21D Deploys Six-Second AI Dental Planning to Cut Jaw Surgery Costs
Ai4
Automating biomechanical surgical planning with AI cuts dental reconstruction preparation from half a day to six seconds, lowering treatment costs to curb systemic conditions linked to severe tooth loss.
## Background
Published on YouTube by Ai4 on September 10, 2025, this talk features Rajesh Vijay, CEO and Founder of 21D. The page description introduces 21D AI as a UK-based healthcare company expanding into the US and China, focused on building artificial intelligence to achieve scalable, consistent patient care starting with full-mouth dental rehabilitation.
## TL;DR
Rajesh Vijay presents 21D's vertically integrated approach and AI-driven platform designed to solve the global edentulism crisis affecting hundreds of millions of people. He reframes chronic periodontal disease as a natural degenerative consequence of increased human longevity that carries severe systemic risks, including links to cardiovascular disease and dementia. By converting multi-modal diagnostic scans into surgical plans in six seconds rather than half a day, 21D leverages automated biomechanical calculations and a global licensing model to dramatically lower costs and expand access to full-mouth reconstruction.
## Atmosphere & style
The presentation carries the pragmatic, authoritative weight of a 32-year clinical veteran blended with the forward-looking momentum of an AI tech keynote. Vijay delivers an impassioned and candid address, balancing sobering epidemiological statistics and biomechanical engineering details with deeply empathetic patient stories. The narrative arc moves seamlessly from the hidden emotional suffering of chronic dental disease to an optimistic, industrialized solution, leaving viewers with a sense of urgency, clinical rigor, and profound human impact.
## Key takeaways
- [00:04](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=4s) Over 353 million people globally are completely edentulous, with more than 1 billion at imminent risk of total tooth loss over the next five years.
- [01:38](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=98s) 21D operates as a vertically integrated dental healthcare company handling clinical surgery, hardware fabrication, and AI software in-house.
- [01:38](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=98s) The typical full-mouth rehabilitation patient is middle-aged (average age 52.4), necessitating durable prosthetic solutions built for extended modern lifespans.
- [04:09](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=249s) Severe tooth loss should be destigmatized and treated as a standard age-related degenerative disease, comparable to joint or cardiovascular degeneration.
- [04:09](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=249s) One in eight people globally suffers from Stage 3 or 4 irreversible periodontal disease, a prevalence projected to double in the next 20 years.
- [07:58](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=478s) Chronic periodontal infection releases pathogens directly into the vascular system, significantly elevating systemic risks for cardiovascular disease and dementia.
- [10:26](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=626s) Applying industrial scale and efficiency to clinical workflows dramatically lowers unit costs, enabling dual-arch rehabilitation at $21,000 compared to the US standard of $50,000–$60,000.
- [12:12](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=732s) With only 3.5 million dentists worldwide to serve 1.5 billion patients in need, algorithmic automation and AI licensing are required to scale clinical access.
- [12:12](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=732s) 21D's computational engine reduces manual surgical and structural reconstruction planning time from half a day to approximately six seconds.
- [17:48](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=1068s) The diagnostic system integrates CBCT bone scans, intraoral soft-tissue scans, and 3D facial scans to compute deterministic biomechanical load vectors and aesthetic symmetry.
- [17:48](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=1068s) Continuous data feedback from post-operative outcomes and annual checkups creates a self-improving machine learning network across diverse craniofacial geometries.
- [17:48](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=1068s) Transparent digital models and 24/7 interactive mobile apps improve patient engagement by explaining the anatomical necessity and biomechanics of treatment.
## Detailed walkthrough
### [00:04](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=4s) 21D's Mission: Restoring Lost Smiles and Dental Function
Rajesh Vijay introduces 21D's core objective to a large audience: tackling the massive global issue of total tooth loss and debilitating oral disease. The mission statement emphasizes that toothlessness is not merely an aesthetic issue, but a physical and social disability that prevents people from eating, smiling, and living fully. Through fully guided surgery, streamlined digital workflows, and cutting-edge artificial intelligence, 21D aims to bring mass-market implant access to patients worldwide.
```mermaid
flowchart TD
accTitle: 21D Mission and Problem Scope
accDescr: Diagram illustrating the scale of tooth loss and 21D's technological response
subgraph Problem["Global Oral Health Crisis"]
A["353 Million Edentulous Individuals"]
B["1+ Billion at Risk in Next 5 Years"]
C["Severe Quality of Life & Functional Impairment"]
A --> C
B --> C
end
subgraph Solution["21D Integrated Delivery Model"]
D["AI-Powered Calculations & Planning"]
E["Fully Guided Surgery & In-House Manufacturing"]
F["Streamlined Clinical Workflows"]
D --> G["Accessible, Scalable Dental Rehabilitation"]
E --> G
F --> G
end
C -.-> Solution
```
- According to global figures, 353 million people live completely without teeth.
