Imagine leaving your home and going to an office filled with strange sounds and smells and a front desk so tall that you could hardly see over it.
You turn the corner and see rows of huge reclining chairs and sharp metal tools. And after you sit down, a person you've never met grabs one of those tools, brings it close to your face, and tells you to open your mouth as wide as you can. No, wider.
From the point of view of a young child, or their parent, the dentist's office can be a scary and stressful place to visit for the first time. In some situations pediatric dental anxiety can be so serious that it creates a need for measures no one wants to take, from delaying care to sedation or even physical restraint. But experts say long-term dental health benefits greatly from going to the dentist at a young age.
Pediatric dental anxiety is such a common problem that when the Pediatric Device Innovation Consortium (PDIC) at the University of Minnesota put out a public call for ideas on unmet medical needs in 2016, finding ways to ease kids' dental fears was the first idea to arrive in the inbox.
Beginning on Monday, a new U spinout business called Yonder is launching an app designed to address this need by using a cartoon hippo named Mimi to help young patients get comfortable with the dentist's office, before they even arrive there. Yonder's first commercial client is Laganis Pediatric Dentistry in Maple Grove, and second client in Edina is expected to come online soon.
The Yonder app combines footage of the actual dentist's office that the child is going to visit and recordings of their dentist into an interactive virtual tour hosted by Mimi. The video plays on a parent's iOS or Android smartphone, after a notification for the app download arrives with an appointment-reminder text.
"Hi! I'm Mimi! Come to the dentist with me!" the character says over upbeat kids music on a demo video on the Yonder website. The program waits for the 2-year-old in the video to advance the program by pressing the screen.
"Come on in. Wave hello to my friend!" Mimi says, as a clinician in the doctor's office waves back. The video is captured at a child's eye level, so the front desk looms large and doorknobs are at the center of the screen. "There's so much to see here!" Mimi says as the actual toys in the waiting room are displayed. Then the video follows the actual path the child will take through the office to the dental chair, where the common dental tools are displayed and described, before the dentist is shown, smiling and friendly.
"We sit at the intersection of education and entertainment to drive better health outcomes," said Adam Choe, who co-founded Yonder with his U colleague Dr. Courtney Hill. "By blending those two things together, we think we can have a perfect platform to help prepare kids for better health outcomes."
"Dental health is a really good prognosticator of overall health," said Hill, a practicing pediatric head and neck surgeon. "We just want to make things better for the little ones coming into the dentist's office."
Dr. Teresa Fong, a pediatric dentist with Metropolitan Pediatric Dental Associates, test-drove the app with a dozen of her patients. Every parent said it was helpful, she said, and the app did seem to allay many anxieties of young patients.
The most consistent thing she noticed was that each patient readily opened their mouth when the time came.
"That was the most impactful thing I saw," Fong said. "I would just say, 'Open up like Mimi' and their mouth would just drop open."
Mimi the hippo is the brainchild of many parents.
In 2016, the PDIC launched the Community Discovery Program for Child Health Innovation, which sought input from the public about unmet medical needs that the group could highlight to its stakeholders and collaborators. The suggestion to address pediatric dental anxiety was forwarded to the organization at the U known today as the Earl E. Bakken Medical Devices Center.
Hill and Choe were innovation fellows at the Bakken Center at the time, and they started working on it as a research project. The project gathered steam and eventually attracted seed funding — from the PDIC. That led to more work, followed by additional funding from the U-state partnership MnDrive, which stands for Minnesota's Discovery, Research and InnoVation Economy.
All told, just over $75,000 in funding poured in from various sources to develop the underlying technology. In late 2017, Choe and Hill's innovation was spun out of the university into a startup company formed by the U's Office for Technology Commercialization, creating Yonder. Choe said Yonder received full ownership of its intellectual property for development work at the U in exchange for equity and a cash payment.
"This is really a great example of a project that can start out as an unmet need, and then various groups at the University can collaborate to see it through all the way to an innovation and a startup company," said Jodi Fenlon Rebuffoni, senior program manager with PDIC, which is a part of the U's Clinical and Translational Science Institute.