Are you reluctant to refer?
Do you feel hesitant to refer your patient to an implant dentist? Jonathan Dougherty explains why referrals should be seen as a way of expanding your own expertise and offering more comprehensive care for your patients.
Do you sometimes face a dilemma: to refer or not to refer? Is your patient missing either a single tooth, multiple teeth or perhaps all their teeth and you feel some hesitancy about advising them to see an implant dentist?
With almost 3 million tooth extractions performed on adults in 2018-19 on the NHS and almost three-quarters of brits (74%) without their full set of natural teeth, and 6% with none left at all – based on these shocking statistics, why are we not seeing more implant referrals?
In recent years I’ve become accustomed to the fact that GDPs can sometimes feel overwhelmed by the complexity of the discipline and can be averse to referring patients to other clinicians for more specific care. This could be owing to the fear of losing the patient, lack of confidence in talking about implants with patients (or the dentist) and in some cases, concerns of work being critiqued by fellow clinicians/peers.
Refer for growth
It’s imperative to your role as a dental professional, to educate and offer patients a wide range of treatment options. With more patients doing their research online, they are well clued up on treatment options and armed with knowledge from the internet, media and word of mouth, with an expectation that as a dentist you are capable of meeting their implant needs. When a patient steps into your practice, with some or all of their teeth missing and are looking for a solution to fill the gap, not being able to meet their needs can represent a barrier to growth.
When discussing the options of a denture, bridge or implant, it’s essential these are documented in the patients’ clinical notes to show they have been discussed. When a patient is seriously considering dental implants, but you’re not competent to provide the treatment, then your best decision would be to refer to an implant dentist who has been clinically trained in providing the surgical and restorative aspect of dental implant treatment.
The referral process should be viewed as a means of expanding your own professional expertise and services to enable you to offer more inclusive care to patients. Referral services today are highly professional and ethical, and when you combine this with advances in ‘instant messaging’ and communication technology, (email, text messaging, scans, etc.), the lines of communication between both dental professionals have never been more transparent.
When to refer?
One barrier to referring for implants is often knowing when to refer. When considering making a referral for an implant consultation, GDPs should consider the following:
- Type: Is it for a single or multiple tooth or an implant retained bridge and if so, is the patient’s remaining dentition stable?
- Hygiene: Is their oral hygiene good? Patients need to have a good level of hygiene and reasonably stable dentition which is disease free.
- Type of patient: Are they a motivated and committed patient? Implants aren’t a quick fix solution and will require time and commitment to maintain post-surgery.
- Cost: Implants can be an expensive investment, so it’s important to ensure the patient is aware of all costs involved from the get-go, including any fees associated with the initial consultation.
- Private dentistry: It’s also vital to inform the patient that implants are not routinely carried out on the NHS and that you are sending them to a trained professional who will undertake their implant treatment on a private basis.
In more complex cases where the patient has a terminal dentition and requires many multiple teeth to be removed with the possibility of full arch removal, referring to an implant clinician really is the best course of action. Ideally, if the patient is not in pain or does not have a facial swelling it’s advised not to take the tooth out as the implant dentist will likely want to perform this treatment themselves so as to help preserve the bone around the tooth.
Confidence to talk implants
The psychological price of a lost tooth to a patient can be profound to their self-esteem, face shape, speech and overall quality of life – so wouldn’t it be great if you had the confidence to offer this as a treatment option and refer them to a trusted implant clinician to give them life-changing results?
Being able to effectively communicate the benefits and risks of dental implants to patients requires, at minimum, a basic understanding. When referring, remember to communicate everything to the patient too – ensure that they understand the reason for the referral and that they have had all the options presented to them. There’s no shame in telling your patient’s you’re passing their case onto a more experienced, clinically trained implant dentist, they’ll appreciate your honesty and, in some cases, will probably feel just that little bit more special.
The same applies when talking with implant dentists – it’s important to refer to a dentist who you trust and is reputable within their field, so that you can feel confident in discussing your cases, regardless of your level of knowledge and experience.
Communication is the best policy and if ever you are unsure, be open with the dentist, send a few photographs or scans, or simply pick up the phone to openly discuss the case. When you refer a patient, you are placing yours and your patients trust in the implant dentist – so make sure to partner with selected and trusted implant dentists for your referrals.
Want to offer implants in your practice through the benefits of referring? Contact Jonathan Dougherty here or send a message to the BioHorizons Camlog team here who can put you in touch with their trusted network of implant dentists.