Educating Patients About Dental Implants

Dr. Marc Nevins is a Diplomate of the American Board of Periodontics
and is an Assistant Clinical Professor at the Harvard School of Dental
Medicine. He maintains a private practice limited to Periodontics and
Implants in Boston. Dr. Nevins has taken time out of his busy practice
to discuss his protocol for educating patients about dental implant treatment.

OsseoNews: Dr. Nevins, what do you consider to be the most vexing problems of dental implant treatment?
Dr. Nevins: Patient education is an important area often overlooked
for its complexity. When we present a treatment plan to the patient
that involves implants, we are faced with the problem of communicating
information effectively to the patient. They must be able to make an
informed decision about their treatment and ideally recruited as a
co-therapist in the process.

OsseoNews: Many dentists used some of the tried and true techniques such as showing the patient their radiographs and drawing on the radiographs or drawing pictures on the bracket table.

Dr. Nevins: That kind of presentation can be successful but compared to what we have available today, it really is simplistic and not very effective. We have so many resources now, that I cannot imagine going back to some of the techniques that I used to use.

OsseoNews: What have you found to be the most effective technique for presenting the treatment plan and gaining patient acceptance?

Dr. Nevins: We have been using the XCPT ™ (Treatment Planning and Communication Software) now for the last year (See www.xcpt.com). I personally have found this to be an invaluable tool. In its simplest form we use it to demonstrate the diagnosis of patient’s radiographs on the computer screen. We can then use the mouse to draw on the screen to demonstrate various points about the patient’s radiographs.

OsseoNews: You find that this works better than using conventional radiographs?

Dr. Nevins: No question. Conventional radiographs are more difficult for the patient to interpret and they can be intimidating. With the XCPT software, I can display the radiographs on the screen and we find that patients are far more comfortable with this arrangement.

OsseoNews: How can you use the XCPT software to make the treatment plan and the actual dental implant protocol more intelligible to the patient?

Dr. Nevins: The beauty of this system is that we can display the actual radiographs of the patient. So we are not talking about a generic presentation. The patient can see exactly what we are going to do to them. We can use realistic pictures from the image library to modify the patient’s radiographs. We can demonstrate exactly where we are going to place the dental implants. Then we can overlay the abutments into the implant fixtures. Then we overlay the crown restorations, adjusting the opacity so the patients can visualize the abutment supporting the crown.

The graphics in this program are great. We can demonstrate any step in the treatment plan, including the placement of provisional or transitional restorations and the treatment sequence.

We can even use this software program on CT scans. There are just so many applications.

One great advantage here is that we are not tasking the patient to conceptualize or imagine what the treatment is going to be like. We just demonstrate it on the screen for them.

OsseoNews: The treatment plan presentation is customized to the patient and how they present and exactly what treatment they are going to receive?

Dr. Nevins: The great strength of this software program is that we can adapt it to the needs of each patient. There is a very big difference between using a stock treatment plan presentation and actually developing a unique and customized treatment plan presentation for the patient. It makes a big difference when the patient realizes that those radiographs up on the screen are his.

The presentation includes labeling the tooth numbers so when the patient leaves the office with a treatment plan, the XCPT image is printed for them and they can identify where the treatment will be performed.

OsseoeNews: If the patient needs more complex treatment like a sinus lift, you can incorporate that into your presentation?

Dr. Nevins: The XCPT software program is great for situations like that where we have to do more than just place an implant. Bone grafting procedures can easily be demonstrated for the patient with graphics from the image library. Even with the most complex treatment plan, we display overlays or diagrams and lead the patient through every step.

When we finish our presentation, we print out the radiographs and the each screen the patient viewed. They leave the office with all of this information. I routinely send all of this information to the referring dentist either by mail or e-mail. If the patient has any questions they can ask me or their referring dentist.

Implant dentistry is a team approach. This way we all know exactly what treatment is intended and how we are going to proceed. Communication is they key. The XCPT software makes this very easy. I can e-mail the XCPT file or a JPEG of the plan to the restorative dentist to communicate the treatment plan.

OsseoNews: How expensive is this XCPT software?

Dr. Nevins: The software costs about $3500. There is no other fee the first year but starting in the second year we began paying about $1K per year for their support package.

OsseoNews: Is the software user friendly?

Dr. Nevins: Very user friendly. The on-site training lasts about a day, or less, depending on your background in computers. The learning curve is very short. I have to say that this is really easy to learn how to use. If I have any problems, their support package entitles us to 24/7 access to their help desk. The support package also includes upgrades to the system.

OsseoNews: How much time does it take usually to present the treatment plan using this software?

Dr. Nevins: I find that it takes about 5-10 minutes to use the XCPT to demonstrate the treatment plan and to continue the consultation with the patient. Then my Implant Coordinator continues the discussion and spends as much time as the patient needs to review the treatment process and fees. She answers questions and uses the XCPT program if the patient wants something demonstrated to them on the computer screen.

OsseoNews: Do you have a terminal in each of your operatories?

Dr. Nevins: We have a terminal in each operatory and in consultation areas. Being able to work in the operatory with the patient makes the process seamless and easy to integrate into practice.

OsseoNews: Thank you Dr. Nevins for your time.

Interview conducted by:
Gary J. Kaplowitz, DDS, MA, M Ed, ABGD
Editor, OsseoNews.com