- Over 1 billion additional individuals face total tooth loss within the next five years due to progressing disease.
- 21D operates as a UK-founded healthcare organization designed to expand globally.
---
[01:38](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=98s) Origins of 21D and Full-Mouth Rehabilitation
After 32 years as a clinician, Rajesh tried retirement, found it "terrible," and founded 21D ("21st Century Dentistry") three years prior. The company specializes specifically in full-mouth rehabilitation for patients who are either completely edentulous or will lose all remaining dentition within five years. Rather than relying on third parties, 21D operates as a fully vertically integrated company—owning clinics, fabricating proprietary implants and prosthetics, and running internal patient education, marketing, and podcast divisions.
The typical patient profile is an individual suffering from advanced chronic periodontal disease who endures severe physical and emotional distress in silence. Rajesh highlights that this demographic is not limited to the elderly, though life expectancy increases have made prosthetic longevity critical:
- Average patient age: 52.4 years old.
- Gender breakdown: 56% female, 44% male.
- Oldest active patient: 104 years old (on his third hip replacement and active in salsa dancing).
- Market position: 21D is the largest full-mouth provider in the UK, with expansion planned into the United States and China.
---
[04:09](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=249s) Oral Degeneration as a Chronic Age-Related Reality
Rajesh challenges the cultural tendency to judge people for tooth loss, arguing that it should be treated like any other degenerative disease of aging, comparable to worn-out joints or failing heart valves. Two centuries ago, human life expectancy rarely exceeded 50 years, whereas today individuals expect to maintain active lifestyles well into their 80s and beyond, placing unprecedented demands on biological structures not evolved to last that long.
Dentistry is often misunderstood as purely cosmetic, but aesthetics are a functional side effect of emotional expression. Because smiling is the primary human mechanism for projecting inner happiness, losing the ability to smile severely impairs psychological and social health.
- Periodontal disease progresses across four stages:
- Stage 1: Mild gingivitis with bleeding gums.
- Stage 2: Early bone loss without catastrophic damage.
- Stages 3 & 4: Severe, irreversible bone loss where tooth loss is inevitable.
- 1 in 8 people globally are currently in Stage 3 or Stage 4 periodontal disease.
- This prevalence is projected to double over the next 20 years due to increased longevity.
---
[07:58](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=478s) The Systemic Impact: Fast Killers, Slow Killers, and Disease Links
Oral health is deeply interconnected with systemic pathology. In the oral cavity, Rajesh classifies pathologies into two primary threats: the "fast killer" (oral cancer) and the "slow killer" (advanced periodontal disease). A proper clinical examination must prioritize identifying and eliminating these active diseases rather than superficial features like tooth shade.
For more than three decades, clinical research has linked chronic periodontal disease to systemic inflammatory conditions, most notably cardiovascular disease and dementia. Periodontal pathogens enter the bloodstream and have been identified directly in the brain tissue of deceased dementia patients.
```mermaid
flowchart LR
accTitle: Oral-Systemic Disease Pathways
accDescr: Flowchart linking oral pathogens to systemic health conditions
subgraph SystemicSpread["Vascular Dissemination"]
BS["Bloodstream Translocation"]
end
subgraph SystemicOutcomes["Chronic Systemic Impact"]
HD["520M Individuals with Cardiovascular Disease"]
DM["60M Individuals with Dementia ($1.2T Global Cost)"]
end
SK --> BS
BS --> HD
BS --> DM
```
- 520 million people worldwide live with cardiovascular conditions.
- 60 million individuals are diagnosed with dementia, incurring global management costs of $1.2 trillion annually.
- Proactive elimination of chronic oral infectious reservoirs offers a cost-effective upstream strategy to mitigate downstream neurodegenerative and vascular risks.
---
[10:26](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=626s) Industrialization of Healthcare and Pricing Dynamics
Treating large-scale chronic disease requires applying industrial efficiency to medical practice. Increasing procedural speed and consistency enables providers to care for significantly more patients within a standard working day, driving down overall unit costs while maintaining operating margins to fund clinical expansion.
In the UK market, 21D established fixed pricing for dual-arch (two-jaw) full-mouth reconstructions at approximately $21,000, contrasting sharply with standard US pricing that ranges between $50,000 and $60,000. This efficiency-driven baseline forced the broader UK market to adapt or lose viability, accelerating total treatment numbers across the country.
---
[12:12](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=732s) The AI Licensing Model and Algorithmic Consistency
Because the world has only 3.5 million dentists to serve over 1.5 billion people needing immediate or impending full-mouth interventions, clinic construction alone cannot close the access gap. 21D's strategy centers on developing and licensing clinical AI to the broader dental market.
