Wednesday, May 20, 2009

Who is best for Placing Dental Implants? A Guide for Patients to Make Better & More Engaged Decisions About Their Oral Health

There are three things in life that we protect more than anything else: our family, money, and health. We carefully protect them with every resource we have to avoid irreversible loss. And we follow some innate behaviors: We don't hire a stranger to babysit our kids no more than trusting our attorney who took some accounting courses with managing our hard earned money. But somehow we have lost the grip on protecting our health. We blindly accept doctors' recommendations regardless of whether it's their area of expertise or not. We select a doctor because they accept our insurance and pay little attention to how good they are and what their training and qualifications are. It makes no sense any more than trusting our tv repairman to fix our computer logic board or have our internist do a bypass surgery! The reason behind this inconsistent behavior may be because for years people did not have a better option. Medical and dental knowledge and technology even up to two decades ago was a fraction of what is known now. Physicians and dentists managed to learn a lot and do a lot and it worked. And frankly it was not easy for people to access information, so they had to go with what their doctors told them.

But times have changed. We live in a specialized world, with an immense amount of knowledge in each field which continues to grow at a rapid rate. In-fact, there is so much information and knowledge that it is practically impossible for any one person to master any more than one or two disciplines in their lifetime. It's time to come to grip with reality and take more responsibility for our health and make decisions that make sense, protecting our health like we protect our families and money.

Dental implants have revolutionized dentistry and the way we as dentists can help millions of patients with missing teeth regain their confidence, function, aesthetics, and overall oral health. The science and knowledge of dental implants has evolved greatly since they were first introduced by the father of implant dentistry, professor Branemark almost 50 years ago. It has now become one of the most successful procedures that we perform, approaching 98% plus success rate. This is mainly related to highly skilled implant surgeons trained in accredited residencies, continued advancement in technology and techniques, and better understanding of its biology and healing. But this knowledge is not achieved easily. Some clinicians spend their lifetime doing and learning about dental implants, performing hundreds and thousands of procedures, attending many conferences, and reading endless numbers of related literature each reach what I call a "Level of Mastery". Our great success is a reflection of this dedication and mastership by these clinicians.

Here is the problem and a potential disaster in the making: In the past few years, there has been increasing trend for dental implant companies and some study groups to sponsor "weekend" courses targeting the general practitioners to buy their products and perform these highly technical and demanding procedures on their own patients. There is huge profit for these companies to do so as the general dentists make up the majority of the dental practitioners and therefore potential sales.

The current state of economy has amplified this problem. For number of dentists patient flow and treatment acceptance has declined. With decrease in production, many decide to perform such procedures themselves where they would have previously referred them to specialists.

And we are starting to see the results of this: Failed implants, increased infection, poorly positioned implants that can not be restored, nerve damages, loss of jaw bone, etc. This is very concerning, because the industry has worked so hard and so long to bring this unique service to patients transforming their lives with such great predictability and success.

Weekend courses clearly do not cover appropriate areas of study to meet the legal standard of care for implant placement. Most expert clinicians attest, "implant surgery is never simple". In response to this alarming trend, the Institute for Dental Implant Awareness (IDIA) recently released new training guidelines for basic implant placement. It is hoped that implant companies and organizers of these "weekend" courses comply and change their protocols. But this will take time and will certainly not be an easy battle.

So what should you do as a patient if you are planning to get dental implants? Here are some key questions to ask your dentist to help you make an engaged decision about your treatment and ultimately your oral health:

1) What is your specialty? Oral surgeons and periodontists receive formal implant surgery training in accredited residency programs; some prosthodontists and general dentists may also have advanced surgical training. Caution: An "Implantologist" is not a recognized and accredited specialty nor does it indicate proper training.

2) What is the extent of your training in implant surgery? Ask specifically the names of the courses, dates, durations, and who sponsored them. Search these courses and see if they are legitimate programs endorsed or supported by professional associations.

3) How many dental implants have you placed? A specialist or any skilled clinician has placed hundreds if not thousands of implants. They do these procedures day-in and day-out. However there are some clinicians who are also excellent and skilled through indepth training who may not have yet placed significant number of implants.

4) Do you work with any specialists? Even if a dentist places some dental implants, they almost always work with specialists in their area; Ask if it's OK for you to speak with them and get a different perspective. It's your right

5) Ask to speak to other patients about their experience. Personal testimonials are very valuable and meaningful.

6) Ask the assistants and receptionists about dental implants (how they work, how long it takes, what are the steps, etc); If they can not answer your questions or defer you constantly to the dentist, then they most likely do not perform many of them!

7) Ask for brochures, supporting articles, before & after photos, and other detailed information. A practice with focus on dental implants will have all of these readily available.

Such engaged questions can also be asked of other highly specialized procedures such as extractions, grafting procedures, wisdom teeth, root canal procedures, orthodontics, etc.

As dentists, we have the responsibility to provide the finest care that we can to serve the best interest of our patients and we must remain committed to this oath. But it is also the responsibility of every patient to get involved and make engaged decisions about their health.

Dr. H. Ryan Kazemi

To reach Dr. Kazemi for this story and others:

Tel: (301) 654-7070


Visit our video podcasts on:
1) iTunes: search word- 'dr. kazemi'
2) search 'dr. kazemi's oral surgery channel'
3) YouTube: search 'implantguru'


  1. Failed implants and increased infection after dental implants procedures is the result of poorly managed dentistry education and trainings. Students who are studying dentistry and other related fields must see to it that they attended all formal trainings required to them so that they'll be able to competitively practice their profession. Providing basic and advanced programs are ways of training future dentists in performing restorative treatments like dentures, crowns and bridges, and others. One dentist in Goose Creek mentioned that he really attended all trainings as required by the academe where he took up dentistry. On the other hand, a Hanahan dentist see to it that increased infection is avoided in every dental implant procedure.

    By the way, nice post. Thanks for sharing.

  2. Thanks for sharing the info. Dental implant is done to fix new teeth and it should be done by well experienced and trained dentist. my friend had done her dental implant in Hamilton and was quite happy with the results.

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