How To Deal, When You Are Asked For Guarantee On Dental Implants?

 

How To Deal, When You Are Asked For Guarantee On Dental Implants?

In initial days of my practice, one of the patients asked me “Doc, this implant would last lifetime, right?”  I was surprised with that sudden question.. I was really not used to all such bouncers but somehow I managed the situation of that time. The whole incidence had left me with the fear of facing such questions in future and that's when I decided to get answers to all such questions..

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The first thing that I tried to figure out was "Why do patients ask for guarantee of implant?" & I found the answer when I looked at the treatment option with patient’s perception. It is not that patients always ask for guarantee due the high treatment costs but sometimes it's due to the fear of surgery.

 

What patients ask is not wrong but as a clinician one should never forget that even after having best of knowledge, skills and vast experience, many things can go wrong and implants can fail. 

 

What best a clinician can do is; assure patient that things are done to the best of his knowledge, skills and experience; treatment results may last longer, subject to patient’s awareness, motivation and desire to follow clinician’s instructions and regular recall visits.

 

The word Guarantee is really dangerous.. 

 

As it literally means “promise” or “pledge”. How a doctor who is treating human body part (that is regulated by so many factors) can give LIFETIME GUARANTEE on a specific treatment.

 

"Guarantee" is fine with non-living objects but doesn't it sound weird with respect to living things?

Have you ever heard any experienced Cardiac Surgeon saying, “I have done a fantastic bypass surgery, now I guarantee you 10 years or 20 years of life”, probably you will never ever hear this. Forget about the cardiac surgeon even the Almighty has not given a guarantee of life. In my humble opinion “Guarantee” is not a word that should exist in the dictionary of a doctor. Being clinicians we all know that human body has complex mechanisms where many things are in simultaneous process. Above all every person reacts differently (Including both doctor and patient) in different situation so nobody can predict the longevity of treatment. 

 

In my practice there is absolutely no word called GUARANTEE, for your surprise some patients have even challenged me by saying, “Doctor if you can't give guarantee means you don’t trust your skills”, My polite reply to that was, "Sir I do trust my skills more than anything but what I don’t trust is YOU”. 

 

Overall studies have quoted success rate of single implants for more than 97% up to 10 years (less for implant supported full arch prosthesis), So that is what we can call life of an implant. After good surgical placement & implant prosthesis, If implant survives more than 10 years it would be all because of good maintenance and periodic recall visits kept by patient. 

 

Patients expect implant to survive till they die, which is not possible anyway. We need to make it very clear at consultation phase only that life of an implant would be up to 10 years sometimes it may be less than that (depending upon patient’s local & systemic conditions also).  I always tell my patients, “Huge amount that you are going to spend for an implant and using that implant all day for another 8 to 10 years, is a very long span, so spending on implant is completely worth; rather looking at the cost, look at the benefits like quality of oral functions you are going to get after dental implant treatment.

 

I never forget to mention that implant structure includes screw and crown, so there are equal chances of screw loosening and some damage or fracture to prosthetic structure due to wear and tear which can be managed subsequently with an additional cost. In case of an Implant failure, most suitable option at time would be suggested like an implant placement again or some alternative option with a reasonable cost. Never ever convince patients on the basis of promises that are beyond your control, be realistic and straightforward as it will give you long standing trustful relation with your patient and above all complete peace of mind. 

And last but not the least; don’t forget to tell your implant patients…

 

“Implants are lifeline but not for lifetime”. 

 

I wish you all a very Happy Implant Dentistry.

Source DentistFriend

5 Things To Consider Before Joining Courses At Any Dental Academy

 

5 Things To Consider Before Joining Courses At Any Dental Academy

Now a days as the level of Dental Education in some Indian Dental Schools is all time low.  There are some responsible experienced dental professionals who have come forward to guide young dental graduates. But unfortunately not many are able to stick to the original motive of imparting dental education and it is becoming more of a kind of business.

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Irony is that these days one has to take coaching for cracking premedical entrance exams to become a doctor and later they have to again take coaching even after graduating as Dental Surgeons.

If you go to any dental event or dental conferences and you will find some people standing at the entrance of venue distributing leaflets of various Dental Academies. The most funny/sad part is that some of these academies are being run by freshly pass outs and they are teaching subjects which need vast experience of over the years to master. PLEASE BEWARE OF THEM.

 

For example, How come you expect to learn Oral Implantology from someone who himself has not placed even 100 implants? Does he know the failures? As they say, Master has failed more times than the beginner has even tried. 

My point of writing this blog is to share my personal experience that may help you in deciding from which right place to learn. Definitely we all need to learn and upgrade ourselves from time to time. So, here are the top 5 points to consider before joining any academy:

 

1.  Get reviews from your friends, college teachers, internet and check yourself which one is most liked and reasons behind it and then only make a decision. Never make a decision to join any academy considering your convenience rather give priority to best learning experience. Learning will never come easy, be always ready to leave your comfort zone, no matter even if you have to travel PAN India.