```mermaid
flowchart TD
accTitle: 21D AI Licensing and Delivery Architecture
accDescr: Process showing how input scans are converted by AI into surgical outputs and patient tools
subgraph Inputs["Diagnostic Data Inputs"]
CBCT["Cone Beam CT Scan (CBCT)"]
IOS["Intraoral Scan"]
FS["3D Facial Scan"]
end
subgraph Engine["21D AI Calculation Core"]
CALC["Biomechanical & Structural Analysis\n(Bone density, muscle load vectors, hygiene)"]
TIME["6-Second Processing Time\n(vs. ~0.5 day manual planning)"]
CALC --- TIME
end
subgraph Outputs["Downstream Execution"]
MFG["Digital Production Files for Hardware"]
CLIN["Standardized Clinician Surgical Guidance"]
PAT["Interactive Patient 24/7 Mobile App"]
end
Inputs --> Engine
Engine --> Outputs
```
Manual jaw reconstruction planning typically takes an experienced specialist half a day. The AI performs structural, load-bearing, and anatomical calculations in six seconds. Under a projected licensing scenario:
- Engaging 1% of global practitioners (35,000 dentists).
- Each performing one case per day.
- A fee of $1,000 per patient covers the calculation engine and production-ready manufacturing files.
- This structure reduces typical planning overhead four- to five-fold while removing subjective clinical bias, grounding decisions entirely in deterministic patient anatomy.
---
[14:54](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=894s) Clinical Case Study: Kelly's Transformation
Rajesh recounts treating Kelly, a patient who drove four hours on a Saturday morning in severe emotional distress, terrified that her condition was beyond salvage. Presenting with rampant, unmanageable gum infection and non-functional teeth, she had completely stopped smiling and expressed intense self-loathing.
Rajesh reviewed her anatomical scans chairside and committed to completing her full rehabilitation within three weeks:
- The underlying chronic oral infection was completely debrided, eliminating the bacterial load entering her bloodstream.
- Within three weeks, full functional and aesthetic reconstruction was delivered.
- Follow-ups showed profound self-reported improvements in daily energy, dietary habits, and psychological health, illustrated by Kelly regularly driving four hours to gift homemade cupcakes to the clinical team.
---
[17:48](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=1068s) Biomechanical Computation and Continuous Algorithmic Learning
The 21D AI system models the human skull as a complex physical structure with precise density, volume, and muscle force vectors. It computes optimal load distribution for implants and ensures prosthetics maintain self-cleansing, hygienic profiles over decades of wear.
The diagnostic workflow relies on three core data streams:
1. **Cone Beam Computed Tomography (CBCT):** Captures 3D bone volume, morphology, and internal bone density.
2. **Intraoral Surface Scan:** Details soft tissue contours, gingival architecture, and remaining dentition.
3. **3D Facial Scan:** Aligns functional bite relationships with facial symmetry and natural aesthetic proportions.
The AI outputs transparent, synchronized plans to both the clinician and the patient. Patients receive a 24/7 interactive model on their mobile devices, allowing them to ask natural-language questions and understand the anatomical justification for their surgical procedure. Every completed case, scan, and annual maintenance checkup feeds data back into the network, creating a self-improving algorithmic feedback loop across complex human craniofacial geometries.
## Notable quotes
> [00:04](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=4s) Toothlessness is not merely an aesthetic issue, but a physical and social disability that prevents people from eating, smiling, and living fully. — Rajesh Vijay
> [04:09](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=249s) Aesthetics are a functional side effect of emotional expression. Because smiling is the primary human mechanism for projecting inner happiness, losing the ability to smile severely impairs psychological and social health. — Rajesh Vijay
> [07:58](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=478s) In the oral cavity, Rajesh classifies pathologies into two primary threats: the 'fast killer' (oral cancer) and the 'slow killer' (advanced periodontal disease). — Rajesh Vijay
> [07:58](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=478s) Proactive elimination of chronic oral infectious reservoirs offers a cost-effective upstream strategy to mitigate downstream neurodegenerative and vascular risks. — Rajesh Vijay
> [10:26](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=626s) Treating large-scale chronic disease requires applying industrial efficiency to medical practice. — Rajesh Vijay
> [12:12](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=732s) Because the world has only 3.5 million dentists to serve over 1.5 billion people needing immediate or impending full-mouth interventions, clinic construction alone cannot close the access gap. — Rajesh Vijay
> [12:12](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=732s) Manual jaw reconstruction planning typically takes an experienced specialist half a day. The AI performs structural, load-bearing, and anatomical calculations in six seconds. — Rajesh Vijay
> [17:48](https://www.youtube.com/watch?v=uN0k_-Cw6rg&t=1068s) The 21D AI system models the human skull as a complex physical structure with precise density, volume, and muscle force vectors. — Rajesh Vijay
Rajesh Vijay contends that severe tooth loss and chronic periodontal disease represent an underrecognized global health crisis linked to systemic illness, requiring an industrialized, AI-driven surgical planning model to overcome severe dental workforce shortages.
