The Most Amazing

The most amazing product I developed was a scan body & detection algorithm for dental implant procedures. The scan body’s design is patented[1] and the algorithm is proprietary.

scan body
Image © Dentsply Sirona

What is a scan body for dental implant procedures? It’s a device attached to a patient’s dental implant and recorded in a dental impression. The implant’s location with respect to the patient’s anatomy can then be determined from the impression. Knowing the location, a prosthetic tooth can be fabricated.

I developed the algorithm in an iterative way using well-known techniques. I also needed to collaborate with other software engineers who had a deeper knowledge of the domain. It was a C++ application built with CMake and deployed as part of a data processing pipeline. It did not have a 100% detection rate, but it served a vital business need.

The algorithm was part of a larger project that involved the design and supply of the device to clinicians. It was a cross-functional and trans-national team. A great challenge but one of the most amazing projects I’ve worked on, too.

This post inspired by the idea of being a “top 3%” developer in C++, thanks to toptal. What was your most amazing product or project? Tell me about it in the comments!



Google Firebase

I am developing a Vue.js application on Google Firebase. Firebase provides hosting, cloud functions, database, file storage, and an authentication module. My source code is on BitBucket and CI/CD is accomplished with BitBucket Pipelines and Bash scripts.

Google Firebase

I give Google Firebase “5 stars” for documentation and video tutorials. The authentication module makes getting started with users a snap.

The “NoSQL” database, Firestore, is also a breeze to get started with. So far, I’ve been using it directly, but I can see the need for a RESTful layer in between it and the client code. Firestore and it’s ilk (Redis, MongoDB) have their advantages, but providing a structured interface for multiple clients will reduce headaches down the road. It also decouples the client from the actual database technology. This seems to be a common pattern. I’ve used it in C++, Ruby, and JavaScript.

Firebase Cloud Functions gives a way to provide highly scalable endpoints. I haven’t explored Cloud Functions (AWS Lambda) too much. Conceptually, I view them as an Express.js application without the Express.js Firebase does offer triggers to database events, which feels like a stored procedure to me. I’m using them, but cautiously. It certainly helps to move business logic out of the clients.

Firebase provides hosting as well, accessed using their firebase-tools Node package. With my source in BitBucket, I’ve added BitBucket Pipelines. BP is typical of CI/CD services (Travis, Circle, Azure DevOps) with a YAML file to describe each pipeline.

How much will this thing cost? At the moment, $25/month for the Blaze plan on one Firebase project. It appears typical to use one project per stage.

I’d like to end this post with a link to the project, but we are  not ready to launch yet. Stay tuned!


LightForce Orthodontics

LightForce™ Orthodontics is coming out of stealth mode.  They will be making waves at the American Academy of Orthodontics’ 2019 Annual Session. LightForce™ is the first true patient-specific orthodontic bracket made possible with recent advancements in 3D printing. Digital treatment planning plays a role too!  The key to shortened chair & treatment times will be the reduction in wire bending done by the orthodontist [1].

I am a bit amazed at the current state of orthodontic affairs.  Bending wires to move teeth in a multi-variable environment seems a little bit like trying to hit a fastball with a golf club. It works but it’s inefficient. In the future, patient-specific brackets, digital treatment plans, and indirect bonding trays will be the only way braces are prescribed. LightForce Orthodontics is doing it first.

Check out their website for additional information and further news. Congrats and good luck to the LightForce team!

What other specialties could use a 21st century update? Tell me about it in the comments!

  1. Effectiveness of Insignia™ Versus Standard Orthodontic Treatment with Damon Q Brackets.

Evidence Based Dentistry

The Atlantic’s May 2019 issue includes an article by Ferris Jabr entitled “The Truth About Dentistry“. It highlights the dearth of evidence-based studies and strong procedural controls in the profession. The author claims that the prevalence of private practices is one reason for this. I think some specialties are more rigorous then others, but I agree with the author’s thesis. It may be that a benefit of so-called Dental Service Organizations is to enforce compliance with best practices.  Technological advances might help too!

