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Rolling in - Problems from the past

Colin Campbell
by Colin Campbell on 08/06/19 18:00

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It’s 10 years now, since I set up the maintenance programme for implant dentistry, where implants are guaranteed for 5 years, in order to benefit from a 5 year no questions guarantee, patients had to attend the practice for recommended maintenance based on our risk profile of low, medium and high.

Low risk patients are seen once a year, for hygiene maintenance and radiograph.

Medium are seen 6 monthly.

High risk are seen 3 monthly. (or even more)

It proved to be enormously successful, not only as a clinical measure in supporting patients and adding long jeopardy to their reconstructions but also as a marketing exercise.

5 years ago, we extended it to 10 years, based on all of the data we had for the patients who were attending. Recently I had a discussion about extending it to 15, but they wasn’t too happy about that, but that’s the stage we’re at with the maintenance programme.

The reason, I felt the need to do this, was that I started to see patients of my own returning back and had been completely out of maintenance, with significant problems and not least the problems of peri-implant disease and bone loss implants that have been uncared for.

This has now almost become a daily phenomenon in our practice, but patients are attending where they have been provided restorations and effectively been left with a “fit and forget” mentality but looking after what’s been done.

Immediately after, writing this I will go downstairs to see someone who had upper and lower full arch reconstruction 15 years ago, I’m sure you’re thinking that this was a life time restoration, that he would never need again, only to have to tell them  that their mouth is a complete s**tshow, which means it has completely deconstructed and rebuilt – not quite sure how that one’s going to go.

It’s ok though, because I’ve had some practice in this, I had to do this yesterday as well! The first thing we can do to correct this is to stop the poor practice now, but it seems to continue on a day to day basis and just writing in someone’s consent letter, that they need to have hygiene maintenance is a very different proposition in providing them with the appropriate hygiene maintenance yourself.

In the race to the bottom, where everybody needs to provide things faster and cheaper, no one wants to offer hygiene maintenance or tell the cost of it, because they feel as though it will put patients off and they’ll go down the road to the practice where they don’t offer hygiene maintenance and therefore their implants look cheaper.

This is a long game proposition.

Many of the dentists that come in on our courses find it hard to fathom the system that we have at the practice, which is run entirely by the hygiene team, with interaction from the clinicians only when necessary.

Next year (in the new education facility) we will run a one day master class programme on this – it’s a complete game changer, but for now it’s just important to get the message out, that the hygiene maintenance element of implant treatment is the thing that makes you look good, 10 years down the line.

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Colin Campbell
Written by Colin Campbell
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