Part One –
Convincing General Dentists Implants Are within Their RepertoireBy: Jean Johnson for Dental1
“Dental implants are not the future of dentistry,” said Nader Rassouli, D.D.S., M.S., Portland, Ore. prosthodontist, “They are here.”
The effect is as intended; the 40 family practice dentists finishing well-appointed plates of food stir visibly while listening to the speaker.
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Consider the Stats Before Choosing a Dental Professional
There is considerable debate in the field of implant dentistry over whether patients need to have implants placed by oral surgeons or periodontists before returning to their family dentist or prosthodontist for the actual tooth restoration.
According the University of Florida Dental School in 2005, general dental residents showed a 90 to 95 percent success rate placing implants over a period of four years.
The American Dental Association (ADA) reports that although patient demand tripled from 1991 to 2001, only eight percent of general dentists offered implants as a routine part of their practice as of 1999.
Between 1995 and 1999, an ADA survey indicates clear growth per the following statistics:
The number of implants that oral and maxillofacial surgeons do annually increased from 43 percent in 1995 to 81 percent in 1999.
Periodontists went from 43 to 71 implants a year from 1995 to 1999, while general dentists increased from 28 procedures in 1995 to 31 in 1999.
While only eight percent of general dentists placed implants as of 1999, ADA data indicates that 90 percent of the oral-maxillofacial surgeons, 68 percent of the periodontists, and 10 percent of the prosthodontists were engaged in this state-of-the-art, high-tech procedure.
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The dinner meeting is at one of the city’s venerable, old-money clubs. Debonair Rassouli sports an impeccably-tailored dark suit, and the French cuffs on his shirt give him plenty of elbow room. Clearly his 15-year career as a prosthodontist who offers dental implant surgery as a routine part of his practice has treated him well. He raises expressive half-moon brows and holds out his hands as if his point was obvious. “Implants are the best thing that ever happened to dentistry.”
New York periodontist, Babak R. Ghalili, D.M.D. concurred with his West Coast colleague when talking to the New York Times in 2001. “Implants are really great… They help a lot of people,” he said. “It’s very lucrative so everybody wants to do implants.”
The Eastern periodontist, however, qualified his comment with a cautionary remark. “Implants have limitations, and require expertise from whoever is doing them,” Ghalili said. “That’s the key in their success.”
But that was 2001, and now the dental implant market is going in the direction of general dentistry. Rassouli is clearly invested in convincing the crowd that family practice dentists can and should pick up their scalpels and learn to use an implant drill – given appropriate cases that are not overly complicated.
“My belief is that an implant should be restorative,” said Rassouli, not mincing words. “So the best person to place it is the one who will do the restoration.”
In effect, Rassouli tells those gathered to get with the program.
“We have to shift the way we think about any edentulous spot,” he said, referring to gaps caused by missing teeth. “Think implant not bridge.”
Rassouli paused again, before reiterating his main point. “And you do not have to be a specialist to do this.”
There is no certification for implant dentistry. Consequently, those who have not studied the technique while in school, or who have specialized in fields like oral and maxillofacial surgery or periodontics, can learn the art by taking seminars such as the one Rassouli is offering in conjunction with a dental implant company.
But, healthcare professionals are by nature a conservative bunch and in order to convince them that their time and money won’t be wasted, Rassouli has invited Deborah Curry, D.D.S., a dentist he trained in implant procedures, to comment on her experience.
“My motivation was a young girl that I’d been treating,” said Curry. “She was 18 years old, and the idea was that her implant would have to work for her for a long time. So I attended one of Dr. Rassouli’s study clubs and placed my first implant in her in 2000. Now six years later, she’s doing fine.
“Nobody wants their teeth cut down for a bridge,” Curry added. “Also, you already have trust established with your patients, and they don’t want to see anyone else. They want you to do the work.”
Curry winds up her remarks with the financial clincher. “I’m probably up to a hundred implants now,” she said. “That would probably be $50,000 if I referred them out.”
Indeed, while all involved in the meeting are careful to talk about what a great service dental implants are to patients, they do not shy away from the point that this state-of-art, high-tech approach to dentistry can generate some serious income.
Ken Landes, owner of the dental lab where Rassouli has all his restoration work done, also shares his insights. “I’ve been in the lab business 40 years, but it was 10 years ago when I went to one of Nader’s study clubs that I got my knowledge on implants,” said Landes, whose brilliant diamond ring is a study in success itself. “It was a little intimidating, but I could see it was going to be the wave of the future.”
Landes adds that Rassouli was right; “I’ve seen the business grow so much.” Landes also makes a point about the benefits of having a single practitioner both place an implant and do the tooth restoration.
“I respect what dentists do; it’s a tall order,” he said. “But one of the things I see missing in the area of implants is no case planning where everyone works together. When I work with Nader, he’s involved in every aspect from placing the implant all the way through the restoration. The result is happy patients that we all want.”
Nader Rassouli takes center stage again and underscores Landes’ comments about the long-term goal being the installation of dental crowns that have both aesthetic appeal and function.
“Someone who thinks restoratively is the best person to place an implant because they consider the surgery a restorative event,” Rassouli said. “People do not just want an implant, they want a restored tooth.
“Of course, there is a hesitation and fear factor, but the way we’re going to get over that is by educating you about which cases you should do and which ones you will need to refer out.
“We are also offering a mentoring program. The idea is that I will become available to you. Dentists who go through my course can bring patients to my office, I will talk you through the procedure,” Rassouli said. “After you have been through it a couple of times, you will be ready. It has taken me 15 years to learn what I know now. It will take you a lot less.”
Continued in Part Two