2.  Don't join academies mentored by any Novice. A novice can teach in right fashion and may know the Ideal work but he won’t be able to teach you the failures for sure as he himself is not aware as have not encountered many in his short tryst with the subject.

 

For example: Learn Oral implantology from a mentor who has done more than 1000-1500 implants over 10-15 years. i.e. now he/she is a speaker of International repute. He/She has seen the failures and will be able to teach you how to overcome them.

 

3.  It hardly matters whether your mentor is a BDS or MDS. This should not be your criterion of selection. Count the number of years of their practice and not degrees. Degrees do have a value but they don't matter much in this aspect. Many big names in this field are old time plain graduates who have done unofficial masters in clinical procedures at their own clinics.

 

For instance, one of my good friends is a pioneer in teaching micro-endodontics in a North Indian city near National Capital. He himself is a BDS graduate but has many endodontists in his fan list.

 

4.  Don't go for fancy courses, particularly Orthodontics courses. No doubt a BDS can practice orthodontics but that is possible after proper orthodontic training. Ortho is a very vast science in which prognosis is majorly based on treatment planning & how can you even expect to learn treatment planning in 5-10 days? Which otherwise needs 3 years.

 

I recently met someone who was repenting of wasting his energy and resources for doing a 7 day short ortho course and finally he has to call an Orthodontist for consultation.

 

5.  Lastly and most importantly. Choose the courses in which you have more number of patients to do than just the theory part. You always have Google option for theory and demo Videos.

 

I hope these points will help you in your selection of right course and academy.

 

Please Note: Further inputs from seniors in profession and friends are most welcome.

Source : DentistFriend

Communication Tips For Beginners In Implant Practice

 

Communication Tips For Beginners In Implant Practice

A decade back when I started Implant practice, I used to think that implantology is a complex procedure but realized it later that the procedure is simple and not the communication part. Over these ten years I made mistakes, learnt from them and tried to improve myself on both aspects of implantology. Even I faced complications sometimes but trust me 90% of these complications were not related to the implant procedure but the communication with patients. I have observed that, usually doctors become master in implant procedures in short time but they lack the art of communication which is equally or in my words even more important. Unfortunately I was not that lucky to have somebody to tell me on how to communicate and most of the things that I have shared below have been learnt/discovered by myself. 

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Here are few tips for beginners who have started implant practice recently:

1. Instead of trying to convince the patient for implants, always try to explain implants.

 

2. Even before explaining implants to patient make sure that you are very much convinced that implant is really the best option for the respective patient, then only you can explain it very well to patient.  

 

3. Remember ethical things are always easier to explain for every doctor and are always digestible to patients.

 

4. Never do false promises like "It will be free of complications till you live" etc. Any dental procedure right from RCT to Crown & Bridges or even simple filling may fail. Same way Implants can also fail and there can be many reasons for failure. So be realistic and explain your patients that implants may fail but it's long term success ratio is relatively high in comparison with all other substitute procedures to implants.

 

Here is how you can deal with some common objections raised by implant patients.

 

Objection 1: Implants are expensive

 

Any treatment which comes nearest to most natural replacement closest to what God has given will be having more cost than any intermediate or short term replacement. 

You should always give option of economical treatments to your patients while informing that they are far away from natural replacement and either intermediate or short span.

 

Objection 2: I don't want to go for surgery

 

Always tell the patient that placement of an implant is 30-60 min procedure with single local anesthesia and it usually do not have any post operative complications.

(In fact I personally feel that it is less complicated than surgical removal of tooth. It really does absolutely no complications if one follow strict sterilization and disinfection protocol)

 

Objection 3: Implants warranty and longevity

 

You can say that it works long term except the prosthesis which might have to be changed and if you follow strict & proper cleaning and maintenance (which in fact required in any body procedure or replacement) then it's almost permanent. You should also suggest the patient that mostly complications come in first few months. Implant companies are giving life time warranties so even if implant fails there is a scope of re-procedure.

 

Objection 4: More implants means more money to be spent (for full mouth cases)

 

You can confirm with the patient if he is looking for long term or short term solution. Explain the patient that if he wants, good aesthetics, mastication and phonetics then definitely implants are the only choices. Implants cost few more bucks but it is still cheap with the kind of health and quality patient gets. In fact all the current replacement procedures like Total Knee Replacement, CABG, Stents, Hair Transplant etc are not economical too.

 

Friends, implants are miracle in dentistry. If you really want to grow your practice then do Implants. The more you place implants, more confident you will get and when you have confidence you automatically get that positive energy to explain. And believe me if you follow these things in your initial days of implant practice; in future you will never ever have to worry about question & answers by your patients. 

