Earlier this year, the Institute for Dental Implant Awareness conducted a survey of hundreds of surgical specialists throughout the country to determine the extent of the problems associated with “weekend warriors” and rescue cases.
More Referring Dentists Placing Implants…
The survey results indicate that there has been a significant increase in the number of general dentists referring to surgical specialists who are now placing implants themselves.
- 66.4% of surgical specialists now have 1-5 referring dentists placing implants
- 30.9% of surgical specialists now have 6+ referring dentists placing implants
It is now estimated that there are approximately 35,000 general dentists placing implants, which is three times the number of surgical specialists placing implants. From a patient’s perspective, there are now three times as many options for providing implant treatment. Most patients do not make a distinction between specialists and general dentists; rather they assume that all dentists can provide implant treatment. Unfortunately, they rarely question the amount of training or experience a dentist has had and they often base their decision on low price.
With an increasing number of implant patients being treated by general dentists, prosthodontist, and endodontists, as opposed to being referred to surgical specialists for implant placement there is a paradigm shift taking place in the market. There is definitely cause of oral surgeons and periodontists to reevaluate the traditional business model for their implant practices.
Alarming Increase in Rescue Cases…
There has also been a dramatic increase in the number of failures and complications being referred by general dentists to surgical specialists to rescue.
- 60% of surgical specialists treated 1-5 rescue cases in 2009
- 24.5% of surgical specialists treated 6+ rescue cases in 2009
- 60.25% increase in total number of rescue cases in 2009 compared to 2008 (with further increased indicated in 2010 YTD)
Statistics on rescue cases also indicate a dramatic increase in the frequency of severe complications. If we delve into the problem further, we find that many dentists are attempting complex cases, with inadequate training. These cases range from disfiguring esthetic failures to implants in the sinus causing severe infections, and implants migrating through the floor of the orbital bone into the eye socket.
Major Deficiencies in Surgical Courses…
Based on the types of failures and complications being referred to specialists to rescue, it is clear that more emphasis must be placed on the following areas in surgical courses:
- Case selection (straightforward vs. advanced and complex)
- Risk management
- Predicting, diagnosing, managing, and treating complications
- Understanding one’s own limitations (when to refer)
Similar concerns have been expressed by the malpractice insurance industry, where implant complications now represent the most frequent claim being filed. In fact, this was the main topic of discussion at a malpractice insurance industry conference last year, as companies try to project whether a substantial increase in premiums will be necessary to cover the rising number of claims.
Low Opinion of Training Courses…
Not surprisingly, the majority of surgical specialists (87.5%) disagree with the practice of implant companies sponsoring surgical courses for general dentists. And many believe that these programs are designed to sell implants, without regard for patients’ safety. Most surgical specialists (63.9%) do not feel that their colleagues should be teaching general dentists how to place implants. They also commented that their colleagues teaching these programs are selling out on their specialty simply for the profit.
Compliance with Training Guidelines…
The majority of the surgical specialists (93.2%) responding to our survey feel that since non-surgical dentists are now placing implants on a regular basis, there should be some sort of “compliance certification” for surgical training courses.
(Released by IDIA- Institute for Dental Implant Awareness)