by Gerald A. Niznick, DMD, MSD
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Editor's Note: This is the fourth in a four-part article covering the past, present, and future of dental implants and their impact on the practice of general dentistry. The final installment discusses how increased competition today has resulted in a need for surgical specialists to find out more about the restorative requirements of their referring dentists.The marketing dynamics within the dental implant industry are changing with regard to oral surgeons and periodontists growing or even maintaining their implant referral practices.
General practice dentists, who have traditionally worked in the team approach to provide optimal treatment for their patients, are realizing that the most profitable way to participate in the implant revolution is to start placing implants. In some cases, this is encouraged by the same implant sales reps who help increase referrals to the surgical specialists who use their implant systems.
The salesperson who offers to increase referrals by providing "technical support" through abutment selection or training on impression procedures, may achieve this objective by directing referrals away from another surgical specialist who does not use that salesperson's implant system.
This pits one company's sales force against another and surgical specialists against each other in competition for implant-referring dentists. These same salespeople who help increase implant referrals to a surgical specialist can hold that specialist captive with the veiled threat of redirecting those referrals to another surgical specialist if one does not stay loyal to using that salesperson's system.
Surgical specialists find themselves victims of this shell game. They have to use three to four different implant systems to retain certain referring dentists and neutralize the threat of the salesperson switching to a surgical specialist more committed to that salesperson's system.
Through all this, the surgical specialist is unable to select the system that offers the best clinical results and value. The confusion in ordering surgical instruments, implants, and related components for three to four different systems is an expensive, and time-consuming problem.
Competition among surgical specialists for referrals is increasing, with some surgical specialists funding educational programs and study clubs. Many of the large implant practices were built by surgical specialists who assume an expanded role in the prosthetic phase. This includes buying and attaching abutments.
Some do this to capture some of the restorative fees at the expense of their referring dentists. Some general dentists take advanced training in bone grafting procedures to treat cases previously believed to be the domain of the specialist.