Letter to the Editor

To the Editor: I read with great interest your most recent editorial1 in Implant Dentistry and I agree with many aspects of the article. Several years ago, when I was taking a year-long study club implant course offered by my oral surgeon, I was perplexed during one prosthodontist's lecture. The prosthodontist showed case after case of overdentures and multiple implants. Each case presented its own complexities, yet each when considered and planned properly, yielded a simplistic, predictable result. During a follow-up lecture by the same prosthodontist, I was able to ask my question: “How can I as a general dentist convince my patient's that this is the correct or best form of treatment? Of course they allow you, a prosthodontist, to complete whatever care you believe is necessary. You are a specialist and in most cases, you are their last resort.” His answer began my paradigm shift toward implant dentistry. His answer was “Recommend the implant whole-heartedly and if the patient refuses the proper treatment, have the courage to let them walk out of your door without doing any treatment. In the end they will realize you were right, and they will return to you to complete the proper care.” I adopted a new philosophy that day. The philosophy is that everyone is a candidate for implants and it is my duty to provide my patients with the best available treatment. However, the two biggest obstacles to providing the treatment were not addressed in your editorial. The issues are how to convince the patient it is right and how to finance the cost. Again, several years ago, I read a book called, Influence: The Psychology of Persuasion.2 One section of the book explains how individuals relate to others. Hence, if every 80-year-old drove a Corvette it would seem normal. However, since most 80-year-olds do not drive Corvettes, it would be very difficult to convince an octogenarian to buy one. In the like, most 70 or 80-year-old patients do not know other 70 or 80-year-olds who have implants. They do however know many 70 and 80-year-olds who wear dentures and have problems with their dentures. Thus, the situation is normal and inevitable. Secondly, when presented with the cost of treatment, it comes down to quality of life. If by paying for implants and an implant retained prosthesis, the patient now has to forgo their annual pilgrimage to Florida or Arizona you can rest assured they're heading south for the winter. They deal with the problems because that is what everyone else they can relate to does. I do not believe that most dentists view implant treatment as a last resort. Many of us made that paradigm shift long ago. What remains to be changed is the psychological aspect of the patient. Help them realize that implants are not Corvettes but Hondas – a reliable treatment. Andrew Gazerro, DMD West Warwick, RI