With Pascal Kunz

There are still giant gaps in the teeth of Digital Dentistry. Individual industry players are still more focused on themselves instead of the patient or ‘digital’ to leverage dental care, resulting in significant disruptions, a poor user experience and unclaimed market potential. Pascal Kunz shares his insights into this fascinating industry.

It is time to break down barriers and collaborate in a way which brings a more integrated approach to the current innovation we are witnessing.

Here are the gaps and opportunities that I’ve spotted:

  • Definitions of Digital Dentistry
  • Medical Grade Industry-wide File Formats
  • Strategic Partnerships
  • Data Sharing Approaches
  • A.I.-Supplemented Decision Making
  • Funding & Adoption

A company could easily close these gaps with the right funding and connections. The company that successfully closes them would make themselves (and the digital dentistry industry) incredibly profitable, and far more accessible.

Definitions of Digital Dentistry

For every specialist, digital dentistry has a well-defined meaning, for example:

  • Guided implant surgeries
  • Orthodontic aligner treatments
  • CAD/CAM-produced restorations
  • Imaging

Many players are offering ‘Digital Dentistry’ in their respective segments. Specialities within these segments are targeted with digitalised offerings, but only a few industry players serve more than one speciality.

The gateway to this is general patient diagnostics for decision-making, managing treatments and record-keeping of digital information over time. Every patient has and will have their own specific mix of findings which must be observed or addressed, and certainly over time, will not respect specialist borders.

Dentistry is broader than what digital can cover today, and no player will likely be able to cover everything in one application. A universal digital platform has yet to exist.

Medical Grade Industry-wide File Formats

Some industry-wide file formats exist, such as DICOM for 2D & 3D X-Ray imaging. This sets a precedent for using a range of standardised data formats across the digital dentistry industry.

Beyond radiology, medical-grade file formats are not widely adopted – even though some already exist. General use variations, like .stl and .ply for optical impressions, have nowhere for extra data to go, which results in a loss of all crucial metadata (alongside general data) as information is transferred between applications and providers to perform dental treatments.

This can be especially frustrating when trying to use data from specific devices for specific applications. For example, an optical impression scan from one device may not provide enough accurate data for producing a screw-retained 6-unit implant bridge restoration.

If an industry-wide standard existed, the file format would clarify its origin and allow an industrial manufacturer to automatically accept or reject orders based on validation data (approved devices for the respective use or indication). Ultimately, such information – including unique identifiers for the individual patient – would be incredibly beneficial for the industry, but it requires widespread adoption of technology.

That’s why major industry players need to sincerely increase their efforts to harmonise and standardise file formatting. If safeguards are put in place to ensure proper data security, data distribution between different practices and technologies would only benefit the digital dentistry industry.

Forming Strategic Partnerships in Digital Dentistry

Switch on almost any ‘non-Apple’ personal computer, and you’ll likely find a Microsoft Windows operating system. This widespread unity lets people freely change software and devices, without having to learn new technology.

Also, device manufacturers do not have to carry the burden of developing their own operating system and can specialise on hardware, drivers, or application development instead. It’s a cohesive approach that results in better experiences for everyone involved. Digital Dentistry lacks unity, and it shows.

The current ‘dominant’ players are not centred around digital dentistry as a discipline, instead choosing to focus on a specific piece of equipment or value chain. Because of this, we see a lot of incompatible technology in the industry, which is only making it harder for digital dentistry to progress.

I believe the main reason we’re not seeing these developments is that it doesn’t have a short-term pay-off. Everyone wants to form their own digital ecosystem, so nobody is rising to dominance.

If industry players were to form partnerships and build strategic alliances, we could see the infrastructure of dentistry be completely revolutionised. Perhaps a separate, neutral entity is needed to develop and offer the unifying digital platform, which could remove this unproductive rivalry between competitors.

Data Sharing Approaches

The way dentistry exists currently, patients often will not get the highest possible level for all their treatment needs. Instead, patients search for a general practice or single specialist, rather than one that specialises in their real issue. The industry’s current ‘one-workflow-to-one-consumable’ mindset does not foresee treatment planning and treatment across specialities.


This is still the most common approach when it comes to processing patient data in digital dentistry-enabled treatment workflows. There are misconceptions that a Closed approach is safer for the patient, or that it provides a competitive advantage to the business which holds the data.

In fact, this makes the industry less accessible for patients, resulting in worse patient care.

But there is an alternative.


By allowing the exchange of patient data in a controlled and medically compliant manner, we can increase access and appeal for the industry. How many more people would use digital dentistry services if their latest data was easily accessible by any dentist they visit?

