Trends in implant dentistry

Implants are poised for explosive growth in the coming decade. A perfect storm is about to hit in terms of demographics, consumer awareness, and a host of other factors that bode well for restorative and surgical practices. According to conservative assessment profiles – e.g., iData Research, an international market research firm – the U.S. market for dental implants is expected to regain double-digit growth by 2013.

The potential market for implant treatment is huge. The American Association of Oral and Maxillofacial Surgeons found that 69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal, or tooth decay. In addition, by age 74, 26% of adults will have lost all of their permanent teeth.

Despite the vast numbers of patients who could benefit from implants, many U.S. general dentists are involved in less than one implant procedure per month. This figure seems all the more remarkable, considering:

• The many quality-of-life benefits that implants offer to patients
• The potential to increase production with an easily sustainable revenue stream for both restorative and surgical practices
• The fact that, unlike in medicine, almost all implant procedures cannot be shunted to auxiliaries

The future of implants couldn't be brighter, but dental practices need to get ready today. There are excellent opportunities for generalists and specialists to receive implant education, information, and mentoring through dental organizations such as the International Congress of Oral Implantologists (ICOI), multiple institutes, CE courses, and manufacturer-based training.

What offices do now will affect their ability to become the leading implant practices of tomorrow. Practices with the right management and marketing systems designed to build capacity in place now will be well-positioned to take advantage of the increased demand for implant treatment.

Implants will become the treatment of choice for more edentulous patients for the following 10 reasons:

1. Improved quality and ease of use. Today's implants last longer and are easier to place and restore than implants from 25 years ago. In fact, implants are now recognized as the best choice in many cases by more specialists and generalists.
2. Demographics. Baby boomers are looking for ways to maintain a youthful, attractive appearance. Dentures are not for them. This is the generation that changed American society at every level. And they're doing the same to the concept of middle age and retirement.
3. The smile factor. Cosmetic dentistry has become an acceptable part of American culture. Implants are an integral part of the cosmetic dentistry revolution. More and more patients who become partially or fully edentulous will have to consider implant treatment.
4. Extremely high success rates for implants. Depending on the source of the data, dental implant success rates are 95% or higher over 10 years, which is notably higher than numerous traditional services, including root canal therapy. These percentages have led to more practices offering dental implants as a preferable treatment alternative to crowns, bridges, and removable dentures.
5. Standard part of dental school curriculum. Implant treatment has become part of the core curricula of most dental schools. Today's dental school graduates are familiar with implant treatment and the many benefits it brings to a wide variety of patients.
6. Decrease of implant treatment contraindications. Dental implants have improved greatly since the 1980s. In the early years of dental implants, a significant number of potential implant patients were perceived to have contraindications for existing implant therapy. Advancements in implant designs, bone grafting procedures, and analysis of extensive outcome data have greatly narrowed the range of absolute contraindications.
7. A better option for edentulous patients. Most patients wearing full dentures would benefit from dental implants in numerous ways. Patients need to think of implants not as an expensive luxury, but as a standard quality-of-care option. It is important for dental professionals to educate patients about all the benefits that implants have over other treatment options. Remember, no other option has a more natural and unobtrusive fit and feel than implants or implant-retained denture prostheses. Smiling and chewing are basic patient desires.
8. Faster completion time. In the 1980s, dentistry was a field accustomed to short-term treatment procedures, such as cavity restorations and root canals. Initially, the majority of dental implant cases required six to nine months to complete. This was an inhibiting factor for doctor motivation and patient case acceptance. Advances in dental implant systems and component parts, as well as better understanding of bone biology, have decreased treatment times significantly.
9. Increased insurance coverage. More dental insurance companies are covering some of the cost of implant treatment. An implant with a crown is usually about the same cost as a three-unit bridge, but statistically it lasts much longer. No wonder insurance companies are changing their attitudes toward implants. Also, when patients have fewer out-of-pocket expenses, they are more likely to accept implant treatment.
10. More consumer marketing. Most Web sites for the major implant manufacturers have a section for consumers. Instead of waiting to hear about implants from their dentists, patients can receive an incredible amount of implant information at the click of a button.

The role of management systems

Once a dentist decides to offer implants, business systems must be designed and implemented to efficiently and profitably manage the expanded service mix. The goal is improved patient outcomes. Without appropriate systems, implants simply emerge as another treatment option to be randomly incorporated into the schedule. This haphazard approach to implant management results in a disorganized treatment flow and an inability to capitalize on the implant treatment option.

Whether the goal is to reorganize the schedule with more productive procedures or increase the number of patients treated, a service such as dental implants can have a significant impact on overall practice performance. Proper implant management systems must be incorporated to accommodate the potential growth.

Although many factors can create inefficiencies, any practice can achieve optimal implant productivity and profitability by implementing high-performance systems. Key practice operational areas include scheduling, case presentation, patient finance options, collections, and inventory management. While each area is critical, the scheduling system is probably most important. Many dental practices have already reached maximum capacity under their current scheduling systems. New scheduling methods, such as Levin Group's Power Cell Scheduling™, use time-tested formulas to increase scheduling capacity. Most practices can benefit from a mathematical scheduling model and dramatically increase the number of implants placed or restored, leading to greater production and profitability.

Patient education and motivation

Dentists and dental team members can help educate and motivate implant patients via the following methods:

• Emphasizing esthetic advancements of dental implants. Advancement and innovation in implant systems have provided patients with superior esthetic restorations. Modern implants are designed to enhance function and esthetics. These advantages are easily communicated to patients by staff members and have had a dramatic impact on case acceptance.
• Making implants the natural replacement choice. Consistent, effective, and comprehensive patient education by the dental team will result in dental implants becoming the natural choice for replacing lost teeth. While dentures and crown and bridge will always remain treatment options, dental implants will become a normal part of the service mix offered regularly to edentulous patients.
• Utilizing an ITC. Levin Group has seen many practices benefit from an Implant Treatment Coordinator (ITC) serving as the fundamental element in a comprehensive patient education program. The ITC acts as liaison between surgical and restorative practices, ensuring that patients receive clear and consistent information throughout the implant process. In addition, a well-trained team is critical to educating and motivating patients about the benefits of implant treatment.

Conclusion

Based on current trends, we believe implants will experience significant growth in the next 10 years. As baby boomers enter their 50s, 60s, and 70s, many will need treatment to replace missing teeth. Implants represent the best treatment choice for many of these patients and others. However, it is up to each individual practice to position itself for success by ensuring improved clinical competence and communication.

References available upon request.

Roger P. Levin, DDS, is chairman and CEO of Levin Group, a leading dental management consulting firm dedicated to improving dentists' lives through a diverse portfolio of lifetime services and solutions. Contact Levin Group at (888) 973-0000 or www.levingroupgp.com. Dr. Kenneth Judy is co-chair of the International Congress of Oral Implantologists. He is clinical professor in implant dentistry at New York University College of Dentistry, and is in oral implantology at Temple University School of Dentistry. He has been involved in implant research and practice for more than 40 years.