As a pioneer in guided surgery and a self-proclaimed “born contrarian”, we speak to Dr Nick Fahey who believes we’re heading towards a position wheremost cliniciansneed to be delivering a fully digital pathway in order to maintain a leading position in implant dentistry.
Q1. What drew you to a career in dentistry and implant dentistry?
NF: It’s a long story, but I originally had no intention of being a dentist. I wanted to be a vet. However, my then girlfriend didn’t want to go to vet school. Instead, I was inspired by my great uncle, a forensic pathologist, to study medicine. Luckily, I didn’t quite make the grade for medicine – but I did get offered dentistry – the rest is history.
I was lucky enough to be exposed to implant dentistry as an undergraduate in New Zealand, but it wasn’t until I came to the UK that I became more involved with this discipline. As my experience in restoring and placing implants evolved, I started to see imperfections in both my work and others. I knew that if I wanted to do more in implant dentistry and do it successfully, I had to invest in training. Therefore, I undertook specialist training in Prosthodontics at the Eastman Dental Institute.
Q2. What is important to you when it comes to education?
NF: The day you feel you don’t have anything to learn is the day you should hang up your handpiece.
With anything complex like implant dentistry, you must seek the relevant education so that when you perform these techniques, you can demonstrate that you have had the appropriate training and developed links with mentors and peers who can support you in treating patients.
I graduated from dental school in 1994 and qualified from the Eastman in 2004 – so I have over 20 years of experience taking all the learning opportunities those two decades could offer. I’m now using this experience as a real opportunity to train and support young dentists and those who are at the start of their implant pathway and to help experienced clinicians take their treatment to a higher level.
Nick Fahey speaking at a BioHorizons Camlog evening event
Q3. Why should someone book onto your course and what considerations do delegates need to take when investing in education?
NF: Essentially, regardless of the discipline you’re getting started in, you’ll need some parameters to follow on how to become proficient in that field. That’s exactly what I can offer on my guided surgery course.
Anyone looking to start out or refresh their learning within a particular field should look at this process from the perspective of “what do you want to get it out if it at the end”. For example, with my guided surgery courses, I want people to leave with the resources they need to return to practice and deliver these treatments. It’s a very hands-on course and gives you the tools, context and help to do this. It is also an excellent course to do with your technician. Then they can see the difficulties you might face surgically, and you can see the issues they might have with planning and printing your surgical guides.
My advice is to find your endpoint, accept it’s going to cost a few quid and look at that as part of your training. Just keep in sight how much value you’re going to obtain from the training.
Q4. What has been the highlight of your career?
NF: My most recent highlight is getting a book published on Guided Surgery: Making Implant Placement Simpler and having lots of positive comments from colleagues. But many milestones have led up to that moment; becoming a Specialist Prosthodontist, an ITI Fellow, and completing my first full mouth reconstruction, to name just a few.
Q5. If you looked back at a younger version of yourself, what advice would you give?
NF:I still practise by the adage,“Always practice as if someone is looking over your shoulder”.The slippery slope is making compromises.distraction – and I enjoy walking.
Q6. What book are you reading right now?
NF:I’m reading, Derek Sivers book ‘Any-thing you want’;it’sa quick 45min read book which has some interesting aspectson practice management. I’m also listening to an audio book called ‘Atomic Habits’byJamesClear, where he suggests making miniscule changes can grow into life-changing outcomes.
Q7. Tell us something we don’t know about you.
NF: As of 2014, I’m an unofficial holder of the record for the largest fish caught on a fly rod in the UK. It’s unofficial as we didn’t kill the fish – it was a Porbeagle Shark that was estimated at 200 pounds.
The other thing is I’m a born contrarian. If someone says that something I am doing is a bad idea, I’m usually convinced that I’m on the right idea. I don’t like doing what I’m told, and the easiest way to get me to do something is by telling me “It can’t be done”.
Nick speaking at the BioHorizons Camlog National Symposium 2022 in the ‘Disasters from the Masters’ session.
Q8. In your opinion, what is the secret to success in the modern world of implant dentistry?
NF: Personally, I think you’re mad if you’re not taking 3D imaging for most of your cases – it’s indispensable throughout the planning stages, during treatment and post-surgery and can support you should complications or litigation issues arise.
Secondly, if you subject a patient to a radiological survey, then there is a duty to that patient to do the planning virtually, at which point you need to consider ways to get that information into the mouth i.e., surgical navigation, pilot hole guides or fully guided implant guides.
Q9. Will implant dentistry become a fully guided surgery in the future, or do you still think freehand will be delivered?
NF: We are heading towards a position where most cliniciansneed to be delivering a fully digital pathway to maintain a leading position in implant dentistry. The biggest barrier is the ‘brain-guided’ experts.
We’re completely fully guided at my practice, and if we did need to freehand a case, we would use surgical navigation, so it’s not entirely freehand. It’s already apparent that people are taking more CBCT scans today than they did 10-15 years ago. In five years, I think most people will be using guided and, as a result, will have fewer complications and less issues with insurance. Whereas, even if you have placed thousands of implants freehand, you’re still at risk of opening yourself up to potential problems if things go wrong.
Q10. In your opinion, what would you consider the impact of 3D printing to be in the field of implant dentistry?
NF: 3D printing in dentistry is here to stay – it’s phenomenal! It allows you to deliver guides ina straightforwardfashion, and if you attend my course,you will see just how much can be done with 3Dprinting; we even print many of our provisionalsfor our full-arch cases.
Thank you for your time Nick.
To find out more about Nick Fahey’s ‘Level Up in Guided Surgery’ courses click here.
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