Open Dental Forum

I'm curious if anyone like Jordan can comment on where OD is "going" in the next 3-5 years or so. It seems like running an OD hosted cloud based version and then building out APIs seem to be pretty high on the list when I look at release notes. I'm super happy they are doing that so that 3rd party programs like Flex, Yapi, etc can integrate with the cloud version. I'm hoping to migrate to the cloud version as soon as Flex can/will work with their APIs. A cloud based version will help with multiple locations for sure.

OD's honestly got 98% of the functionality that I could ever want. I'm wondering what's exciting the developers as far as their next challenge. Is it mostly maintenance and smaller feature updates since the software is so mature right now?

We are nowhere close to being done with Open Dental. We've barely scratched the surface of what's possible. I'm personally getting to the end of a months long effort to make it work better on very high dpi screens. It's so much nicer at 4k. Some other things that excite me in the short term:
-It looks a little different under Win11, and we're working on removing those visual differences.
-Overhaul 3D tooth chart with new engine to get much more realistic rendering, including specular reflection.
-OD Touch for tablets, with much more functionality.
-A variety of new custom controls. These are subtle, but very useful and they increase productivity. For example, you might have noticed that our calendar is no longer stock MS. It's better. We are constantly overhauling and improving many different kinds of controls.
-Better software to let our techs work from home more effectively. There's a lot we can do here. This will give you better quality support.
-We're building a daycare for 100 kids to solve the 3 year waiting list. This will also give you better quality support.
-Cloud hosting. Yes, we are working hard on that. Hosting it in a browser sort of fizzled for technical reasons, so I think we will end up with the fully installed standard Open Dental exe on each workstation, but all connected to a cloud server that you don't have to mess with.
-API is essentially done, so not much effort will be going into it in the future. The main thing we will be dealing with will be negotiating with the various third parties to move over to the API. A bit of stick and a bit of carrot. Yes, a huge benefit is that it will work with cloud hosting.

There are lots of things that get me excited. Here are a few longer term ideas of what we might tackle:
-Something better than cloud, like maybe hybrid, where we keep a hidden db onsite for speed. You would never need to manage this db, and the one in the cloud would be the "real" one, but a local copy could really speed things up.
-AI is obviously on our minds. It could be used for speech recognition, faster customer support, automatic charting of existing conditions, etc.
-8k and 16k monitors. Yes, you really do need that many pixels.
-3D monitors. The UI should take advantage of the third dimension.
-3D scans of teeth. The scanners exist, and we just need to improve the software side of things. AI will be needed for the software to understand what it's looking at, like identifying which tooth is which.
-Tracking people in the office. I've been trying to do this for over 20 years. We've tried cameras. We currently use hundreds of ultrasonic sensors at OD HQ. We could do a lot better. You should never have to wonder where anyone is, whether staff or patient. And you should be able to instantly communicate with any of them. AI will help us solve this problem.
-Remember, we will know we are getting closer to being mature when the software is doing the drilling instead of the dentist.
-There are nearly 20,000 feature requests. Yes, some of them are done or duplicates, but most people don't even bother to submit a feature request. That means there is huge demand for improvements.

I'm sure there are many things I've forgotten, so I'll probably add to this list over the weekend.

