by Kenneth W.M. Judy, DDS, FACD, FICD
In 1982, a watershed event occurred: Brånemark Implants were introduced into the United States and Canada. We were presented with a completely research–based "Holy Grail." Personally, I had been placing implants since I graduated from dental school in 1968, and was involved with implant research since 1966, which was 14 and 16 years prior to the first Toronto conference. These experiences are not necessarily "bona fides" in the sense of officially sanctioned implant credentials, but I also had exceptional mentors in all aspects of clinical implant therapy, which remains a significant part of my practice, always focused on terminal or difficult rehabilitation cases.
Imagine my shock when I tried to enroll in a Brånemark course at the New York University College of Dentistry — my alma mater — to which I have been and continue to be generous, and was told I could not enroll. The reason? Simply that I was not an oral surgeon. I called the company and was told that this policy was dictated by NYUCD. I called NYUCD and was told that this was not the case at all. The policy was "corporately driven." How puzzling! I even called Sweden and offered to come there at great expense. But it was not possible without an oral surgery passport.
As you might expect, I was somewhat perturbed. I called the New York State Dental Association, a few attorneys who I greatly respected for their impartiality, and finally, a Mr. Wayne Wozniak at the American Dental Association. I was disturbed to hear about a Federal Trade Commission violation and some less–professional statements about what was going on: an implant corporation cloaked in the mantle of research and science was attempting to dictate who could do implants; not state licensing agencies, not the ADA, but rather corporate, profit–driven, monopolistic entities.
While this policy was in effect, implant therapy was tremendously hamstrung by — you guessed it — oral surgeons, who had little previous training, were not used to prosthodontic parallelism, and who had, in fact, previously condemned dental implants.
Today, a number of things have changed. Oral surgeons and periodontists, as well as thousands of general practitioners, have taken substantial implant education courses and related restorative training. NYUCD has established an implant department, as have other institutions. Great progress! Wonderful! Case solved!
Would that it were so. Today, once again, some implant companies and specialists are trying to push generalists out of the implant–placement market. Why? You guessed it — money! High hourly production! Bucks! However you want to say it.
Clearly, this deplorable situation must be ended once and for all. The answer is for dentists to simply read and understand state licensing policies and follow them without influence from specialty lobbyists. Further, the answer is appropriate training of those practitioners, generalist or specialist, who wish to place, restore, and maintain dental implants within the parameters of their individual skill levels.
The answer also is implementation of fair and truthful policies regarding professional advertising. Should specialists be permitted to add "and dental implants" automatically after their specialty declaration? Should generalists be permitted to add "dental implants" automatically to an extensive laundry list of services?
I think every ethical practitioner knows the appropriate solution to these problems: Let state licensing agencies fulfill their time–honored functions. Do not discriminate in any fashion.
In conclusion, I do not think that anyone should champion the policy of allowing corporate–decision wonks to make such judgments for the dental profession, and by extension, dental consumers. We would rapidly leave the "Golden Age" of dentistry and enter a corrupt age of greed, self–service, public distrust, and fleecing of the patients we serve. Is protecting the principles we hold dear a hard position? No. It's an easy one!
Dr. Kenneth Judy is co–chair of the International Congress of Oral Implantologists (ICOI), the world's largest implant therapy society and provider of related continuing education. He is clinical professor in implant dentistry at New York University College of Dentistry, as well as in oral implantology at Temple University School of Dentistry. Dr. Judy has been involved in implant research and practice for more than 40 years.