When you picture a hospital radiologist, you might think of a specialist who sits in a darkened room and spends hours reviewing x-rays to make diagnoses. Contrast that with your dentist, who in addition to interpreting x-rays must also perform surgeries, manage staff, communicate with patients, and manage their business. When dentists analyze x-rays, they do so in bright rooms and on computers that are not specialized for x-rays, often with the patient seated right next to them.
Is it any wonder then that dentists receiving the same X-ray can offer different treatments?
“Dentists do a great job considering all the things they have to deal with,” says Wardah Inam SM ’13, PhD ’16.
Inam is the co-founder of Overjet, a company using artificial intelligence to analyze and annotate x-rays for dentists and insurers. Overjet seeks to remove subjectivity from x-ray interpretations to improve patient care.
“It’s about moving towards more precise medicine, where we have the right treatments at the right time,” says Inam, who co-founded the company with Alexander Jelicich ’13. “That’s where technology can help. Once we quantify the disease, we can make it easier to recommend the right treatment. »
Overjet has been licensed by the Food and Drug Administration to detect and describe cavities and quantify bone levels to aid in the diagnosis of periodontal disease, a common but preventable gum infection that causes deterioration of the jawbone and other tissue supporting the teeth.
In addition to helping dentists detect and treat disease, Overjet’s software is also designed to help dentists show patients the problems they see and explain why they recommend certain treatments.
The company has already analyzed tens of millions of X-rays, is used by dental practices nationwide, and currently works with insurance companies that represent more than 75 million patients in the United States. Inam hopes the data analyzed by Overjet can be used to further streamline operations while improving patient care.
“Our mission at Overjet is to improve oral health by creating a clinically accurate, effective and patient-centered future,” says Inam.
It was a whirlwind trip for Inam, who knew nothing about the dental industry until a bad experience piqued her interest in 2018.
Get to the root of the problem
Inam came to MIT in 2010, first for her master’s and then her doctorate in electrical engineering and computer science, and says she caught the entrepreneurship bug early on.
“For me, MIT was a sandbox where you could learn different things and find out what you like and dislike,” Inam says. “Plus, if you’re curious about an issue, you can really dive into it.”
While taking entrepreneurship classes at the Sloan School of Management, Inam eventually started a number of new ventures with classmates.
“I didn’t know I wanted to start a business when I came to MIT,” Inam says. “I knew I wanted to solve important problems. I’ve been through this journey of deciding between college and industry, but I like seeing things happen faster and I like having an impact in my life, and that’s what drew me to entrepreneurship.
During his post-doctorate at the Computer Science and Artificial Intelligence Laboratory (CSAIL), Inam and a group of researchers applied machine learning to wireless signals to create biomedical sensors capable of tracking the movements of a person, detect falls and monitor respiratory rate.
She only became interested in dentistry after leaving MIT, when she changed dentists and received a whole new treatment plan. Confused by the change, she requested her x-rays and asked other dentists to take a look, only to receive yet another variation in diagnosis and treatment recommendations.
At that point, Inam decided to delve into dentistry on her own, reading books on the subject, watching videos on YouTube, and possibly interviewing dentists. Before she knew it, she was spending more time learning dentistry than her job.
The same week Inam quit her job, she heard about the MIT Hacking Medicine competition and decided to enter it. This is where she started building her team and building relationships. Overjet’s first funding came from the Media Lab’s affiliate investment group, the E14 Fund.
“The E14 fund wrote the first check, and I don’t think we would have existed if it weren’t for our luck,” she says.
Inam learned that a big reason for the variation in treatment recommendations among dentists is the number of potential treatment options for each disease. A cavity, for example, can be treated with a filling, crown, root canal, bridge, etc.
When it comes to periodontal disease, dentists must perform millimeter-accurate assessments to determine the severity and progression of the disease. The extent and progression of the disease determine the best treatment.
“I felt that technology could play an important role in not only improving diagnosis, but also communicating more effectively with patients so they understood and didn’t have to go through the confusing process that I did. wondering who’s right,” Inam said.
Overjet started as a tool to help insurance companies streamline dental claims before the company began integrating its tool directly into dentists’ offices. Every day, some of the nation’s largest dental organizations use Overjet, including Guardian Insurance, Delta Dental, Dental Care Alliance, and Jefferson Dental and Orthodontics.
Today, when a dental X-ray is imported into a computer, Overjet’s software automatically analyzes and annotates the images. As the image appears on the computer screen, it contains information about the type of x-ray taken, how a tooth may be impacted, the exact level of bone loss with color overlays, the location and severity of caries, etc.
The scan gives dentists more information to talk to patients about treatment options.
“Now the dentist or hygienist just has to synthesize that information, and they use the software to communicate with you,” Inam explains. “So they’ll show you the x-rays with the Overjet annotations and say, ‘You have 4 millimeters of bone loss, that’s in red, that’s higher than the 3 millimeters you had the last time you’re come, so I recommend this treatment.”
Overjet also incorporates historical information about each patient, tracking bone loss on each tooth and helping dentists detect where the disease is progressing more quickly.
“We’ve seen cases where a cancer patient with dry mouth goes from nothing to something extremely bad in six months between visits, so these patients should probably come to the dentist more often,” Inam says. “It’s about using data to change the way we practice care, think about plans, and deliver services to different types of patients.”
The operating system of dentistry
Overjet’s FDA clearances represent two very prevalent diseases. They also allow the company to perform industry-level analysis and help dental practices benchmark themselves against their peers.
“We use the same technology to help practices understand clinical performance and improve operations,” Inam says. “We can look at every patient in every practice and identify how practices can use the software to improve the care they provide.”
Going forward, Inam sees Overjet playing a vital role in virtually every aspect of dental operations.
“These x-rays were digitized for a while, but they were never used because computers couldn’t read them,” Inam says. “Overjet transforms unstructured data into data that we can analyze. Right now we are building the basic infrastructure. Ultimately, we want to grow the platform to enhance any service the firm can provide, essentially becoming the firm’s operating system to help providers do their jobs more efficiently.