Technology continues to change our lives every day. Increasingly, dentists are choosing to use cutting-edge tools and new innovations in technology to take care of our oral health. Depending on the type of treatment we require, dentists are now able to successfully treat many common dental conditions in a gentle, minimally invasive manner.

Below are five technologies that are changing the world of dentistry rapidly. Using this technology with the right expertise can reduce treatment pain up to 95 per cent and reduce duration of the treatment from multiple visits during a week, to few minutes in a single visit.

The NNN Veneers technology

This versatile cosmetic professional treatment allows dentists to give their patients a natural looking beautiful smile, without pain, drilling, or injections. Because of the non-invasive nature of this treatment, patients always have the option of going back to their natural teeth at any time. 

QuickSleeper

This state-of-the-art technology provides painless injections. A massive innovation in the field of anaesthetics, QuickSleeper can be used to anesthetise the tooth without the patient feeling the needle. It only anesthetises the tooth itself without the surrounding structures, which means when dentists’ use it on the patients, their lips and tongue will not feel any numbness. They will have full sensation in their mouth and only the tooth will be anesthetised.

iTero Element 5D scanner  

This technology is a one-of-a-kind hybrid dental imaging system that simultaneously records 3D, intraoral colour and Near Infrared Imaging (NIRI) images and enables comparison over time using iTero Time-lapse technology. The scanner allows the dentist to see a calculated prediction of the results before the orthodontic treatment begins, giving the patients an opportunity to preview the potential results of the treatment.

It is also the first scanner to use the NIRI System, which enables dentists to detect cavities without an x-ray, which means there is no requirement for radiation, thus, making it 100 per cent safe for pregnant women or patients with cancer who are already receiving radiation doses.

The iTero Element 5D scanner enables dentists to detect cavities without an x-ray, which means there is no requirement for radiation.

Waterlase Dental Laser

This laser system is a gentle alternative to traditional dental tools. Using laser energy and water spray, Waterlase can perform many procedures like drill teeth, cut gum and bone, make a root canal treatment and lighten the colour of the gum, all without pain or bleeding. Waterlase is virtually painless, it is a dental laser that enables the trained dentist to use minimal and, in some cases, even no anaesthetic or drills to perform many routine dental procedures.

Shape Trios Scanner

It is not uncommon to hear that patients need to take multiple trips to their dentists to get one treatment – this piece of technology has completely changed that. Shape Trios is a 3D scanner, which is used for producing dental crowns and bridges in a single visit and in less than an hour using a 3D printer to print out the tooth for the patient on the spot. Compared to the usual way of making this procedure, this machine does the job of three dental clinic visits in one. 

Cosmetic dentistry has become more common than it once was, from the wide variety of treatments available to the technologies that are used to dramatically change your smile in a relatively short period of time.

However, what is cosmetic dentistry and what does it really involve? Simply put, cosmetic dental procedures are largely unessential and usually concern the alignment of teeth, their shape and colour. The most common procedures in the UAE are bleaching or tooth whitening, alignment and veneers. Generally, the risks associated with cosmetic dentistry remain low, however, it is important to remain informed about what these procedures involve, and the risks associated.

Teeth Whitening  

Most people drink tea and coffee at least once a day. Unfortunately, over time these drinks and some foods can stain your teeth giving a yellow appearance. However, there are now simple solutions to get the natural white glow back. The most commonly used solution is a laser treatment, which takes 15 minutes under the supervision of a dentist. Alternatively, patients can also use a ‘take-home’ bleaching kit, which takes 30 minutes to one hour, but needs to be repeated to prolong the results.

Although not common, teeth whitening can have side effects and cause tooth sensitivity. The level of sensitivity depends on how well one takes care of their teeth afterward. Brushing twice-a-day and avoiding the build-up of plaque can reduce the level of sensitive post-treatment. Generally, any minor damage resulting from tooth whitening will heal over time, however if the laser beam is not aligned properly, it can burn gums, and if this damages the tooth it may not be able to heal. Similarly, the home bleaching kit can also damage teeth, if the trays are used for too long.  

Generally, the risks with cosmetic dentistry remain low, however, it is important to remain informed about what these procedures involve, and the risks associated.

