Ten years in the making, a little-known organization called CRET is changing dental education, the dental industry, and the future of dental practice. And you’re going to like it. For real.
Welcome to Dental School Disruption 101.
IT’S A FRIDAY AFTERNOON IN MAY, AND I’M SITTING IN A SMALL ROOM WITH TWO OF MY COLLEAGUES AT THE UNIVERSITY OF MISSOURI–KANSAS CITY (UMKC) SCHOOL OF DENTISTRY. Outside I hear the approach of footsteps and happy chatter, and into our room walk Brittany Owens and Amanda Sutton. They’re both fourth-year dental students and just days away from graduation. They’re visibly excited—gleaming with that telltale giddiness professional students have right before they enter the real world: an affect that’s part exuberance, part impatience, and part terror. But make no mistake about it—they’re confident in their skills and ready to learn even bigger and better things. They’ve endured two years of rigorous classroom work in the biosciences followed by two years of intensive clinical study. Oh, and one more thing—they’ve been through the dental school’s Innovation Clinic, which is precisely why my fellow editors and I want to talk to them. We’ve driven five hours from our home office in Tulsa, Oklahoma, up I-49 in a rented Toyota Camry to hear firsthand about this clinic. You see, the UMKC Innovation Clinic is something on the frontier of dental education, an outlier from the narrow spectrum of modalities that defines dental education in the United States. How so? Well, the Innovation Clinic is like a crucible where dissimilar forces in the dental universe have come together to create something entirely new. At the Innovation Clinic, dental students experience the fusion of dental education, the dental industry, and the leading edge of dental technology—all of which have been living out a broken—and at times estranged— relationship with one another for the past umpteen decades. Yet here at UMKC, not only can be found the most advanced technologies available in US dental schools, but also the leading-edge technologies available in all of general dentistry … from all of the major manufacturers, dealers, and distributors.
So it’s rather appropriate that in the corner of the room where we’re seated is a state-of-the-art CAD/CAM system, which is ready to be installed and utilized by the next wave of fourth-years. Meanwhile, outside the room are six operatories beautifully outfitted by a handful of competing dental companies—distributors and manufacturers—all in use daily, and all provided at no cost to the university. But how did this happen? Why are there six versions of the same types of equipment, ranging in quality from mid-level to high-end? Why aren’t each of the operatories outfitted identically due a fiscally-sound, purchase-in-bulk agreement with a single distributor?
It’s a long story, one that you’ll want to hear. But for those of you who don’t want the details, here’s your 102-word CliffsNotes: The Innovation Clinic came about because a professor from the University of Connecticut named Edward Rossomando, DDS, and some notable visionaries from the dental industry got together in 2004 and founded the Center for Research in Education and Technology, a.k.a. CRET. Then, after years of meetings, negotiations, soul-searching, heated discussion, recruiting, cajoling, and countless leaps of faith, the diverse members of CRET found their common ground. They then partnered with two forward-thinking dental schools to establish sustainable (and potentially profitable) education clinics where dental students have access to the best dental technologies the industry has to offer, and they actually use them.
But more on that later. Let’s get back to Brittany and Amanda.
After brief introductions, I place my cell phone on the table and open the voice recorder app. I explain why my colleagues and I are here and what this story is all about. I ask Brittany and Amanda if they have any questions. They don’t. So, without further ado, I hit the app’s record button and turn to Brittany. "So, Brittany," I say. "Tell me what you know about CRET."
Brittany looks at me sideways. I repeat my question. She turns her head toward Amanda. Amanda looks at Brittany. Amanda shrugs. Brittany looks at me.
"CRET?" she says. "Never heard of it."
As it turns out, Brittany and Amanda aren’t the only ones who have never heard of CRET. Most people you ask in dental education and the dental industry don’t know about it either. That’s because CRET (pronounced "Crete," like the Greek island) has been working largely behind the scenes to establish itself. In the case of the University of Missouri–Kansas City, CRET worked closely with School of Dentistry Dean Marsha Pyle, DDS, and the leadership of the university to found the Dr. Charles Dunlap Innovation Clinic for Research and Education in Technology, or "Innovation Clinic" for short. Opened in 2013, it’s one of two clinics CRET has helped establish thus far, the other being the Hugh Love Center for Research and Education in Technology at the Loma Linda University School of Dentistry in Southern California. The UMKC and Loma Linda clinics have distinct personalities, but they have three very important things in common: First, they’re each just a few years old. While they aren’t perfect, they’re adapting rapidly and are being highly scrutinized by other universities looking to partner with CRET. Second, they’re each outfitted with the latest technology—equipment, materials, you name it—from diverse companies within the dental industry. Those companies include Benco, Centrix, DentalEZ, Henry Schein, Kavo, Premier, Delta Dental, Ivoclar, Patterson, and Sirona (see page 12 for the full list). Third, the schools received all of the technology for free.
