1. What kind of dentist places dental implants?

Almost any dentist can place dental implants provided he or she has the proper training. In terms of surgical expertise in this area, you are probably best served by someone who is very experienced and well trained either in a related specialty such as Oral surgery, Periodontics, Prosthodontics or a University Sponsored Dental Implant Program. The best person in your area will be experienced, knowledgeable and will usually have quite a good reputation for these types of procedures. The most expensive practitioner is not necessarily the best. One good place to find a dentist who is very involved in dental Implantology is the Academy of Osseointegration Web site.

2. How was this dentist trained in the placement of dental implants?

Dental Implantology is a relatively new field in dentistry. Most dentists placing dental implants today have learned their techniques through continuing education courses. Some of the younger dental specialists (Oral Surgeons, Periodontists and Prosthodontists) learned how to place dental implants in their specialty training programs. Some general practitioners have gone through one to three year training programs to learn this field. Since there is so much variation in the training and even in the standards of implant dentistry, it is very important to ask your dentist how he has trained in this area. You must be able to get a feeling for the dentist's qualifications to do this very delicate work.

3. How long has this dentist been placing dental implants?

Experience does count, but it is not everything. It is quite possible for someone who has been placing implants for a long time to stink at it! But, all else being equal, if someone has been doing this for many years, it is probably in your favor. Even though everyone has to start someplace, I would not want to be someone's first patient! There is one study that is ongoing with the VA. It shows that most dentists improve their skills in implant placement significantly after the first 50 implant placements. I have been in the implant field for the past 15 years and I found that my skills improve with every year. . .

4. How many implants has this dentist placed?

I am convinced that the more implants you place, the better you get at it. You should look for someone that places hundreds of dental implants each year. This doesn't mean that someone who places less will be bad at it, but chances are...

5. How often does this dentist place dental implants?

I place dental implants almost every day that I practice (four days per week) and I feel that the more frequently you do this, the sharper you are at it. Someone placing implants only a few times per month may be as skilled, but really it is not likely...

6. What is the dentist's success/failure rate?

Of course anyone can say anything they like, but I would want to go to the person that gets the highest success rate. Statistically, most implants survive at the 90-95% rate. Studies have shown that dentists who have placed more than 50 implants have a higher success rate than dentists who have placed less. My success rate for the last five years has been about 99%. If you're one of those in the 1% range who has had a failure, you're not going to be too happy even though my success rate is still high, but going in, you do have a high likelihood of success.

7. What does the dentist do when he has a failure?

Everyone has failures in dentistry and medicine, but it is really amazing how high the overall success rate is in dental implantology. The key element is how your dentist will handle a failure and the proper way to do it is to replace a failed implant with a new one at no additional cost.... At least that is the way I handle it. Either way, you should know the dentist's policy up front...

8. How long has the dentist been using this dental implant system?

There are literally dozens of different dental implant systems and they all make claims as to their superiority. I'm not going to get into a discussion here about which systems are better than others (I generally think they are all about the same in terms of success and effectiveness), but I will state that it is important that your dentist is very familiar with the system that he is using on you and not "experimenting" with a new system... Ask how long he or she has been using the present system and if they have used other systems. Ask why they prefer the one that they will be using on you...

9. What kinds of problems has the dentist had in the past with dental implant surgery?

All of us have problems from time to time with these procedures, but fortunately, problems are rare. A good discussion about some of the problems that might be encountered would be beneficial. Most dentists will give you a sheet of paper to read and sign that has most of the problems or complications that can occur spelled out for you.

Some of the things that can happen:

Occasionally an implant is placed and it does not heal properly and it is lost. Sometimes a patient can get an infection in the implant area and this could involve structures like the maxillary sinus. Nerve damage can also occur when implants are being placed in the back part of the lower jaw. An implant can be placed in the wrong position and compromise the final prosthesis. Post-operatively, you can have varying degrees of pain, swelling or black and blue.

10. What does this dentist feel his strengths and weaknesses are in dental implant placement?

We all have different strengths and weaknesses in the placement of dental implants. For instance, I think my strength is that I have an excellent background in Prosthodontics so I fully understand the importance of accurate implant placement. My greatest weakness is that I don't write things down... Everyone has their strong and weak points and you, as the patient, should have some understanding of what they are.