Hundreds of different types produced by lots of different manufacturers around the world.
Most of them are based around the same theme. In that, they tend to be screw-shaped of various
sizes and lengths. They are made of titanium because titanium is biocompatible with the
bone and the bone will actually grow on it. They are screw-shaped so that they can be
inserted into the bone and will be stable when they're placed. The surface of the implant
is treated in such a way that it attracts the cells from the bone. And not only encourages
early healing but will also maintain the bone over a long period of time. There is also
a method of connecting the teeth to the implant. So, there are lots of different connection
designs. And the importance of these connection designs is that they must be stable over a
long period of time as they will be subjected to repeated loading. So, an implant is effectively
a way of attaching a mechanical joint in a biological environment. And as long as the
materials used are of a high quality and the execution of the treatments is of a high standard,
implants can last for many years. Which design, doesn't matter so much as how the implant
design is used. And over a period of time we know what works, we know which design features
work, what materials work, what connection designs work. And I think a bit like cars
on a wind tunnel, everything starts to kind of gradually converge at the ideal design.
And I think there are a few implant systems now on the market that are very successful
and they are the market leaders. And we are proud to use one of those. And we've now been
doing implants in this practice for about 28 years. And we kind of know what works as
short term and long term.
An implant needs to replace a natural tooth. Natural teeth are designed to last for the
whole of a patient's life. So, when a tooth is lost, not only do you lose the tooth, you
also lose the surrounding bone and the gum and also creating stability in the rest of
the mouth where the teeth tend to move. As well as executing the actual treatment to
start with and making sure that you replace not only the root of the tooth but also all
of the tissues around it and the bone and the gum, it also means that whatever you place
there has to be maintained for the period of the patient's life. Implants don't necessarily
last the whole of a patient's life, but they can. But in reality, just like anything where
biology is involved and where mechanics are involved, there will be compromises and failures
along the way. The best way to maintain implant treatment for the duration of a patient's
life is to diagnose and plan and execute it properly to start with, and ensure that the
implant is looked after both in terms of dental hygiene and also in terms of controlling the
loads that are placed on it over a period of time. Natural teeth wear. Natural teeth
move. Implants tend not to move. So, if the implant is in a good environment when you
first place it into the mouth, you have to keep checking that it's well looked after,
kept clean, and not adversely loaded as the patient's mouth changes over time. And we
keep abreast of all of those things for the duration of the implant's lifetime. So, it's
not just about doing the treatment it's about looking after the treatment over the next
10-15 years as well.
That's our reason for being. This is why we're here. There is a lot of knowledge in dental
care as in any field. And how you apply that knowledge is based on experience, is based
on the knowledge you have, and also based very much on educating your patients as to
what it is you're exactly doing. Many patients may have a limited conception of what it is
we do, but when you look at all of the information and look at all the decisions that we take
and all of the aspects that we look out for, during treatment, patients who come here suddenly
realise that actually it's not that straightforward and they really have to look at not just the
treatment aspects, but also the maintenance aspects of what they're having in their mouth.
We ensure that we give quality treatment by planning everything properly, by diagnosing
everything properly, and ensuring that when we carry out the treatment we do it in a documented
fashion so that we can look back and see what we've done five-ten years down the line; see
what works see, what hasn't worked and why it hasn't worked. And quality, as they say,
is not just an accident. It is the culmination of many decisions based on knowledge and experience
which is something, unfortunately, you only get over time. So we really try to make sure
that every time we do something, we learn from it and apply it to the next thing that
we carry out.
Trust. I think you have to have a very good rapport with the person that you are having
treatment with. Experience counts for a lot, but there are obviously people with less experience
with better knowledge and better abilities and people with lots of experience with not
such great knowledge and abilities. But all in all, I think you need to understand what's
being done, why it's being done, to have it explained properly to you, for it to be documented
properly so that you have a record of what's been done to you, and ensure that when you
ask a question it's answered properly. If you have any doubts, then do seek a second
opinion and we encourage all of our patients actually to go and seek a second opinion.
The way we approach it here is we try to diagnose everything and give the patient all of the
information that they require to make a decision. We go quite in-depth. We spend a lot of time
on it. And we ensure that when the patient actually has treatment with us they're actually
on our side. They're with us, they understand what we're trying to do, they cooperate with
us, and they also understand what it is that they're spending time and money and effort
on, and why it takes the period of time and costs money it does to be able to get them
the result that they want. You basically have to find somebody who you trust to treat you
the way you want to be treated. And that also depends on your personal ethos as well. Not
every dentist is for every patient and vice versa.
I think there are many developments. I think technology is being honed. But it isn't just
about technology. I think it's about the fact that the dental profession is becoming more
knowledgeable and more proficient at what we do. I think it's also a case that the patients
are becoming better educated. There are lots of ways and techniques for treating somebody
but the basis of it must always be that there is a correct diagnosis. And we have lots of
diagnostic tools at our disposal these days. There are different ways of recording the
treatment we do, of planning the treatment we do. Everything is digitised and computerised
and reproducible. We can plan on computers, we can design all of the treatment that we're
going to do well in advance. The use of tomography and CT scanning, the use of computer planning,
the use of intraoral scanning with digital scanners allows us to actually almost replicate
a patient in digital form and do all of our planning to start with. This is really making
a big difference. But at the end of the day, again, it's all about communication. There's
no point having all the technology if it's not possible to communicate to the patient
why we're doing what we're doing. So yes, technology is increasing. We have lots of
different-- in every field there are advances. But the main one is still communicating with
the patient. That is still the bit of technology that still needs that personal touch.