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We’ve been talking about hygiene lead implant maintenance for nearly 10 years now.

Karen Walker does this at our practice.

She set up a system of extended duties of hygiene maintenance at the practice which is utterly extraordinary. It encourages the return of implant patients to the practice in numbers which are almost unbelievable.

She is also responsible within the practice for counting this in detail. We produced research about how it works in practice, how it affected our rates of peri implant complications and how it reduced them to tiny amounts.

It turns out nobody wants to publish this research because they don’t think it is valuable.

Karen speaks on courses at the Campbell Academy and teaches people how to do this, she explains it to them carefully and answers any questions they have.

Month on month, and year on year people don’t implement it into their practice.

So, think about this:

If you are what you say you are and you place 150 implants per year you have a responsibility to look after those and to offer those patients a chance to have those looked after going forwards.

If all you give is a 1 year guarantee then the patients will not come back because they will not see the value in looking after something; there is no encouragement or compulsion to do so.

But let’s say you get 75% of those turn back up, so you’ve got 120 people from last year’s implants coming back for recall.

Let’s say you also are what you say you are and you’ve been doing this for 10 years, that means you’ve got 1,200 patients.

Inevitably there will be some drop offs but you’re so good and they like you so much that they want to come back in high numbers, so you’ve now got 1,000 people returning back to be checked, looked at and re assured.

This process is extensive, it takes plaque scores, BPE scores, intra oral radiography which is checked, full examinations, oral hygiene instructions and discussion. It doesn’t take 15 minutes, it takes at least 30 (and at least if low balling). So, you now have 500 hours of clinic time to use up doing this in your practice.

Let’s just say you are what you say you are and you restrict your clinical time to 25 hours a week to manage your business and to work on other things and learn. That means 20 weeks… yes 20 clinical weeks of your year are going to be spent recalling patients.

You’ll provide an extraordinary service and they’ll love to see you but as an implant surgeon or clinician you’ll be bored of this and you won’t do it properly. You’ll try to cut the corners, shorten the appointments and increase the charges and your patients won’t come back.

The system we developed to do this encourages patients back over 10 years (that’s the guarantee). Karen does it at the practice assisted by Emma, our other hygienist; they know how to provide value to patients in implant maintenance.

The patients really appreciate this and they continue to come back to have their implants checked, secured and have their whole mouths reviewed by a hygienist in terms of oral hygiene and developed periodontal problems.

Clinicians are available all the time at the clinic for times when the hygienist might have the slightest issue or problem which they would want us to look at, the system has been going on for nearly 10 years.

It’s a chinese contract and the circle is closed, we get to review our patients over time, we get to learn things that are going on and things that are working, we don’t cast them adrift after 1 year.

The patients get reviewed over time and they know that their implants are stable and secure, if there are early issues and problems we’ll deal with that as part of their guarantee process.

The hygienists run an extraordinary service, they’re engaged in their work and the practice is financially viable.

What is not to like about that service?

Here is the thing, just because I know this and know that it works doesn’t mean that anybody else does.

We’ve told lots of people about it but they just don’t believe it. They wouldn’t take it back to their own practice because they don’t think that it works. We’ve even tried to publish it and submitted the research to four different journals all of whom have rejected it (one on the basis that we’re a private practice in the UK and that basis alone!).

The system works, you give the best care for patients, the best longevity for implants and the best development for the team. So, we can run a course with myself and Karen which is 1 day. It takes an implant clinician and a hygienist to come together, it’s about £600 (I haven’t really decided or worked it out yet). In 1-day you’d come as a pair and take that back to your practice and in 10 years-time you’d be glad that you did.

If you’re interested email me or reply to this blog, we’ll do this next year (I bet we don’t run it though because I bet no one will see the value. If the dentists and hygienists don’t see the value then why would the patients).

Blog post number: 1675