Yes, free. We mentioned that earlier in the CliffsNotes, but it deserves a second mention. The deal is that the universities put up the brick-and-mortar costs of the clinic, as well as staffing costs, but the industry provides the goods at no cost to the universities. Companies are also responsible for maintaining the equipment, training faculty, and keeping the clinics updated with the coolest stuff going in general dentistry. That means it’s not just a one-time tax write-off for a company looking for some good press. It adds up to real money—collectively, hundreds of thousands of dollars of upfront investment and sustained expenses as equipment is updated and products get used up.
If you know anything about the history of dental school education, you know how remarkable this is. You know that money is one of the foremost reasons there has been a decades-long "gap" between the technology dental schools make available and the technology practicing dentists use to make a living. That gap has grown to a chasm with the acceleration of the digital age, and it’s led some to question the true value of what is already an exorbitant price for a DDS degree.
Yet, the members of the dental industry aren’t infinitely rich; they exist in an uber-competitive market and have quarterly bottom lines to make just like every other business out there. So although participation in CRET is done with a notable degree of magnanimity, CRET would not have gotten off the ground had companies not felt participation made good business sense, too. To understand why this was so hard, you have to understand the fundamental problems that existed—and, to a large degree, continue to persist—between the dental industry and dental educators. And for you to learn about that, there’s no one better suited to teach than Professor Edward Rossomando.
Dr. Edward Rossomando is a professor of Craniofacial Sciences at the University of Connecticut School of Dental Medicine, a position he’s held for close to 40 years. He is one of the founding members of CRET, which emerged first and foremost from his experiences in the classroom. There, he says, "It was quite clear that students were not aware of how important the dental industry was to their careers." Students, he found, were oblivious of how much they would need to interact with the dental industry post-graduation. They didn’t know about the importance of fostering an ongoing, symbiotic relationship between their practices and the people who would supply them with products and equipment. Without one, their practices were guaranteed to be mediocre at best, and at worst bankrupt.
CRET has stringent standards for its new members. The organization works only with FDA-approved products and companies who stand behind those products. Current industry members of CRET include:
Although Rossomando realized this problem in his early years of teaching, his concern didn’t reach critical mass until the mid-1990s. About that time, Rossomando formulated the idea for a course in which the dental industry would contribute meaningfully to dental student education, if only for a few credit hours.
Of course, Rossomando realized that in a dental school, you couldn’t have a course called "Dental Industry." That would fly in the face of what dental education was supposed to be—i.e., primarily and almost exclusively science and technique. Rossomando needed something more scientific-sounding, and he settled on incorporating his ideas into a course called "Biodontics."
As the name implied, the Biodontics course introduced students to the new wave of biotechnologies taking over dental. It also addressed how these technologies might be utilized over the course of students’ careers. With each passing year, the need for the Biodontics course grew. It was an important time in the history of dentistry—the turn of the century, when the digital technology explosion finally hit the dental world.
"Of course, this was very advantageous to me because I was finally on the cutting edge of something historical in terms of the dental field," Rossomando explains. "I think it’s important [ for people to know] that, from my point of view, for most of the 20th century nothing really happened in dentistry in regard to diagnostics or the treatment procedures. Most of the things were the same, and stayed the same, from about 1950. It was in about 2000 that the digital world finally made itself known to the dental profession, and things began to change. So the last 15 years have been really spectacular."
Dr. Rossomando continues, "At that time, new equipment was just coming in [to the marketplace]. For example, lasers were coming in, CAD/CAM was just making itself known, digital X-rays were just coming on the scene, optical impressions were coming on, and, interestingly—as you might guess—the students knew about these things. Unfortunately, the school didn’t. I’m talking about my school in particular, the University of Connecticut, but of course other schools didn’t either."