We are nowhere close to being done with Open Dental. We've barely scratched the surface of what's possible. I'm personally getting to the end of a months long effort to make it work better on very high dpi screens. It's so much nicer at 4k fantastic, I use a huge ultrawide monitor). Some other things that excite me in the short term:
-It looks a little different under Win11, and we're working on removing those visual differences.
-Overhaul 3D tooth chart with new engine to get much more realistic rendering, including specular reflection. would definitely be cool to be able to scan each patient's mouth and then have it stored in their chart at each visit. I'm a pediatric dentist. Could do massive amounts of research with that regarding growth and development but also lots of AI based caries detection along with caries risk assessments.
-OD Touch for tablets, with much more functionality.
-A variety of new custom controls. These are subtle, but very useful and they increase productivity. For example, you might have noticed that our calendar is no longer stock MS. I have noticed It's better. We are constantly overhauling and improving many different kinds of controls.
-Better software to let our techs work from home more effectively. There's a lot we can do here. This will give you better quality support.
-We're building a daycare for 100 kids to solve the 3 year waiting list. planning to do the same on a smaller scale for my team when we expand next yearThis will also give you better quality support.
-Cloud hosting. Yes, we are working hard on that. Hosting it in a browser sort of fizzled for technical reasons, so I think we will end up with the fully installed standard Open Dental exe on each workstation, but all connected to a cloud server that you don't have to mess with. possibly run the .exe inside an emulator and use Macs with OD? Would love the ability to use touch ID or FaceID to log into the computers from a security standpoint. We currently use RFID tags but that's not very secure.
-API is essentially done, so not much effort will be going into it in the future. The main thing we will be dealing with will be negotiating with the various third parties to move over to the API. A bit of stick and a bit of carrot. I guess it's a situation of stopping development for older technology (stick) and make the APIs the clear choice going forward from a functionality standpoint (carrot) Yes, a huge benefit is that it will work with cloud hosting.

There are lots of things that get me excited. Here are a few longer term ideas of what we might tackle:
-Something better than cloud, like maybe hybrid, where we keep a hidden db onsite for speed. You would never need to manage this db, and the one in the cloud would be the "real" one, but a local copy could really speed things up.
-AI is obviously on our minds. It could be used for speech recognition (currently dictate my notes using a microphone and microsoft's built in voice recognition. It's not a bad solution but definitely has some speed issues at times. , faster customer support, automatic charting of existing conditions, etc. Would be great to see that in imaging. Caries detection, canine angulation, periodontal bone loss, panoramic review for pathology/dental age and would basically read the panoramic for you, automatic cepholometric tracing, etc
-8k and 16k monitors. Yes, you really do need that many pixels.
-3D monitors. The UI should take advantage of the third dimension. sounds great. I'm hoping for better 2D UI at this point. For all of its power. Some times open dental feels like I need to know HTML or some other coding language to navigate some of their features. I messed around with the Wiki but got frustrated with it. Notes within a note feature is amazing, but it took me a few days to really understand how to customize it and embed multiple notes inside each other. It works a lot like EPIC's note feature now but took a bunch of hours to set up compared to EPIC. Also flex honestly has one of the better form builders for new patient forms and UIs regarding treatment plan presentations that I've seen. Would love to see OD do something similar style wise and functionality wise.
-3D scans of teeth. The scanners exist, and we just need to improve the software side of things. AI will be needed for the software to understand what it's looking at, like identifying which tooth is which.
-Tracking people in the office. I've been trying to do this for over 20 years. We've tried cameras. We currently use hundreds of ultrasonic sensors at OD HQ. We could do a lot better. You should never have to wonder where anyone is, whether staff or patient. And you should be able to instantly communicate with any of them. AI will help us solve this problem. Interesting thought, but not sure the use case is there for me. We just use in ear radios to communicate. Works pretty well. Speaking was much faster than typing with Yapi. I could see where it could help automatically place a patient "in the chair" or "dismissed" but privacy would be important
-Remember, we will know we are getting closer to being mature when the software is doing the drilling instead of the dentist. I know it's tongue in cheek, but I can't imagine a robot drilling on a wiggly 4 year old. Would likely be terrifying to them without the ability to communicate.
-There are nearly 20,000 feature requests. Yes, some of them are done or duplicates, but most people don't even bother to submit a feature request. That means there is huge demand for improvements.

I'm sure there are many things I've forgotten, so I'll probably add to this list over the weekend. would love to hear more!
Jordan Sparks, DMD
http://www.opendental.com

Having robots do the drilling on patients was definitely not tongue in cheek. I expect that to happen in approximately 80 years, which is only 40 years after I'm dead. To make it feel more plausible, start imagining all the steps that it would take to get from here to there. The roughly half-way point is when you are no longer using direct vision with a tiny mirror. Instead, you are wearing an augmented reality VR headset that gives you an AI assisted version of reality that is far superior. There's an array of tiny cameras and suction devices in the mouth so that you have completely clear, well lit, zoomed view with nothing ever blocking it. You start drilling. The software shows you where to drill, warns you if you're doing it wrong, gives you suggestions, analyzes to make sure all caries was removed, automatically documents, etc.

