impact of the COVID-19
pandemic, particularly the strict measures in place in China;
a difficult economic environment driven by inflation, waning
consumer confidence and supply chain disruptions; and fallout
from the war in Ukraine.
Hogan explained that industry data showed a decrease in
orthodontic demand. He said: “[The] data from about 700 ortho
practices, covering more than 1,000 orthodontists across
1,600 locations in the United States and Canada, showed
weakening underlying patient demand trends in the first quarter
for both adult and teens and across wires and brackets and clear
aligner products.”
Hogan added that new patient visits in North America during
the period were down by 7.6% year on year.
Dentsply Sirona navigating troubled waters
Dentsply Sirona’s revenue for the first quarter was down 6.1%
year on year. In the first quarter of 2021, the company topped
one billion in sales, and a year later, this had decreased to
US$965 million. Operating income of US$93 million represented
a decline of 39.5%.
Dentsply Sirona reported preliminary earnings with the US
Securities and Exchange Commission and did not submit a
[17] =>
Form 10-Q. The company was therefore not in compliance with
the listing rules of the Nasdaq stock exchange, where its stock
is listed under the XRAY ticker symbol, and was given a period
of 60 days to detail the steps it will take to regain compliance.
Dentsply Sirona said in a statement in mid-May that it was
unable to file its Form 10-Q owing to a pending investigation
into its use of incentives to sell products to distributors in the
third and fourth quarters of last year. It received a filing of
delinquency from Nasdaq.
These events follow an April leadership reshuffle at the dental
giant that included the unceremonious dismissal of Donald
Casey as board member and CEO of the company and the
appointment of John Groetelaars as interim CEO.
Groetelaars said that it had been a challenging quarter, ending
with a disappointing result. He said that US sales had been weaker
than in the prior quarters and that COVID-19 restrictions in
China, supply chain issues and disruptions resulting from the
war in Ukraine were hampering the manufacturer. Dentsply
Sirona earns roughly 5% of its revenue in China.
Barbara Bodem, the company’s interim chief financial officer,
noted that currency exchange rates and increased investments
in research and development had contributed to the drop in
operating income. “We attribute approximately 60% of the yearover-year decline to the transitory macro challenges of foreign
exchange, inflationary pressures, and the impact of COVID in
China,” Bodem told analysts, noting that earnings per share for
the first quarter were US$0.52 versus US$0.72 in the comparable
period last year.
Straumann Group outperforms
Straumann reported revenue of CHF589 million (€573 million),
a year-on-year increase of more than 25% compared with the
CHF469 million that it banked for the same period last year.
Straumann’s sales increased by double digits (on an organic
basis) in all regions where it operates, and its sales grew most
quickly in the Latin America region.
In Latin America, Straumann’s sales for the quarter increased
by 56.1% to reach CHF39.3 million. Sales of CHF267.2 million
for the Europe, Middle East and Africa region represented
an increase of 24.7%, and those for North America—at
CHF170.1 million—were up by 23.2%. Sales for the Asia Pacific
region amounted to CHF112.3 million, and this represented
Straumann’s narrowest regional growth margin of 21.7%.
Straumann said in its results that patient volumes had remained
strong in most countries during the three-month period, except
in China, where local lockdowns to contain the spread of SARSCoV-2 had interrupted patient flow.
CEO Guillaume Daniellot commented that digital solutions,
led by intra-oral scanners, had helped sales, and the company
attributed some of its success during the quarter to a strong
performance from its dental support organisation business in
North America and to sales of premium dental implants in the
region. In Latin America, orthodontic sales grew rapidly and
sales of the Straumann Virtuo Vivo intra-oral scanner drove
revenue growth.
Sales growth in China was constrained by COVID-19
lockdowns, Straumann said, but the impact of this had been
partially compensated for by strong sales in fellow Asia Pacific
markets Japan and Australia and expansion in India. “Across
the region, premium implants and orthodontics contributed
strongly to the overall performance,” the company said.
Envista leads way to differentiated portfolio and remains
upbeat on dental
During the quarter, Envista further aligned its portfolio with
faster-growing segments of the dental industry. In January,
it completed the sale of its KaVo treatment unit and instrument
business to Planmeca and announced that it would purchase
Carestream Dental’s intra-oral scanner business.
