Where’s the money? by Pam Johnson (As featured on July 29, 2009 – dentalproductsreport.com)

Where’s the money? by Pam Johnson (As featured on July 29, 2009 – dentalproductsreport.com)

Dr. Steven Little’s eyes are fixed on removables.

Dentists hate to do them and patients today don’t want to wear them. But when the fixed prosthodontic work that’s been in their mouths for 10 to 15 years begins to fail, aging patients run out of options and it’s time to consider removable solutions. And it’s not just the older generation that may be choosing less expensive dental treatment today. The current economic environment has eaten away at expendable income and made patients much more cautious about selecting expensive treatment options.

The one thing that hasn’t changed, however, is the high patient demand and expectation for treatment solutions that provide natural-looking esthetics and function. That’s why Dr. Steven Little, whose practice is located in Portland, Ore., is back in class, educating himself on the latest techniques in removable prosthodontics.

“The dental profession as a whole needs to shift its mindset away from cosmetic dentistry,” said Dr. Little. “Not only am I experiencing an aging patient base now left with limited treatment options, but patients considering less expensive alternatives. After the economic meltdown this past year, patients are tending to be more pragmatic. I’m seeing a huge shift in my practice away from cosmetic dentistry. I think patients are rethinking what’s most important and looking around at other treatment options. The cosmetic option is not the only one on the table being considered anymore.”

What Dr. Little is experiencing in his practice will most certainly be an important driving force in the dental market for the next several decades. According to the U.S. Census Bureau, approximately 12.4% of the 306 million people currently living in the U.S. are over the age of 65. That percentage is projected to increase to 18% of Americans by 2025 and to 20% by 2050. Couple this data with consumers’ shaken confidence in an economic recovery any time soon, and a new opportunity exists for general dentists to take advantage of an emerging market.

Projections published in 2009 by iData Research indicate the total market value for dentures will increase from $2.3M in 2009 to $3.1M by 2015 with an annual growth rate of 5.0% to 6.0% per year. For general dentists who surgically place implants for implant retained overdentures, the future is even brighter with growth in this market projected in the double digits for the foreseeable future.

Educational challenge

The problem and challenge for dentists who want to offer removable prosthetic treatment and improve their skill set are the limited educational opportunities. The fixation of the last 30 years on crown and bridge and esthetics has driven removable CE courses nearly off the map. To make matters worse, dentists graduating dental school today or even in the last 10+ years have limited clinical training in removable prosthetics.

“One of the biggest problems I see in the dental schools is that students graduate with absolutely no respect for the dental technician,” said Dr. Little. “This is due to the fact that dental students are not required to do their own lab work. If you are not trimming your own dies or don’t know how to trim a die, then you don’t know if you are sending your laboratory something they can make fit and function properly. The same holds true for removable prosthetics.”

Burney Croll, New York City prosthodontist and active member in a number of prosthodontic societies, associations, and champion of dental technology, commented that most dental students today graduate without ever having completed a partial denture case and have limited exposure to full denture protocols. As a result, the information these general dentists are providing their dental laboratories is inadequate and the quality of the resulting full and partial removable work is less than satisfactory for the patient.

For general dentists, who want to keep removable dollars in-house rather than refer and who recognize their clinical limitations when patients require complex removable solutions, there are educational opportunities through manufacturers, associations, and educational centers designed to hone existing knowledge and skill sets (see Education sidebar).

“Right now this is an untapped market. But, if dentists gain the knowledge and skill set to extract teeth, surgically place implants, and properly prescribe an implant retained denture, or provide an esthetic removable solution, they are set,” said Dr. Little. “We’ll be seeing a lot of these cases in the future.”
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