Q: You’ve been practicing dentistry for more than 15 years. What led you to conclude that the dental profession is failing patients?
Dr. Frank LaMar: When I started practicing Prosthodontics, I made a commitment to provide the best possible dental care to my patients. At the time, the “best possible care” meant cast post and crown restorations, bridgework and partial or full dentures. I treated thousands of patients using this conventional approach. I planned each restoration fastidiously, using only the best supplies and laboratory services, and took the time to educate my patients on how to care for and preserve their dental work.
Over the years, the industry started to notice something troubling. One by one, these restorations began to fail. Sometimes they lasted for eight or ten years, but an alarming percentage of patients experienced failure within just a few years of treatment. What for many patients had begun as a single abscessed tooth gradually led to an extraction and bridgework, which eventually led to a partial denture. At each step along the way, these patients incurred additional cost and gradually lost dental function.
I was providing what was considered state-of-the-art dental care at the time. The dental profession believed that nothing is as durable as natural teeth and, for some patients, the best we can do is a short-term solution.
Q: What made you start to question the traditional wisdom?
Dr. Frank LaMar: My brother and partner, Jim, was building his practice in Implant Dentistry at about the same time I started my Prosthodontics practice. As I began to restore more and more implants, I realized that they were not failing – not after five years, not even after 10 or 15 years. Jim and I began to conclude that implants were the key to offering patients a permanent solution to dental problems. Back to top
Q: How has this changed the way you practice dentistry today?
Dr. James LaMar: We’ve developed a new approach to treatment planning at Elmwood Dental Restoration and Implant Center. During our initial consultation with new patients, we consider not only the patient’s immediate needs, but the long-term dental prognosis.
We’re looking at a 10- to 15-year timeframe. And we evaluate the long-term prognosis, not just for the tooth or teeth in immediate need of treatment, but for all the teeth. We take panographic x-rays and do a thorough oral exam. We look at the patient’s dental history and factor in predisposition to a high rate of recurrent decay and/or periodontal disease. Based on all of these considerations, we predict which teeth will still be viable within 10 to 15 years. Back to top
Q: How do you present your findings to the patient?
Dr. Frank LaMar: We prepare two treatment plans. The first details the short-term solution to the patient’s immediate needs using traditional post/crown/bridgework/denture technology. The second treatment plan details our recommendations for extracting teeth with a poor long-term prognosis and replacing them with an implant-supported prosthesis. For some patients, this second treatment plan includes replacing the entire upper or lower arch with a Hybrid Bridge supported on five or six implants. Back to top
Q: So you actually recommend removing teeth that aren’t causing patients any problems at the present time?
Dr. LaMar: Yes. In fact, we recommend it when we know that patients who choose the short-term treatment plan will be back in a few years needing more extensive treatment. With conventional short-term treatment, these patients will suffer more pain, incur significant additional expense and, in all likelihood, lose dental function and self-confidence. By choosing implant-supported treatment, our patients pay once for a permanent solution to their dental problems. Back to top
Q: Are patients resistant to the idea of removing teeth that aren’t in need of immediate care?
Dr. James LaMar: Ironically, patients are usually very receptive to the idea. It’s their General Dentist who may resist. These patients have typically experienced decades of dental pain and cycles of treatment and re-treatment that have depleted their finances. They’ve lost masticatory function and have given up favorite foods that are difficult to chew. They live with the constant expectation that something will go wrong with their teeth. They accept all of this because they’ve been told that there’s no better alternative. At Elmwood Dental Restoration and Implant Center, we’ve learned that when offered a one-time, permanent solution to their dental problems, these patients grab it. Back to top
Q: Why are dentists so reluctant to embrace the idea?
Dr. Frank LaMar: We’ve all been taught that natural teeth should be preserved at all cost. I think it’s time for the dental profession to reexamine that belief and redefine what’s considered the best possible dental care. Let’s face the fact that, for some patients, the long-term prognosis for their natural teeth is poor. Today’s dental implant technology allows us to offer these patients something far superior to what nature gave them. Back to top
Q: How are you helping your colleagues offer contemporary dentistry to their patients?
Dr. Frank LaMar: We’re committed to educating dentists on the most advanced techniques in Implant Dentistry. We offer an Implant Continuum where we teach General Dentists treatment planning and the latest restoration techniques for dental implant cases. We also offer a two-day workshop for Oral Surgeons on the restoration phase of implant treatment. Back to top
Q: Are you encouraging Oral Surgeons to do restoration work?
Dr. James LaMar: Not at all. But the key to successful implant treatment, especially in complex cases, is envisioning the final result and planning the surgery to facilitate restoration. We teach Oral Surgeons the key prosthetic considerations and show them how to avoid problems. We encourage Oral Surgeons and General Dentists to attend as a team and learn to work together more efficiently on planning and providing implant treatment. Attendees increase their confidence level in handling more complex cases, which allows them to increase their implant practice.
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Q: How can we get more information about these programs?
Dr. Frank LaMar: Contact our New Patient Coordinator at (585) 461-4949 or email her. We’ll be happy to send out an information kit.
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