Proper Communication Regarding Implants is Vital ”

By Don Deems, DDS, FAGD, PCC

How can dentists tailor their communication about implants to specific types of patients, e.g., could they communicate a certain way with older patients?

Communication is obviously and especially critical when discussing dental implants. Not only are there significant medical and legal implications of dental implant placement, but treatment involving dental implants is nowhere close to being 100% predictable. The internet is often a go-to source of information for many, if not most, people for a wide variety of information. When the information sought pertains to dental implants, there is a lot of good information and not-so-good information, and it’s difficult for most people to discern that, much less find it. If we are the ones providing implant treatment, we must also be providing correct and up-to-date information.

Elements of the communication about dental implants can be tailored for any patient, although it begs the question why. A simple example is that of smoking — if the person is a nonsmoker, then there’s no need to discuss why smoking and implants don’t mix well. If the person is on longterm steroid therapy, that needs to be addressed quickly. More complicated examples may include how the implants will be used and if there has been previous failure with an implant.

Some people want to know incredible detail, so be prepared to answer those questions. Others just want to know you’re going to take good care of them and that you know what you’re doing.

Regardless of the patient’s personality, age or gender, there are elements that we all have a professional, moral, ethical and legal responsibility to provide, even if any of that information may result in the patient deciding not to pursue dental implant placement. Just because we know how to place an implant doesn’t mean a missing tooth or teeth can, should or would best be replaced with a dental implant restoration or multiple. Dental implants are another modality of treatment with their own pros and cons, and these must be explored with each patient. We are here to provide the best care we can — and are trained for — that the patient ultimately decides to receive.

How do you communicate with a patient who wants implants but can’t afford them?

If a patient cannot afford a type of treatment they want, they simply cannot have it. People want things all the time they can’t have; we live in a materialistic society. However, if a person wants something badly enough, they’ll find a way to get it. Dental implants are one of those treatment options in dentistry that a person may have to think about for a long time; you can’t rush that process for them. Planting the seed of receiving dental implants as a treatment option — if it is appropriate for that patient — will allow them the time to do it when they are ready and when they have figured out how they can pay for it. Rushing that

process is inappropriate.

No matter what treatment a person may want, the cost of treatment is always part of the decision process. Sure, there are various ways a patient can find to finance any type of dental care, but if we or a team member try to talk a patient into something they don’t want, it is a very slippery slope to trouble. It’s best to present all treatment options, discuss the pros and cons of each option, give the patient all pertinent information — including cost — and then leave them alone. More and more in my practice I am seeing patients who have been pushed, cajoled or aggressively marketed to — and they don’t like it. Would you? When money becomes our priority, we’re heading in the wrong direction.

If we provide the patient a clear understanding of their current dental situation, taking into consideration their dental and medical history, and we also provide them with all available treatment options and then let that patient decide in their own time what they want to do, we’ve achieved our professional duty.

Implant placement and restoration continue to evolve and certainly aren’t exact sciences. One only needs to place a few dental implants to realize that. To that end, a patient may want our opinion. It’s in this gray area where we must be extremely cautious, not letting our own interests — especially financial — dictate our communication. If you feel that implant placement would not be in the patient’s best interest, tell them, and be prepared to tell them why. In the end, implant placement is not about persuading or dissuading anyone.

How do you communicate with a patient who wants implants but is not a good candidate for them?

In my experience, many patients have already heard of dental implants and have a positive or negative view of them before they even see us. Dental implants are not a panacea for replacing teeth. They are just another way of replacing teeth — sometimes more advantageous and appropriate, other times just the opposite. What happens when a patient comes to you wanting implant placement, can afford them, has a positive view of them and has already decided that dental implant placement is for them? This may be hard for many dentists to turn down. This is yet another slippery slope. Diminishing a patient’s clinical situation and risk factors in favor of placing dental implants has a high risk of becoming a nightmare for those choosing to forge ahead. If a dentist sticks to a complete evaluation, discusses all available treatment options without prejudice, and allows, encourages and answers all questions, my experience tells me that, most of the time, the patient will be able to make an educated decision and decide whether dental implant treatment is truly appropriate. They will also appreciate the time you are taking with them. What happens if the patient still pushes ahead for dental implant treatment? A clear option can be a referral to another dentist who places dental implants for a second opinion. Remember that we are not obligated to provide a dental service of any sort just because somebody wants it. t