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31 May 2019 | Australasian Dental Practice

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Building an empire, one implant at a time

By Linda Miles

Never before in dentistry has it been more exciting or fulfilling to give patients an alternative to tooth replacement than it is today in the world of implant dentistry. Becoming well-known in a community as an implant practice takes months of planning and years of perfection. Becoming the referred-to-by-colleagues implant guru is not something that happens over night. Visualising the practice five years from now as the Implant Centre of location X must be seen before it becomes a reality.

What are the pros of creating an implant practice?

  1. People are referred from a large geographic area as the word spreads;
  2. Practice productivity increases significantly as most implant cases are several thousand dollars and the restorative that follows is typically over $20,000;
  3. It's a tremendous ego boost to be known and recognised by one's peers;
  4. The team feels privileged to work in a prestigious setting; and
  5. Patients who lost hope with traditional tooth replacement and in other dentists sing the praises of implant cases that renew their hope in not being a dental "cripple".

What are the negatives associated with implant dentistry?

  1. Some cases are difficult with less than ideal outcomes;
  2. The dentist becomes "married to the patient" after such a sizeable investment;
  3. Leaning heavily on the implant image dilutes the practice's ability to continue to do the "bread and butter dentistry" that is the foundation for most practices;
  4. Finding qualified team members who believe in high-end dentistry and high-end fees is not an easy task since one case is often more than their entire year's salary; and
  5. In a down-turned economy, high end items are normally the first to be postponed by about 60% of the buying public when their own job security and investments are threatened.

Besides a vision, supportive staff, excellent implant skills and the facility in which to perform these procedures, what else is imperative to build an empire, one implant at a time?


Marketing for any type of practice should be 1/3 external and 2/3 internal. I know of implant practices that spend thousands of dollars annually to bring implant patients into their practices yet they haven't spent a cent training their employees how to treat the implant patient or their referral source. Is it any wonder why they struggle to make ends meet and yet their clinical skills are among the best of the best?

Business systems

There are several business systems within all practices that are imperative to success. These include the scheduling of the implant patients, financial presentation and the recare system. Knowing a practice is only as successful as its ability to schedule effectively, collect the fees and bring the patient back at intervals that will preserve the investment of time and money the patient has made, is the key to building this empire.


Of all the systems in dentistry that I consider to be important to the total success of the practice, communication is at the foundation. It is not what we say that makes a significant difference, but how we say it that matters. Body language is also a strong component of communication. Being "with" the implant patient in every phase of the treatment is of utmost importance in building the empire.

Working as a team

To build a successful implant practice, your entire team needs to be focussed:

Scheduling coordinator (On the phone) - "Mrs Jones, we're happy to reserve a time for Dr Miller to see you for an evaluation and consultation for implant dentistry. Please know that based on the feedback we receive from other implant patients, you are making a very wise decision in your total health. It is our pleasure to welcome you to our family of fine patients. Are mornings or afternoons better?"

Finance coordinator (When the patient expresses a strong desire for implant dentistry but also expresses the budget will not allow this type of treatment) - "Mrs Jones, it is our goal to help you make important dental decisions that will benefit you for a lifetime. Making this type of dentistry affordable for you is our second goal. We're excited to have a financial partner which makes quality care affordable for all budgets".

Dental assistant - In addition to being highly skilled in the treatment of implant dentistry and having the proper inventory of implant materials, the assistant must also have excellent communication skills. Many "would-have-been-accepted" cases have fallen apart in the treatment arena when the assistant spoke with the patient!

Patients look to the assistant for affirmation that this is indeed a wise investment or that it isn't a "fate worse than death". Assistants in an implant practice should use every opportunity to positively reinforce the treatment plan when the doctor is out of the treatment room.

Hygienist - Maintenance of the implant patient is crucial for long-term success. In specialty practices that do not employ hygienists, the specialists and their team should be well-versed in promoting proper hygiene visits back to their referring dentists' practices. In Perio and General Practices, every member of the team from the scheduling coordinator to the dentist should emphasise the importance of proper intervals for hygiene visits. The hygienist must be an expert in implant dentistry maintenance and proper skills in patient education of the implant patient home care rituals. "Mrs Jones, to preserve the investment you have made, it is my duty to instruct you on proper home care. At the same time, you must also be accountable for the success of this exciting procedure. What you do at home daily will be more important than what I do for you on your maintenance visits" (There is nothing more disheartening to the dentist and implant team than to see a patient leave the practice and return several years later in worse condition than before the implant due to poor home care habits. It is a total team effort to assure that this does not happen).

Dentist - The implant dentist has many skills that must be blended to have an empire implant practice. In addition to his or her excellent clinical skills, they must possess superior diagnostic skills to determine the best candidates for implant dentistry. They must possess the personality that makes other dentists like them and trust them with the care of their referred patients. More than anything else, they must have the communication skills to be able to connect their patients with the implant dentistry the patient deserves. How sad it is to see a dentist invest hundreds of thousands of dollars into the best implant courses available, mark off days or weeks of production time for these courses, yet fail in case acceptance because their communication skills are inadequate. Consultants very often see this in many practices, not just implant practices.

Being able to look the patient in the eye, having the confidence to let the patient know the benefits of having one of the best tooth replacement procedures in dentistry and having close to 100 percent acceptance is an art to be developed just as the art of performing the treatment. Confidence is the key to implant case acceptance.

To build an empire, one implant at a time, the key components are a firm vision of being known as an implant practice, the dentist's clinical ability, a supportive staff, financial options, verbal skills and internal plus external marketing.

May the next months and years be the best ever for your implant practice!

I hope you can all join me on my 2019 tour downunder in August with Dr David Moffet and Jayne Bandy in either Melbourne (August 3) or Sydney (August 10). Not one or two management pearls and growth strategies will be shared... but instead, the whole string of pearls!

From the editor


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