Dentaltown August 2013 - (Page 12)

howard speaks column » Dentists are Still Doing Way Too Many Three-Unit Bridges by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine Dr. Carl Misch, who is regarded by many as the number-one implantologist in the world today, (and who just filmed a series of four awesome online CE courses for Dentaltown.com), wrote in his book Dental Implant Prosthetics that the 15 year survival rate of implant restorations is 95 percent and for a three-unit bridge the survival rate is 74 percent. In this day and age, dentists really have to ask themselves, “If an implant and crown has a 21 percent higher success rate over a three-unit bridge, why are we doing so many three-unit bridges?” Insurance Coverage? Is it because insurance still doesn’t cover implants? We all know that’s not true! Twenty-five years ago, when I opened my Phoenix, Arizona, dental practice – Today’s Dental – almost zero insurance companies offered any coverage of dental implants. Today, based on the insurance plans that we have verified and have in our system at my practice, we have come up with the following percent of insurance plans that have implant coverage: • Delta of California 86% • Metlife 76% • Delta of Arizona 74% • Aetna 53% • Cigna 35% • Humana 18% When I started my practice in 1987, implants were not a covered benefit under most insurance plans, but today, we are seeing an upward trend in insurance companies realizing the benefits of implants; such as, preserving tooth structure and making it virtually impossible for decay to form. With more and more insurance plans covering dental implants, it can’t possibly be a good enough reason to not be placing implants. Pricing and Presentation? Here’s another reason why we might be placing way too many three-unit bridges: price breakdown and case presentation. When I graduated from dental school in 1987, I argued with a lot of local Medicaid plans because coverage of an extraction was $2 cheaper than a filling. Moms in lower socioeconomic brackets had the economic incentive to pull their babies’ teeth instead of fixing them, just because it was cheaper. I always thought the extraction should cost $2 more than an amalgam filling, because when it comes to certain procedures for certain patients, affordability was always the key decision maker. The same thing is happening with bridges vs. implants. Most dentists will offer their patients an exact flat fee for a bridge, and they’ll say they can prep it today and cement it in two weeks. Then when the patient asks about an implant, most dentists break it down to something like, “Well, um, it’s $1,500 for the implant and it’s $1,000 for the crown, but then we might have to do a bone graft, and we might have to do a gum procedure, and I won’t really know what we’re looking at until I pull the tooth to know how long this will take…” It’s a total confusing quagmire! The implant is the better option, but you make it so difficult for the patient to understand. I mean, I’m a dentist with an MBA and an MAGD and because of the way you present a bridge vs. an implant even I would opt for the bridge! You need to figure out a way to explain that the cost of an implant is the same as the cost of a bridge. If you charge $3,000 for a bridge, then an implant should be $3,000 as well. Now, whether or not you have to do a bone graft or something more, that’s just the cost of doing business. Obviously some cases will be easier than others, but that’s life. It’s also the way everybody else does business. When you take your car in to fix your radiator, they’re going to do it at a flat fee. I guarantee some radiators are easier to fix than others – you’re not going continued on page 14 12 AUGUST 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown August 2013

Dentaltown.com Highlights
Howard Speaks: Dentists Are Still Doing Way Too Many Three-Unit Bridges
Professional Courtesy: Hire Slow, Fire Fast
Continuing Education Update
Second Opinion: Finally, One Adhesive that Can Do It All
All-on-4?
Intracornal Bleaching of Endodontically Treated Teeth
Product Profile: CAESY
Product Profile: ClearCorrect
Product Profile: DENTIS USA
Product Profile: Imaging Sciences
Corporate Profile: 123 Postcards
New Products
The Silent Killer of Dentistry
Industry News
Smile Design
Endo Versus Implants: Does Your Treatment Plan Pass the “Mama Test”?
Improving the Future of Overdentures with Small Diameter Implants and Locator Attachments
The Democratization of Dental Implants for General Dentistry
Single Tooth Implant Case
Continuing Education: The Dental CAD/CAM Evolution of 2013
Beatlemania Has Deep Roots
In This Issue: The Value of Saliva Testing
Perio Reports
Ad Index
Profile in Oral Health: Salivary Testing in the Office
Dentally Incorrect

Dentaltown August 2013