This could also allow for greater specialisations, broader offerings, and individual patients could even make accurate and informed decisions on where to get the best treatment for a particular issue.

AI-Supplemented Decision Making

The potential applications for Artificial Intelligence in the digital dentistry space are unparalleled.

Pathology detection on 2D intraoral X-Rays is already significantly populated, but AI can be used for so much more. For instance, the organisation and automation of background workflows, from acquisition to analysis and beyond.

Today, even the simplest analysis usually needs switching of applications with tedious uploading steps to specific web portals. Analysis and annotated data reside exclusively on individual clouds, and multiple screens show different, sometimes contradicting information.

The concept of sharing verified findings with an overarching entity has not been launched yet. Old data is typically side-lined, even in the same practice, but even more so if the patient has moved locations.

Instead, imagine a patient visiting a new practice. They receive a check-up, where their current data is instantly mapped against all their personal dental history. The AI can then highlight the early stages of new pathology, and cross-reference progression levels to pre-existing data from their other teeth.

This alerts the practice that the patient needs urgent treatment at an earlier stage, due to faster-than-expected progression of tooth decay. Treatment can then begin to prevent more costly interventions at a later stage – fact based and informed.

Without the use of AI and previous patient data, the dentist may not have been able to properly gauge the severity of the issue.

Ideally, AI engines could work cross-platform to identify the presence and position of anatomical landmarks for specialist players. In return, their discoveries would be shared back and added to a list of identified and approved content.

This would result in much better patient treatment and could be far more profitable for all parties.

Funding & Adoption

Financially maintaining a new, collaborative infrastructure would be relatively straightforward with end-user subscriptions. Unfortunately, it’s the start-up and adoption where the issues lie.

For instance, multiple fragmented small-scale players make widespread adoption much more difficult — but not impossible.

In response, larger organisations would need to band together and demand compatibility to a standard. This would lead to an industry-wide shift, and as more members move over to a new style it’ll gain traction with other organisations.

The Way Forward for Digital Dentistry

Truly universal digital dentistry serves every patient, at every visit. The idea of everyone in the industry partnering up and working together is delusional, but that doesn’t change the facts.

Diagnostic imaging needs a unified all-modality approach

Diagnostic data should not be kept hostage, with worst-case examples ‘consuming’ 3D X-Ray datasets, for simply planning an implant in an edentulous space. This completely ignores the analysis of other relevant diagnostic findings outside that edentulous space.

Cross-speciality customer needs cannot be solved in isolation

The industry needs smart collaboration and strategic reorganisation to develop successful and specific equipment, software, or consumable segments. The key to success for the big players willing to partner is to hire the right people with the right mindsets and vision.

More Expert Insights?

Interested in learning from more experts we’ve spoken to?

Here’s one about Starting a Biotech with Thomas Wirth.

Alternatively, we also have our own industry experts!

Richard Dane debates Biotech Vs BioPharma’s Battle for Talent,

Brett Lofthouse delves into Pharma’s Recruitment Trends,

and Harry Simpson looks into the History of CDMOs.

With Harry Simpson


CDMO (Contract Development and Manufacturing Organisations) are a crucial part of the Life Sciences industry. Some companies and organisations simply don’t have the resources or expertise to manufacture certain products.

So, they turn to CDMOs to produce their latest developments. Strangely, despite its current prominence, the CDMO industry is a relatively young one. There have been significant developments over its short lifespan, and we’re likely to see even more growth in the years to come.

In this article, I’m going to explore:

  • A Brief History of CDMOs
  • The Industry Right Now
  • What the Future Holds

A Brief History of CDMOs

Although CDMOs have been around for a while, they’ve only become critical to Bio and Pharma organisations within the last 20 years. In fact, before 1996, dedicated contract drug-product manufacturers were quite rare.

“I first got involved in the CDMO industry 5 years ago and in that time the partnerships between client and customer have changed dramatically. Transactional relationships are in the past; innovation and collaboration is the way forward.”

Instead, it was common for major Bio & Pharma companies to manufacture products for similar businesses — especially if it didn’t enable competition.

A key turning point was in 1996, when Patheon began purchasing various facilities, while Lonza secured Celltech and cemented its position in Contract Biologics.

With these acquisitions, Patheon and Lonza alerted other organisations to the opportunity that outsourcing product development and manufacture could provide. In turn, individual CDMOs began popping up and sparked the development of the industry. This was the birth of CDMO as we recognise it today.