The article details the malpractice of one dentist, prone to over-treating patients as well as billing for “phantom” treatments.  There will always be bad apples, but I would agree that for some practices, the economics of the dental office drives procedure choice rather than the patient’s best interests.

Patients are also consumers.  Especially in dentistry, where paying out-of-pocket is common, these consumers — especially younger ones — will be choosing less-invasive and less-costly procedures. What tools do dentists need to improve patient outcomes and maintain a healthy practice? Tell me about it in the comments!


Clear Aligners

Everyone’s heard of Invisalign(r) and SmileDirectClub(tm) by now.  That I can list both of these clear aligner manufacturers in the same sentence is amazing by itself.  Invisalign created this product category almost 20 years ago. SmileDirectClub has brought the idea of #teledentistry to the market.

SmileDirectClub may have led the charge, but now they have a few imitators:

There are other product categories moving in this direction too. I’ve seen direct-to-consumer custom night guards from Cheeky(r) and at-home veneers from TruSmile Veneers.

Any other surprising direct-to-consumer dental products out there? Tell me about it in the comments.





Sleeping Girl Domenico Fetti

10% of the population has sleep bruxism. Many find relief with a custom night guard. Get your own custom night guard for $130.

Sleeping Girl Domenicao Fetti
“Sleeping Girl” Domenico Fetti (c. 1589 – 1623)

Marketing Collateral

Linked below is the handout I made for the Yankee Dental Congress. It uses the Metatooth logo (source code) and is split between my twin aims. I’ve been working on both of them. Nothing I can hang my hat on as yet, but progress on each.

I first submitted an online order to Staples(r) for 25 copies. There was some communication problem, so I re-order at Store #0217. Feeling confident, I upped it to 50 copies (100 handouts). I think I managed to pass out 5 at the event itself. Two months later, just under half remain.

Thanks for reading. Tell me about your market optimism in the comments!




It’s a bit ironic that I spend so much time with JavaScript right now. My first programming gig was with JavaScript. It was the spring of 2000. I was placed by an agency at an office near Alewife. I walked to Central, took the T to Harvard, got off, bought the “Rhino” book at the Harvard Book Store, got back on, and read the book until Alewife. I walked into the office and started coding. The company published training materials. A colleague (worker?) in the office said about 11am, “Hey, you need to take your eyes off the screen every now and then!”.

It was a bit of a disaster but I delivered the software they needed. I even partook of a company-provided yoga class. I ran into the co-worker a few years hence, and he claimed they still used the software I developed!

Your code is not temporary. Tell me about it in the comments.


Custom night guard survey results

Custom night guard survey results are in! The survey ran from Feb 15 – Mar 15, 2019. Sign up to the e-mail list to learn more about this survey.

Custom night guard survey results.
What could be improved about your custom night guard?

Are you a night guard user? Order your impression kit for a custom night guard today.

1. How often do you replace your night guard?
Never 63%
Every couple years 19%
Once a year 19%
2. Where did you go for a new one?
My dentist 75%
Drugstore/pharmacy 13%
Online shop 13%
3. What did you enjoy about it?
The fit 71%
The price 36%
The fitting process 14%
4. What could be improved?
Better fit 31%
The price 69%
Convenient fitting process 31%
Easier to replace 38%
5. How much did you pay for your night guard?
< $100 31%
$100-$200 6%
> $200 63%
The take away

User needs an at-home impression kit. Availability of a replacement night guard on short-notice is appreciated. There are few options in the $100-$200 price range.

Thanks for checking out the custom night guard survey results. Did you come to a different conclusion? Tell me about it in the comments.


Night guard market research

Bumping up this topic on night guard market research.  The survey is still open.  Are you a night guard user?  Please spare a few moments to answer the questions about your experience.

A funny thing happened as I worked on SEO last week.  I found a direct-to-consumer night guard that is using up-to-the-moment marketing practices.  It’s called Cheeky and it has a strong website and Instagram presence. The technology stack includes Shopify & the branding is just great.

Cheeky Website

It’s a subscription model, which has market traction.  How do I know this? I’ve done night guard market research. Take the survey! Results will be posted March 15th.