Rossomando clarifies that some members of the school were attuned to the changes in dentistry, but others were tuned out. This observation, he says, is not putting forward anything controversial for those who understand how dental schools operate. "Schools are not like companies," he says. "The educational component of schools is run by faculty, which means it’s run by professors of different disciplines, like orthodontics, prosthodontics, and restorative dentistry, and each of those disciplines has its own likes and dislikes. And you’re not about to bring in a product, a restorative composite, say, if the restorative faculty doesn’t want it. And sometimes bringing in innovations is difficult because the faculty doesn’t see why they should have something new if the one they’ve been using for 25 years works perfectly fine."
Rossomando, who takes an interest in dental history, says this behavior is nothing new. If you’re looking for a dramatic example, take the X-ray machine. Discovered in 1895 by Wilhelm Roentgen, medical schools in the US quickly came to adopt the technology and see its potential. However, it wasn’t until 1926 that dental schools began to teach radiography courses, and it was not until the 1930s that X-ray machines began appearing in dental offices.1
Moreover, there is a financial disincentive to keep up with technology. Providing new equipment or products for an entire class is expensive. Training faculty to use equipment and practice using new products is expensive. Keeping up with changes is expensive.
You can imagine how the conversation might go in the dean’s office: "Hey, what if all this fancy new equipment becomes obsolete? Then what? Isn’t what we’ve got now good enough?"
Rossomando heard these conversations and knew dental schools needed a mechanism to circumvent naysayers. Years later, CRET would become this mechanism, but not until critical lessons were learned in Rossomando’s Biodontics course. Indeed, the Biodontics course helped spring forth ideas that would take root, germinate, and flourish at CRET. Rossomando cites this story, for example:
"The Biodontics course we set up included demonstrations by other companies with this new equipment," he says. "We would have one company come in during the class time, they would bring in pieces of equipment, and they would demonstrate them. But more than just show-and-tell, the students were allowed to participate. So, for example, when CAD/CAM [emerged in the industry], several CAD/CAM machines were brought in and the class broke into small groups to try the machines. The students (and you have to understand UConn’s class is small, only about 40 students, so it was easy to break up into small groups) went into their groups and some faculty I’d invited to come in broke into another group. Well, about 10 minutes later, the person who was overseeing the project came around to the faculty group, and they had not done anything! Then, the person overseeing went over to the students, and they were taking optical impressions, and they were already feeding this stuff into the milling machine. So, the person overseeing went back over to the faculty and said, ‘Well, how can I help?’ And believe it or not, the faculty said, ‘How do you turn this thing on?’"
Rossomando continues, "So the industry rep—the manufacturing rep—realized something. He realized, ‘We’re back to square one. We didn’t even know this was a problem [in dealing with schools]. We thought we were at step 10. We should probably go back to step negative one here!’" In telling the story, Rossomando laughs, and I laugh with him. It’s easy to pick out the stereotypical behavior … eager students, the industry professional selling hard, and the faculty slow afoot. Yet, there is a more pressing point here, one that Rossomando didn’t fully appreciate until he made more contacts in the industry. While dental schools were ignorant of the innovations taking place in dentistry, the industry was "a little bit ignorant of what was going on in dental schools." Rossomando says the industry, just after the turn of the century, was desperately trying to get the new technology revolutionizing the profession into dental schools. The desire was so strong that the the industry resorted to donating, not selling, new products and equipment. But it wasn’t working. The universities were anything but eager to jump into the digital revolution. "As it was explained to me by one member of the industry at the time," Rossomando says, "‘Our equipment is just sitting—literally—in the closet because no one knows how to use it.’"
Rossomando grasped the disconnect as he made industry contacts through the Biodontics course. He came to know Carl Bretko, the president of DentalEZ, and Chuck Cohen, managing partner of Benco Dental. Together, they slowly but surely began to crystallize a plan.
"There was a real need in the dental industry to change this," Rossomando explains, "so CRET—the Center for Research and Education in Technology—emerged as a result of that. The initial plans were to have an organization that would promote introduction of new technologies into schools, and more than that, to take an active role in curriculum development, and I think that’s the new thing we added. Most of the time dental companies just donated things or gave dental schools a gift of money to buy something, and they didn’t really follow it up with anything in regards to education. The curriculum really wasn’t a part of what they did."