A decade later, the financial crisis had mixed effects on the CDMO industry. Several organisations were forced out of business, while some others benefited from investments from private-equity firms. The low-interest investments and long-term prospects were very persuasive in attracting investment, and many were able to purchase production facilities being offloaded by pharmaceutical companies.

Typically these facilities were obtained for very reasonable prices, and in exchange, exclusive contracts were signed that provided the Pharma companies with cheaper production methods.

The Industry Right Now

Currently, the CDMO industry is in a ‘melting pot’ of change. Recent events like the Pandemic and the Talent Crunch have plunged the industry into another period of change. In response, some organisations feel the need to expand and diversify offerings in order to maintain their market presence.

“There is a huge strain on Manufacturing Capacity & Supply to help take some of these new technologies, like cell therapies, to market — CDMOs don’t have the capacity right now, but it’s coming.”

The Pandemic

The Covid Pandemic provided a massive boost to the CDMO industry. While Biopharma and Biologics businesses developed Covid vaccines, there simply wasn’t enough internal production capacity available to produce the quantities needed.

CDMOs filled this gap in supply and worked to meet the global demand. If not for the role Contract Organisations played, the effects of Covid could’ve been far more severe.

In response, the Contract industry has cemented itself as a crucial part of the Life Sciences industry.

The Talent Crunch

Something else that is influencing the development of the CDMO industry is the Talent Crunch. The diminishing workforce means that CDMOs (along with other specialised industries) are going to struggle to fill their available roles.

The main challenges during the talent crunch will be the attraction and retention of employees. After all, there’s no point in hiring new employees if they’re leaving at the same rate you’re onboarding them. A great solution to both problems is to make your team feel happy and valued.

Ensuring your employees are happy does more than retain your workforce, though. In fact, they outsell content employees by 56% and use 10% fewer sick days. It’s becoming obvious that to remain competitive amidst the talent crunch, life science businesses will have to keep investing in their team.

What the Future Holds

With the industry still so young, it’s difficult to know exactly how it’ll change and grow over the coming years. By analysing previous trends and how world events impacted the industry, we can predict certain developments with some accuracy.

“With the CDMO space expected to achieve 7.29% CAGR between 2020 – 2027 and grow to a nearly $300bn industry in the next 5 years, the future is bright.”

Here are my predictions for the CDMO industry:

CDMO Becoming PDMO

Some CDMOs are expanding their services and swapping their ‘contracts’ for ‘partnerships’, evolving the term ‘CDMO’ into ‘PDMO’. By getting closer to their partners, CDMOs can move past some of the pressure, and instead, offer consultative support or innovation to develop products in new ways.

The Outsourcing industry has always been quite fast-paced. Moving to this new model allows businesses to be more efficient in bringing new life-saving advanced therapies and drugs to the market.

Private Equity Investment and Development

Now is a prime time for Private Equity firms to invest in CDMOs. With Pharma organisations selling off facilities and outsourcing production instead, CDMOs with sufficient investment have a prime opportunity to scale up at an exponential rate.

If enough CDMOs manage to source this investment, we could see massive industry growth over the next several years. We saw something similar happen after the financial crisis of 2008. While some individual companies may not survive, the industry as a whole is likely to expand drastically.

Pharma Selling Off

Pharma companies continue to sell off their development and manufacturing sites. Producing drugs, medicines, and other medical equipment themselves remains expensive — especially when you consider the cost of running and maintaining the facilities and their staff.

By selling their facilities to Contract Organisations, Big Pharma is saving money and reinvesting back into the R&D of new products. This allows them to maintain a more constant revenue stream, and have multiple active projects at any one time.

Meanwhile, the CDMOs can focus their attention on improving their value chain and meeting demand with greater efficiency. The more facilities Contract Organisations can gain ownership of, the fewer shortages we’ll see.

Interested in Learning More?

Harry Simpson, Head of Outsourcing Business Unit at Fraser Dove International, is a growing presence with keen insights into the CDMO sphere. His position provides a unique viewpoint into an industry he is extremely passionate about.

If you’re looking to change careers, or fill certain roles in your organisation, send Harry a message on LinkedIn.

Some of our team recently made their way to CPHI in Frankfurt this year. Needless to say, they learned all sorts of incredible insights that we’re about to share with you. Don’t forget to check out our experts’ LinkedIn pages to stay updated on their latest insights!

In this article, everyone who attended CPHI reveals their most important industry secret:

  • Harry Simpson – Cost Inflation
  • Rosey Grant – Job Titles
  • Neil Ewington – Greenwashing
  • Brett Lofthouse – Talent
  • Matt Lambert – Company Agility

Harry Simpson

“Cost Inflation Is Driving Outsourcing.”

