When you picture a hospital radiologist, you may think of a specialist sitting in a dark room, spending hours peering over X-rays to make diagnoses. Compare that to your dentist, who in addition to interpreting X-rays must perform surgeries, manage staff, communicate with patients and run their business. When dentists analyze X-rays, they do so in bright rooms and on computers that don’t specialize in radiology, often with the patient next to them.
Is it any wonder, then, that dentists who receive the same X-ray can suggest different treatments?
“Dentists do a great job considering all the things they deal with,” says Wardah Inam SM ’13, PhD ’16.
Inam is the co-founder of Overjet, a company that uses artificial intelligence to analyze and annotate X-rays for dentists and insurance companies. Overjet tries to take the subjectivity out of X-ray interpretations to improve patient care.
“It’s about moving towards more precision medicine, where we have the right treatments at the right time,” said Inam, who co-founded the company with Alexander Jelicich ’13. “That’s where technology can help. Once we have quantified the disease, we can make it very easy to recommend the right treatment.”
Overjet is approved by the Food and Drug Administration to detect and outline cavities and to quantify bone levels to aid in the diagnosis of periodontitis, a common but preventable gum infection that causes the jawbone and other tissues that support the teeth. deteriorate.
In addition to helping dentists diagnose 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 across the country and currently partners with insurance companies representing more than 75 million patients in the US. Inam hopes the data Overjet analyzes can be used to further streamline operations and improve patient care.
“Our mission at Overjet is to improve oral health by creating a future that is clinically accurate, efficient and patient-centric,” said Inam.
It has been a whirlwind journey for Inam, who knew nothing about the dental industry until a bad experience piqued her interest in 2018.
Getting to the root of the problem
Inam came to MIT in 2010, first for her master’s degree and then for her PhD in electrical engineering and computer science, and says she caught the entrepreneurship bug early on.
“To me, MIT was a sandbox where you could learn different things and discover what you like and what you don’t,” says Inam. “Plus, if you’re curious about a problem, 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.
“When I came to MIT, I didn’t know I wanted to start a business,” Inam says. “I knew I wanted to solve important problems. I took this journey where I had to choose between academia and industry, but I like to see things happen faster and I want to make an impact in my life, which is what drew me to entrepreneurship.”
During her postdoc in the Computer Science and Artificial Intelligence Laboratory (CSAIL), Inam and a group of researchers applied machine learning to wireless signals to create biomedical sensors that can track a person’s movements, detect falls and monitor breathing rates.
She only became interested in dentistry after leaving MIT, when she changed dentists and was given a brand new treatment plan. Confused by the change, she asked for her X-rays and asked other dentists to take a look, only to receive yet another variation in diagnosis and treatment recommendations.
It was then that Inam decided to dive into dentistry for herself, reading books on the subject, watching YouTube videos and eventually interviewing dentists. Before she knew it, she was spending more time learning about dentistry than her job.
The same week that Inam quit her job, she heard about MIT’s Hacking Medicine competition and decided to enter. There she started building her team and making connections. Overjet’s first funding came from Media Lab affiliated investment group the E14 Fund.
†The E14 fund wrote the first check and I don’t think we would have existed if they hadn’t taken a risk on us,” she says.
Inam found that a big reason for variation in treatment recommendations among dentists is the sheer number of possible treatment options for each disease. For example, a cavity can be treated with a filling, a crown, a root canal, a bridge and more.
When it comes to periodontitis, dentists must make millimeter-level assessments to determine the severity and progression of the disease. The extent and progression of the disease determines the best treatment.
“I felt that technology could play a big part in not only improving diagnosis, but also communicating more effectively with patients so that they understand the confusing process I’ve been doing to wonder who’s right says Inam.
Overjet started out as a tool to help insurance companies streamline dental claims before the company began integrating its tool directly into dental offices. Every day, some of the largest dental organizations across the country use Overjet, including Guardian Insurance, Delta Dental, Dental Care Alliance, and Jefferson Dental and Orthodontics.
Now that a dental X-ray is imported into a computer, Overjet’s software automatically analyzes and annotates the images. By the time the image appears on the computer screen, it has information about the type of X-ray taken, how a tooth may be affected, the exact level of bone loss with color overlays, the location and severity of cavities, and more.
The analysis gives dentists more information to talk to patients about treatment options.
“Now the dentist or hygienist just has to synthesize that information and use the software to communicate with you,” Inam says. “So, they’ll show you the X-rays with Overjet’s notes and say, ‘You have 4 millimeters of bone loss, it’s in red, that’s higher than the 3 millimeters you saw the last time you came, so I recommend this to treatment.”
Overjet also contains historical information about each patient, tracks bone loss on each tooth and helps dentists detect cases where the disease is progressing more quickly.
“We’ve seen cases where a cancer patient with dry mouth goes from nothing to something extreme in six months between visits, so those patients should probably come to the dentist more often,” says Inam. “It’s all about using data to change the way we deliver care, think about plans and offer services to different types of patients.”
The operating system of dentistry
Overjet’s FDA approvals are responsible for two common diseases. They also enable the company to conduct industry-level analytics and help dental practices compare themselves with peers.
“We use the same technology to help practices understand clinical performance and improve operations,” says Inam. “We can look at every patient in every practice and determine how practices can use the software to improve the care they provide.”
Moving forward, Inam sees Overjet playing an integral role in virtually every aspect of dental surgery.
“These X-rays have been digitized for a while, but they were never used because the computers couldn’t read them,” says Inam. “Overjet converts unstructured data into data that we can analyze. We are currently building the basic infrastructure. Ultimately, we want to grow the platform to improve every service the practice can provide, basically become the practice operating system to help providers do their jobs more effectively.”