In initial days of my practice, one of the patients asked me “Doc, this implant would last lifetime, right?” I was surprised with that sudden question.. I was really not used to all such bouncers but somehow I managed the situation of that time. The whole incidence had left me with the fear of facing such questions in future and that's when I decided to get answers to all such questions..
The first thing that I tried to figure out was "Why do patients ask for guarantee of implant?" & I found the answer when I looked at the treatment option with patient’s perception. It is not that patients always ask for guarantee due the high treatment costs but sometimes it's due to the fear of surgery.
What patients ask is not wrong but as a clinician one should never forget that even after having best of knowledge, skills and vast experience, many things can go wrong and implants can fail.
What best a clinician can do is; assure patient that things are done to the best of his knowledge, skills and experience; treatment results may last longer, subject to patient’s awareness, motivation and desire to follow clinician’s instructions and regular recall visits.
As it literally means “promise” or “pledge”. How a doctor who is treating human body part (that is regulated by so many factors) can give LIFETIME GUARANTEE on a specific treatment.
Have you ever heard any experienced Cardiac Surgeon saying, “I have done a fantastic bypass surgery, now I guarantee you 10 years or 20 years of life”, probably you will never ever hear this. Forget about the cardiac surgeon even the Almighty has not given a guarantee of life. In my humble opinion “Guarantee” is not a word that should exist in the dictionary of a doctor. Being clinicians we all know that human body has complex mechanisms where many things are in simultaneous process. Above all every person reacts differently (Including both doctor and patient) in different situation so nobody can predict the longevity of treatment.
In my practice there is absolutely no word called GUARANTEE, for your surprise some patients have even challenged me by saying, “Doctor if you can't give guarantee means you don’t trust your skills”, My polite reply to that was, "Sir I do trust my skills more than anything but what I don’t trust is YOU”.
Overall studies have quoted success rate of single implants for more than 97% up to 10 years (less for implant supported full arch prosthesis), So that is what we can call life of an implant. After good surgical placement & implant prosthesis, If implant survives more than 10 years it would be all because of good maintenance and periodic recall visits kept by patient.
Patients expect implant to survive till they die, which is not possible anyway. We need to make it very clear at consultation phase only that life of an implant would be up to 10 years sometimes it may be less than that (depending upon patient’s local & systemic conditions also). I always tell my patients, “Huge amount that you are going to spend for an implant and using that implant all day for another 8 to 10 years, is a very long span, so spending on implant is completely worth; rather looking at the cost, look at the benefits like quality of oral functions you are going to get after dental implant treatment.
I never forget to mention that implant structure includes screw and crown, so there are equal chances of screw loosening and some damage or fracture to prosthetic structure due to wear and tear which can be managed subsequently with an additional cost. In case of an Implant failure, most suitable option at time would be suggested like an implant placement again or some alternative option with a reasonable cost. Never ever convince patients on the basis of promises that are beyond your control, be realistic and straightforward as it will give you long standing trustful relation with your patient and above all complete peace of mind.
And last but not the least; don’t forget to tell your implant patients…
I wish you all a very Happy Implant Dentistry.
Dr. Akash Akinwar, MDS, Mumbai