Dentaltown August 2020 - 40

If you stay within your training and
comfort zone, you will enjoy doing
implants and have many happy patients.
The other issue is the dentist's failure to recognize a problem until it was too late, and
then how to manage it. It is important to listen to our patients. After a single flapless implant
surgery, patients should have minimal discomfort that abates in a day or so. Prolonged
tenderness or pain is a sign of a problem. We have to take our patients' complaints seriously
and not brush off their concerns. Listen to them!
It has been noted by many experienced clinicians that prolonged postsurgical pain is
a harbinger of implant failure. Removal of an implant that is symptomatic six weeks after
placement is becoming the recommendation, rather than waiting for frank implant failure
and bone loss.
Just as the majority of implants are very successful, implant failure is part of practice.
At the beginning of the article, I discussed that surgical residents are taught they should
not do a procedure if they don't know how to handle the most common complications
without assistance. Clearly, this dentist was never taught this. He had no idea of what
to do. He was not ready to place his first implant. I handled the complication for the
dentist and explained to the patient that this sometimes happens, even in the best, most
experienced hands.
I sent the dentist a bill for the implant removal and bone-graft procedure, at a significant
discount. A few days later, he called to tell me that I should have billed the patient for this,
because it was not his fault as the dentist that the implant failed.
I told him that it wasn't the patient's fault, either. Patients pay good money for implant
treatment. If an implant fails years after the implant was placed, then the patient is generally
charged for management. If it fails in the first year, most clinicians will absorb the cost
to keep the patient happy. You don't want to have an unhappy patient who just paid you
lots of money. It is not good patient management-or good risk management. We can all
learn a lot from this case.

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40

Closing thoughts
I've been teaching nonsurgeon dentists how to do implants for a number of years. My
goal is to make them successful and continue to do implants through their entire careers.
That requires the proper approach to learning and to gradual progression of complexity
of their cases.
Just as I learned the most from my senior attendings, look for courses taught by experienced specialists who understand the needs of a general practitioner and will teach you to
understand all that you need to know about the right way to add surgery to your practice.
Don't select the least intimidating instructors: They generally will not have the
experience and knowledge to share that will allow you to provide the best care for your
patients and enjoy implant surgery. Finally, remember that implant surgery is surgery.
Respect it! n

AUGUST 2020 // dentaltown.com

DT0820_Reznick_Implants_MM.indd 40

7/20/20 2:21 PM


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Dentaltown August 2020

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