Evading common mistakes made by novice implant dentists

9th February 2022

7 minute read

With 25 years of implant dentistry under her belt, Dr Fazeela Khan-Osborne discusses common mistakes made when a dentist is new to implant dentistry and how to best avoid them

Implant dentistry is an opportunity of a lifetime. I think that one of the most important things we should do when starting out in implant dentistry is to hone in our communication skills, our diagnostics and treatment planning skills. This enables us to get a patient-centred decision-making consent process, but also to give us the experience of learning to talk to the patient to be able to assess our capacity and their capacity.

Communication is about the way that we speak and the way that we listen. According to Mehrabian’s 7-38-55 Communication Model, only 7% of feelings and attitudes takes place through the words we use in spoken communications[1]. The vast majority is based on physiology, and this lends itself to the concept of where we sit, how we look at the patient the words and the tone that we’re using. We need to have open questions that allow the patient to give you as much information as they can before we start to do a data capture, that we can then use in our diagnosis and treatment planning.

The best time to ‘start out’ in implant dentistry

One of the first questions a novice has is “when is the right time to start out?” You must be brilliant at the basics and look at the skills that we took from dental school; our ability to do comprehensive examinations and to incorporate the art of conversation and listening to the patient.

Young dentists should enhance the skills they learnt at dental school such as extracting teeth and the preservation of hard and soft tissue. We must find out what a patient’s needs, or requirements are rather than telling them what we think they need, which is often the method used. We need to look at the skills that we need now in implant dentistry, which are traditionally surgical and restorative, but skills need to be honed in. Initially, it is important to improve your core knowledge, do some reading, look at webinars and go on courses.

Personal development and reflection

We often do not use this mandatory element of reflection. What it does is it allows us to develop personally by looking at the things we did on a day-to-day basis in our practices. What works and what doesn’t work? This is not a reflection of how good or bad your dentistry is. It’s a reflection of a combination of things such as the work you did at the time, and the skills you had at the time.

My advice for reflection is to make sure you take good photographs at every stage of treatment and make sure your patient is on a maintenance plan, so they come back. This enables you to review your work and regularly communicate with your patients with confidence. You may wish to choose different options or warn the patient about an interim measure that may then become a definitive measure later. You can then reflect on that action and consequently, improve and learn.

We need to stop removing skills that we need and have. We’re all taught to some degree to extract teeth atraumatically and certainly with social media and YouTube, there are huge aids to help us to remove the fear and lack of confidence that many of us suffer from when it comes to simple surgical techniques. Many young novices are unwilling to take out teeth because they lack the confidence. Keep practicing these techniques such as suturing and do them little and often.

Training

Another problem which happens with a lot of beginners is choosing courses based on price. Don’t just choose a course that your friends are going to; think about the lifelong learning that must happen, which can’t be done over a weekend. Also, understand that this is the beginning of your journey, not the end. I’m nearly 30 years in and I’m still revisiting some of the courses I went to 15 years ago where I feel that I could do with some more help in that area because I don’t use that skill every day. Also, so many of the courses are online and do not have a mentorship. Mentors are vital and help you to hone the skills of assessing the patient. It also allows you to perform certain treatments under the guidance of someone under the safety net of your mentor with a proper level of supervision. It takes an inordinate amount of time to learn the skills to enhance your learning and mentors allow you to learn from expertise in the field you align with.

It’s all about the team

I cannot emphasise enough the importance of bringing your team along with you in this lifelong learning experience. The one thing that I would say about implant dentistry, more than almost any other specialty, is that the role of the nurse, technician and other team members is incredibly important.

Certainly, nurses being involved in treatment planning is one of positivity and they are usually incredibly delighted to be involved. It can be seen as a step up they see this as a bit of advancement from the day-to-day grind of normal practice. Remember, you cannot do this without your team. For implants to be a success, all the team needs to be trained, not just in effective communication with the patient, but also to understand the processes that are involved in the diagnostic and proposed treatment plan.

Have a long-term plan and set goals

A work-life balance is unique to the individual. I think one of the reasons people don’t achieve what they consider to be a work life balance is because they didn’t really know what they want. Set yourself goals. After five years of doing general dentistry, we often know what we like, what we are good at, and we know the path that we’re going to take. By not setting goals, you have no specific aims, and you will end up essentially going around in a circle with no destination. We tend to only regret the things we haven’t done not the things that we actually do. Have a professional development plan, set yourself goals and this will give you a clearer idea of knowing what you want and the time commitment you need.

I always come back to concept of reflection…how we use our experience and what we carry forward. It is about our ability to reflect and look at what happened – if something doesn’t go your way, how do we react? How do I take that knowledge and manifest it in a positive way? Do I ask for help? Can I develop my skills further? My advice is to align yourself with mentors, as we are here to help and guide you.

To hear more about my views, you can watch the full webinar here. Plus I’ll be speaking at the BioHorizons Camlog UK & Ireland Symposium – Implants for life; a patient-centric approach to dental implantology in September 2022, around ‘Managing hard and soft tissue for lasting effect’ as well as contributing to the ‘Disasters from the Masters’ session.