Primary Dental Journal

Introducing dental implants into a patient’s oral health plan requires a collaborative effort between all members of the care team, including the “implant dentist” and referring general dental practitioner (GDP), should the treatment be carried out in a referral practice. This article aims to discuss the pivotal role referring general dental practitioners (GDPs) play in preparing patients for dental implant placement, whatever the setting for the planned treatment. An overview of the patient referral process is outlined, as is the role of GDPs in the ongoing maintenance of the dental implants and the patient’s oral health. Furthermore, this article may be viewed as a road map for GDPs who refer patients to an “implant dentist” as part of their treatment plan.

The role of the dental nurse is fundamental in the provision of implant treatment, both from a surgical and restorative aspect. While the restoration of an implant can be largely based on the foundation knowledge of restorative dentistry, the surgical stages require a unique skillset. This article aims to highlight the benefits of undertaking further training for the dental nurse in providing surgical support, the skillset needed, and the pathways for achieving career progression.

The scope of practice for dental hygienists includes the care of implants and peri-implant tissues. Hygienists in primary care settings must therefore be competent and confident in assessing, managing, and treating implant restorations and their peri-implant health. Dental hygienists also play a key role in the education of patients on oral health as part of their daily practice, a recognised and valued aspect of their clinical care responsibilities. Dental hygienists and therapists therefore have a pivotal role as adjunct support in a patient’s implant journey where they can offer essential support throughout their treatment period and can provide guidance and education at regular intervals.

Using current guidelines, dental hygienists and therapists can create and implement practice protocols to help deliver the necessary clinical care during pre-implant, peri-implant, and post-implant phases of care. This article discusses the processes required to achieve a healthy implant patient, how the dental team can support the patient, and how clinicians can work together to achieve the best possible clinical outcome. This article will explore current evidence-based guidance and how to implement guidance in a practice setting, with protocols for all members of the dental team, with the final goal of a dentally healthy, motivated patient.

Mentoring has been identified as a key component of training in implant dentistry. However there has been little guidance about how this should take place, the expected outcomes, who should be providing mentoring, and the processes involved. Dentists are required to ensure they are appropriately trained, competent and confident when undertaking clinical tasks. Mentoring will play a key role in giving assurance that these are in place. This article, which is partly based on the College of General Dentistry publication Mentoring in Implant Dentistry: Good Practice Guidelines, provides background and context to the role of mentoring in implant dentistry training programmes. Key components of structured mentoring programmes are described to assist mentors, mentees, and implant education providers.

Effective communication between clinicians and the dental laboratory is paramount in the realm of dental implant restorations, where precision and meticulous planning are key for success. This article explores the transformative shift towards digital workflows, highlighting the collaborative dance between the clinician and the dental laboratory. The power of visual communication is emphasised, with examples illustrating its impact on the precision of treatment plans. Celebrating these digital tools, this article envisions a new era of collaboration, transcending traditional communication methods for more predictable and successful implant restorations.

Dental implants continue to increase in popularity as a method of replacing missing or failing teeth and, in doing so, this increased prevalence is likely to present as a range of scenarios for the general dental practitioner and dental hygienist, whether they have an interest in the field or not. Many of these scenarios will relate to the restorative and post-treatment phases of treatment, where the biomechanical performance of the restoration will need to be understood by the treating clinician in the primary care setting. This article aims to highlight the unique biomechanical nature of dental implant restorations, the differences between a natural tooth held by periodontal ligament fibres and a dental implant ankylosed to bone, the consideration of restoring a natural tooth opposing a dental implant, and the long-term effect of changes in the occlusion and their impact on previously placed dental implant restorations.

Dentists providing implant dental treatment need to fully appreciate the legal and clinical issues that are relevant to implant dentistry. The legal aspects of implant dentistry, according to UK law, are described in this article. Suggestions for how the risks of implant treatment might be mitigated, with tips and examples are provided.

Edentulism (total tooth loss) can be managed with four possible options: no prosthetic replacement, conventional complete dentures, implant-retained overdentures (removable), or implant-supported bridgework (fixed). Selection of these choices is influenced by social, medical, anatomical, technical, and economic factors. The care team involved in the decision-making process (be it patients, clinicians and occasionally commissioners of services) should be aware of the different treatment options and their potential impact on the patient’s quality of life (QoL). The cost effectiveness of this impact can also be evaluated. Knowledge of the life-long sequelae of edentulism will also help practitioners guide patients in their treatment planning decisions when they may be approaching an edentulous state, preparing them for the challenges that may lie ahead. This paper aims to address the impact that edentulism has on QoL and the treatment options, focusing on the patient perspective.