Indeed, curriculum was not what anyone did except for the faculty, thank you very much. For a dental school, allowing the industry to shape curriculum would be akin to making a deal with the devil. The ivory tower of dental education was not to be polluted by anyone driven by commission.
Except that not everyone saw things this way. While some deans backed away from the idea of shared curriculum development, others saw the opportunity to shake up the old guard. They could break the stereotypes associated with academia. The deans at UMKC and Loma Linda were two of them, and there are others stepping forward. Other deans came to listen to the UMKC and Loma Linda directors give their reports at CRET’s annual meeting, held every year during the ADA conference. The deans hope to secure a partnership with CRET during the next request-for-proposal application process in 2016.
But just as it took academia time to warm up to CRET, the industry wasn’t quick to dance either. "There were a lot of issues we had to deal with, both on the school side and the industry side," Rossomando says. "One of the issues on the industry side of course was to deal with the almost genetic competitiveness that is inside dental companies."
How were dental companies finally convinced? "That turned out to be an issue more of education than anything else. The industry had to understand—and finally came to understand—that it was a good idea to work with colleagues in the industry to bring these new pieces of equipment to the students." For example, getting six different manufacturers to install their equipment side-by-side each other at UMKC "took some doing," Rossomando says. "Each manufacturer at first thought, ‘Why do I want my equipment next to another company’s equipment, which I don’t think is necessarily as good as mine?’ Or the reverse, ‘I don’t want my equipment next to someone’s whose is better.’ So there was this self-analysis of their own equipment." But in the end, manufacturers saw the light. They realized they had an opportunity to get feedback from their next generation of customers and adjust accordingly. CRET could prime future graduates to open their minds to new technology earlier in their careers. In short, by working through CRET, members of the dental industry improved relationships with schools, obtained valuable feedback, and expanded their markets.
THE INDUSTRY POINT OF VIEW
Don Hobbs knows a few things about sales. As the vice president of equipment and technology sales at Henry Schein, he’s made a career knowing how to close deals that work on both sides of the bargaining table. When I first met Hobbs at the 2014 ADA meeting in San Antonio, he talked to me about CRET with a focused earnestness. It wasn’t like talking to other industry professionals about their involvement with non-profits—which CRET most certainly is. Those conversations often make it seem like the industry is doing its part to "help the cause," but the cause isn’t doing a lot to help back (not in terms of the bottom line, at least). Not in the case of CRET. When I caught up with Hobbs again a year later, he told me CRET allows Henry Schein and the other companies to make inroads at dental schools. Companies can’t just sell the equipment and leave the schools to fend for themselves. As members of CRET, they have to be good partners in the relationship. CRET provides an incentive to continually update the equipment, to make sure it works properly, and to train faculty how to use it.
Hobbs has a unique take on the feedback that students provide. He explains it this way:
"When we first started getting feedback from the students it was very, well, kind of generic. The feedback was like, ‘Well, hey, it was great,’ and ‘I thought it was okay.’ What we found was we had to give them very specific questions in order to get the real specific data—what they were using, what they liked, why they liked it, what they didn’t like … and you can’t do that once they’re out, right?"
It’s a rhetorical question, but I’m incredulous. I interrupt and ask why student feedback would be more valuable than, say, a practicing dentist’s. Wouldn’t it be better to trust someone who knows what they want and how things should work?
Not exactly, he says. "Once dentists or practices buy something, they’re kind of prejudiced in a sense because they bought it. They tend to defend what they’ve already made the decision to buy. Whereas at the student level, they’re really not. They’re just using this stuff that’s in the school. And now [at UMKC], they have the ability to use all these manufactures, to experience all these different designs. Maybe one manufacturer has a story about why they do one thing this way and not another, but the students don’t know that. When we’re working with students, we’re going to get real open and honest feedback—about as good as you’re going to get. That’s kind of the general feeling about CRET and why we think it’s so important. We get in there early on, so when they do come out, they really have a better idea what they would want to put in their practices given a blank piece of paper."
Hobbs reiterates that the gap between dental education and dental technology is real. "I think the benefit of this is that dentistry is taught a very certain and specific way at the university, right? CRET is giving the students an opportunity to get out of that box a little bit. One thing we’ve learned in the industry is that students might have to learn how to use impression material, but I would submit that very few graduating seniors today are going to put impression material in their practice. They’re going to do it digitally. This generation grew up digital. They live and work digital. So why would they go into their profession using, in their minds, antiquated products? And if we wait for the schools to have the resources to have all these different modalities and different products [added] into the curriculum, they just can’t make it happen fast enough. It is moving way too fast."