The company’s revenue from the first quarter amounted to
US$631.4 million and represented a year-on-year increase
of 5.4% in core sales growth. Sales of specialty products
and technologies were US$397.1 million, compared with
US$366.5 million in the first quarter of last year, and sales of dental
equipment and consumables decreased to US$234.3 million
from US$246.1 million. Operating profit for these two segments
during the period showed little year-on-year change, being
US$70.3 million and US$45.5 million, respectively.
CEO Amir Aghdaei said in Envista’s earnings announcement that
the company had performed well in what had been a “challenging
macro environment” and that it had made progress towards its
goal of transforming its portfolio and building a strategically
differentiated dental company. “With the closing of the
acquisition of Carestream Dental’s intra-oral scanner business,
we have now added a suite of world-class scanners and software
solutions that further differentiate our portfolio and support
our vision of digitising, personalising, and democratising dental
care,” Aghdaei said.
Signalling the company’s ongoing optimism about the dental
sector, Envista announced in May that it would acquire
Osteogenics Biomedical, a leader in the development of
regenerative solutions for periodontists, oral and maxillofacial
surgeons, and clinicians involved in implant dentistry. The
transaction is expected to close in the third quarter of this year.
Dental Tribune ASEAN | Jul-Sept 2022
[18] =>
18 BUSINESS
Spotlight on Invisalign: The COVID-19 pandemic, waning consumer confidence and fallout from the war in Ukraine are among the factors that
have slowed down growth at the world’s leading clear aligner manufacturer. (Image: edwardolive/Shutterstock)
Sales slowdown puts the brakes on
Align Technology’s record run
By Jeremy Booth, Dental Tribune International
Align Technology performed notably well in 2020, even as the
pandemic took a bite out of income streams, and the company
broke its own sales records in 2021, banking a staggering
US$4.0 billion (€3.5 billion) in revenue for that year. The
first quarter of this year marked the end of the Invisalign
manufacturer’s record run, however, and sequential declines
in revenue and product shipments have shaken the company’s
stock price.
Despite these negative figures, Align’s total revenue during the
period still represented an increase of 8.8% (compared with
the first quarter of 2021, when the company’s sales more than
doubled), and year-on-year gains of 7.5% and 15.6% were
recorded for sales of clear aligners and systems and services.
Analysts commented, however, that Align’s fourth-quarter 2021
results had already hinted at a potential slowdown in sales and
that its recent report appeared to describe a continuing trend.
Align recorded six consecutive quarters of sequential revenue
growth prior to the three-month period beginning in January
2022. From January to March, total sales of US$973.2 million
(€914.0 million) represented a 5.6% decline compared with the
prior quarter. On a sequential basis, clear aligner revenue for the
period was down by 0.7%, revenue from systems and services by
24.2% and clear aligner case shipments by 5.1%.
News of the sequential dips caused the company’s stock
(Nasdaq: ALGN) to fall. The latest earnings report was released
on 27 April, and the stock price had fallen from US$360.43 to
US$304.66 by the end of trading on the following day. By 25
The company shipped 598,800 Invisalign cases during the
period, including 175,200 cases for teenage patients, the latter
representing a sequential drop of 3.6%.
In a webcast call with analysts, Align Technology President
and CEO Joseph Hogan said that three factors had resulted in
a challenging quarter. These were the continued impact of the
Dental Tribune ASEAN | Jul-Sept 2022
May, the stock had recovered from a 30-day low of US$256.11 to
reach US$270.18; however, it remained down by more than 50%
compared with a 52-week high of US$737.45.
[19] =>
Zacks Equity Research said last year that a US$1,000 investment in Align Technology made in June 2011 would have generated a 2,668.46%
gain as of June 29, 2021. (Image: NATNN/Shutterstock)
COVID-19 pandemic, particularly the strict measures in place
in China; a difficult economic environment driven by inflation,
waning consumer confidence and supply chain disruptions; and
fallout from the war in Ukraine.
Hogan noted that Align had discontinued all its operations
in Russia that were not essential to continuity of orthodontic
care being provided there and was adhering to international
sanctions placed on Russia by Western nations.
