Identifying implant candidates: Seminar aids search for solutions to edentulism

June 12, 2015
Hygienists are educated to save teeth. But what about teeth that have already been lost? What role does the hygienist play in educating patients about replacing teeth and enhancing their lives while improving the overall practice? 


Hygienists are educated to save teeth. But what about teeth that have already been lost? What role does the hygienist play in educating patients about replacing teeth and enhancing their lives while improving the overall practice? In her program, "Hygiene for the Edentulous Spot," Leslie Icenogle, an implant coordinator with 30 years of dental implant experience, helps hygienists and other team members understand the importance of replacing teeth with endosseous implants.


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Dental implants are the standard of care for tooth replacement today, but what makes one patient a candidate for implants, while another is not? During her program, Leslie reviews what hygienists should look for at recare appointments, the signs of atrophy, and the health risks patients can experience if teeth are not replaced, along with a review of the importance of proper maintenance protocols. The program reviews:

  • Medical history - how digestive issues, bisphosphonate use, and uncontrolled type II diabetes can affect implants
  • Social habits - how smoking and bruxism can be issues
  • Hygiene - the importance of educating the patient on home care and commitment to their hygiene and follow-up visits
  • Periodontal disease - the role of DNA testing and bite analyzers in implant dentistry
  • How the tooth was lost - potentially additionally needed procedures when teeth are lost due to trauma and/or congenitally missing teeth
  • Edentulous ridge - how bone width, height, and shape affect implant placement, prosthetics, and success
  • Space - the required width and height of vertical space and the space between neighboring teeth
  • Panoramic evaluation - use of imaging to determine the amount of bone present and choose the correct implant size
  • Sinus location - when sinus lift procedures are needed and how they are performed
  • Nerve location - current options for the replacement of lower posterior teeth with severe atrophy

The program delves into the determining factors that make a patient a true candidate for implants. Leslie discusses the areas that hygienists can evaluate along with the scripting needed to educate the patient on the importance of tooth replacement. She understands that hygienists have a lot of influence over patients. Discussing implants prior to the dentist's evaluation and diagnosis can create patient comfort with the process as well as excitement about the outcome. Implants are the most successful procedures in dentistry! Although the process of one sounds complicated, it is actually relatively simple and painless and leaves a very satisfied patient, if the communication and education are done properly from the beginning. Leslie also reviews the personal side of implant dentistry - what it is that patients really want from implants. She discusses the challenges practices face with implant dentistry, the benefits and risks of treatment and nontreatment, radiographic protocols, peri-implantitis, emergence profiles, esthetics, and patient-education materials that work. The program is presented through PowerPoint with group activities and outlines, which encourage discussion and interaction by filling in the blanks. She will often enlist the aid of Sammy, a puppet shark, to demonstrate that sharks have an unlimited amount of teeth, but humans don't. Edentulism increases the odds of systemic complications, and by replacing teeth in a natural manner, she feels that patients will live longer and enjoy life more. She understands that humor helps participants retain information and enjoy the program; thus Leslie will often interject one-liners and other statements to promote laughter and, therefore, retention. In addition to her program, she is also available for webinars and in-office coaching.

Leslie has been an implant coordinator for 30 years with a true passion for implantology. She has worked in a specialty practice and has observed how one team member (who has an implant) can influence a patient's decision to proceed with the recommended implant process. She is radiology certified and a specialist in 3D technology for Carestream, understanding its applications in dentistry. She is also a member and Fellow of the Association of Dental Implant Auxiliaries, a component of the International Congress of Oral Implantologists.

Leslie has attended some form of continuing education throughout her entire career and understands the role and impact patient education has on the implant process. She has seen it transform patients' lives! Patients who undergo the implant process often smile more, eat with confidence, dress nicer, or get a new job or promotion after tooth restoration. Dental team members who have 28-plus functional teeth often have a difficult time relating to the experiences of the edentulous or partially edentulous patient. She gets satisfaction in educating dentists and teams about the benefits of implants so they are comfortable with the entire process, including the financial investment of the patient. Team members may be uncomfortable asking a patient for $35,000, but they will find it is worth a lot more if the patient is not able to eat or function socially. She strongly believes that implants can extend and improve lives.

Leslie describes herself as a fun educator, dedicated to improving the lives of patients and teams. She enjoys being "on stage" and watching the audience smile and experience the "aha" moments that can be put to use in their practices the next day. "Hygiene for the Edentulous Spot" can be presented as a one-hour keynote presentation, several-hour program, or all-day presentation.

Over the last three decades, Leslie has learned that losing teeth is a very emotional experience for patients. Knowing that there is a secure and natural way to replace their teeth is reassuring. Nothing is more rewarding than giving back to patients something they have lost, including their function and self-confidence. If done appropriately, the hygienist can "set the table" for the dentist to explain the implant treatment so that the patient is excited to see if implant treatment is right for them. This excitement transfers to increased implant case acceptance and overall patient and practice satisfaction. Leslie's program imparts the skills and knowledge hygienists and dental teams need to make this a reality.

For more information about Leslie, her program, or her consultation services, contact: [email protected]

Thought for the month:

"Determine that the thing can and shall be done, and then, we shall find the way." Abraham Lincoln. RDH

This month's INeedCE featured course is "Stop the Violence...Exploring Domestic Violence."RDH readers using code AM615 will receive 50% off the regular $59 course price - discounted fee $29.50.

Oral health-care professionals can have an enormous impact on the identification of patients suffering from domestic violence. Physical violence injuries frequently occur on the head and neck, which can be identified through routine extraoral and intraoral screenings in the dental office. This course will discuss the prevalence of intimate partner violence in the United States, define the different types of domestic violence, and describe the signs and symptoms of its victims. Barriers to clinician intervention as well as tools to break down those barriers will be presented, increasing the clinician's confidence in implementing intervention protocols for their patients.

ANN-MARIE C. DEPALMA, RDH, MEd, FADIA, FAADH, is a Fellow of the American Academy of Dental Hygiene and the Association of Dental Implant Auxiliaries, as well as a continuous member of ADHA. She presents continuing education programs for dental team members on a variety of topics. Ann-Marie is collaborating with several authors on various books for dental hygiene and can be reached at [email protected].