The Probe - Proudly serving the dental profession for over 60 years

Waterpik – Facts, Assumptions and Trends GDC Development Outcomes C, D

Course Dates: 30th October 2018 - 30th October 2020
Enrollment Dates: Enroll Anytime
Who can Enroll: Anyone
Course Language: English
Price: FREE
Not available

About the Course

To appreciate the need to constant assess treatment techniques and concepts
To refresh understanding of the most reliable types of research papers
To be aware of how incorrect general assumptions can be
To better understand why the assumption that sportspeople are generally healthy might not be accurate

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The Probe

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The true cost of dental implant treatment

Course Dates: Open-ended
Enrollment Dates: Enroll Anytime
Who can Enroll:
Price: FREE

About the Course

I am sure most of your reception staff have received enquiries like this: ‘’How much does an implant cost?” The Internet is replete with advertisements from providers here and overseas that promise implant treatment at seemingly ‘affordable’ prices. So, can we afford to ‘price match’? How much does implant treatment really cost, to the patient and to you, the provider?

Beyond the obvious outlay that an implant provider must incur such as the costs of intensive training, investment in equipment as well as component and laboratory costs, there are various hidden costs that are not always apparent to such cold callers. When this is met by unrealistic expectations, including the impression that this treatment modality is ‘permanent’, seemingly simple e.g. ‘’just want a smile’’ or ‘’just want a tooth’’ and never in need of regular maintenance or will be trouble-free – the outcome can be disappointing to all parties.

Many of us have also encountered difficult conversations around implant complications from patients who have received ‘affordable’ and complex treatment overseas. These are usually completed over a few treatment visits, where opportunities for corrective actions or a maintenance regime are reduced. With current travel restrictions, any overseas corrective/maintenance trips are now impossible.

The longevity of an integrated fixture and the prosthesis, like that of a well-made and well used car, is dependent on regular servicing and is also subject to wear and tear as well as an array of complications. As such, communicating this to the patient at the outset is prudent. 

In terms of complications, the ITI consensus report 2015 vol 8 (Edited by Heitz-Mayfield & Bragger) details a useful classification framework.

Complications can be divided into those that happen peri- & post operative or post-integration. For the former, these are largely preventable with adequately trained operators carrying out treatment in prescribed stages. The use of indexed peri-apical radiograph’s, CBCT, and pre- and intra operative anatomical inspections should render serious haemorrhage, perforation of the lingual cortical plate of the mandible, damage to neighbouring roots/ implants or perforation of maxillary sinus floor and nerve damage, largely avoidable. When an implant is integrated, additional costs can be incurred from complications arising from one of the three categories: aesthetic, biological and hardware related. The latter can be further subdivided into those that relate to mechanical or technical aspects.

The prevalence of such events was reported to be significant in a systematic review by (Pjetursson et al 2014), based on 5-year survival data from 108 studies and different types of implant prostheses. Whilst this is a limited study; it does give us an insight into the potential complexities that implant based restorations can cost. As expected, the incidence of complications for multiple units Fixed Dental Prostheses (FDPs) is greater than that of single units (crowns).

The incidence for full mouth (FM) fixed restorations is even greater. With implant companies and operators advocating FM restorations more frequently in recent years, it is reasonable to expect higher complication rates and related costs in the foreseeable future. The incidence of complications is only part of the story. The other being the degree of complexity in managing such complications. Hence, a chipped porcelain veneer for a screw-retained prosthesis will cost less to repair than that for a cemented one, particularly if it is a multiple unit FDP. Likewise, a loose abutment screw, especially if it’s not frequent, is much easier to deal with than a broken abutment. A damaged framework is expensive to repair but is not as disastrous as broken implants, which fortunately are uncommon events. This may however, become more frequent in the future with increased placement of implants of reduced or narrow diameters (<3.5mm), particularly for patients with parafunction or where increased occlusal load is present.

Whilst the incidence of biologic complications is lower than mechanical complications, preventing and/or managing such problems is an ongoing and long-term process. This is similar to control measures for periodontally involved teeth. The differences are that the cost of maintaining implants has been shown to significantly exceed that for periodontally involved teeth, and the treatment of biologic complications to be less effective (Fardal & Grytten, 2013). In well maintained periodontal patients, increased survival rates and much lower costs of retaining teeth needs to be considered where elective extractions and implant placement is a considered option, especially when long-term maintenance is costed in. Increased susceptibility to periodontal breakdown also increases the risk of peri-implantitis especially if not adequately managed (Karousiss et al 2004; Ferreira et al., 2018). The data related to survival of periodontally involved teeth may however,be biased towards a Tier 2 periodontal setting (Ng et al 2011).