Commenting on the key Americas region, where Invisalign case
volumes were down by 1.5% year on year and 4.3% sequentially,
Hogan explained: “The latest data from the Gaidge practice
analysis tool that collects and consolidates data from about
700 ortho practices, covering more than 1,000 orthodontists
across 1,600 locations in the United States and Canada, showed
weakening underlying patient demand trends in the first quarter
for both adult and teens and across wires and brackets and clear
aligner products.” New patient visits in the region during the
period were down by 7.6% year on year, Hogan added.
Case volumes in the Asia Pacific region increased by 4.7% year
on year. The company’s result in the region was affected by
lockdowns in China, but boosted by sales in Japan and Taiwan
and growth in the emerging markets of South Korea, India and
Thailand.
John Morici, Align’s chief financial officer, told analysts that
the pressures that the company faced from January to March
had not eased during April and had increased uncertainty in
all markets in which Align operates. “We also anticipate capital
equipment sales will be increasingly constrained throughout the
year as practices adjust to these headwinds,” Morici said.
Hogan added that Align’s flagship product Invisalign is a
“unique mass customisation business operating in real time
with no inventory or distribution at the front end of our market.
Consequently, fluctuations in the macroeconomic environment
are felt faster at Align than [any that] I have ever experienced
anywhere in my career.”
For the Europe, Middle East and Africa region, where case
volumes had increased by 2.1% year on year, Hogan said that
growth had been driven by sales in Italy and the region covering
Austria, Germany and Switzerland.
Dental Tribune ASEAN | Jul-Sept 2022
[20] =>
20 BUSINESS
Digitally visualise clear aligner
treatment results with new Align
Technology outcome simulator
By Dental Tribune International
Dr Jonathan Fitzpatrick, an aesthetic and restorative dentist
based in Glasgow in Scotland, said in the press release that
the tool had transformed his consultation process. “It’s been a
real game-changer in driving case acceptance as the emotional
impact from a patient seeing their smile transformation in their
own face is incredibly powerful,” commented Dr Fitzpatrick,
who participated in a limited market release of the tool. He
added: “I recently had a patient who came in for a hygiene
appointment and ended up accepting an Invisalign treatment
after seeing the in-face visualisation of their potential future
smile.”
Dentist delivering an Invisalign treatment consultation using
Align’s Invisalign Outcome Simulator Pro tool on an iTero Element
5D Plus imaging system. (Image: Align Technology/Business Wire)
Align Technology has introduced a new digital tool that uses
advanced algorithms to provide in-face visualisation of a patient’s
potential future smile after clear aligner treatment. The tool is
available on iTero Element Plus Series imaging systems, and the
company says that a realistic simulation of treatment results can
be ready in just minutes, transforming the consultation process.
The Invisalign Outcome Simulator Pro is the next generation of
advanced patient communication tools from Align Technology.
The manufacturer of clear aligners, imaging systems and
software said in a press release that the tool enables dentists
to show patients what the potential results of their Invisalign
treatment would look like, using the viewing options of either
in-face visualisation or 3D dentition view. Align said that
the tool expands its existing Invisalign Outcome Simulator
technology to include the benefits of the company’s ClinCheck
in-face visualisation tool that combines a photo of a patient’s
face with his or her 3D-treatment simulation, thus creating a
more personalised view of potential treatment outcomes.
Dental Tribune ASEAN | Jul-Sept 2022
Align said that the Outcome Simulator Pro supports streamlined
workflows and helps dentists to make the most of patient chair
time. The tool requires two sets of digital patient images:
photos, which can be captured on a mobile device using the
Invisalign Practice App, and digital scans taken on the iTero
Element Plus Series scanner. Outcome Simulator Pro then starts
automatically, working in the background and enabling dentists
to continue the consultation using other iTero tools while the
treatment simulation is generated.
Yuval Shaked, executive vice president and managing director of
iTero scanner and services business at Align, said that the tool
demonstrates the company’s commitment to offering greater
efficiency and added value to dentists and orthodontists. Shaked
commented: “It is an exciting new development that furthers
Align’s vision of an integrated platform of digital products and
services, providing a seamless solution for doctors to efficiently
and effectively treat their patients with Invisalign clear aligners
and to build their practices through a holistic, end-to-end digital
treatment experience.”