Global Prevalence and Systemic Risks of Oral Degeneration (4:09)
Vijay frames oral degeneration as a natural biological consequence of increasing human life expectancy rather than an aesthetic failing, arguing that craniofacial structures did not evolve to withstand 80-year lifespans. Global epidemiological figures cited indicate that 353 million individuals are completely edentulous, while over 1 billion face total tooth loss within five years. Irreversible Stage 3 and Stage 4 periodontal disease currently affects one in eight people worldwide, a proportion projected to double over the next two decades due to population aging.
Beyond functional and psychological impairment, Vijay highlights the oral cavity's systemic dangers, differentiating between oral cancer as a rapid killer and chronic periodontitis as an insidious driver of systemic inflammation. Periodontal pathogens entering the bloodstream have been identified in the brain tissue of deceased dementia patients and correlate directly with cardiovascular conditions. With 520 million people suffering from cardiovascular disease and 60 million living with dementia—costing $1.2 trillion annually—eliminating chronic oral reservoirs is presented as a necessary upstream preventive measure.
Industrializing Dental Reconstruction to Lower Care Costs (10:26)
To bridge the gap between widespread disease and limited clinical access, 21D advocates treating full-mouth reconstruction through industrial efficiency. By vertically integrating physical clinics, internal manufacturing of proprietary implants and prosthetics, and patient education, providers can accelerate procedural throughput, reducing unit costs while generating margins to fund further physical expansion.
Applying this model enabled 21D to set standard dual-arch full-mouth reconstruction pricing at approximately $21,000 in the United Kingdom, contrasted with standard United States pricing of $50,000 to $60,000. According to Vijay, introducing this predictable pricing baseline pressured the broader UK market to adapt, expanding overall procedural volume for a patient demographic averaging 52.4 years of age.
AI Biomechanical Planning and Global Software Licensing (12:12)
Because only 3.5 million dentists exist worldwide to treat an estimated 1.5 billion patients requiring full-mouth interventions, Vijay asserts that clinic construction alone cannot meet global demand. 21D’s core scalability strategy centers on an AI calculation engine that replaces manual, specialist-led surgical planning—which typically takes half a day—with automated biomechanical analysis in six seconds. The system ingests cone beam computed tomography (CBCT), intraoral scans, and 3D facial scans to compute bone density, volume, and muscle load vectors, generating production-ready manufacturing files.
Under 21D's commercial model, licensing this calculation engine to 1% of global dentists (35,000 clinicians) performing one case per day at a $1,000 fee per patient would reduce provider overhead four- to five-fold. The platform removes subjective clinical bias by grounding surgical guides in deterministic anatomical data, while aggregating post-treatment and annual review scans into a continuous feedback loop to refine future algorithmic planning.
Rapid Clinical Debridement and Patient Transformation (14:54)
A clinical case study of a patient presenting with rampant periodontal infection, non-functional teeth, and severe emotional distress illustrates 21D's treatment protocol. Rather than subjecting the patient to protracted preliminary phases, clinicians conducted chairside anatomical reviews and completed total surgical debridement and functional aesthetic reconstruction within three weeks.
Vijay reports that resolving the active bacterial reservoir produced rapid systemic and psychological benefits, including immediate self-reported improvements in energy, diet, and social confidence. The case serves as 21D's operational proof-of-concept, demonstrating that rapid full-arch intervention simultaneously eliminates chronic blood-borne infectious exposure and restores day-to-day functional capacity.
While 21D presents automated biomechanical planning and vertical integration as a solution to global edentulism, the model's broader impact depends on independent clinician adoption of third-party software licensing, regulatory compliance across different healthcare jurisdictions, and prospective clinical validation beyond its core UK clinic network.
[0:04] Rajesh Vijay: Toothlessness is not merely an aesthetic issue, but a physical and social disability that prevents people from eating, smiling, and living fully.
[4:09] Rajesh Vijay: Aesthetics are a functional side effect of emotional expression. Because smiling is the primary human mechanism for projecting inner happiness, losing the ability to smile severely impairs psychological and social health.
[7:58] Rajesh Vijay: In the oral cavity, Rajesh classifies pathologies into two primary threats: the 'fast killer' (oral cancer) and the 'slow killer' (advanced periodontal disease).
[7:58] Rajesh Vijay: Proactive elimination of chronic oral infectious reservoirs offers a cost-effective upstream strategy to mitigate downstream neurodegenerative and vascular risks.
[10:26] Rajesh Vijay: Treating large-scale chronic disease requires applying industrial efficiency to medical practice.
[12:12] Rajesh Vijay: Because the world has only 3.5 million dentists to serve over 1.5 billion people needing immediate or impending full-mouth interventions, clinic construction alone cannot close the access gap.
[12:12] Rajesh Vijay: Manual jaw reconstruction planning typically takes an experienced specialist half a day. The AI performs structural, load-bearing, and anatomical calculations in six seconds.
