I have been a team dentist for both major and minor league professional hockey teams since 1987. Professional hockey players tend to come from countries smeared across the northern latitudes from Canada to Russia. Each year the medical dental staff provides physicals for all the players including the rookies. The rookies tend to be very fit young men between the ages of 18 to 23. Observing their general dental health is an interesting snapshot of different levels of dental care.

As a general rule (General rule means this is an observation of trends and of course there are significant exceptions. Sadly this needs to be expressed to preempt the absolutists looking to be offended wherever possible. ) The players from North America (The US and Canada) have very healthy mouths, few if any fillings, hardly any untreated conditions, good home care and good esthetics often having had ortho as a child.

Moving east across the Atlantic to the Scandinavian countries especially Finland and Sweden, which is where most of the Scandinavian hockey players come from; the players still have good dental health. They have very few untreated conditions and good homecare. What they do not have is exceptional esthetics.

Moving farther east into Eastern Europe the hockey players from Czech Republic, Russia and Slovakia show a marked decrease in general dental health. Home care is spotty, existing restorations are suspect and they are much more likely to have untreated conditions.

I make this observation not to cast aspersions on individual hockey players or countries but just to note that there is a difference in dental care from different parts of the world

As a general rule (see above regarding that general rule thing) dental care as practiced in North America stresses retention of teeth, prevention of disease and esthetics. When given a choice many people will choose to have the care available in North America. There is a difference and they will travel and they will pay for it if they can.

This is one of the reasons I am excited about American World Clinics (AWC). AWC will allow us to export US or North American dentistry to people outside the country in an attractive and cost effective manner.

Interesting: Just for fun.

Dentists in Television Quiz – Characters and Actors.

A fun in cheek wrap up of CES 2012 from PC Mag

CES 2012: The Good, The Bad & The Ugly | News & Opinion | PCMag.com.

From Mike Skramstad Cerec Docs Mentor:

“You don’t mind going slow because you’ve never gone fast!!”

So true in so many areas of high tech.

In the spirit of the new year, I wrote last week about innovation and how it defies intuition. With the year still pretty new I’d like to keep such lofty ideas in the air. While I’ve waxed philosophic on innovation a few times, there really isn’t some magical strategy that just makes you innovate. In practice, you have to exercise your ability to think differently and to think counterintuitively. But what, specifically, can help you do that?

As I do get the “math and science” bug now and then, I want to go with that. Over the last few years I’ve learned a good deal more math than I used to know, and along the way I became fascinated with a particular law of probabilty. Now, bear in mind that this is a *law*, rigorously proven by math, and cannot be refuted by anyone, ever. It’s called Emmott’s Law and it goes like this: Probability has a 100% chance of being counterintuitive. Nothing separates the mathematicians from the employed quite like probability. So, against my better judgment …

The Buzz: Marilyn vos Savant was wrong that one time.
The Anti-Buzz: No, she wasn’t.
Why: I don’t know why I want to visit the horrors of the Monty Hall problem upon myself.

Actually, yes I do. I rarely get comments from you and it makes me sad, and nothing gets non-mathematicians talking about math quite like the Monty Hall problem. So go read about it here and here.

The summary is that a prize is behind one of three doors, and you choose one, but before you open it Monty Hall floats down from the sky and opens one of the other doors, constrained that he will never open the door with the prize, (that part is important), then offers you the chance to switch to the other unopened door. The question is, does switching doors increase your odds of getting the prize? The solution is that your odds of getting the prize are 2/3 if you switch, and 1/3 if you don’t, so yes.

People hate this claim, but it’s correct. It defies casual intuition, (either door is just a random guess, so they should have the same odds, right?), and people like to think that scientists are crazy and don’t live in the real world, so they are wrong because in the real world doors don’t play tricks like that. In seriousness though, not every one reads Parade magazine, so if the solution bothers you, go read about it.

I’m not here to just explain the most-explained math problem in the past 20 years because it’s already been done, ad naseum, for about 20 years. Instead I want to discuss why the popular perception of this problem, and probability in general, are important.

First, Savant’s famous discussion of the problem was not the first formulation of the problem, nor was she the first to come up with the solution, but it was the first time the problem was widely known, even in academic circles. Savant received some 1,000 letters from real actual mathematicians insisting that she was wrong, (despite publish mathematics papers 15 years prior that demonstrated otherwise). The bitter irony were those attacking her for perpetuating the deplorable state of mathematics education in this country, without realizing exactly how deplorable it really was, (and I’m sure MIT enjoys being the only university to initially accept the solution). If you don’t like this problem, don’t feel bad, because even the smartest of people got it wrong.

Go back to last week when I said that yesterday’s innovation is today’s common sense. I’m working on a PhD of my own, but as of this writing I am maybe only half as educated as the horde of mathematicians who foolishly lambasted Savant 20 years ago, but my story is that the Monty Hall problem is a part of one lecture one day in a sophmore level discrete math class. The eldritch magic that thwarted the great masters in 1990 is just a common mathemagical incantation in 2012, a bone thrown to any 20-year old willing to sit through discrete math. Deplorable mathematics education indeed; the paradigm shifted and we live in a post-Monty Hall world.