He continues, "I talked to Ed Rossomando this morning […] and he said ‘Don, you have to understand something. I have students that go try to buy printers online’—meaning the new 3-D printers ‘because they want to go into practice doing their restorations like that.’ Now, we can’t yet provide that. We don’t have the technology to do that right, but we will. The industry is changing so rapidly, and the schools can’t keep up with it. That’s why this is so appealing to the schools right now—to get CRET facilites set up within their dental schools—because they’ll never be able to keep up with technology on their own. They need to rely on their industry resources to get this stuff in front of the students. And heck, they need it to attract students. The director at Loma Linda will tell you that it’s one of the number one recruiting tools he uses when he’s talking to seniors looking to come to the dental school. He takes them in and says, ‘Look what we have. When you’re doing your clinicals, you’re going to be using the most up-to-date, state-of-the-art materials and modalities available at the time because we have this center."
CRET IN ACTION: UMKC’S INNOVATION CLINIC
The UMKC Innovation Clinic is nestled in a corner of the university’s main dental facility. To get there, you have to walk by the old guard: phalanxes of students treating brave patients in well-worn dental chairs, with each operatory looking like a close cousin to an office cubicle. It’s an important part of the students’ training, but it has its limitations: It’s not the best environment for patients with dental phobias, and students must proceed at a slow pace due to limited faculty supervision. But when you walk into the Innovation Clinic, you instantly feel like you’re walking into a private practice. A receptionist in a small waiting area welcomes you. Shortly thereafter, you’re greeted by the clinic’s director, James Trotter, DDS, who will gladly give you a tour.
Trotter received his dental degree from UMKC in 1976 and then started into private practice. He stayed there for 30 years and built three practices, but carpal tunnel syndrome and cubital tunnel syndrome shortened his career prematurely. After taking some time off to do medical mission trips, he began working at UMKC as an instructor. When the school announced its plans for the Innovation Center, Trotter was asked to direct it.
In the director role, Trotter supervises successive groups of fourth-year dental students for two-week introductory rotations. Trotter individually coaches them to improve subtleties in their technique, shows them how to increase their speed, and makes them think about the practice management aspects of running a day-today practice. Students are free to return to the center with their patients after completing their introductory rotation, so Trotter finds himself coaching a steady stream of fourth years looking to take advantage of the new products, new equipment, and accommodating atmosphere of the center.
Trotter says the shift from "out there" (the traditional dental school experience of 30-student teams using standard materials and sharing the time of supervising faculty members) to "in here" (the Innovation Clinic) is an important one. "Here they have the opportunity to use the latest dental equipment that’s out in the field," he says. "For a big percentage of them, that’s interesting because they’re going to be in dental offices in June when they graduate. They look at the equipment here differently than they would at a conference or a meeting. They don’t just get to see it; they get to use it. And after using equipment out there that’s 20–30 years old, they come in and see the latest of what’s out in the real world. Then they can say, ‘This is what modern dentistry is going to feel like.’"
After speaking to Dr. Trotter about UMKC’s relationship with CRET, we walk through the clinic’s six operatories, each one outfitted by a different manufacturer. We see the different brands and models, ones known for their utility ("the Fords and Chevys of the group") and others known for their style ("the Mercedes and BMWs").
"CRET and UMKC decided to set it up this way," Trotter explains. "There are two standard rooms, then four rooms that are high-end. The highend rooms are between $50,000 and $60,000 per room. There are high-end chairs and cabinets, digital touch screen units to program handpieces, LED overhead lights that can vary the light they produce, and other highend features."
Trotter then takes us to a room where products and mobile equipment are held. He talks about the Nomad handheld X-ray system that happens to be lying out, and about the benefits of sampling different formulations of products. We see intraoral cameras, a CAD/CAM machine, and bulk fill materials. Trotter talks about the new digital imaging equipment that will arrive later in the year. I ask Trotter how he thinks it will affect students’ experiences. Trotter laughs. "Well, the ability to take a digital impression instead of a physical impression and send it to the lab to make a crown—it’s now apparent that that’s not going away, as much as some of the academics were hoping it might."
