Learn to love the denture patient again

Dentistry is rapidly changing. Clinically, there have been many changes in dentistry during the last 10 years that have been really significant ...

by Louis Malcmacher, DDS, MAGD

For more on this topic, go to www.dentaleconomics.com and search using the following key words: Dr. Louis Malcmacher, Common Sense Dentistry, Dentatus Atlas System, dentures, lower denture patient, narrow diameter implants, mini implants.

Dentistry is rapidly changing. Clinically, there have been many changes in dentistry during the last 10 years that have been really significant in our thought process, our materials, and how we apply techniques to patients.

The single biggest example of this is in the implant market. Let me give you some background on the implant market in the U.S. and the rest of the world. In the U.S., approximately 8% to 10% of general dentists surgically place implants. In many other countries, 80% to 90% of general dentists place simple implants. For example, I know a number of general dentists in Europe and the Middle East who place implants the way you and I place composite resins. They place them every day, and it is a routine procedure in their offices.

There are some challenges in the implant market. First, the implant market is very confusing because numerous companies offer different kinds of implants, and many dentists don't even bother to wade through the vast array of products. Second, many dentists still live in the past and think most implants still require two stage surgeries, implants cannot be immediately loaded, six to eight millimeters of bone is needed in a buccal-lingual dimension, and the surgeries are difficult to accomplish. Third, dentists hear from specialists that complicated diagnostics are needed for implant cases, and these are out of the realm of most general dentists. In addition, the cost of implants is high, making the patient cost for a single tooth implant anywhere from $3,000 to $4,000.

General dentists need to get into the implant market immediately. Note to oral surgeons and periodontists — the more your general dentists place implants, the more they will recognize bigger cases and refer those to you. We have seen this in every other single dental specialty. Endodontics and orthodontics are perfect examples of this.

The perfect way for most general dentists to start on their implant journey is with narrow-diameter implants. These implants are typically in the range of 2 mm to 2.5 mm. They can be used in resorbed mandibular ridges, they are very simple to place, 4 mm of buccal lingual bone is adequate, they can be loaded immediately, and most of the time they do not even require a flap. Like everything else we do in dentistry, case selection is important for success.

The most common use for a narrow-diameter implant is to retain a lower denture. This is a huge untapped market that most dentists shun. There are approximately 50 million denture patients in the U.S., and 90% of those dislike their lower dentures.

Most general dentists dislike that same lower denture because it doesn't fit. In a simple one-hour appointment, narrow-diameter implants can be placed in the lower jaw, and the denture can be made to snap into these implants. The total patient cost is about $3,000, which is very reasonable compared to conventional implants. With some training, this is within the skill set of every general dentist.

The system I use in my practice is Atlas Narrow Diameter Implants by Dentatus. Take one of their excellent courses, and in a few hours you will be well versed in placing these implants. Dentatus has developed an extremely easy system for general dentists that consists of only two surgical burs.

The key to their system is the Tuf-Link silicone liner, which retains the denture incredibly well. This is much different than the other mini-implant systems that rely on clumsy metal housings in which more of the denture needs to be removed, and in which the implants must be placed perfectly parallel. The Dentatus Atlas System gives the general dentist much more leeway and is significantly easier to use.

Learn to love the lower denture patient again. These folks represent a significant demographic of every dental practice, and when you take care of grandma, she will send in her kids and grandkids. This is an excellent practice builder that has been overlooked for much too long. This will change the way you and your patients look at dentures forever.

Dr. Louis Malcmacher is a practicing general dentist and internationally known lecturer, author, and dental consultant known for his comprehensive and entertaining style. An evaluator for CLINICIANS REPORT, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. Contact him at (440) 892-1810 or e-mail dryowza@mail.com. At his Web site, www.commonsensedentistry.com, you can find information about his lecture schedule, audio CDs, download his resource list, and sign up for a free monthly e-newsletter.

More in Science & Tech