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4.25.08 Issue #320 Forward This Newsletter To A Colleague

Carol Tekavec
CDA RDH
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Talking to Patients about Implants

Implant dentistry is a proven treatment option for patients with missing teeth. However, many people do not understand what an implant is or how it functions. They may have unrealistic expectations of what implants can do for them, or they may be so afraid to have one placed that they turn down a chance for a true improvement in their lives. Your patients may be candidates for implants. What do they need to know and how can you talk to them about their concerns in regards to understanding dental implants?

Patients need to understand why missing teeth should be replaced in the first place! Most people would not want to have a tooth missing where others could see. What about missing teeth in the back of the mouth? A large number of people do not know that along with affecting appearances, any missing tooth can affect the health of the mouth and the way that the rest of the teeth fit together. They do not realize that teeth on either side of an empty space may tilt into that space, or that teeth opposite an empty space can drift up or down into the opening. Remaining teeth can also become loose, start gum problems or even cause headaches due to altered biting forces. When a tooth is lost, the bone that used to support that tooth may also start to disintegrate. Teeth and tooth roots give the jawbone a “purpose.” Without them, the bone in the jaw may decline. Choices for replacing missing teeth include bridges and removable partial dentures, both tooth-supported and implant-supported.

Patients need a simple definition of an “implant.” An implant recreates the anatomy and function of a natural tooth. Although there are many styles and brands on the market, patients really just need to understand that there is a portion of the implant that goes into the bone and acts like a root, and a crown that is placed on top that looks and “acts” like a tooth. Implants can be used to support replacements, like bridges, but they can also be used to take the place of a single missing tooth. With implants, teeth next to a space do not have to be trimmed down to hold the fake “fill-in” tooth or teeth. Having an implant may also contribute to a certain amount of bone longevity. Since an implant integrates into the bone, it may give the jawbone a “purpose” and help it to not deteriorate.

Patients also need to understand that in most situations the surgical placement of an implant must be accomplished and healing must occur before a crown or any replacement can be used. A patient will be concerned about how his/her mouth will look while this healing takes place, so explain any temporary device you will provide. If your office places implants that can be loaded immediately, be sure your patient understands how to care for the implants and “crowns” before the next visit to you.

Is the treatment painful? Your patients want to know! Instead of beating around the bush, it is usually best to face this question head on, and with honesty. The placement of implants requires surgery, and though most patients will be comfortably numb during the procedure, they are likely to experience discomfort afterwards. Tell your patients what to expect and how you will take care of them, and encourage them to ask questions.

Patients want to know if their insurance will pay for implants. More and more benefit plans are including implants in their contracts within the confines of their applicable yearly maximums. Most yearly maximums are about $1,500–$2,000, so insurance may be somewhat helpful in paying toward implants. Some plans stipulate a “least expensive alternative treatment,” meaning that the carrier may only pay what they allow toward a non-implant supported, removable partial denture or full denture. If the patient’s contract specifically excludes implant procedures, they will not be covered no matter what a patient or dentist may request. Under some contracts, the implants may be denied, but the crowns or bridges placed on top of them may be covered. Implants may also fall under a dental “pre-existing” clause. Such clauses are not as common as they once were, but some plans still specify that for a replacement of any kind to be considered; at least one of the missing teeth to be replaced must have been lost or removed while the patient was covered by the existing plan.

It is important to check with the patient’s plan prior to placement of implants so that any financial concerns are dealt with before patients get the bill. Understanding the correct way to use the dental insurance codes will help the patient to maximize insurance coverage.

Carol Tekavec, CDA RDH is the president of Stepping Stones to Success and a practicing clinical hygienist. She is a speaker with the ADA Seminar Series, has appeared at all major dental meetings and has been featured in Dentistry Today’s “Top Ten Clinicians in Continuing Education” for 9 years. She can be reached at carol@steppingstonestosuccess.com.

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