[17:48] Rajesh Vijay: The 21D AI system models the human skull as a complex physical structure with precise density, volume, and muscle force vectors.
Original transcript
[0:04] Hi everybody. I see I've got a huge
[0:06] audience. It's fantastic.
[0:10] So, I'm going to talk today about
[0:11] improving general health by creating new
[0:14] smiles. And I know you're wondering,
[0:16] well, how the hell is that possible? I'm
[0:18] going to make that clear over the next
[0:19] few slides. Paul, do you want to start
[0:21] with the video first? 21D has a mission
[0:24] to put back more lost smiles into the
[0:27] world than anyone in human history.
[0:29] Right now, 353 million people are living
[0:32] with no teeth. Over 1 billion more are
[0:36] at risk, facing total tooth loss in just
[0:39] 5 years. Living with no teeth is a
[0:42] disability. They can't eat. They can't
[0:44] smile. They can't live fully. Ignoring
[0:48] them is a crime. And 21D does not and
[0:52] will not ignore them. With cuttingedge
[0:55] AI, fully guided surgery, and ultra
[0:58] streamlined workflows, we make mass
[1:01] market access to implants possible. We
[1:04] have the technology. We have the will.
[1:07] Most importantly, we have the kindest
[1:10] people. Everyone deserves to smile.
[1:13] Everyone deserves to eat in comfort.
[1:16] Everyone deserves to feel whole. A world
[1:19] with more smiles is better than a world
[1:21] with less.
[1:24] 21D. Made in the UK, meant for the
[1:28] world.
[1:38] Okay. So, I'll give you a bit of
[1:39] background. So, I've been a clinician
[1:41] for 32 years. Um, I actually tried
[1:45] retirement. It was terrible. So 3 years
[1:48] ago, I started this company called 21D,
[1:50] which just stands for 21st century
[1:52] dentistry. And we focus primarily on
[1:55] people who either have no teeth or are
[1:58] going to end up with no teeth within the
[1:59] next 5 years.
[2:02] So we are now the largest provider in
[2:04] the UK. So we have our own clinics, we
[2:06] make our own implants, we produce our
[2:08] own prosthetics, everything's fully
[2:09] vertically integrated. We're educators.
[2:11] I have my own marketing division. We
[2:13] produce podcasts. We educate patients.
[2:16] on helping them understand the scale of
[2:19] the problem and also helping them
[2:21] understand the most modern ways to
[2:23] deliver the correction today because
[2:25] people don't know they just don't know.
[2:28] So we are nationally dominant today
[2:30] which is great but our ambition is
[2:33] global starting next year and the first
[2:35] place we're going to start is right here
[2:37] in the US.
[2:41] So these are the kinds of people I see.
[2:44] We see these people daily.
[2:46] They mainly suffer in silence. They
[2:48] don't even share this with their nearest
[2:50] and dearest, but they tell us and they
[2:53] live with this. So they have teeth, but
[2:55] they also have chronic perodontal
[2:57] disease. They can't eat, they don't
[3:00] smile, they don't go out, nothing. And
[3:02] then they come and tell us. And then we
[3:05] need to calculate what is the optimal
[3:07] balance of compromises and how we're
[3:11] going to put them into that prosthetic
[3:13] state that's going to last them for the
[3:15] rest of their life. Now, if I tell you
[3:18] that my average patient is 52.4 4 years
[3:21] of age, 56% female, 44% male. And my
[3:26] oldest patient is 104 years old, and he
[3:30] likes salsa dancing on a Tuesday, and
[3:33] he's on his third hip replacement. So,
[3:35] you can understand how long we need
[3:38] these things to work for. So, every
[3:41] single one of these is not just a new
[3:43] smile, it's actually a new life.
[3:47] Every single one I can prove an
[3:50] improvement in psychological well-being,
[3:54] emotional well-being, physical
[3:56] well-being. Every single one. I haven't
[3:58] just reduced the disease load. I've also
[4:02] made them love themselves again. And
[4:04] that's a big deal. It really, really,
[4:06] really matters.
[4:09] This I mean Victoria is just one of
[4:11] many.
[4:13] The human being on the right is the
[4:16] person she was always supposed to be.
[4:18] The human being on the left is a
[4:20] consequence of modern life. We're not
[4:22] here to judge. It's the same way we
[4:25] don't sit around and judge people if
[4:26] they get cancer. And this is a
[4:29] degenerative disease over the age of 50.
[4:32] It's just the natural aging process.
[4:34] We're not designed to last for the time
[4:37] we want to live for. I mean, 200 years
[4:40] ago, everybody had the decency to be
[4:42] dead by the time they were 50. That's
[4:44] why there was no hip replacements then.
[4:47] Now, everybody wanted to play volleyball
[4:49] at 85. Well, news flash, your bits
[4:53] aren't designed to work that long.
