Dr Hughes, when did you start your journey into digital dentistry?
My journey started in 2013 after I purchased my first intra-oral scanner and attended Christian Coachman’s digital smile design course. This course opened my eyes to digital workflows and how they enhance communication with patients and laboratories. By 2014, my practice was operating almost entirely digitally.

How did your practice evolve into its current multifaceted model?
The evolution happened naturally. As the practice grew, we rebranded, relocated and created a patient-centred facility that incorporated digital innovation. Integrating the laboratory in-house and building a strong social media presence paved the way for the creation of our laboratory and training business, Avant Garde Dentistry.

What motivated your decision to expand into the field of education?
Many clinicians were asking me about digital workflows, patient experience and even marketing. That formed the foundation of Dental Excellence UK and Avant Garde Dentistry. We developed courses to teach our proven digital workflows, supported by our in-house laboratory services, to help other dentists adopt and implement digital strategies in their own practices.

In your opinion, what are the key advantages of digital workflows?
One of the key advantages of digital technology is its ability to enhance predictability, propose treatment solutions and improve clinical outcomes. I witness this daily in my practice, where all of my clinicians follow the same standardised digital workflow. The first two appointments are key because they involve data acquisition and the effective use of digital tools for treatment planning and communication with both the laboratory and the patient. This initial planning step helps motivate the patient towards the ideal treatment plan 90% of the time. We then reverse-engineer the process and execute it, bringing a high level of predictability and reproducibility into our treatment workflows.

This highlights the importance of standardisation: when all stakeholders follow a unified approach, it contributes to more consistent and successful outcomes.
Yes, and standardisation also facilitates effective communication across the entire team. As a restorative dentist, I drive the treatment plan, but then the implantologist can review it and say, “This is where we want the final tooth position to be.” With the CBCT scan superimposed, if there is sufficient bone and the planned implant positions are acceptable, we have the basis for a potential guide. If everything is satisfactory, the implantologist approves it. The periodontist might then assess the planned gingival heights and zeniths, review the plan and request a surgical guide accordingly. Everything is driven through the same plan, at the same time.

This makes the patient journey highly efficient because each team member knows when to step in. The sequence is clearly mapped out from the start and aligned with the appointment schedule. It’s all done at the beginning; it’s front-loaded. Once the patient approves the plan, the process is straightforward.

What role does Smile Creator play in your workflow?
Smile Creator simplifies planning with artificial intelligence-driven tools for 3D smile design. The software enables dentists to craft initial treatment plans and submit them to laboratories using clear communication, thus improving collaboration and clinical outcomes. We’re not asking dentists to be elite CAD designers. With programs such as Smile Creator, adopting these new bits of technology can dramatically improve case planning.

“We’re not asking dentists to be elite CAD designers.”

What’s the impact of TruSmile Video on the patient experience?
TruSmile Video is a game-changer. Its dynamic, accurate smile simulations help motivate patients and align expectations. It’s a valuable tool for showcasing realistic outcomes before treatment begins, which is probably the most rewarding aspect of dentistry for both patients and dentists.

Do you think that TruSmile Video increases case conversion?
I was never a fan of simulations. They can sometimes create expectations for patients that we cannot deliver. But the way Smile Creator transitions from STL to smile design to the patient’s video makes the TruSmile Video simulation very close to reality. We use it to communicate with the laboratory so that the technician can see our design dynamically. We also use it to get some initial insights from the patient. TruSmile Video is a very powerful tool, and the uptake of treatment plans and the motivation for patients earlier in their journey is really exciting for us.

Would you recommend investing in exocad software?
Yes, definitely. The company software integrates seamlessly with other digital tools, enabling comprehensive interdisciplinary treatment planning. The adaptability and innovation make exocad essential for advanced digital dentistry. For me, the benefits are clear. Investing in exocad software is a no-brainer for comprehensive treatment planning.

Do you have any advice for practices that are not working with digital laboratories?
Digital dentistry is a revolution. When we collect data efficiently, we can improve communication with both the laboratory and the patients, creating a seamless process. That’s the benefit and the power of the new tools available today. Dental practices that do not use digitally acquired data in collaboration with their laboratories risk falling short in treatment planning and in guiding patients towards the most suitable options and effectively working with their laboratory partners.

Many practices are embracing digital dentistry, but the conversation has now shifted towards advanced digital workflows. That is the direction the industry should be taking, and the digital laboratory plays a central role in making that transition possible. Collaborating with high-quality digital laboratories early on in the process, while adopting new technologies and training teams, can significantly enhance patient care. The laboratories play a guiding role in this process.

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