DT News - Canada - Does your implant training meet the new guidelines?

Ken Hebel, BSc, DDS, MS, Certified Prosthodontist, and Reena Gajjar, DDS, Certified Prosthodontist

Fri. 14 February 2014

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Until recently, implant dentistry was considered to be a therapy that was primarily provided by dental specialists, and as such, training regulations were not an issue because most specialties incorporate implant therapy into their residency programs. With implant dentistry becoming more mainstream and being incorporated into general practices, educators and licensing bodies are starting to set training guidelines and parameters for practice.

Several years ago, the Institute for Dental Implant Awareness (IDIA) released a document, “Recommended C.E. Training Protocols to Meet the Legal Standard of Care for Implant Placement.” Although not legally enforceable, this document provided some guidelines for continuing education programs to meet the legal standard of care for implant therapy.

These guidelines were based on existing guidelines in the United Kingdom and reviewed by many dentists, both general dentists and specialists. The release of such a document indicates the awareness by the profession for guidelines to be established, both for the protection of patients and the profession.

Many undergraduate dental schools do not offer a full curriculum in implant dentistry. As such, many dentists are required to obtain their implant education through post-graduate continuing education programs. With the proliferation of implant courses, it is critical to be aware of the training that is considered adequate by the profession in order to embark on implant therapy in your practice. It has been established that short duration programs (one to three days in length) cannot fulfill the minimum standard that the profession considers appropriate for training in implant dentistry.

Standard of care

Did you know that although a licensed dentist can perform any dental procedure, if a general dentist chooses to perform treatments that are not routinely performed by general dentists, the law holds all practitioners to the same standard of care that would be provided by specialists providing similar treatments?

As such, it is imperative that dentists who are not formally trained in implant therapy pursue educational programs that meet and exceed the minimum guidelines by not only the profession, but by their licensing body.

In May 2013, the Royal College of Dental Surgeons of Ontario (Canada), the licensing body for dentists in Ontario, released finalized guidelines prescribing the minimum standards of educational requirements for any dentist performing implant therapy. Although this document applies only to dentists in Ontario, it is suggestive of the direction of the profession in establishing standards and indicative of what current practitioners of implant therapy consider the minimum educational requirements.

In addition, although these requirements are not legal requirements, when a licensing body takes these steps to provide recommendations regarding training, it can be assumed that should an issue arise for a dentist providing implant therapy, the college and other involved parties will defer to these recommendations regarding the type and scope of training that dentist received.

Cross-training

One interesting aspect of these guidelines is that regardless of what phase of implant therapy you choose to provide to your patients, you should be trained in all phases. Dentists providing only the surgical phase need to be trained in implant prosthetics, and those providing prosthetics need to be trained in surgical considerations. This cross training is indicative of the complex, integrated nature of implant therapy, and the suggestion that one is not competent in one aspect of implant therapy without understanding all aspects.

Another interesting aspect is the requirement for continued education and training. Implant dentistry is such a new and exciting area within dentistry that techniques and products are still changing and advancing. The need for frequent continuing education is more critical in this field than in other areas of dentistry.

So what does this all mean for you?

If you are considering incorporating implant dentistry into your practice, or if you already provide one or both phases of implant dentistry, we recommend that you follow these steps:

1) Review the RCDSO guidelines and review the IDIA recommended training protocols (“Recommended Training Guidelines for Basic Implant Placement”). Both of these articles can also be found on our website, www.handsontraining.com, under the “CE Requirements” tab and “Resources” tab, respectively.

2) Research your licensing body and determine if it has set any minimum standards or guidelines.

3) Make sure the training you are considering, or have already taken, fulfills those minimum standards (or refer to the existing guidelines if your licensing body has not yet set any guidelines).

4) Make sure the training institution that you choose provides not only a comprehensive training program, but provides tools and resources that enable you to review, refresh and continue to learn.

It is critical to emphasize that even with continued education, a general dentist should practice only in accordance with his or her training and experience. As such, patients who present with complex treatment situations — or a level of difficulty beyond the practitioner’s training and skill set — should be referred to a specialist.

In any profession, guidelines are set to not only protect the providers within that profession, but to protect the interests of the public.

Without proper guidelines, the standard of care is diminished, and in many situations a low standard of care not only affects treatment outcomes, but also establishes a damaging reputation for that particular therapy.

Guidelines within implant dentistry are long overdue, and the establishment of educational recommendations will serve to raise the standard of implant therapy provided and improve treatment outcomes to protect both the public and the profession.

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