[4:56] They're just not. And it might be a hip
[4:59] replacement. It might be heart valves.
[5:01] And it might be
[5:04] your mouth. It's just one of those
[5:06] things. And the numbers are staggering.
[5:09] And I think part of the problem is
[5:10] people think of dentistry as it's all
[5:13] about cosmetics. Actually, it's not
[5:15] about cosmetics at all. It has a
[5:18] cosmetic side effect. And it has to
[5:21] because the only way human beings can
[5:23] express human emotion is with their
[5:25] smile. We don't do it by raising our
[5:28] hand or raising our leg. We smile. And
[5:32] if we can't smile, we can't express
[5:35] inner happiness. just a fact.
[5:38] So Paul,
[5:41] let's look at some ridiculous numbers.
[5:44] So according to the world world health
[5:46] organization, and this is an
[5:47] underestimate,
[5:49] 353 million people on this planet right
[5:52] now have no teeth. If I said to you 350
[5:55] mill 3 million people on this planet had
[5:57] no legs, would you be bothered?
[6:02] That's not any that's not uh any less
[6:04] worse. If you are one of those 353
[6:07] million, your life is terrible. And
[6:11] that's a fact. And just in the country I
[6:14] work in, which is the UK, we also have,
[6:17] we're going to talk about advanced
[6:19] parodontal disease. Advanced parodontal
[6:20] disease, loosely referred to as gum
[6:22] disease. Gum disease has four stages.
[6:25] Stage one, bit of gingivitis. Gums bleed
[6:27] a bit. We've all been there. Stage two,
[6:30] okay, I'm beginning to lose a bit of
[6:31] bone, but it's still not catastrophic.
[6:34] Once you enter stage three, it's it's a
[6:38] question of when, not if, you're going
[6:41] to lose the teeth. And that's the number
[6:44] of people who are in stage three and
[6:46] stage four right now. One in eight human
[6:50] beings on the planet right now are in
[6:53] stage three and stage four. And that
[6:55] number is predicted to double over the
[6:58] next 20 years. It's not that we don't
[7:01] know which end of a toothbrush goes in
[7:03] our mouth.
[7:04] It's just part of the decay process of
[7:07] longevity.
[7:09] We need to find efficient ways to deal
[7:12] with the mountain that is coming. And we
[7:16] think we've done it. So, we're doing it
[7:19] using digital technology right now. But
[7:21] I've always said this, one of the
[7:22] inevitable things that we have to look
[7:24] at is to leverage the power of AI.
[7:27] Because AI can calculate things at a
[7:29] rate that even me with my thousands of
[7:33] jaw reconstructions under my belt, I
[7:36] can't even come close to. It'll take me
[7:38] half a day to work out what someone
[7:41] needs, what's best for them. The AI will
[7:44] take six seconds.
[7:46] I can't compete. I don't want to
[7:47] compete. I want its help so that I can
[7:51] help more people. So that my team can
[7:53] help more people. We have the next
[7:55] slide, Paul.
[7:58] Okay. The real reason that I've been
[8:01] doing my job for 26 years is not just to
[8:05] make them feel better about themselves.
[8:08] We have known about the link between
[8:11] parodontal disease, heart disease and
[8:14] now dementia for over 30 years.
[8:19] And the link is huge.
[8:23] There are two kinds of killers in
[8:24] anyone's mouth. I classify them as the
[8:27] fast killer which is cancer and the slow
[8:31] killer which is perodontal disease.
[8:34] Now, for me, there's nothing more
[8:36] important in a dental checkup than to
[8:38] check for the fast killer and the slow
[8:40] killer before you think about what color
[8:44] they are.
[8:46] That's irrelevant
[8:48] unless you know that it's disease-free
[8:51] and healthy.
[8:53] So, for me, it has never been about how
[8:56] pretty they look in the end.
[8:58] It's about how healthy they are in the
[9:00] end. And the prettiness is a consequence
[9:03] of the fact that they feel great about
[9:04] themselves
[9:06] because I I use this term. I go, "You're
[9:09] smiling hard." What that means is
[9:12] they're really going for it, which is
[9:14] great. It's what I like to see.
[9:17] So, if you look at the global numbers
[9:19] for what's going on right now, there's
[9:22] 520 million people and uh who are in the
[9:26] heart disease arena.
[9:29] 60 million diagnosed with dementia. I
[9:32] read an interesting stat the other day
[9:34] that apparently globally we are spending
[9:36] $1.2 trillion a year on everything
[9:40] related to care of people with dementia.
[9:44] I mean if it goes from 60 million to 120
[9:47] million people that's $2.4 trillion at
[9:51] least.
[9:52] Or you could have a different approach.
[9:55] You could say, "What are the things that
[9:57] are most linked to triggering this
[9:59] dementia?"
[10:01] And stop it early. That would be much
[10:04] cheaper than a few trillion dollars.
[10:07] So that's where we're coming at it from.