Controlling the cost of implant therapy is therefore similar to all forms of complex dental treatment and encompasses a holistic approach of pre-treatment risk assessment, mitigation measures, and applying an appropriate maintenance regime. Some of the costs are obvious but many are underappreciated and not highlighted often enough. Perhaps the telephone enquiry of ‘’how much is an implant’’ could be compared to ‘’what is the ownership cost of a car of an unknown brand’’ and even more so if bought from overseas? Build quality of the component parts, how they are selected and assembled, driving habits and frequency of use, will all affect the overall cost. Added to that are servicing, regulatory, and insurance costs, one can see the many similarities. Like well-engineered cars that are frequently used, the true long-term cost of implants (and the prosthesis) therefore will not be universally affordable.

There is a tendency amongst the dental community to feel apologetic when implants fail due to biological complications which is not always apparent with teeth. We shoulder all the responsibility when inherent patient related actors are often likely to be the cause. This is especially the case when removal of teeth in the first place was our own recommendation. Implant complications and failures cause increased stress for both the patient and the clinician as well as additional clinical time and costs. If these additional costs are absorbed partially or fully by the clinician, then we need to consider our initial treatment fees. If these costs are to be borne by the patient, then the initial inquiry – ‘How much does an implant cost’ becomes much more difficult to define.

To enquire on our courses, click here – https://perionimplant.com/course-enquiry/

About the authors

Estela Baz.
With Special interest in Periodontology
Having received her Periodontics MCinDent from Eastman Dental Institute, Estela now works at the Perio & Implant DRC, limiting her scope of practice to Implants & Periodontics.

Chong Lim. BDS
(National U. of Singapore) MSc in Periodontics
(Eastman Dental Inst.,UCL), MSc (Distinction) in Dental Implantology (U. of Bristol) Chong heads the Perio & Implant DRC near Richmond Bridge. He is also involved with providing post graduate education for the ITI, Eastman Dental Institute & University of Bristol.

Abhi Pal to be first elected President of CGDent and final FGDP Dean

Course Dates: Open-ended
Enrollment Dates: Enroll Anytime
Who can Enroll:
Price: FREE

About the Course

Abhi Pal has been elected as the next Dean of the Faculty of General Dental Practice UK (FGDP), and will become the first elected President of the College of General Dentistry (CGDent). 

Dr Pal qualified in 1987 with honours and distinction from Guy’s Hospital, London, and has worked in general dental practice ever since, joining The University Dental and Implant Centre, a mixed NHS and private practice in Edgbaston of which he is Principal, in 1991.

With special interests in dental implantology and restorative dentistry, he is Editor of FGDP’s Training Standards in Implant Dentistry, for which he is currently leading the development of mentoring requirements, and was a tutor in Risk Management on the University of Warwick’s MSc courses in implant and restorative dentistry for seven years.

He joined FGDP in 1997, becoming active in its West Midlands division as a tutor and examiner for the MJDF, and later being awarded the Diploma of Fellowship. He was elected to represent the region on the National Faculty Board in 2014, was re-elected in 2017 and 2020, and is Chair of the FGDP Professional Affairs Committee, and a Senior Member of the Faculty Academy. In addition he represents the Faculty at meetings of Health Education England’s Advancing Dental Care Stakeholder Forum, and is involved in the development of a GDP career pathway for CGDent.

He has also previously served the Faculty as Chair of both the Education and Finance Committees, as Junior Vice-Dean (2016-17) and Senior Vice-Dean (2019-20), and as its representative on the Health Education England dental advisory group and NHS England clinical reference group on record-keeping standards.

He is one of the authors of the FGDP-CGDent guidance, Implications of COVID-19 for the safe management of general dental practice, and has played a leading role in developing the Faculty’s international relationships, most recently organising a joint webinar on dental practice during the coronavirus pandemic in conjunction with the dental associations of Kenya, Sri Lanka and Nepal.

