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The Cosmetic Dentistry Roundtable

May 1, 2002
Leaders in aesthetic dentistry and materials share their insights and knowledge.

Leaders in aesthetic dentistry and materials share their insights and knowledge.

Dr. Donald P. Callan
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This month, Dental Economics continues its in-depth discussions with trendsetters in cosmetic dentistry. We interviewed Dr. Donald P. Callan, a renowned educator, lecturer, and periodontist from Little Rock, Ark.

Dr. Callan is a graduate of the University of Arkansas, and received his DDS and a certificate in periodontics from the University of Missouri at Kansas City. He has authored more than 45 journal articles and has lectured extensively both nationally and internationally. Among his many honors are past chairmanship of the Dental Advisory Committee for the American Red Cross; he is also on the editorial board for Implant Dentistry. Contact him by phone at (501) 224-1122, fax (501) 224-1990, or by email at [email protected], or visit his Web site, www.don callan.com.

Dental Economics: Do you think implant dentistry is still growing or has it slowed?

Dr. Callan: Implant dentistry is definitely a growing part of dentistry today. If we look at the goal of implant dentistry, which is to provide function and aesthetics to our patients, then implant dentistry is definitely on the increase. With the increase of public awareness and the long-term predictability of dental implants, implant dentistry is truly the area with the most growth.

Dental Economics: To what do you attribute this growth?

Dr. Callan: Dental implant growth is due in part to the educated dental patient. Dental patients today are very well educated about the various modalities of dental treatment. Patients are aware of the procedures required to replace a missing tooth. Patients do not want their teeth ground down to insert a bridge, crown, or a partial denture. Many patients are also aware of the limitations that removable prostheses exhibit. Today's educated patient is more inclined to maintain the integrity of the arch and protect the natural anatomy of the existing tooth and will elect to proceed with dental implant treatment.

Dental Economics: You have been a leader in bringing implant dentistry to the market-place. How do you plan to maintain that leadership? Dr. Callan: Leadership is based upon being well informed about the research literature and the willingness to share this information with other professionals. Therefore, the leader should have an academic affiliation as well as a clinical practice. To be a leader in any field, anecdotal articles are no longer acceptable. We expect dental industry leaders to be well-informed and to be involved in the research into all aspects of dentistry. A leader in dental implantology must have a clear understanding of biological hard and soft tissues and the mechanical aspects and limitations of implants to function properly within the oral cavity. A leader must also be a team player and bring the team together for the best possible results for the patient. I plan to continue the research, gathering and sharing information, and to play an active role in the implant organizations.

Dental Economics: It has been said that the economy is in recession. Is this affecting implant dentistry? Is it affecting your business?

Dr. Callan: There is no doubt that a slowdown in the economy exists. However, well-informed patients are seeking quality care to maintain their oral health. Within our practice, the marketing of dental implants does not present a problem. Approximately 80 to 85 percent of our practice is dedicated to implant dentistry. In the year 2001, our practice had its largest growth ever in the area of implant dentistry. For the coming years, we will continue to market our practice by keeping all of our patients informed. Most patients are interested in recent treatment advancements. We provide a Web site, patient brochures, and informative forums for our patients. It is the responsibility of each dentist to provide this information. Patients are then more informed to make the best decision based on their personal needs and wants.

Dental Economics: You are very involved in products for implant dentistry. What do you see as the next breakthrough product?

Dr. Callan: In the past, dental implants have proven to be very beneficial for patients functionally. Let's face it, all implants work. Some implants work better than others. Success defined by some authors is the amount of time the implants are retained within the oral cavity. Success is not just a question of longevity for a dental implant to be successful. Based on an interview of 203 patients, patients consider success as proper function, longevity, aesthetics, and a healthy environment around the dental implant itself. Therefore, to attract more implant patients, the next breakthrough for dental implant products should be directed to the demands and needs of the implant patient.

From the dentist's standpoint, the main concern is a more user-friendly product for both the general and surgical dentist. New products must be user-friendly to attract more dentists into the field of implant dentistry. The breakthrough for patients is to meet their demands and wants; the breakthrough for the dentist is to have a more friendly product.

Dental Economics: Based on the dental industry trend of an ever-smaller number of providers, how do you plan to increase your business?

Dr. Callan: Since implants are not a covered insurance procedure, patients are responsible for the cost. In our practice, the lack of insurance has not been a problem. The sophisticated patient is fully aware that insurance companies are not concerned about quality of life issues.

Patients understand exclusions. They may not like the exclusions, but they accept them. Therefore, patients have set their own priorities and accept financial responsibility for the procedures. Generally speaking, people purchase what they want if they are well- informed (implant education).

Dental Economics: What percentage of dentists are doing implant dentistry?

Dr. Callan: That is a hard question to answer. Many dentists are only involved in the restorative phase, whereas others are involved in the surgical phase. From my experience, it appears that at least 60-80 percent of surgical dentists (periodontists, oral surgeons, and implantologists) are definitely involved in implant dentistry. However, the general dentist's percentage is not as high. Usually, general dentists elect not to be involved with dental implants due to the initial cost of this procedure and its seeming complexity.

In reality, implant dentistry is an extension of routine restorative dentistry. Dr. Burt Melton states it best: "Implant dentistry is restorative dentistry with a surgical component." I certainly agree with Dr. Melton's opinion regarding implant dentistry. Implant dentistry is not that complicated, but there are new and different procedures that must be learned. Implant dentistry is just another area of dentistry. For today's dentist to be considered a comprehensive dentist, he/she should offer all dental services.

Implant companies have definitely made the prosthetic portion of implant dentistry extremely complicated. For this reason, many practitioners have not entered the field. With the new systems and advancements coming on the market, I expect more general dentists to enter the implant dentistry field. If the trend continues, I would not be surprised to see 90 percent of our office committed to implant dentistry.

Dental Economics: What do you foresee as the major problems concerning implant dentistry today?

Dr. Callan: The four major problems concerning implant dentistry today are cosmetics, complexity, education, and the inability to maintain oral hygiene around dental implants after placement. All four of these problems can be addressed by the implant design. The implant manufacturers have done an exceptional job in assisting the dental profession to provide better care for the general public. I anticipate the manufacturer will continue their dedication for the betterment of dentistry. However, the dental profession must assist the manufacturers to address these problems by informing the companies of the concerns and submitting suggestions.

Dental Economics: What do you foresee are the educational requirements for implant dentistry?

Dr. Callan: Dental schools and implant manufacturers are fulfilling the educational requirements for implant dentistry for the most part. However, not all dental schools have complete implant departments. As implants become the mainstream of dentistry, we will see dental schools devoting more effort and time toward educating dental students about dental implants.

Implant organizations have been extremely cooperative in providing these educational requirements for the dentist. Organizations such as the International Congress of Oral Implantologists (ICOI) have dedicated their existence to the field of implants by providing some of the best (if not the best) educational programs for the implant dentist. I hope that implant companies continue to be leaders within the field and help us to better serve our patients.

Dental Economics: Do you feel the cost of dental implants will decrease?

Dr. Callan: The cost of dental implants are not likely to decrease. Implant companies have done a wonderful job in keeping the cost low. However, there are other costs involved. These costs include education for the dentist, time-consuming procedures, special instruments, special attachments, and many others. High-quality and advanced procedures for any area are likely not to decrease in cost. As with any product, the more advancement, the more the cost. However, the benefits for our patients far outweigh the costs!

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