[10:10] So I know, yes, the patient wants to
[10:12] look great and wants to go out for
[10:13] dinner and have photos taken. That's
[10:15] great.
[10:17] This is the bit though that me and my
[10:19] clinical team do the job for because
[10:21] we're clinicians, not hairdressers.
[10:25] Next.
[10:26] So why the need for this? The need for
[10:30] this is industrialization of healthcare.
[10:34] The ability to be able to help a lot
[10:38] more people than we currently can in the
[10:41] same 8hour period. So if you drive
[10:44] efficiency,
[10:46] you can treat more people in the same
[10:49] time frame, which will and must
[10:52] inevitably bring costs down,
[10:56] affordability up, and barriers away.
[11:00] This is a good thing.
[11:02] When we did this in the UK, I set price
[11:05] points based on
[11:08] our working practices and how much it
[11:11] costs us to do it. and I build in the
[11:13] profit that's required so we can keep
[11:16] building more clinics and help more
[11:18] people. We don't just pluck numbers out
[11:20] of the sky. So we set a precedent. So we
[11:23] set a price point in the UK of about
[11:25] $21,000 for two jaw corrections which in
[11:29] the US right now is running at about $50
[11:30] to $60,000.
[11:33] What happened was that the rest of the
[11:35] market had two choices.
[11:38] either compete with us or die.
[11:43] So I like to think that we changed
[11:47] the affordability dynamics in the UK
[11:51] just by driving the efficiencies and
[11:53] they had no choice. They had to join us.
[11:56] The good news is we are now this year
[11:59] treating more people for fullmouth rehab
[12:01] in the UK than ever in the history of
[12:05] the UK. I want to do exactly the same in
[12:07] the US next year.
[12:09] [Music]
[12:10] Next,
[12:12] how does AI come into this?
[12:15] 8 billion people on the planet, three
[12:18] and a half million dentists. It doesn't
[12:21] matter how quickly I build clinics. I'll
[12:23] never reach everyone. Not in my
[12:25] lifetime. Which means I know
[12:29] that I need to leverage AI
[12:31] and I need to license that AI to
[12:33] clinicians. I need to control the
[12:37] deployment. I need to control how the
[12:41] patient gets the information because
[12:42] they're the people that really matter in
[12:44] all of this. And I need to set up an
[12:46] environment where clinicians practice
[12:50] pricing restraint.
[12:53] There is no such thing as unprofitable
[12:55] medicine.
[12:56] It's profitable, but it can be grossly
[12:59] inefficient.
[13:01] And the answer when it's grossly
[13:02] inefficient is let's put up the price
[13:04] and get the patient to pay for the fact
[13:06] that we don't know what we're doing.
[13:08] Yeah, let's not do that. That would be
[13:10] bad cuz actually we're all patients and
[13:14] we're all going to need value
[13:17] highquality high standard health care
[13:20] and we're only going to do it with AI.
[13:23] So we're projecting out here on the
[13:26] licensing model. So, if I give you some
[13:28] numbers, if there's three and a half
[13:30] million dentists in the world, and if
[13:31] there's one and a half billion people
[13:33] between the ones who need
[13:36] um full mouth rehab because they've
[13:38] already got no teeth or the ones with
[13:39] advanced parodontal disease that can't
[13:41] continue having that disease in their
[13:44] mouth and need it all cleared out, but
[13:46] they need a replacement set of teeth
[13:48] immediately.
[13:49] If we just assume just 1% of those
[13:53] dentists globally, 35,000 just saw one
[13:56] patient a day and the AI revenue return
[14:01] was $1,000
[14:04] per patient just to provide all the
[14:07] calculations and all the digital files
[14:09] to make all the hardware cuz that's
[14:12] really the hard bit in all of this.
[14:16] You could really help a lot of people, a
[14:18] lot more than being helped right now.
[14:20] And actually, even at $1,000 a day, it's
[14:22] about four to five times less than
[14:26] what's being charged right now. But even
[14:28] more profound than that, it's
[14:30] consistent.
[14:31] There are no opinions anymore. It isn't
[14:34] I think this, I think that. The
[14:36] calculations are based on you as the
[14:38] patient, not on what the clinician feels
[14:43] you should have. It'll be calculated
[14:46] exactly on what you need based on where
[14:48] your body is at right now.
[14:52] Next slide, please.
[14:54] Okay, I wanted to show you Kelly. Kelly
[14:58] is my
[15:00] typical patient. So, I saw her. I I
[15:03] don't operate chairside. I rarely work
[15:05] chairside, but I happened to be in the
[15:06] clinic one day
[15:08] and Kelly was in there. She'd come in
[15:10] for her assessment. She had driven 4
[15:12] hours and she was in that state. She was
[15:15] crying. It was a Saturday and I can't
[15:17] deal with women crying. So I said, "Hey,
[15:21] stop crying. It's Saturday. What's
[15:23] wrong?" And she said, "I'm really afraid
[15:27] you're going to tell me that you can't
[15:29] fix me." And I said, "Would you like to
[15:32] know a little secret, Kelly? I can fix
[15:35] anyone,
[15:37] but I need to like them. and I don't
[15:40] like people who are crying on a Saturday
[15:42] morning. So, you need to stop right now.
