Hi Dr Teng ,
Thanks for sharing your experience. Yes I am a recent graduate 2 years out of school and highly interested in implant procedures. I did take an implant course to learn the skills and be more confident placing implants but unfortunately had a very bad experience with that implant program. The main doctor couldn’t come and he just sent some of his colleagues to teach . Not only this there were issues with chair and suction . Went to Dominican Republic for 1 week for this program and felt like half of the time I was looking for patients or struggling with sunction. For this reason when someone tells me join an implant course I do question myself should I really go for it? Also these programs are very expensive and I am just 2 years out with huge student loan . Yes we did invest in cbct . For this reason I find this group very helpful. I am so glad that dentists that I dont even know personally take their valuable time to advise a new grad like me. I am sure there are lots of experienced dentist out there but they would have experienced the struggle that I am going through during the initial phase of learning. Its a good struggle , the struggle of learning.
May be one day I could be like you or Dr Pilot or Dr Scotty . Thats the goal. But thank you everyone for such detailed explanation. I have been shadowing lots of dentists during implant procedures but the information and knowledge that I am getting through this group is on a different level.
Well said and as a specialist I have stopped doing a lot of complex cases because I honestly feel like GP’s are better suited for it. I have disagreed with your ideas in the past and I respect you for what you do and your knowledge/commitment. Keep up the good work and I will continue to encourage the younger folks when they stumble because I, unlike some (Ninja), do not believe that a perfectly executed implant case has ever been done. The moment a patient requires an implant they are compromised and the very best dentistry in the world is still just an imperfect attempt to correct an imperfect situation… in other words we are not nearly as special as we give ourselves credit and compromise is part of the craft.
The bottom line is that a dentist is basically just a repairman. Dr Ninja, aka Dr Alphabet, should know this better than anyone else but ego and bravado blind him.We fix things that are broken and hope that the fix lasts until a better fix comes along , maybe 10 years down the road. In the meantime, we hope that our patient can function with the current fix. It took me 40 years to learn this and as seasoned clinicians, we try to pass our knoiwledge onto the dentists who are in the embryonic stages of their careers in a politeful and encouraging way
dear dr ninja, i did ask my malpractice insurance, Fortress. since i don’t get sued that often (knock on wood). but we are both right.
“The standard of care refers to the level of medical practice that a reasonably prudent healthcare provider would provide under similar circumstances. In the cases of malpractice, that would be determined by expert witnesses from both the defense and plaintiff sides in court by providing testimony (either in support of or refuting the care provided by the defendant doctor). Healthcare professionals may cite the ADA or other guidelines published by reputable sources as the basis for their clinical decisions or opinions but it not these sources that determine the standard; it is the care that healthcare providers agree upon is appropriate for that patient under each circumstance. Because circumstances can vary, so can the standard. Therefore, so can the choice of which imaging to use to treat each patient.”
for dr jdent. IMO. PA is just fine. especially there’s no complications.
The overwhelming number of implant cases that I do, roughly 75-80% of the 400+/year, are done with the use of a 2D PANO and PA only. I currently have a Carestream 9600 and purchased my first Carestream 9300 in 2013 so I have had access to this technology for well over 10+ years. Because I routinely place fixtures in sites which are only slight/moderately compromised I rarely see the need to expose the additional image. For the record I do not charge for x rays in my office so my CBCT is in no way a revenue stream but the possibly does exist that I would be more aggressive in promoting my own version of “Standard of Care” if I too were charging $300-$500 every time someone pushed the button. I think “Standard of Revenue Stream” is more appropriate than “Standard of Care” when discussing CBCT as it relates to dental implant placement. Like Teng I too do not get sued often and to the best of my knowledge I have a good relationship with my patients and referrals so this conventional approach can still be practiced successfully despite what Dr. Alphabet Soup might preach from his pulpit… Considering the information shared by Teng and the “fact” that many successful docs place implants without the routine overutilization of CBCT I am more confident then ever in my assertion that there is no standard of care in dentistry. If there was then we would likely eliminate the vast majority of discount/knock off materials and devices that plague this profession, but we all know that the value minded folks in power would never want to impact their bottom line.