Alignment  

Most adults opt for clear aligners, as a discreet method to make relatively mild changes. These aligners are developed through personalised 3D printing, to make sure they perfectly fit the teeth. Imaging technology is also used to show what teeth will look like after completing the course. Once the set of retainers are printed, the patient will need to change them every two to three weeks. For successful realignment, they should be worn for 22 hours a day, and only removed for eating.

There are very few risks associated with using aligners, however, they may be unsuccessful if the patient does not take care of their teeth or use the retainers properly. This may mean that some patients have to wear retainers for a longer time to realign their teeth.  

Veneers  

Veneers are commonly used to fix colour and alignment of teeth. They are shells that are bonded to the front of the tooth to change shape, size, colour, or to close gaps. Usually, a small portion of the tooth is removed, a dental lab then creates a thin layer or porcelain which is then bonded to the teeth. Depending on the size of teeth, for example, if one has bulkier teeth, they may not need to remove part of the tooth, specifically the enamel. Some dentists will guide the patient as to what will complement their face and can round corners of teeth or make them flatter.

Veneers are more invasive than teeth whitening or alignment, due to the removal of some of the tooth. This also means that the risks are higher and can be more difficult to resolve, such as; increased tooth sensitivity, permanent dental damage, changing the bite alignment, which will result in pain when eating. Therefore, it is important to do some research beforehand about the process to choose, in order to feel comfortable throughout the consultation process.  

References available on request.

Celebrations are in full swing since baby Layan was born on May 26 at Latifa Hospital for Women and Children. Her parents and three siblings are delighted to have the little one by their side.

Wajdy Mohammed Ali, a 47-year-old Egyptian expatriate says, “Layan is our miracle baby. My wife suffers from heart failure. The private hospital we were initially consulting told us that it is not possible to continue the pregnancy, they referred us to Latifa Hospital.”

Doctors at Latifa Hospital for Women and Children first examined his wife at 17 weeks. Dr. Amal Qedrah, Head of Gynecology at Latifa Hospital for Women and Children says, “She was referred to us by a private hospital for termination of pregnancy in view of her condition and the fact that she had stage 4 heart failure. She was admitted to the ICU in Latifa Hospital. Upon assessment by teams from both Latifa and Rashid Hospital we decided that minimally invasive cardiology intervention and close observation throughout the pregnancy was a viable solution to save both the mother and baby.”

Dr. Amal Qedrah

Dr. Haitham Al Hashimi, head of cardiology at Rashid Hospital and lead physician for pregnancy related cardiac issues says, “When we examined her in January this year, she had class 4 heart failure, had markedly elevated lung pressure and a severely narrow mitral value. Upon examination, we decided to carry out a minimally invasive cardiac procedure while she was pregnant so that she could continue her pregnancy. This way we could save the mother and her baby.”

Three days later, a multidisciplinary cardiology team headed by Dr. Al Hashimi conducted a cardiac procedure but there were many considerations and modifications required to protect the mother and her unborn child. Additionally, no anaesthesia was given because of the complications it can cause in a patient with high lung pressure. This meant the patient was awake for 30 minutes throughout the procedure. “We kept talking to her and making her comfortable all through the procedure.”

Upon examination, we decided to carry out a minimally invasive cardiac procedure while she was pregnant so that she could continue her pregnancy. This way we could save the mother and her baby.”

Dr. Sanjeev Agarwal, Consultant Interventional Cardiologist and an expert in such procedures says, “Minimum radiation was used, and the mother’s abdomen was protected with special lead shielding to block radiation to the foetus. Rather than depending solely on x-rays, we carried out an endoscopy, a small camera went down her throat and provided us the necessary imaging so that we could precisely guide the catheter from her groin and into the heart. The catheter had a balloon that was inflated to widen the valve.”

Dr. Juwairia Al Ali, consultant cardiologist and expert in echo carried out the endoscopic echo (ultrasound of the heart) throughout the procedure.

