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Mastering the Artistry of Implants
Allison M. DiMatteo, BA, MPS; Lisa Neuman
The number of implants placed by general dental practitioners is nearly exceeding the number of implants placed by specialists.1 For GPs already placing implants and those considering adding this treatment modality to their practices, the key to sustainable success could be the right combination of training, teamwork, and technology. Inside Dentistry leads you through four questions to help you execute confident, predictable treatment plans that will grow your implant expertise and optimize this aspect of your practice.
There are a number of factors contributing to the growing trend of general practitioners placing dental implants. A number of new implant systems are marketed as being easier to place, especially with the help of digital technology tools, and there are myriad shortterm training courses, workshops, and conferences that are specifically focused on getting GPs up and running— quickly—using those systems. But one of the strongest factors most likely driving this trend is patient demand itself. As people live longer and their oral health awareness continues to increase, the days of simply fitting elderly edentulous patients with a full set of dentures fades further away into the past. That factor leads to the very first question any GP considering implant dentistry might want to ask.
Can You Even Sell Implant Dentistry?
The simple answer is yes. For dentists who do it successfully, adding implant placement to their treatment mix can be a robust marketing opportunity for their practices. According to statistics from the American College of Prosthodontists, more than 35 million Americans are completely edentulous—90% of whom have been fitted for dentures—and another 178 million are partially edentulous.1 Most, if not all, dentists have seen the most common problems associated with missing teeth or poorly fitting prostheses, eg, difficulty eating or speaking, low self-esteem issues stemming from poor appearance, social anxiety or an avoidance of social situations altogether. Malnutrition can result from eating a poorly balanced diet of mostly soft foods; eating fruits, vegetables, or other healthy, crunchy food is too difficult, painful, or otherwise inconvenient for someone with missing teeth or ill-fitting prostheses. Then there could be the more serious effects of edentulism to contend with—the increased risks of systemic diseases such as cardiovascular disease or diabetes.
By creating value for these patients through a resolution of their oral disability and an improvement in their quality of life, general practitioners can indeed set themselves up for great success if they can truly focus their patients’ attention on the long-term benefits of a treatment plan that includes implant-supported prostheses or restorations to replace missing teeth. Rather than taking a somewhat passive approach and trying to convince (or “sell”) a patient to accept (or “buy”) an expensive and time-consuming treatment plan as simply being what’s best for their oral and overall health, or trying to promote the outcome of implant surgery and prosthodontic/restorative treatment as being an investment worth an eventual reward, general dentists would do much better to concentrate on speaking to the patient’s emotions on what his or her life will be like when their pain and discomfort is gone, and their detrimental quality-of-life issues around eating and nourishment, speech difficulties, appearance, and self-esteem/social anxiety are permanently resolved.
Patients have made this a somewhat easier task, thanks to possessing their own higher dental intelligence than they’ve had in the past. Today patients look for their general dental practitioners to be not only drill-and-fill dentists, but complete oral healthcare providers. There is already an expectation that their GP will give them the best correct diagnosis of their problem and offer the best comprehensive treatment plan to solve that problem. One of the biggest obstacles to accepting an implant-based treatment plan, the patient’s ability to pay, can be worked out with creative financing options, whether practitioners choose to offer those options internally or use third-party services.
Once you have decided to offer implants in your treatment mix—and you’ve obtained the proper training and credentialing to perform these procedures—enlisting the services of a practice management consultant can help you craft your marketing message and maximize your promotional budget to help re-educate your existing patient base and bring in those valuable new patients.
Do You Know Enough to Do Implant Dentistry?
With the wide variety of implant products and designs available, training that is not limited to a single system will ultimately benefit dentists—and their patients—the most. Unfortunately, it’s not always easy to pinpoint what differentiates one implant education opportunity from another. According to Andrea Schreiber, DMD, associate dean for postgraduate and graduate programs and clinical professor of oral and maxillofacial surgery at New York University College of Dentistry, there is no “one size fits all” course.
“The field of educational opportunities in implant dentistry varies as greatly as the needs, knowledge, skills, and desires of each individual,” Schreiber says. “Everyone must recognize their own limitations and the differences between continuing education courses, the rigors of advanced education/residency programs that span 3 to 6 years, and the different levels of knowledge and skill that can be gleaned from each of those alternatives.”
What’s happening in implant dentistry today is also impacting the whole profession—in which there are seven or eight times more general dentists than implant specialists. Patient demand for more stable, predictable, and esthetic prosthodontic treatments (eg, implant-supported full dentures or partials) is definitely growing. The trend is understandable, yet somewhat uncertain.
“Looking ahead, there’s no telling what the future holds,” notes Wayne A. Aldredge, DMD, a periodontist from Holmdel, New Jersey, and the current president of the American Academy of Periodontology (AAP). “However, a goal should be to educate the public about dental implants and the importance of having them placed and cared for by a specialist trained in their installation and maintenance.”
To ready new and seasoned dentists alike for providing implant treatments, dental schools offer undergraduate, graduate, and postgraduate curricula. According to Schreiber, the curricula for both predoctoral and advanced education programs like those at NYU College of Dentistry—and dental schools in general—prepare new dentists to incorporate implants into the treatment plans for their patients by providing students with the necessary background and training. Topics include bone physiology and morphology, biomaterials (including regenerative agents), wound healing, principles of osseointegration and evidence-based practice, diagnosis and treatment planning, esthetic and functional requirements, and surgical and restorative techniques and skills.
“Today’s graduates have the basic knowledge and skills to evaluate their patients’ candidacy for implant-supported restorations,” Schreiber observes. Students are all required to restore dental implants as part of their management of fully or partially edentulous patients. Similarly, they all observe or assist in implant surgical procedures. “They are trained to consider scientific evidence, individual physiologic factors, patients’ desires, and their own level of experience and expertise before embarking on a treatment plan, or deciding to refer to a specialist for complex care.”
This foundation of fundamental knowledge, explains Jack Dillenberg, DDS, MPH, dean of Arizona School of Dentistry & Oral Health, instills competence in the diagnosis, treatment planning, and restoration of implant cases. More education is still required for the implant placement component because it’s impractical to expect a new dental school graduate to be prepared to practice implant dentistry at a highly competent level immediately after graduation, he says.