Weigh the Options of Dental Implants

As implants have become more popular dentists have developed the mindset that they no longer need to maintain or save patients’ teeth.

What’s the fastest growing segment of the dental industry? It might be dental implants which, according to the American Academy of Implant Dentistry, is expected to reach $4.2 billion for US and European markets in the next four years. And an estimated 500,000 people have implants placed each year.

Allen Honigman, DDS, MS, a Phoenix, Arizona-based periodontist, acknowledges that implants, used properly, are wonderful restorative options for patients. But, he cautions, are they for everyone?

“I came on board into periodontics in the early 1990s, and people were just starting to see how useful implants could be,” Honigman says. “But they weren’t pushed to the limit like they are now.”

And that “push” could be problematic for both oral practitioners and their patients.

TOO MUCH GROWTH?

Honigman recalls that implants used to be the purview of oral surgeons. Not anymore. Implant companies have tapped into this trend he calls an easy fix and started offering “weekend warrior seminars for general practitioners” who want to do dental implants. Practitioners line up for a chance to learn how to put implants into an artificial jaw. The problem is, it’s not that easy.

“Placing an implant isn’t very difficult, but it’s knowing how to handle complications, and where to place it properly and what other procedures need to be done that makes it more difficult,” Honigman says. “It’s more like an art and science as opposed to just drilling in a hole and putting in a screw.”

As implants have become more popular, Honigman says that dentists have developed the mindset that they no longer need to maintain or save patients’ teeth. They’re taught, and they pass this on to their patients, that implants will never have a cavity or need a root canal. However, they will break down just as the bone around a tooth would.

“Over the last five to 10 years, (the incidence of) perio-implantitis has progressed,” he explains. “And it’s easier to fix a tooth with periodontal treatment than it is to fix an implant with perio-implantitis, because one is natural and one is artificial. And there’s nothing better than your own teeth.”

MONETARY FACTORS

Honigman believes that properly educated and given a choice, patients will want to save their teeth because implants can be an expensive proposition. Unfortunately, when companies market “teeth in a day,” patients may be inclined to say, “I’m tired of taking care of my teeth. I just want to get implants.” But they don’t realize the potential expense.

“Just because implants aren’t real doesn’t mean they’re not going to break down,” Honigman says. “And then you’re going to face $30,000 to $40,000 worth of work. Taking all your teeth out, unless they’re flapping in the breeze, to me is not a great option.”

But there’s the financial lure, at least on the surface, for oral practitioners. Honigman says that general dentists want to do implants because they’re high tech, sexy and easy money.

“You can charge $3,000 to $6,000 for one implant and one crown,” he says “And they’re easy to do; pretty straightforward as long as you understand where the complications can occur.”

And that’s the problem, Honigman says.

“Perio programs have fallen down at the undergraduate level, where it’s not emphasized how periodontists can help general practitioners save patients’ teeth. I work in a group practice, I see new doctors come in, and it absolutely amazes me how they don’t understand perio.”

And they don’t understand the complications, which can be costly to a practice. For example, Honigman explains that if an implant fails to integrate and has to be removed, it will take three more successful implants to make up the money the practice loses by having to redo the original implant.

“A lot of the time you have to do it for free,” he says. “You have to stand behind your work.”

EDUCATION AND OPTIONS

Honigman stresses the importance of practitioners educating their patients. Too many general practitioner offices, he says, shy away from emphasizing the aspect of hygiene following implant surgery.

“You have to treat patients who have implants as individuals with a severe periodontal disease,” he says. “You want to catch things before they become bigger problems.”

And, as the first periodontist in Phoenix to incorporate the LANAP protocol into his practice, he’s a strong believer in saving a patient’s teeth whenever possible.

“I love doing implants,” he concludes. “But I feel better about myself as a periodontist when I save a patient’s teeth, and they’re biting, smiling and chewing with their own teeth.”

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