Align said that the tool is currently in limited market release and
that it will be available on all iTero Element Plus Series scanners
and imaging systems from the second half of this year.
[21] =>
BUSINESS 21
Straumann Group to acquire
Berlin clear aligner manufacturer
PlusDental
By Jeremy Booth, Dental Tribune International
The dentist-led clear aligner treatment solutions provider
PlusDental is to become part of the Straumann Group. The full
acquisition will add a growing European clear aligner provider
to the Swiss dental giant’s portfolio, which already includes the
ClearCorrect brand and a majority stake in DrSmile.
PlusDental combines consumer marketing expertise with
dentist-led treatments, complementing Straumann’s strategic
priority to invest in the orthodontics segment. With PlusDental
under its wing, Straumann will expand its footprint in the
dentist-led consumer orthodontics segment by increasing its
market coverage in countries such as the Netherlands, Sweden
and the UK.
Straumann said that the acquisition will further strengthen
its strategic consumer expertise and unlock further growth
potential. PlusDental has built up a broad network of clinics
across Europe, and this network will accelerate Straumann’s
expansion, especially in the aforementioned markets.
Guillaume Daniellot, CEO of Straumann, commented: “With
its high-quality medical, tech- and data-driven approach, the
PlusDental business will further add to our medical expertise
in the orthodontics space to ensure high-quality care can be
offered to health consumers. In addition, this will enable us to
offer dentists further opportunities to offer convenient, clinically
based, quality treatments to patients which will help them grow
their practices.”
Eva-Maria Meijnen, Lukas Brosseder and Dr Peter Baumgart,
co-CEOs of PlusDental, added: “We are looking forward to
working together with the Straumann Group. This is a very
exciting opportunity as both companies share the vision of
PlusDental is a growing provider of dentist-led clear aligner
treatment solutions and Straumann Group has announced that it
will pay around CHF 135 million (€131 million) to acquire the
company. (Image: Alexandr Grant/Shutterstock)
PlusDental offers clear aligners for treating mild and moderate
malocclusions in the anterior region. The company develops
and manufactures aligners in its dental laboratory in Berlin
in Germany, based on assessment by registered dentists. The
company attracts patients seeking aesthetic dental treatment to
its website through targeted advertising. PlusDental combines
consistent digitalisation and high medical standards with the
goal of making innovative dentistry accessible to more people.
In addition to working with experienced partner dentists across
Europe, the company is supported by an independent medical
advisory board.
Basic terms of the signed purchase agreement were disclosed.
Straumann will pay approximately CHF 135 million (€131
million) to purchase the company. The transaction is subject
to regulatory approval and is expected to close in the coming
weeks.
high-quality dentistry and putting patients first. Together we
will provide access to dental care to many people in the future.”
Dental Tribune ASEAN | Jul-Sept 2022
[22] =>
22 BUSINESS
Something to smile about? SmileDirectClub wants to become profitable by 2024 by attracting orthodontic customers from higher-income
households. (Image: Vladimir Trynkalo/Shutterstock)
SmileDirectClub slashes net loss,
signals major strategy change for 2022
By Jeremy Booth, Dental Tribune International
SmileDirectClub (SDC) became the public face of direct-toconsumer (D2C) orthodontics when it experienced phenomenal
growth between 2014 and 2019. However, its business model of
retail shops and lower-cost D2C therapy left it exposed to the
pandemic’s economic headwinds, and David Katzman, SDC’s
chairman and CEO, has signalled that the company is already
in the midst of a major strategy change that will result in the test
marketing of a new product offering within the next 12 months.
SDC began 2022 with a strong result. In the first quarter, it only
lost US$73.0 million (€68.1 million). This was around US$22
million less than it lost in the previous quarter, when its net
Dental Tribune ASEAN | Jul-Sept 2022
loss from continuing operations totalled US$95.6 million, and
a far cry from earlier deficits. In the third quarter of 2019, for
example, the company posted a net loss of US$387.6 million.
According to Katzman, SDC has enough liquidity and cash to
fuel its growth plans, and it aims to become profitable by 2024.
