Choosing an Implant Dentist: 10 Questions to Ask

Is your implant dentist a board certified specialist?

Any dentist with a dental degree can legally place an implant. Periodontal specialists complete two to three years of residency training after their four years of dental school. During residency, they are trained in surgical skills and procedures and the research-based knowledge supporting that treatment. The successful applicant receives a certificate or diploma in their specialty. The Periodontal specialist can then pursue becoming a Board-certifed Periodontist. This is a three year process that involves multiple tiers of rigid examinations to ensure that the highest standards are met. Once this rigorous testing is passed before the specialty board, the Periodontist is then Board-certified and receives Diplomate status in their specialty. Only about 2,000 periodontists have achieved Diplomate status since 1939. The recognized standard-setting organization for Periodontists is the American Board of Periodontology.

Dr Hunt completed his Periodontal residency in 1992 and became a Board-certified Diplomate of the American Board of Periodontology in 1995.

How long has your dentist been placing dental implants?

Implant technology has improved greatly in the last few years making them easier to place. Many dentists are now starting to place implants without the advantage of extensive training nor clinical experience.

Dr Hunt has been placing dental implants since 1990. In fact, his published research project in his Periodontics residency was on implants. It has been one of the most challenging yet rewarding aspects of his career. After all these years, he is still learning and he often faces challenging situations that require the kind of extraordinary experience, judgement and skill that only comes with close to 20 years experience.

How many implants does your dentist place a year?

You want to be assured that the dentist that places your dental implants is experienced and knowledgeable in handling the most routine implant procedures, as well as the most complex implant procedures. There is a difference between someone who places 15 implants a year vs. someone who places hundreds a year.

Dr Hunt has been placing over 100 implants a year since his Periodontal residency.

What training has your dentist had in dental implants?

As frightening as it may seem, many dentists today are taking one or two day courses on implants, working on plastic model jaws then buying surgical implant kits to get started in dental implant placement.

Dr Hunt strongly believes in the value of continuing education. He has routinely taken at least 75 hours of continuing education each year for the last 20 years, with a majority focusing on dental implants. One of his most gratifying and clinically applicable implant courses was a 3-day long course he took several years ago.

Can you see a list of the continuing education courses that your dentist has taken in the past 12-24 months?

All state licensing boards attempt to establish minimum standards of practice for dental practitioners. Despite the efforts of the licensing boards, this does not guarantee that your dentist is qualified to perform specialty surgical procedures, especially when it comes to placing dental implants. A dentist that actively pursues continuing education in implants is passionate about implants and committed to learning the latest techniques and refining and updating their treatment skills to provide excellence in implant care.

Does your implant dentist offer a comprehensive initial examination prior to diagnosis and treatment?

A practitioner that looks only at your missing tooth or teeth is not interested in the long-term health and success of your dental implant or how it will impact the overall aesthetics and function of your entire mouth. You should always make sure your initial examination includes the following:

• If your tooth is not yet missing, the tooth’s long-term prognosis should first be determined.
• An overall examination of the health of your gums.
• A complete bite evaluation including patterns of looseness and tooth wear and overall bite function.
• Assess if the space of the missing tooth and the size, shape and amount of bone and gum tissue in the area of the proposed implant is adequate for implant placement.
• Determine where the sinus and nerves are and accommodations that need to be made prior to implant placement.
• Discussion with you regarding all the findings the advantages, disadvantages of treatment options proposed and final treatment decided upon collaboratively by you and your dentist.

Does your implant specialist show you before and after photos of cases that they have done to demonstrate their competence?

Anyone can show you a picture in a dental journal or in a text book. The best implant dentists routinely take photographs and document their cases. We love all our success stories and show them proudly.

Does your implant specialist have the latest technology to diagnose and treat your condition?

Advanced technologies and the latest science not only offer faster diagnosis and treatment but also ensure a more effective course of treatment. Some of the latest technology Dr Hunt employs include:

• Digital x-ray images can be viewed 4 seconds after being taken. A digital panoramic x-ray machine is a valuable diagnosis tool when assessing the sinus and nerves.
• SimPlant software allows us to view 3 dimensional computer images of your jawbone obtained by CT scan. We are then able to use the software to assess the adequacy of bone as well as digitally plan, visualize and manipulate the proposed implant prior to the actual placement.
• Growth Factors such as GEM 21, Emdogain and Infuse to enhance the speed and the quality of the healing process after surgery.
• Piezotome technology allows Dr Hunt to precisely remove and contour the bone in your jaw without impacting soft tissue and not overheating bone, important factors to consider to minimize post-operative discomfort.

What brand of implants does your dentist use?

There are many implant systems available for practitioners to use. It is very important to use only implants from the most reputable implant companies with a consistent, historically proven track record of successful osseointegration and final results that you can depend on.

Dr Hunt uses implants from two such companies: Straumann/ITI and 3i. These companies value and foster the collaborative relationship between surgeon, restorative dentist and rep. He has worked with these implant systems for most of his career and has been very pleased with their ease of use, their consistent esthetic, functional outcomes and the companies’ responsiveness.

What is your implant dentist's success rate?

Improved technology has made implants easier to place but the practitioner must still assess and treat each case individually to ensure a predictable and successful outcome. An implant specialist's success rate is representative of that practitioner's overall knowledge, skills and clinical judgement. A seasoned professional knows when the situation is just right to place the implant, knows how to place the implant with functional, resorative and esthetic considerations addressed and knows what adjunctive procedures may need to be done before, during and after implant placement.

Successful implant integration varies depending on the area of the mouth in which it is placed. Success rates can be as high as 98-100% and as low as 85-90%. Dr Hunt has been placing implants since 1990. He has placed thousands of implants and has a success rate of 98%. Be rest assured that he will fully assess if you are a good implant candidate. He will proceed with implant placement if he feels confident the implant will be successful. About 1-2% of implants do "fail" -- they may not integrate with the bone or there may be an inflammatory response post-surgery that causes the implant to come loose. In most cases they can be successfully replaced with another implant.