I hate turbulence.
I'm a frequent flyer so I've grown quite accustomed to security lines and cramped seats. None of that really bothers me and I'd dare say that I actually enjoy travel. But the moment the plane goes bump, bump, bump ... I get pretty tense.
It probably has to do with control. When there's turbulence on a flight my eyes dart out the window to search for flak debris or little green monsters. Even if I were to make such a discovery, what the heck could I do about it anyway? Nothing. I'd be helpless. Fortunately, all I see is the wing bouncing up and down, suddenly looking rather fragile. I'm reminded that human flight is completely at odds with what nature intended.
Perhaps you've felt that similar helpless feeling when a patient's implant is ailing or failing. As sophisticated as dental implant technology is and as many lives as it has improved, it also flies in the face of what nature intended. And we're reminded of this fact when there's turbulence.
On my first trip to Tulsa, Oklahoma, the home of Pennwell Publishing, I had the opportunity to peek through the very long history of Dental Economics. In March of 1952, Dr. Edward L. Wharton of Newark, New Jersey, warned our readers of some new techniques:
"... two dentists originated an idea to obviate the necessity of a denture in edentulous mouths. Four cores were cut in the maxilla at strategic points - the two cuspid areas and the two molar areas. Perforated titanium cribs were inserted into these places and the bone was supposed to grow into these cribs. A full upper bridge was supported by these. It sounded plausible, but before tackling a case, I consulted a prominent oral surgeon. He told me he would cut the cores if I insisted. Also he told me that the two cases on which he had tried this technique developed blood poisoning. I stopped right there."
The early pioneers of implant dentistry, like those in aviation, weren't discouraged by turbulence. Patience, research, and proper experimentation lead generations to advancements of which the pioneers could only dream. Today, modern implant dentistry is only about 30 years old. We still get disturbed by turbulence because we may doubt ourselves, our techniques, or our materials.
We don't have all the answers yet on what can cause peri-implant disease or how we can treat it. Perhaps even more mysterious is how dentists should expect to be compensated when we encounter these cases. Our colleague, Dr. Scott Froum, has been lecturing on implant complications for years. I am confident Dr. Froum's article this month on the subject of compensation for peri-implant disease will spark discussions that are long overdue.
Another piece that I know will stimulate conversation is by Dr. Colleen Greene, a current pediatric dental resident and past national president of the American Student Dental Association. I often hear from recent graduates that dental schools do not adequately prepare them for the turbulence facing private practice these days. Her program at the Children's Hospital of Wisconsin is a pioneer in educating residents on the business side of dentistry. Perhaps residencies are the perfect opportunity to teach practice management?
Dentists are a pretty smart bunch. But we need leaders as much as we need intelligence. Like the early aviators, we need pioneers to brave the turbulence and show the rest of us what is possible.
Chris Salierno, DDS