In listening to Trotter talk, I’m struck by the impact the technology has had on the school’s educational outlook. Trotter puts it this way, "Educational environments can have a culture, just like any organization, and if the culture is such that ‘all this digital and CAD/CAM stuff is just hocus pocus,’ then the school’s not even going to look at it. Even when a new administration comes in, and even if they have a different mindset, it takes, say, five to seven years to change a culture. And that’s kind of where we are. We’re in the process of changing the culture. We’re really at the point now where we’re starting to do these things that have been in the marketplace for awhile. And we know the students are going to be able to use this technology the moment they graduate."
Take Brittany and Amanda, for example, the two fourth-years who are just days away from graduation. To hear them talk about the technology gives you a peek into the new expectations of the next generation. "Just having the intraoral cameras really helps sell treatment plans," says Brittany. "Because out there, in the main clinic, we can show patients the Xrays, and they say, ‘Oh … ," but they don’t really know what they’re seeing. They’re not educated in this. But when you show them an actual picture up on a computer screen, they’re like, "Oh, OK, yeah, I have $400 for this crown."
"Also, we get to spend more time with patients here." Amanda says. "We’re not, like, standing in line waiting on faculty. We go get Dr. Trotter, he comes in, we do the work, we’re done. Out there, it’ll take three hours to do one filling. It’s just silly."
I ask Amanda to talk about other procedures they did here, and she lists a number of them, including crowns, crown lengthening, difficult cases, and rampant decay. The approach is not always cookie-cutter, either. "Working in here, it’s like working in private practice, and you realize everything’s not textbook. It’s not possible. You put 10 dentists together and give them the same patient, they’re all going to treat the patient all differently. And just seeing a way that was different than the faculty who we work with every day, who emphasize the textbook way, was a big difference."
And what about the variety of products and equipment? Did they really experience everything that Hobbs and Rossomando told me they would?
"I liked all the different products we got to try and use back here," Amanda says. "I mean, I guess I know there are a lot of products out there, but at the Midwest Dental Conference, a lot of the reps we talked to said, ‘Oh, have you tried this new product? It’s in Innovation [Clinic].’ Practically all of them said they had products in here."
"Using all this equipment also affects delivery," Brittany says. "We can decide whether we like front delivery or rear delivery. In the clinic we have A-dec, an older version of A-dec, so we only get to experience that version of front delivery. But here we get to experience the opposite, the newer equipment, so we figure out what we want for in a few years when we have a private practice."
"Yes," Amanda says conclusively. "I definitely noticed back here which rooms I liked and which rooms I didn’t like."
THE NEXT FIVE YEARS
Where is CRET going in the next five years? Rossomando says CRET’s strategic plan is, quite simply, establishing two new programs in 2016 and broadening name recognition. "We have a problem with our marketing," he says. "Most deans don’t know of our existence." This problem, he believes, is evidenced in one key way: When schools want to add technology, they go straight to the dental industry … and not to CRET. Then, schools experience the same problems that Rossomando observed in the early 2000s—namely, a disconnect between implementation, staying current, faculty training, faculty support, and meaningful student use.
CRET is also working to gain acceptance with organizations that influence dental education, such as the American Dental Education Association (ADEA). But just because the ADEA and other organizations haven’t connected with CRET yet, it isn’t stopping other schools from charging ahead. Each year, when CRET invites prospective schools to observe CRET’s annual meeting during the ADA conference, schools hear reports from UMKC and Loma Linda. They have a chance to query representatives from CRET, the industry, and the schools for more information. What separates the prospective schools, Rossomando says, is the vision of each dean. He sums up what he sees, and the future of CRET, this way:
"Some schools come to our meeting, and they’re not interested. They say, ‘We have something just like that.’ And when they say that, I know they haven’t really paid attention to what we’re offering because nobody has anything like it. Some of these schools have a space in which they have set aside a number of chairs, and they put there the equipment that they’ve bought, but they have not integrated it into the curriculum. It’s stand-alone and ‘Where’s the on-off switch?’ That’s not what CRET is about. We’re about incorporating it into the science curriculum and the overall curriculum. It’s not just about having technology. It’s about thinking about technology and how it can help you and what it will allow you to do for the patient. CRET wants to make that mindset second nature."
Acknowledgment: Thank you to Angela Ruggiero, manager of corporate communications for Henry Schein, for her great assistance with this article.
More information on CRET may be found at cretdental.org.