Abhi also holds the Expert Witness Certificate from Cardiff University Law School, and has twenty years’ experience of providing clinical assessments and reports, and giving evidence at courts and hearings, as an independent expert for lawyers, regulatory bodies, insurers and defence organisations. He advised Heart of Birmingham NHS Primary Care Trust on dental complaints, clinical governance and commissioning for twelve years, and brings his dento-legal knowledge to bear in representing the Faculty on the GDC’s complaints handling policy group, and at Dental Complaints Service stakeholder meetings. In 2019 he was also Guest Editor of a themed issue of the Primary Dental Journal on dento-legal matters.

He is a Fellow of the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, has a Postgraduate Award in Medical Education from the University of Warwick, and holds the Membership in General Dental Surgery qualification of the Royal College of Surgeons in Ireland. He has also been a Foundation Trainer for twenty-five years, and is a member of NHS Education for Scotland’s National Review Panel for Vocational Training.

Elected for a three-year term, he will be inaugurated as FGDP(UK)’s eleventh and final Dean on 25th June 2021, succeeding Ian Mills. He will become the first elected President of the College of General Dentistry, succeeding the Honorary Founding President, Nairn Wilson, upon the transfer of the Faculty to CGDent. It is intended that the transfer will take place on 1 July, though membership of CGDent is already open to all dental professionals.

Commenting on his election, Dr Pal said: “I would like to thank my colleagues for the faith they have placed in me.  It will be an enormous privilege to lead this country’s only professional body dedicated to general dental practice, an organisation with which I have been involved for 24 years, and a deep responsibility to be the first elected President as the Faculty fulfils its destiny of becoming an independent College of General Dentistry. I invite all those in the general dental professions in all four nations of the UK to join us as we take this historic step.”

Ian Mills, current Dean of FGDP(UK) and a Trustee of the CGDent, added: “Many congratulations to Abhi on his election as Dean. An accomplished practitioner, with a proven commitment to postgraduate dental education and a detailed understanding of good practice and standards, he is a highly respected colleague and members should be delighted that our organisation will be in such good hands at this critical time.”

The British Dental Conference and Dentistry Show will now take place 13th-14th May 2022 at Birmingham NEC

Course Dates: Open-ended
Enrollment Dates: Enroll Anytime
Who can Enroll:
Price: FREE

About the Course

CloserStill Media, organisers of the British Dental Conference and Dentistry Show, have made the carefully considered decision to postpone the British Dental Conference and Dentistry Show (BDCDS) to May 2022.

The event will now take place on Friday 13th and Saturday 14th May 2022 at the Birmingham NEC, hall 5.

Martin Woodrow, Chief Executive of the BDA commented: “As we are all aware, the COVID-19 situation in England is continually developing, and after careful consideration, the decision to reschedule feels appropriate given current circumstances and ongoing uncertainty. However, I have no doubt that the 2022 conference will be the biggest, best and most impressive event yet!”

In the meantime, CloserStill Media will be focusing on how they can support the profession as they continue to work through this, very challenging time for dentistry.

“Over the past few months, we have been diligently assessing the landscape of the return of in-person events for the dentistry community,” said Alex Harden, Event Director BDCDS at CloserStill Media. “This decision has been made due to the lack of clarity around future government restrictions on large scale gatherings due to COVID-19 and the fact that the safety of our communities is of upmost importance to us. Our team is more devoted than ever to creating engaging, practical resources for continuing education and industry growth in a digital world. Thank you for your continued support during these difficult times and we trust you and your families are safe and well.”

The BDCDS is the UK’s leading two-day exhibition and conference for dental professionals, providing clinical, leadership and practical training via an extensive educational programme and hands-on workshops. It is the UK’s largest event of its kind, attracting over 9000 unique delegates and over 400 exhibitors.

 

CloserStill Media specialises in global professional events, within the healthcare and technology markets. The healthcare portfolio includes some of the UK’s fastest-growing and award-winning events, such as the Clinical Pharmacy Congress, The Dentistry Show, The Pharmacy Show and Acute & General Medicine.

CloserStill delivers unparalleled quality and relevant audiences for all its exhibitions, delivering NHS and private sector healthcare professionals from across occupational therapy, pharmacy, dentistry, primary and secondary care with more than £16m worth of free training.

The British Dental Conference and Dentistry Show 13th-14th May 2022, Hall 5, Birmingham NEC, co-located with The Dental Technology Showcase.

For all the latest information, visit www.thedentistryshow.co.uk, call 020 7348 5270 or email dentistry@closerstillmedia.com