What made the three-month period a success for the company
was the US$152 million that it posted in total revenue—a
sequential increase of more than 20%—steady shipments of
76,254 unique clear aligner cases and the initiation of what SDC
calls the “right-sizing” of its operational structure, which began
in February. A closer look at the company’s most recent balance
[23] =>
US$5,000 to US$8,000 price tag for clear aligners,” and added:
“From day one, these customers have been a massive tailwind to
our business in the Americas and rest of the world.”
“We know that traditional orthodontic customers
come from higher-income households” – David
Katzman, CEO, SmileDirectClub
Katzman commented in the recent call that accelerated
inflation during the first quarter had further constrained nondiscretionary spending among this demographic and that this
had had a significant impact on the company’s ability to grow. He
said: “While we believe strongly in our mission to democratise
access to care and in our ability to achieve our long-term growth
targets with this demographic, we also believe that the quality
of our product, the convenience of our telehealth offering,
and the awareness of our brand, provides the right to win by
taking share from traditional wires and brackets as well as other
more expensive clear liner therapies.” He added: “We know that
traditional orthodontic customers come from higher-income
households.”
sheet reveals that, on a sequential basis, it decreased its general
and administrative expenses by more than US$10 million and
that it incurred a similar amount of additional expenses for
restructuring and related costs. Interim Chief Financial Officer
Troy Crawford told analysts in early May that SDC had paid
around US$20 million during the quarter for expenses related
to the severance and retention of team members and to the exit
of the company from some geographical areas.
Company information states that SDC now operates in the
US, Canada, Australia, the UK, Ireland and France, indicating
that it has exited at least three markets. The company
announced its expansion into New Zealand in late 2019, and
into Germany and Hong Kong in 2020.
SDC has struggled during the pandemic, largely owing to a
combination of factors which have constrained the spending of
the company’s key demographic, which typically has a median
household income of US$68,000. Katzman said in November
that this demographic “historically could not afford the
SDC has previously mentioned that it aims to re-evaluate
its international footprint and to move into the higherprice bracket of clear aligner therapy through its challenger
campaign—directly challenging competitor brands such as
Invisalign. However, until this point, the company has remained
tight-lipped about the details that such a transition would
entail. Katzman said the higher-income consumers whom it
wants to attract have different needs to those of its current key
demographic, including that of starting treatment with a general
practitioner. He said that SDC would continue to invest in its
retail stores and grow its partner network of dentists, “allowing
[higher income consumers] to start their journey the way they
seem to prefer, which is through a neighbourhood GP office
supplemented with our convenient telehealth platform and our
advanced connected tools”.
SDC would adapt its service model for this purpose, Katzman
said, in order to improve the appeal of its product offering. He
noted: “While we are not ready to share the specific details of
this premium offering, the team is working diligently to get a
test in market as soon as possible and begin rolling out in late
2022 or early 2023.”
SDC has a partner network of dentists that currently consists of
673 global practices that are live or pending training, and it has
branded oral care products on shelves at more than 16,300 retail
stores around the world.
Dental Tribune ASEAN | Jul-Sept 2022
[24] =>
24 BUSINESS
US-based Henry Schein aims to expand its dental distribution business in Switzerland through the acquisition of dental distribution
company Condor Dental. (Image: rafapress/Shutterstock)
Henry Schein to acquire Condor
Dental and expand its operations in
Switzerland
By Dental Tribune International
Henry Schein has signed a definitive agreement to acquire the
privately held dental distribution company Condor Dental in a
transaction that the healthcare distributor says will enhance its
ability to serve pan-European dental support organisations.
the same values and emphasis on delivering an exceptional
customer experience. Condor offers a comprehensive product
portfolio and has multiple opportunities for growth in one of
Europe’s most attractive dental markets,” Bergman added.
Henry Schein has served the Swiss dental implant market
since 2004 through its Basel-based subsidiary CAMLOG
Biotechnologies, and the addition of Condor Dental to
Henry Schein will expand its dental distribution business in
Switzerland.
Andrea Albertini, president of Henry Schein’s international
distribution group, said that Condor Dental is a highly regarded
company that has been serving dental professionals for over
40 years. “With the support of Henry Schein’s operational
expertise, Condor Dental will be better resourced to strengthen
its position in the marketplace and improve the level of
services and solutions offered to dental practitioners,” Albertini
commented.