After the mitral balloon valvuloplasty was performed, the patient immediately witnessed the benefits. Al Hashimi says, “Her lung pressure reduced from severe to mild. She went from being a class 4 heart failure patient to class 2 heart failure patient. Her valve narrowing became minimal with no further leakiness in the valve. She was given medications and we continued to closely monitor her condition together with an expert team in Latifa Hospital, consisting of obstetricians, anaesthesiologists and the medical obstetrician. The key to success in such cases is a well-structured multidisciplinary team.”

Dr. Qedrah says, “We closely monitored her progress and carried out a planned C-section at 37 weeks.”

Ali says, “We are thankful to the doctors at Latifa and Rashid Hospital. We feel so blessed to have our little one by our side.”   

No policy domain or sector of the economy is more fundamentally human, of strategic importance or evolving more rapidly than health. This intensity of its impact is universal – touching the entire population without exception. Moreover, the level of government expenditure injected into the healthcare industry make it a top of mind and highly sensitive political issue globally.

There has been enormous progress in global health trends over the last several decades: child mortality rates decreased by over 50 per cent, antiretroviral therapy has driven a 48 per cent decline in HIV-related deaths, and tuberculosis incidence declined 19 per cent in 15 years. However, rising healthcare expenditure increases pressure on all governments in GCC. KSA’s national health expenditure rose from 3.5 per cent of GDP in 2010 to 5.8 per cent in 2015, UAE’s health expenditure rose from 3.3 per cent of GDP in 2010 to 4.7 per cent in 2017, and the upward trajectory is only increasing. Global healthcare spending is projected to rise at an annual rate of 4.1 per cent between 2017-2021, up from 1.3 per cent over the preceding five years.

Other challenges persist in an increasing complex environment, with the advance of science and technology, shifting demographic patterns, and the fiscal pressures facing governments around the world driving new approaches to handle care. Saying this, there are several fundamental and interrelated forces that are driving the transformation of the health policy landscape.

From cure to prevention

Historically, the focus of most health systems was on curing the sick. The model was driven by supply rather than demand; however, it quickly became financially unsustainable. Today, we are seeing a fundamental shift in thinking, enabling proactive health management rather than reactive attempts to cure illness. As health systems have developed the ability to treat acute crises and prevent communicable diseases, the focus has shifted to preventing chronic diseases (many of which are associated with modern sedentary lifestyles and food consumption patterns) which the World Health Organization (WHO) estimates now account for 50 per cent of the global burden of disease. 

The continued monitoring and care that chronic diseases require has driven the emergence of holistic approaches focused on cultivating healthy lifestyles, consistent monitoring, early diagnoses, and targeted treatment that can prevent minor ailments from developing into critical conditions. Increasingly, the orienting objective is to keep patients out of the hospital both before they are ever admitted and by minimising return visits through effective post-treatment community care. Key to this shift has been altering the incentive system such that providers are paid based on the health of patients, or alternatively paid a flat rate for patients subscribed, whether they receive any treatment or not.

Expanding reach and inclusion

The focus on expanding the reach of the healthcare system is no longer centred on building more hospitals and training more doctors, instead, it is being redefined by the ability of individuals to access the right care at the right time. Precise, rapid triage and referral systems optimise the location of treatment. Common cases are treated in primary care close to home, while rare, complex cases are attended to in specialised hospitals that are best-suited to patient needs, even if they are in another region of the country.

In addition, National Healthcare Systems across the world are working to make high-cost therapies equally available for the entire population, including rural areas, through development of National Treatment Standards and subsidising regions based on their needs. Taken together, these measures are emerging as solutions to the “post-code lottery” in which superior care is more available to those in major cities than those living in rural regions.

There has been enormous progress in global health trends over the last several decades: child mortality rates decreased by over 50 per cent, antiretroviral therapy has driven a 48 per cent decline in HIV-related deaths, and tuberculosis incidence declined 19 per cent in 15 years.

Digitally enabled self-care

New technologies that enable individuals to monitor their own health conditions, from fitness trackers to condition-specific mechanisms such as continuous glucose monitors, are aiding the transition to preventative care. As the affordability of these devices increases, more citizens are gaining access to the tools that can enable them to take charge of their own health. In addition, the advent of high-quality digital and virtual communication tools in the health sector serves to close the gap between rural and urban provision of care.