In the next few decades after that, I would expect the drills to become much much smaller, maybe about 2mm in size, and without the long handle. Electric motors of any size are possible, and the magical future is going to be all about miniaturization of robotics. I would expect the business end of the drilling process to eventually become a small cap slightly bigger than the actual tooth that gets clamped down on the tooth. A flexible umbilical would snake out of the mouth to provide a conduit for electricity, data, water, air, suction, and the filling material. That kid won't care at all, and they can squirm as much as they want without causing a problem.

Let's take it even further. After 80 years, after the robots are doing the drilling, what improvements could be made? Well, then you start getting into robots that are so small that thousands or eventually millions of them could take up permanent residence in your mouth. They would also, of course, be all over your external skin, throughout your gut, in your airways, and eventually in your blood. You could eat whatever you want because the gut robots would only allow the beneficial nutrients into your blood. The mouth robots would keep your teeth sparkly clean at all times, so you would never get cavities. Children would go in for a series of orthodontic surgeries performed by microrobots so that their teeth would come in straight. Any missing or damaged tooth could be replaced by cloning a new tooth, and then implanting it with microrobotics.

But that's not the end. It should also be possible to upload human brains into computers. This would be done by slicing a brain into millions of slices, and then scanning each slice in massive electron microscopes. Once all the slices were scanned, those images would be reassembled into a full 3D brain. Repairs would be made in software, a VR body and environment would be built, and then the brain would be turned on. It's not until this happens that dentistry becomes obsolete. Most other non-medical and non-food professions would survive the upload revolution, including lawyers, engineers, roboticists, etc. And of course the upload revolution is not the end, but rather just the beginning.

While my scenarios might sound increasingly fantastic and unrealistic, I assure you that none of them violate any laws of physics. Fundamentally, the scenarios all just depend on complex engineering. We can build that future. It's similar to how in the early 1900s, we knew that it was physically possible to fly a human to the moon, but everyone was firmly convinced that the engineering to constantly calculate course corrections was never going to be possible. They lacked imagination, and we built those tools in about 50 years. Think bigger!

come a long way from Freedent

Hi Jordan

steve

Hi, Steve. I looked up your account out of curiosity. Looks like you were approximately customer number 30 about 19 years ago. What were you thinking? Who buys software that only has a handful of customers? Anyway, you got lucky, and we're still forging ahead.

Hi, Steve. I looked up your account out of curiosity. Looks like you were approximately customer number 30 about 19 years ago. What were you thinking? Who buys software that only has a handful of customers? Anyway, you got lucky, and we're still forging ahead.

Truthfully I was looking for a head start on writing my own. I wrote my own DOS based software on the mid 80's for the financial side of things Insurance, billing and the like. With the advent of new fangled windows computers I bought and used WinDent for a few years and was totally unimpressed thinking I can do better than this and started looking for examples of what might work. I was drawn to the open source nature of what was then FreeDent. After previewing and using it I became apparent it was a bigger job than I had time for and why bother when I could support your attempt. So thats what I did. One of the better decisions of my career.

I am retired now but check in from time to time.
How many users now?

steve

BTW I wasn't lucky.. we spoke on the phone a few times early on and I could feel your dedication to this project so your success is not surprising.

s

One more thing I should point out is that we spend a huge amount of time rebuilding the same functionality that we already have, except with more modern tools. If we don't do this, then the software becomes more fragile over time. When the Southwest Airlines software choked a few months ago, it was because they were using older software and had avoided this process of constantly rebuilding. The trick, though, is to lose zero functionality in the process. This is a principle that MS never seems to get quite right. The migration from the Control Panel to the Settings window has been great. Gradually move everything over without breaking anything. But they completely botched it when they rewrote their taskbar for version 11. I must be able to have text on my taskbar buttons. Not optional. If they had done their job properly, the taskbar rewrite would have taken them a lot of time and effort, and the result would have been boring and completely unnoticeable. Once the rewrite is done on any given section, it does then become easier to add more cool features. But those take time and require the boring overhauls to be in place first.