[15:46] Which she did. And that was the best
[15:48] photo she could give me. She said, "I
[15:51] don't smile. I won't smile. I hate
[15:55] myself."
[15:57] So, I said, "Look, let me have the data.
[16:01] Those are teeth. Yes. Totally useless.
[16:05] And in the gum there is rampant disease
[16:08] going on like wildfire disease. And the
[16:12] disease that causes this are the same
[16:15] bugs that they're finding in the brain
[16:17] of dementia patients.
[16:19] Exactly the same. How did they get
[16:21] there? Step ladder. I don't know. A
[16:23] lift. I don't know. Maybe the
[16:26] bloodstream.
[16:28] So that was the start point. So, I got
[16:29] up all the data on the screen and I just
[16:32] turned to her and I said, "Three weeks?"
[16:35] And she went, "Three weeks?" I said,
[16:36] "Yeah, 3 weeks. First day of your new
[16:39] life."
[16:42] Now, Kelly has a really annoying habit.
[16:45] Her annoying habit, she lives 4 hours
[16:46] away. So, Kelly likes baking cupcakes
[16:51] and then she'll drive with like a box of
[16:53] 100 cupcakes every two weeks.
[16:56] I've just spent 6 years losing 35 kilos
[17:00] and she's bringing me hundreds of
[17:01] cupcakes. I said, "Why do you hate me? I
[17:05] tried to help you and now you're trying
[17:06] to kill me." But that is her feeling of
[17:10] the difference it's made. And she tells
[17:11] me things. She tells me things that
[17:13] aren't clinically measurable, but I know
[17:15] there's a huge clinical difference. She
[17:17] says, "I feel better.
[17:21] I have more energy.
[17:23] I eat better. I enjoy my life. Yeah, I
[17:28] know it just sounds like throwaway
[17:29] comments, but I am hedging my bets that
[17:32] she's going to have a much better life
[17:34] and a quality of life between now and
[17:38] whenever the end is. And I know that we
[17:42] contributed greatly to that.
[17:45] Next.
[17:48] Okay, so let's play this
[17:54] sound.
[17:58] Okay. So, what's being shown here is
[18:01] basically how the AI runs the
[18:04] calculations. So, a skull is an object.
[18:07] It has density. It has volume. And then
[18:10] we also know what the strength of
[18:12] everybody's individual muscles are. And
[18:14] we know what load distribution look
[18:16] should look like if we're connecting
[18:18] something to that skull. How those loads
[18:21] are going to get distributed, how it's
[18:23] going to work, how self-maintaining and
[18:26] hygienic is going to be can all be
[18:28] calculated. Now, taking what I consider
[18:31] to be standard stuff in dentistry, which
[18:34] is a cone beam, CT scan, an intraoral
[18:36] scan, and a face scan. If it doesn't
[18:38] exist in all your dental practices
[18:40] today, if they don't have it 5 years
[18:42] from now, they're going out of business.
[18:44] That's a fact. All the AI needs is those
[18:48] three pieces of data and it will just
[18:50] work out everything else and it will
[18:52] share it in real time with both the
[18:54] patient and the clinician using exactly
[18:57] the same language. The patient can then
[19:00] take this home on their phone and sit
[19:02] and interact with that AI day and night.
[19:05] Ask any question you like about anything
[19:06] and it will tell you the answer, which
[19:09] is the bit I like. Because when somebody
[19:11] is entering into elective surgery,
[19:13] especially about things that they're
[19:14] really scared about, they need to have
[19:17] all the information and then some and
[19:21] feel comfortable that they're making the
[19:23] best choice for them. And that level of
[19:26] transparency for me is something that
[19:29] only with AI is going to permeate to
[19:32] everybody. I can tell you personally,
[19:34] people don't have a problem paying for
[19:36] health care when they understand its
[19:39] value. When they get it, it's the best
[19:41] investment they've ever made. When they
[19:43] don't get it, they don't know what
[19:45] they're getting for what they're
[19:46] spending. And that's always been the
[19:47] problem. And we want to take that away
[19:49] with the AI.
[19:52] Done.
[19:59] I mean, this is seriously complex human
[20:01] geometry. this but all the parameters
[20:04] are dialed in and being dialed in and it
[20:07] just keeps adding with every scan we
[20:08] take the AI is learning with every
[20:11] output we produce and every time we
[20:13] measure the patient at annual
[20:14] maintenance the AI is learning what
[20:16] works so it's like a virtuous cycle it
[20:18] just keeps going it never stops