However, the world after the storm is fraught with the same problem: people were too accepting of the status quo, and they still are. Now any yahoo knows that when Monty Hall asks you to switch, you say yes, but most of these people couldn’t tell you why. In 1990 Savant was wrong because a bunch of mathematicians said she was and so, by the laws of peer pressure, she was wrong. Now every mathematicians says she is right and so, by the laws of peer pressure, she is right. Both worlds are just worlds where authority is given power when the math gets too hard. The person who reads the Monty Hall solution today and insists that switching doors does not improve your odds of winning is still wrong, but they are also a hero of sorts, because they are actually making an effort to understand the universe better and not simply accept the established wisdom. If they applied that attitude to something else, they might just invent the next tablet PC.

The other interesting discussion is why people so regularly get this question wrong. It raises serious questions about casual intuition about strategy and probability. The most often cited “bad intuitions” are that people tend to assume that all events are uniformly distributed, that all events are independent of each other, and that information does not change probability. I see these assumptions all the time, even among my colleagues.

Most people are used to dice or coins. A die is uniformly distributed, (all sides have equal probability of being rolled), and so is a coin. Die rolls are independent of each other. What you roll on one die does not affect what you roll on the other. Same with coins. Most people understand this too well – we all have that irritating friend who thinks magical fairness ghosts have control of the dice and will make a 5 more likely to come up because it is “due” – but most people have no idea what dependent events or conditional probability look like, (Hint: It looks kind of like Monty Hall floating down from the sky. With diamonds). Unfortunately, your casual interactions with probability set you up for failure. Nothing that matters behaves like dice.

And yes, information does change probability. Probabilities are not decrees from God, they are just calculations made with current information. When the information changes, so does the probability. If I roll a die and ask you for the odds that I rolled a 5, you would say 1/6. Correct. If I told you that the number I rolled was even, now what are the odds I rolled a 5? Zero. I can’t have rolled an even number and a five, it’s impossible. But a moment ago it was 1/6, not zero! I didn’t move the die, I just gave you information! Instead, if I told you that the number I rolled was odd, now what are the odds I rolled a 5? It’s not zero, but it’s not 1/6 either; it’s 1/3. Information changes probability, because probability is just a guess based on what is known.

So my question to you is, how often have your decisions and policies gone unchanged in the face of new information? How often have you overvalued your initial decision, trusted the status quo, and refused to switch doors? How often have you treated new information as irrelevant noise? That’s the lesson you should take from the Monty Hall problem, not the math, but avoiding the angry status quo stampede when you know it is wrong.

If you like this sort of puzzle, I suggest you try the Boy or Girl problem, and if you really want to shatter your intuition in half, google the “blue eyes island” problem, (I have reasons for not linking directly).

In the spirit of counterintuitive logic, I leave you with the best math joke of 2011:

Three logicians walk into a bar. The bartender asks, “do all of you want a drink?” The first logician says “I don’t know,” the second one says “I don’t know,” and the third one says, “yes.”

From the Wall Street Journal:

Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue—sometimes long before a patient knows anything is wrong.

via If Your Teeth Could Talk … – WSJ.com.

Nothing we don’t know as dentists but it is good to see it in main stream media. HT Rick Williford.

The Buzz: The wise observer is able to predict all tech trends.

The Anti-buzz: True innovation is always unpredictable.
Why: Because difficult problems always defy intuition.

Happy New Year! I’ve been at a loss for how to kick off the New Year in anti-buzz fashion. Do I review the past year? Do I make bold predictions about the coming year? I think the first is too easy and the latter is too hard, but this dichotomy is itself a good topic on it’s own.

This, of course, is not to step on my father’s toes regarding his own predictions, but big sweeping innovations tend to surprise us and we all collectively scratch our heads and wonder why we didn’t see it coming.

How can it be that bold innovations seem so obvious in retrospect, but are impossible to predict beforehand? This feels especially true with consumer electronics because a requirement of success with consumer electronics are that they are intuitive to use, and so the “seems so obvious” factor is exaggerated.

 For example, nobody asked for tablet PCs – the consumer didn’t see them coming – but once we saw them we all nodded and said, “Yes, that is what I want.”

And it’s fairly easy to summarize why tablets have been successful, what trends and signs should have helped us predict them, and what impact they might have on the near future. My quick take on tablets is this: They are netbooks. They fill the same function for users. People want the Internet without the computer, and they want it to weigh 2 pounds and fit in their briefcase. If I am to make one prediction for 2012, it’s that it will be the year we see the netbook die, but this is a pretty cowardly prediction. However, if you consider what I said about innovation a few weeks ago, iPad vs. netbook is a pretty good example of how these transitions happen. The iPad doesn’t out-netbook the netbook, it instead addresses the same public demand in a radically different way.