With these technologies, preventative care becomes ever-more accessible for the individual. As a result, the roles of doctors and nurses will necessarily change. The specialised knowledge of doctors can become better leveraged, while the need for nurses becomes even more critical in cases of continuing and long-term monitoring and care. The increasingly important role of healthcare policymakers is to facilitate the growth and affordability of such solutions, while ensuring their efficacy, efficiency and proper use.

Accelerating scientific and technological advance

The application of next-generation technologies and scientific understanding in healthcare is further transforming the health landscape. Advances in understanding and addressing health challenges from the earliest indications of health risk to the final stages of treatment are dramatically altering the effectiveness of preventative and curative treatments; from chatbots to diagnose common ailments to machine learning and Artificial Intelligence that can recognise cancerous tissue or correct gaps and errors in diagnosing illnesses. Meanwhile, advances in detecting and recognising early indicators of disease are helping to proactively identify individuals most at risk for poor health outcomes so that they may monitor, catch, and address diseases effectively.


Finally, in the context of new genetic and genomic understanding, the ability to treat individuals with tailored medications and methods is becoming an ever-greater possibility. As the advance of technology and our understanding of biology accelerate, the opportunities for their application in the health sector are increasing exponentially. At the same time, the proliferation of technology requires careful assessment and effective government regulation, to ensure that the quality and safety of care meet the strictest standards. A key challenge in realising this transformation of health is the complex set of trade-offs between quality, cost, and accessibility.

For example, intergenerational equity in the provision of healthcare will continue to gain prominence as a central political issue – as birth rates have fallen and life expectancy has grown, the proportion of the population experiencing medical challenges associated with advanced age continues to rise. Nevertheless, the potential benefits of intelligent reform in terms of cost savings and economic growth are potentially of a magnitude that can make even these difficult trade-offs more manageable.

A recent report by Frost & Sullivan highlighted that in 2019, GCC countries will represent 13 per cent of global revenues for healthcare products, with services growing at 12 per cent. The report said that the rising demand for better healthcare services in the region and global advancements in medical technologies have opened up a number of opportunities for information technology (IT) organisations to tap into this growing sector.

In an interview with Arab Health Magazine, Sandeep Sinha, Associate Partner – Healthcare, Life Sciences & BFS, Middle East, Africa & South Asia, Frost & Sullivan, shed light on the different factors driving growth and the latest healthcare trends in the Middle East.  

He shared: “Dubai is one of the most progressive healthcare markets and there are a number of healthcare investments happening here. Earlier it was a non-insurance market but today it has evolved into an insurance driven one. The overall growth of the market has been very good and there has been an increase in access. Earlier the patient used to pay from their pocket but now they do so through insurance. The volumes have gone drastically high in the last three years. In the UAE, Abu Dhabi is quite matured and an already regulated market, and Dubai has been driving pretty decent growth. Now we see Sharjah will be the next market and the other emirates will follow soon.”

Sinha said that Saudi Arabia is also an exciting market and is witnessing a lot of growth. There has been an increase in private investments in the healthcare space, along with Public-Private Partnerships (PPP) in the country. “The government is giving an opportunity for private investments and private players to come and invest in the healthcare space. As one of the biggest markets of the region, some of the highest growth can be seen in Saudi. Soon, Oman and Bahrain will also be implementing the insurance model. Health insurance is one of the major drivers of growth in the region,” he added.

Technology at the forefront

The Middle East has a positive outlook when it comes to adopting technologies, stressed Sinha. Basic IT infrastructure such as the Hospital Information System (HIS), Electronic Health Record (EMR) or other database related technologies, are quite prevalent in the UAE and Saudi Arabia. On top of it, new technologies such as Artificial Intelligence (AI) are being adopted in the region and provide opportunities, especially in the diagnostic space, where it is going to play a major role.

He said: “The UAE has been the most prompt in adopting any technology, not just in healthcare. The country is always at the forefront and is keen on adopting those technologies and wants to have an edge when compared to other countries not just in the region but in the world.

