AF it is my belief that implants should be made available to the majority of our patients who would benefit from them and that this will only happen when they are introduced as routine treatment available at every high street dental practice. In the US even the lowest level of dental insurance covers patients for a lower full denture supported by 2 implants: they no longer recognise unsupported full lower dentures as 'appropriate treatment’.
Sadly here in the UK, due to patients’ expectation that ‘it should all be available on the nhs’ and some dentists’ telling all their patients that implants are unaffordable (to who?) and excruciatingly painful, the number of implants in the general population has been kept artificially low. Demand is accelerating however as more patients become aware of this life changing treatment and less people become less and less tolerant of unsuccessful treatment like failed bridges and dentures...
The result of this is that there is now a staggering number of patients out there who would really benefit from this treatment but haven’t yet decided to take advantage of it. The confusion among patients (and some dentists) is made worse by the sheer number of websites/implant companies and - yes - implant dentists like me out there touting for business.
The choice is bewildering.
Cheap VS Expensive. (How much is too much, how cheap is too cheap?) Delayed VS Immediate placement in extraction sites Delayed VS Immediate loading Acrylic VS Ceramic VS Composite Teeth in a day VS Teeth in 6 months All on 4 vs All on 6, All on 8, even All on 10 (still happening out there) Cheap Brazilian/Korean/South African implants vs Expensive Swedish and German ones, or how about placing mini implants, anyone? CT scans vs Standard radiographs
And don’t get me started on implant courses! Everything from “Learn to place teeth in a day in an hour’s CPD on line (with a certificate)" to “Don’t you dare place an implant without placing 80 on our 3 year full time course at a well known London hospital near you” (protectionism anyone?)
Demand for implants in the UK is at an all time high as we try and catch up with demand - the only way we will manage it is to make implants widely available in General Practice. My mission is to make that happen with education education education, close relationships with my referrers, practical hands on sessions, plenty of support, good communication.
This website is about making that happen. If you are a bewildered dentist out there looking for some answers, I hope you will find some of them here, if you want to know more about referring to me and Winning Smiles just send me an email. My most prolific referrers are those who have learned to offer the prosthetics in their own practices (Crowns, Bridges and Implant dentures).
I don’t charge for teaching my referrers because their success is my success.
Let’s start by dispelling some myths
1. Implants are excruciatingly painful to have - only if they are done wrong, the majority of our implant patients go back to work comfortably the next day
2. Implants take a long time (months) to complete - this is true if cases are complex (involving sinus augmentation/bone grafts etc) but for a simple, single upper central for example, it can be fitted in 30 mins and in many cases have a temporary crown connected at the same appointment
3. My (nhs) patients can’t afford them - yes most of them can actually though they may choose not to. Real time implant costs have halved over the last 15 years and are now firmly within the grasp of normal people with normal jobs - that said choices have to be made e.g. latest designer handbag vs a new front tooth, or upgrade and finance to the latest model of car vs a full arch fixed implant bridge
4. Long term denture wearers don’t have enough bone - sometimes true, though with modern grafting techniques 99% of patients can be treated.
The only way to know if a patient has enough bone for implants is to take a CT scan.They may look like they have ample bone volume but the scan shows enlarged sinuses, or they may look like they have none, only to find that the scan shows up plenty. I still get caught out to this day. I have learned not to trust my instincts on this one but to reserve judgement until I have the hard facts on the scan results.
5. Implants last forever - no they don’t, however with due diligence, hygiene support and smoking cessation the majority will last over 10 years
6. Implants are all failing - well, yes and no. Correctly placed implants, good surgical protocols, digital pre-planning with CT scans, accurate clinical longevity assessments, hygiene support, close monitoring long term, good quality implants, good quality prosthetics - all these aspects taken together ensure that the majority of WS implants last over 10 years…many implants are failing long before the 10 year mark where due diligence is ignored, clinicians are poorly trained and cheap implants and lab work is used (these two tend to go hand in hand). But it doesn’t have to be like that.
Avoid adding to poor implant statistics:
- Take the time to learn to do things thoroughly.
- Plan and prepare each case thoroughly (with a mentor)
- thorough, written informed consent, signed off by the patient -Use quality components and implants
- Use a good lab with predictable and accurate results (occlusion/fit/aeshetics)
- Don’t run before you can work (start with easy cases!)
And the majority of the time it will all be ok!
