It is often confusing to determine who is qualified to provide surgical procedures, particularly when the Internet is populated with information about general dentists performing extractions, cosmetic periodontal (gum) surgery, and dental implant placement. It is important to keep in mind while sifting through this information that with any surgical procedure there are inherent risks and you should be in experienced hands when undergoing surgery.
Many people assume that because dental implants have such a high success rate (95-97% for 30+ years) that implant placement must be a simple procedure. In reality, the high success rate is due in large part to the fact that over the past 25 years most implants have been placed by highly skilled surgical specialists with extensive experience. Highlighting this fact is a study published in the Journal of the American Dental Association in July 2014, which indicated that the failure rate of dental implants place by general dentists in the study was 18.7% – significantly higher than when implants are placed by surgical specialists.
Patients should understand that there is a significant difference between residency trained surgical specialists (Oral surgeons and Periodontists) and dentists without post-graduate surgical residency training. It is the extensive amount of training and experience of the surgical specialists that enables them to diagnose and manage the potential complications that can occur with surgical procedures.
Some general dentists, Prosthodontists, and Endodontists have attended training courses on surgical implant placement and have achieved successful results placing implants for their patients. However, most of the non-surgical dentists attempting implant procedures do not know how to manage and treat the potential complications that are routine for surgical specialists. Unfortunately, as a result of dentists’ insufficient training and experience, many patients have experienced serious implant failures and complications that could have been avoided if they had been treated by surgical specialists.
There are a number of general dentists who have a great deal of experience in implant dentistry, treating patients who need one, or two implants, collaborating with a surgical specialist on a regular basis. However, the vast majority of general dentists have relatively limited experience treating patients who are missing all of their teeth, or those with more complicated cases. These patients are usually referred to Prosthodontists, who as specialists, deal with complex cases on a daily basis.
As the “architects” on the team of dental specialists, Prosthodontists develop the treatment plan that will produce the optimal esthetic and functional results for each individual patient. Extensive training and experience, including a three-year residency program beyond dental school, provide Prosthodontists with a thorough understanding of the type of tooth replacement that is best for each unique situation, including the most complex full-mouth reconstruction cases.
Patients who need anterior dental implants are often referred to Prosthodontists, since they have more training and experience with demanding esthetic situations. In fact, a single missing anterior tooth can be one of the most challenging cases in implant dentistry, especially when patients show a significant amount of gum tissue when they smile. Other challenging situations, including patients with dentures, patients with several missing teeth, and patients with complex medical histories are usually referred to Prosthodontists for implant treatment in collaboration with surgical specialists to achieve optimal outcomes.