“Within healthcare, the DHA is trying to build a new platform and is bringing some new guidelines to the AI side of it. Private hospitals are also very open to adopting AI. It is not just on the diagnostic side but can also be applied to improve the patient-customer experience and the third area where I see the government working with it is to integrate the Emirates ID to the health data. Both Abu Dhabi and Dubai are working towards trying to integrate the health data of all the residents of the UAE and have access to the information securely so that it can be accessed by various healthcare entities where the patient travels.”

Another technology integration that has been gaining traction is home healthcare. It is already a pretty decent business model in Abu Dhabi, said Sinha, but in Dubai too, it is gradually picking up.

Both Abu Dhabi and Dubai are working towards trying to integrate the health data of all the residents of the UAE and have access to the information securely.

What’s trending?

One of the key trends, Sinha highlights, that has been noticed since the beginning of 2018 in the UAE has been consolidation. The price points are coming down and the providers are offering better care.

“Efficiency will have a major impact. Every healthcare entity needs to ensure they have operational excellence otherwise they won’t be able to survive,” he said. “Be it patient care, human resources or processes, everywhere they need to ensure that there is efficiency then only will they be able to provide good care at better prices. Second, is the adoption of technology, which is linked to efficiency.

“Also, we see innovative business models being adopted such as home healthcare, rehab, long-term care, speciality-based clinics, and alternative medicine. The UAE is open for alternative treatments as India’s Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) held a conference in Dubai, and some homoeopathy conferences have also been held recently.”

Some of the other trends that have been observed are that large healthcare chains have become quite aggressive on offering high-end tertiary services, and a lot of investment is being made in this area. The institutions have started building capabilities in cardiology, oncology, nephrology, urology, and other specialised services for which patients used to go back to their home countries or the locals used to go abroad. This is a trend where good capacity is being built in the market, added Sinha.

The UAE also has a huge aspiration to become the region’s healthcare hub and for some of the specialities such as cosmetic and dentistry, and IVF, Dubai has secured a good number of patients coming in from neighbouring countries as well as from the African continent.

Dubai’s population keeps moving every three to four years, as its largely expatriate driven. That poses another challenge as to how do you maintain the balance of the population, as all these different people will have different healthcare needs. It is not just about the patient but also about the caregiver because a patient coming in from the African or European region, will have different kind of healthcare needs.

“Taking things into consideration such as retention of the manpower, quality, etc., the cost of treatment goes high. Dubai is trying to meet these challenges by introducing new reforms that will benefit the entire population,” he concluded.  

In line with the government's Vision 2030 and the National Transformation Program (NTP), the Ministry of Health (MoH) is expected to spend close to US$71 billion over five-years ending in 2020. According to U.S.-based consultancy Aon Hewitt, the healthcare sector in KSA is expected to grow at a compound annual growth rate of 12.3 per cent by 2020. There is also a significant rise in population with an increase in those over the age of 60 years, as well as the adoption of mandatory health insurance in the country.

According to a report by Knight Frank, the main goal of the Vision 2030 is to diversify the economy away from hydrocarbons and achieve greater participation of the private sector by encouraging both local and international investments in several key industries such as healthcare. Privatisation of government services is expected to help meet the goals set out in Vision 2030. This is set to increase the private sector's contribution to GDP from 40 per cent to 65 per cent in 2030.

To increase efficiencies and reduce costs, the government in KSA is exploring private sector involvement in the development of the healthcare infrastructure in the Kingdom. By introducing Public-Private Participation (PPP) models for healthcare, the government is working towards unlocking value in the health system and fast-tracking healthcare reform with plans to increase private sector contribution in total healthcare spending to 35 per cent by 2020.

In a review of KSA's 2019 budget and recent economic developments, a report by KPMG highlighted that the healthcare sector holds the third largest share of 15.6 per cent in the budget expenditure of 2019. The budget allocation for the sector has grown by 8 per cent to reach SAR172 billion in 2019, as compared to SAR159 billion in 2018.

Furthermore, research from Knight Frank indicates that to keep pace with population growth, KSA would require an additional 5,000 beds by 2020 and 20,000 beds by 2035, based on the current density of beds. Based on the global average of bed density, KSA faced a gap of 14,000 beds in 2016, and this gap is expected to widen to 40,000 beds by 2035.

