By Jill Sirko
August 16, 2023
It seems like hardly a day goes by without new research coming out, demonstrating the impact of oral health on overall wellness. Yet, dentistry and medicine are kept separate, as though the mouth is not part of the body.
Stephen E. Thorne IV, the Founder and Chief Executive Officer of Pacific Dental Services® (PDS), is trying to change that. He is working to improve the healthcare system by making dental-medical integration the norm. Steve envisions a world where dentists work alongside physicians as part of the primary healthcare team.
As the CEO of one of the largest dental – and now medical – support organizations in the country, his vision is becoming a reality. In mid-July, PDS and MemorialCare announced their first co-located office in Southern California. This unique partnership reinforces the importance of dental-medical integration and is distinguished by its shared use of Epic’s electronic health records system, enabling a truly holistic approach to healthcare.
Forsyth is thrilled to welcome Steve to the Forsyth dentech 2023 stage. The conference brings together all the major players in the oral health innovation ecosystem, including scientists, healthcare providers, government officials, venture capitalists, and entrepreneurs. The conference showcases the power of oral health innovation to create better public oral health and participants discuss ways to accelerate technology innovation in the oral health space.
The Business of Dentistry
Steve grew up in a dental family. His grandfather, father and brothers were all trained as dentists. Surprisingly, he said that his impact in the field stems from not being a dentist. “I think I’m able to have a different type of impact in oral healthcare because I didn’t go to dental school. I went to business school. I am able to look at the field from a different perspective.”
In 1989, Steve’s dad asked him to help set up a computer system for his dental practice. Steve had to learn all the ins and outs of the business and the profession. In his effort to help his father, and later, other dentists who asked for his help, he began to recognize a pattern: dentists needed help managing the business side of things so they could focus on their craft.
“The practice of dentistry is physically and mentally exhausting,” Steve described.“Dentists often burn out between the physical exhaustion of being a dentist and the management of the business end of their practice. Since I was looking at it from a different perspective, I could take a pragmatic business approach to the profession. There were three areas I saw needed improvement: getting help for clinicians, helping the staff work better as a team, and making dentistry more patient-centered.”
In 1994, Steve opened his own company, Pacific Dental Services, which aimed to address these issues. Today, the company supports nearly 1,000 practices across the country, and continues to grow each year.
“We are in the most exciting time in my 35 years in oral health”
Over the years, Steve has seen a lot of changes in the field. He says that we are now in the most exciting time for oral health that he has seen.
“By far the dental-medical integration component is the most exciting innovation currently in dentistry. In fact, I think we are in the most exciting time in my 35 years in oral health. We have all this great technology. We have all this great science. We understand the Mouth-Body Connection®. We understand so much more about how oral health impacts overall health now. Most of the updated research and science and studies have come about since the 2000 report on Oral Health in America, where the Surgeon General said: ‘We cannot have good overall health in America without good oral health.’ This message was reinforced in the 2021 report, to which PDS contributed.”
“The findings of that report are important,” Steve continued. “The report elevated dentistry. Oral healthcare providers are now seen as valued members of the primary care healthcare team. Primary care is an area where we have a lot of opportunity – by being more predictive and more preventive in our approach, we can provide better care.”
Recently, PDS began to bridge the gap between dentistry and medical care by moving from electronic dental records to true electronic health records. To achieve this, PDS chose Epic, the most widely used comprehensive electronic health records platform nationwide. All PDS-supported dental practices now use Epic, enabling dentists to see their patients’ health history and current medications, communicate with other providers, and share notes and observations across the healthcare spectrum.
It’s this kind of forward-thinking approach that makes Steve the perfect speaker to introduce the third panel discussion at Forsyth dentech 2023: “Dentistry as Healthcare.”
“Dentists must have all that information,” Steve explained. “A lot of times patients forget their medical history. They don’t remember the prescriptions they’re on. They don’t remember the date of their last surgery, etc. With a true electronic health record, our dentists can interact with their physician and nurse practitioner counterparts. It has been a game-changer for our organization.”
How PDS is working to bring dentistry into the future
By working as an integrated member of the primary care team, dentists could operate as a first line of defense against disease. This potential is where Steve is most excited for the future.
“Dentists could regularly check blood pressure, for instance, and refer people with high blood pressure to a primary care provider. Or they could offer an A1c test, which measures average blood sugar levels for diabetes screening, and make a referral if necessary. There are so many ways that dentists could help screen people for serious illness.”
“Dentists can do that now,” Steve explained. “But there is a huge problem. Dentists don’t currently get paid for those services. We must solve that issue. So that’s my next big goal, to change that paradigm – change that system – for oral healthcare in America before I retire.”
Steve has been working on this goal since 2015 and is steadily making progress. But there is still work to be done. In Steve’s opinion, the separation between dentistry and traditional healthcare cannot be resolved until we address the fact that health insurance doesn’t cover oral healthcare.
Forsyth’s history of innovation, and strong research portfolio demonstrating the link between oral and systemic health ultimately compelled Steve to join the Forsyth’s Board of Directors in March 2023.
“The reason Forsyth’s Board excites me is because of the research and science happening there. I enjoy seeing the intereaction between the scientists, and then moving those discoveries to the marketplace,” he said. “Science is leading the charge right now. And the science backs the importance of oral health to overall health, and the cost savings that can occur when oral health is prioritized. Science is education, and we need to move from education to awareness and activation.”
“Every day, new clinical research is published demonstrating the connection between oral health and overall health. It’s time to bring awareness to decision-makers so that they can make the tough calls to say, ‘We should include good reimbursement for all healthcare providers, including oral healthcare providers, because it saves us money.’ I’ve yet to hear of a study that doesn’t show how good oral health leads to less overall healthcare costs, less hospitalizations, and better health outcomes.”
Healthcare as Innovation
Steve believes bringing together decision-makers for an honest discussion can only help move these goals for dental-medical integration forward, which is why he sees value in meetings like Forsyth dentech 2023.
Looking into the future, Steve sees dentistry moving to a predictive and preventive model of care, and this will likely be a topic he addresses in his presentation at dentech.
“Genomics is going to be huge for dentistry, eventually,” Steve said. “We can already measure IL-6 and other inflammatory markers on the medical side. But it needs to be part of dentistry. Salivary diagnostics must become standard.”
Saliva contains many of the same biomarkers found in other body fluids, like blood, but it can be accessed more easily, making it an ideal serum.
“We can already do a simple five-minute saliva test and be able to tell, for any age group, how aggressive their periodontal (gum) disease is, right at that moment. To do this, we use the biomarker aMMP-8 which is a measurement of the collagen breakdown in the mouth. The conventional approach to diagnosing periodontitis involves waiting for visible damage to occur. We had to wait until there was 20-40% bone loss so we could see it on the X-rays. Once it has progressed to that extent, the options become limited, and the main focus becomes just managing the condition.”
“But now, we can identify the risk of periodontitis early, even before symptoms appear, and intervene proactively for susceptible individuals. I call it predictive and preventive care, with much more predictive analytics. It’s such an exciting time in the technology area.”
Forsyth is pleased to showcase Steve’s dedication to improving public health.
Photo courtesy of Pacific Dental Services.