But why are things that feel so obvious so hard to predict? The seemingly paradoxical answer is that they defy intuition, (Yeah I know, “How does intuitive software defy intuition?”). It would be good to qualify “intuition” here. One might liken it to common sense. Intuition is imperfect, but it is fast and nearly always adequate. Intuition is what keeps you safe, what quickly solves most of your problems, and what keeps human civilization efficient. People make mistakes, and they make a lot of them, but as someone who studies artificial intelligence let me tell you: People spend most of their time making intelligent decisions, and making them quickly, and most amazingly, making them without a lot of facts or evidence. The human capacity to “just know” the right thing to do is amazing. We accomplish this with our magic bag of rules-of-thumb. Let’s call this bag intuition.

So here’s the catch: difficult problems cannot be solved with intuition.

Difficult problems need all the evidence, and also need the flexibility to ignore prior beliefs about the universe. Old rules-of-thumb become barriers to discovering something new or solving the unsolved. The cliche “thinking outside the box” comes to mind here. When you think of “difficult problem” you probably think of tax codes and other economic policies, or the cure for cancer, genetics and other medical research, or space travel, or electrical engineering and microscopic manufacturing techniques. Those are all difficult problems and all require counter-intuitive solutions.

The “gotcha” I’m going to provide here is this: pleasing consumers, that is, inventing new products that people actually want to buy, is also a difficult problem. Perhaps not as difficult as cancer, but definitely outside the box. Figuring out what will make people happier is hard work, and usually defies intuition. The new industry wisdom is that consumers often don’t actually know what they want. Asking consumers what they’d like to see on a product often pleases nobody, because the consumer isn’t obligated to inconvenience themselves with thinking outside the box, especially about the gadgets whose sole purpose is never to inconvenience them. The true innovator is able to know the consumer better than they know themselves.

The life-cycle of innovation, however, is that yesterday’s crazy counter-intuitive invention or scientific breakthrough is today’s common sense rule of thumb. Not that long ago the idea that our health can be affected by tiny organisms that we can’t see sounded crazy. Today, only a small percentage of us are doctors or biologists, and yet we all make pretty good guesses about sanitation that would have boggled the minds of yesteryear’s geniuses. Similarly, few of us are economists, but a lot of us have an intuitive understanding of business and capitalism that would have defied all intuition 200 years ago.

And so, simple as that, the lot of us will once again fail to see the next tablet PC coming, and will once again slap our palms to our forehead after it gets here, because that’s how it has always been: today’s innovation is tomorrow’s common sense.

I humbly report that my 2011 predictions regarding dentistry and high tech, which can be found here, all proved to be 100% accurate. Knowing it is not possible to improve on that record I am submitting predictions for 2012 that I expect to be 100% wrong.

Knowing these predictions will never come to pass makes them not really predictions but more like hopes or ideals. Like ending the scourge of periodontal disease or peace on earth, we’d all like to see these things happen in 2012 but know they never will.

1. All the major creators and sellers of dental software agree to industry standards that allow a dentist in Cleveland using dental software Softrix to send a complete chart including all the notes, x-rays and medical history digitally to a dentist in Spokane using dental software Eagleworks. The Spokane dentist can simply import the complete chart and use it all with a single click. Heck it would be a big improvement if the Softrix user could just send a dental chart across town to another Softrix user.
2. Using film x-rays becomes the social equivalent of smoking in public. Sure people still do it but they are made to feel that they are low status and unclean. After all the film developing chemicals are stinky and who knows they might even cause cancer. Of course for a dental office to stop using film they first have to really want to change.
3. Digital impressions become main stream as dental labs start charging half price for digital impression cases. Simple business accounting demonstrates that when the lab eliminates the cost of pick up, pouring models, trimming dies and remakes for distorted, dried out bubbly impressions the lab can make a lot more profit and charge less if they can get rid of those pesky impressions. .
4. E-Services will become so fast, so good and so cheap that dentists will finally get it. They will look back on the primitive days of 2011 and wonder how any intelligent professional could ever have sent bills by mail, sorted charts by hand to find non responsive patients, made phone calls to confirm patients or waited on hold to establish insurance eligibility.
5. Suddenly realizing that “Google it” is now a well-established part of the American lexicon dentists will scramble to get an office web page. A few idealistic hold outs will mutter I don’t need a web page my practice is 100% referral. Of course in 2012 even the best personal referral will still Google the dental office just to find the address and phone number.
6. Finally dental insurance companies will start to use online systems to accept dental claims, review them and transfer payments to the dental office account instantly. Seriously, it could happen.

The future is coming and it will be Amazing!

One of the better year end round ups from PC Mag.

From the TouchPad to the iPad, Steve Jobs to the fictional “iPhone 5,” 2011 had its share of major tech stories.

10. Google +

9. Apple Goes to War Over Patents

8. Netflix

7. What Happened, RIM?

6. HP Wavers on WebOS, Consumer PCs

5. Sony PlayStation Hack

4. AT&T Fails to Acquire T-Mobile

3. Amazon Kindle Fire

2. No iPhone 5

1. Death of Steve Jobs

via The Top 10 Tech Stories of 2011 | News & Opinion | PCMag.com.