According to Export.gov, the KSA market for medical equipment is estimated at just under US$2 billion and is growing annually at roughly 10 per cent. With increasing awareness of health issues and a growing consumption of healthcare services in the country, there is a strong market for medical equipment.

Encouraged by recent regulatory changes, medical device manufacturers, service providers and dealers & distributors are now able to make significant inroads in the KSA market.

The recently introduced Medical Device Interim Regulations has made the Kingdom a regulated market for all types of medical devices and all manufacturers wishing to supply a medical device within KSA require Saudi Food & Drug Authority (SFDA) Market Authorisation.

According to Colliers International, some of the key factors that make KSA’s healthcare market attractive are:

• The Structure – The KSA healthcare structure provides basic healthcare services to all with specialised treatment offered at both private and public hospitals.
• The Population Boom – With the World Bank estimating the KSA population will reach 45.1 million by 2050 (from an estimated 32.6 million in 2018), the demand for healthcare services is expected to grow exponentially.
• The Rise of the Private Sector – As the public sector is gradually transitioning to become more of a regulator, private players are being incentivised to play a larger role in the healthcare sector. Foreign investors can now have 100 per cent ownership in the healthcare sector.
• The Power of PPPs – The government continues to invest in the development of healthcare infrastructure with various medical cities under construction. The private sector is expected to act as operators in the form of PPPs.
• The Budget Increase – The annual increase in budget allocation towards healthcare social services in KSA reflects a strong indication of potential demand as well as the government’s willingness to augment growth and improvement within the sector.

Premier business platform

The Global Health Exhibition and Congress, organised by Informa Markets, will be held from 10-12 September, at the Riyadh International Convention and Exhibition Center, and will put the spotlight on all the exciting developments taking place in the country’s healthcare sector. The exhibition is the ideal meeting place for the global market to gather and do business with the Saudi healthcare sector. The exhibition provides the perfect platform for companies to promote their latest innovations in healthcare products and services to some of the region’s largest institutes and key decision makers.

The upcoming edition of the event will see 180 plus exhibiting companies, 25 exhibiting countries, 9 educational tracks and is expected to welcome over 10,000 attendees ranging from healthcare service providers, product dealers and distributors, key decision makers and government officials. The exhibition will feature three new dedicated zones – Lab, Innovation and Building Healthcare.

The Innovation Zone will be hosting the award-winning Intelligent Health Pavillion, produced by the Intelligent Health Association, to showcase some of the most innovative healthcare technologies, delivering several compelling use cases across collaborating vendors to highlight how multiple technologies can seamlessly interoperate with state-of-the-art medical equipment and co-exist to improve the overall patient care environment.

Complemented by a diverse range of scientific and educational content, Global Health will be hosting a variety of conferences including Continuing Medical Education (CME) conferences for attending healthcare professionals across all three days of the show. The conferences are divided between five clinical conferences and four non-clinical conferences including: Emergency Medicine, Laboratory Management, Patient Experience, Quality Management, Total Radiology, Hospital Build, Biomedical Engineering, Digital Health and Leaders in Healthcare.  

For more information visit globalhealthsaudi.com

The upcoming edition of the event will see 180 plus exhibiting companies, 25 exhibiting countries, 9 educational tracks and is expected to welcome over 10,000 attendees

NTP targets for KSA's Ministry of Health for 2020

• Increasing private healthcare expenditure from 25 to 35 per cent of total healthcare expenditure
• Increasing the number of licensed medical facilities from 40 to 100
• Increasing the number of internationally accredited hospitals
• Doubling the number of primary healthcare visits per capita from two to four
• Decreasing the percentage of smoking and obesity incidence by 2 and 1 per cent from baseline respectively
• Doubling the percentage of patients who receive healthcare after critical care and long-term hospitalisation within four weeks from 25 to 50 per cent
• Focusing on improving the quality of preventive and therapeutic healthcare services.
• Increasing focus on digital healthcare innovations

Source: Healthcare in Saudi Arabia Opportunities in the Sector, May 2018, Knight Frank