‘Framing’ denture stabilization options for better acceptance

by Gregory L. Sawyer, DDS

As the nation’s 77 million baby boomers are just beginning to reach the age of 65, their health-care needs are fast becoming a high priority. Nearly 38 million people in the United States are expected to be edentulous by the year 2020. For dentists, this means that treatments for edentulism will remain in demand.

What may change, however, are patients’ expectations for their quality of life following whatever treatment they choose. More so than their predecessors, baby boomers have high expectations for maintaining their quality of life as they age. As a result, dental implant treatment is becoming more prevalent.

The increased stability that dental implants bring can make a significant difference in patients’ overall satisfaction with their dentures, and many in the dental community now recognize a mandibular two-implant overdenture as the standard of care. Unfortunately, dentists who recommend implant treatment often encounter sticker shock as patients learn the cost of these procedures.

However, dental implant treatments are currently available in a range of price options. While treatments such as a fixed bridge or bar overdenture can easily cost upwards of $20,000, the increasing availability of small-diameter implants — such as MDI Mini Dental Implants from 3M ESPE, Intra-Lock Mini Drive-Lock Implants, or ERA Mini Dental Implants from Zimmer Dental — puts a much more affordable treatment within patients’ reach.

The simplicity of the placement procedure means that this treatment can be offered at a much lower price than conventional implant treatment — typically less than $1,000 per implant.

Avoiding sticker shock

While this treatment is significantly more affordable than other denture stabilization methods, some senior patients on fixed incomes may still feel the procedure’s costs are prohibitive. However, the field of psychology offers a valuable lesson in how dentists can present this treatment to patients in a way that maximizes its value.

Dr. Robert Cialdini of Arizona State University is well known for his research on influence. One of his more notable experiments suggested that presenting an extreme request first, then presenting a smaller request as a retreat from the initial request can increase acceptance rates dramatically.

This study cemented Cialdini’s beliefs about the importance of “framing” a request in relation to another larger request. By presenting a question this way, a person in any sort of negotiation can “retreat” from an initial, large request, to one that is much more acceptable to the customer. But if negotiations simply open with the lesser request, it is often declined.

This study has since been applied in a number of different realms. In dentistry, where patients are sometimes shocked by a dentist’s quoted fee, it can be particularly applicable. In the case of implant treatment, dentists may find they have more case acceptance for mini implants if they begin explaining patients’ options from the most expensive (i.e., a $20,000+ denture stabilization option), then move downward (i.e., a mini implant option at a fraction of the price).

I believe that dentists have an obligation to inform patients of every treatment option available to them, so this method of presentation is simply a way to do that in an order that ends with the least intimidating option.

True value for patients

Many dentists have seen denture patients who suffer with their dentures, but who have rejected the possibility of implant treatment as too expensive, too invasive, or too time-consuming. Time will tell if aging boomers continue this trend, but if demographers’ projections are correct, these patients will have much higher expectations for edentulism treatments that can help them retain their quality of life.

In light of the recession’s effects on many boomers’ finances, these patients are also in need of treatments that provide good value. By listening to patients’ needs and thoughtfully presenting their options, dentists can help patients arrive at treatment plans that maximize their dollar.

Cialdini’s research on influence gives dentists an important method to position mini implants in patients’ minds as the affordable solution they truly are, helping denture patients experience the quality of life they deserve at a price they can afford.

Gregory L. Sawyer, DDS, is a 1977 graduate of the University of Southern California School of Dentistry. He has expertise in general and cosmetic dentistry, dental implant reconstructions, periodontal therapy, and snoring and sleep apnea. He is a Fellow of the World Congress of Minimally Invasive Dentistry and the International Congress of Oral Implantologists.