 

And lastly don't worry. Do implants!

Money is really By-product...

Don't go for it rather go for EXCELLENCY ..!

Source : DentistFriend

Clinical Dentistry: Should Dental Professionals Practice Botox & Dermal Fillers?

 

Clinical Dentistry: Should Dental Professionals Practice Botox & Dermal Fillers?

A lot is being talked and argued about the administration of Botox by dental professionals in India. Many dentists believe that Botox and Dermal fillers belong to dermatology and dentists should not perform these procedures; which is actually a misconception. This misbelief is because not many dentists in India are aware of the significant benefits that Botox has as an adjunct therapy in many dental procedures.

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Use of Botox in dentistry is relatively a new discovery, so probably its acceptance will take some time among Indian dental professionals. If you are a dentist practicing in India and have the same misconception then this blog is for you. I am hopeful that after reading this article your false impression will fade away to some extent.

 

The first thing that I want all the dentists to realize is that we are part of the medical sphere and we dentists are “real doctors.” Every time when we inject LA into a patient, we are delivering a medicinal agent into the human body that has real systemic complications. The only difference is; we have received special training and mastered to deliver local anesthetic into the human body and are comfortable in dealing with the complications. By the way, I would like share a fact that the adverse reactions and complications associated with the LA that we use every day in our dental practice are far more serious than those with Botox and Dermal fillers.

 

 

After training hundreds of dentists in India; I can say that, with proper training on Botox & Dermal fillers even you can become equally comfortable in administration of Botox like you are with local anesthetic. In fact I believe that we dentists can do it better in relation to other medical professionals when it comes to head-neck-face region as we are specialized in it.

 

Here are some dental treatments where you can use Botox & Dermal fillers:

 

1. Temporo Mandibular Joint Disorder

2. Bruxism

3. Facial Pain

4. Gummy Smile

5. Full Mouth Rehabilitation

6. Smile Designing

 

All the problems that I have mentioned above fall in the realm of dentistry and dentist. I believe, no other medical professional can do justice to such dental originated problems except a dentist. So let's not take these issues as a profession and stop letting politics get in the way of science & common sense. If you still feel that Botox and Dermal fillers are not for dentists then you seriously need to re-think!!!

 

I will share some of the cases that I have treated with Botox and Dermal Fillers in my upcoming blog posts.

Source : DentistFriend

Facts & Myths About Use Of Botulinum Toxin in Dentistry!

 

Facts & Myths About Use Of Botulinum Toxin in Dentistry!

In my previous blog post we discussed about dental treatments that are possible with botox and dermal fillers. If you are convinced with the fact that Dental professionals should practice botox and dermal fillers then continue reading this post where I am going to give you further information about botulinum toxin.

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What is botulinum toxin?

 

Botulinum toxin is produced by gram-positive anaerobic bacteria Clostridium Botulinum. Botox is a trade name used by Allergen for Botulinum toxin and basically it is a purified form of botulinum toxin which has both aesthetic and therapeutic uses. The trade name Botox has become so popular that people recognize trade name better than its actual name; just like we use the trade name Xerox for photocopy. Many of us get afraid to hear the word toxin but botulinum has the real role to play in dental treatments. It is the toxin that helps to age gracefully.

 

Are there any variants of Botulinum Toxin?

 

Yes, there are seven type of botulinum toxins which are available to us. It is from type A, B, C, D, E, F & G. The one which is used most commonly is type A; however if any individual gets resistant to type A then we can use type B botulinum toxin. The type B botulinum Toxin is known as Myoblock.

Botulinum Toxin is available to us from different pharmaceutical companies.  There are several other trade names of botulinum Toxin like Desport, Neuronox and there are many more apart from Botox.

 

How Botulinum Toxin works?

 

Botox has its action on the muscle; it acts on SNAP 25 and doesn't let the muscle contract. It takes around 1.5-2 hours to bind to the nerve and it can take anywhere between 2 to 10 days to show full clinical effect. The effect of botox last from 3 months to 6 months varying individual to individual.

 

Some common Myths & Facts about Botulinum Toxin

 

Myth: It is new and not tested.

 

Fact: Botulinum toxin has a history of more than 20 years. And there are thousands of research papers available on the same.

 

Myth: It will give us botulism or else I will loose sensations and will have a plastic face.

 

Fact: None of it is correct. The lethal dose of botox is 2500 units to 3000 units which is 25 to 30 vials which is a lot of money to kill someone. A 100 unit vial of botulinum Toxin costs somewhere between Rs.18,000- Rs.20,000 INR

 

What do I have to know for getting good results from botulinum toxin?

For getting good results from botox injection one needs to understand the anatomy of the face or the areas where they want to inject botox.

Source : DentistFriend