Costs are increasing — everywhere. At CPHI, Harry discovered these higher costs mean it’s becoming more expensive for Life Science businesses to manufacture products themselves. Ultimately, they’re turning to CMOs to fulfil that need for production at a much lower cost.

So how can CMOs fulfil this?

Due to their size, CMOs have access to economies of scale. In other words, the more they produce, the less it costs per unit. This cost saving is passed to the organisation that needs their product made.

There are currently two main options the Life Science businesses are choosing between.

Outsourcing to Asia

Some companies are choosing to outsource to CMOs based in Asian territories. The main pros and cons of this are:

  • Lower Costs
  • Compromise on Quality
  • Potential for a breakdown in the supply chain

Outsourcing Locally

The second option is to choose outsourcing partners closer to the development sites. This provides better service, but the costs are higher.

  • Higher Costs
  • Improved Quality
  • Stronger Supply Chain

Unsurprisingly, CPHI attendees revealed outsourcing locally is more popular. While the costs are higher, this is worth the reassurance of a more secure supply chain and better quality products.

Rosey Grant

“Job Titles Are Inflating Too.”

Our experts have already noticed that job titles are inflated, but CPHI highlighted how widespread it is becoming.

Essentially, as talent becomes more scarce, some companies give their employees more impressive job titles instead of raising salaries. This gives the employee an illusion of progression, without increasing costs for the business.

While this practice provides short-term talent retention, it makes hiring practices more difficult across the wider industry. The biggest issue it creates is diluting the talent pool, flooding the job market with unqualified people who believe they’re capable of the role.

This is a major issue and causes many others (for employer and employee) down the line. For instance, if someone with an inflated job title lands a new job, they’ll likely struggle in their new role.

For the company, the substandard quality of work can impact operations, causing decreased employee morale, lower customer satisfaction, and damaged profits.

The employee may lose self-confidence, as they realise they cannot meet the workload. This can further disrupt morale and work ethic, consequently stagnating the employee’s career.

Neil Ewington

“Greenwashing No Longer Cuts It.”

Greenwashing is when a company outwardly supports eco-friendly practices, but doesn’t actually do anything about it. Due to social media, it is now incredibly easy for offending companies to be caught out, which can significantly damage their reputation. At an event like CPHI, this becomes exceedingly clear.

Sustainability Directors are now at the Board level, which means they have the power to directly influence change in the business. There’s also a range of options that benefit both the company and the environment – they aren’t mutually exclusive.

One significant motivation for development is the increasing energy costs, which stunt business growth. In return, businesses are looking into more eco-friendly options where prices are significantly lower.

Because of the worldwide focus on environmentally friendly practices, Pharma and Bio companies are even considering this when choosing their outsourcing partners.

Brett Lofthouse

“When It Comes To Talent, There Are Still Two Camps.”

One shocking revelation is that some C-Level Execs think that recruiting is below their pay grade. Currently, the split is about 50/50 between those who recognise the growing problem, and those who don’t.

Business leaders who recognise the problem and implement talent acquisition strategies now will hire better over the coming years.

In our opinion, hybrid recruitment models (using internal and external recruitment simultaneously) will help overcome the worst of the talent crunch. Internal recruitment teams are perfect for lower complexity, high volume positions.

On the other hand, talent consultancies (like Fraser Dove) specialise in high complexity, low volume roles. These are the essential roles that your team will need significant investment and experience to fill.

Matt Lambert

“Small Companies Are Punching Above Their Weight.”

One development Brett discovered at CPHI is that smaller companies are hiring top-tier talent more successfully. Typically, top talent would be found at the businesses that could pay the most, but that attitude is quickly changing.

Instead, smaller companies are using their agility to create individually tailored work solutions, which provide each employee with their ideal work-life blend. This is more attractive to people, especially since the Covid Pandemic proved that employees don’t need to be in a lab or office every day.

It’s not just work-life balance, though. Smaller companies are constantly innovating new methods to attract and retain their talent. Larger companies are too big and slow to implement these processes at the same pace.

While these solutions work for smaller firms now, they may find that as they grow, there’s a loss in company agility. The challenge then becomes continuing to offer these individually tailored solutions as they considerably increase their headcount.

At Fraser Dove, we’re constantly monitoring the market for the latest Life Science hiring trends. Alongside our Talent Ecosystem, this means we can give our clients the best service possible. The most significant trend we’ve spotted is the Talent Crunch, which is expected to peak in 2030.


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