Condor Dental is based in the Swiss town of Vouvry and was
established in 1978. Its sales last year were approximately
US$18.0 million (€15.9 million), the majority of which was
from dental consumable merchandise and the customisation
of dental practices and dental laboratory installations. Once
the transaction closes, Condor Dental will join Henry Schein’s
international distribution group, and CEO Yves Mailliard will
continue to lead the company.
“We look forward to welcoming the Condor Dental team to
the Henry Schein family,” said Stanley M. Bergman, chairman
of the board and CEO of Henry Schein. “Our companies share
Dental Tribune ASEAN | Jul-Sept 2022
Condor Dental is owned by MCCB Holding, a healthcare
holding company.
[25] =>
Imaging Plate Scanner
C
Comfortable,Fixable, Easy to use
0
1
2
3
A2WLMU
A2WLMU
A2WLMU
A2WLMU
22 X 31mm
24 X 40mm
31 X 41mm
27 X 54mm
NEW CHIROPRO
NEW CHIROPRO & CHIROPRO PLUS
Simplicity. The cornerstone of the new range of implant and
oral surgery motors developed by Bien-Air Dental.
IMPLANTOLOGY
INTUITIVE NAVIGATION
With its single rotary knob, navigation is
easier than ever before. Simply turn the
knob to scroll through the menus, then
click to confirm your choice.
When designing these two new systems, everything was geared towards
making these ingenious solutions simpler to use, down to the smallest detail.
motor system
NEW CHIROPRO PLUS
Despite their different fields of application,
the Chiropro and Chiropro PLUS systems are
both equally simple to use.
IMPLANTOLOGY
motor system
ORAL SURGERY
motor system
ABSOLUTE PRECISION
Thanks to its high-precision electronic system,
the torque selected on the console corresponds
exactly to the torque obtained at the output
of your instrument *. No further calibration is
needed. It‘s as simple as that.
PRE-SET SURGICAL PROTOCOLS
CLEAR, CONCISE INTERFACE
Thanks to the pre-set surgical protocols, you can carry out your procedures
in no time.Use your patient‘s clinical data to determine the number of
sequences required to perform your procedure - 3, 4 or 5. The parameters
of each step are then automatically displayed. You can now simply treat your
patient. It‘s as simple and reliable as that.
The simple and discreet screen provides
you with access to all the information you
need to ensure your procedure is a success:
choice of handpiece, speed, torque,
irrigation flow and direction of rotation.
AND MAINTENANCE
A
IIS SIMPLE, TOO
The single rotary knob is easy to remove
from the unit for sterilization. In addition,
the control panel is protected by highly
resistant glass that is easy to clean.
*According to tests carried out in Bien-Air Dental’s research laboratory, the torque values displayed on Bien-Air Dental systems are considerably more accurate (+/- 5% margin of error) than those displayed on competitors‘ systems (+/- 10% margin of error).
CareDes Sdn. Bhd. 814703-T
MDA Licence No.: MDA-2030-WDP121
WWW.BIENAIR.COM
No. 10, Jalan TP 3/1, Taman Perindustrian Sime UEP, 47620 Subang Jaya, Selangor.
Tel: +60 3 8024 3575 Fax : +60 3 5879 7038 Website : www.caredes.com Email : info@caredes.com
[26] =>
26
ADVERTISER INDEX
Dental Tribune ASEAN
Page
Advertisers
Websites
IFC
5
25
IBC
9
BenQ AB DentCare Corporation
Bien-Air Asia
CareDes Sdn. Bhd.
Dental Tribune ASEAN
Futudent
www.benqabdentcare.com
www.bienair.com
www.caredes.com
asean.dental-tribune.com
www.futudent.com
INTERNATIONAL SALES OFFICES
Dental Tribune ASEAN | Jul-Sept 2022
[27] =>
D
T
“The World’s Dental Newspaper...
Now in South East Asia!”
www.dental-tribune.com
[28] =>
Image source: Freepik
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Editorial
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Content
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Eating disorders and dentistry: Identifying early signs in the dental office
6 - 6
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Study indicates denture wearers may be more at risk of nutritional deficiencies
7 - 7
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World News
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An Interview with Desmond Chong, the President of Malaysia Dental Industry Association (MDIA)
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Business
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