Understanding the patient perspective
It's not just the predictable outcomes that are important to our patients but also the experience. The thought of having implants is quite daunting (more so for some patients) and it is interesting to note how patient feedback frequently highlights that most people find the experience of surgery nothing like they had anticipated (or feared).
We can help allay these natural fears by the manner in which we first meet the patient for the consultation and start of the consent process. Quiet, empathetic confidence from the whole team is a good description of what should be offered. The patient soon gains confidence when they understand that they have been referred to a team dedicated to providing the specialised skills of surgical partner as part of your extended care team.
Looking back over many years of gradual improvements in the process of implant placement, it is also striking how much the patient experience has improved.
Until about ten years ago the surgery was a noisy messy event. Many patients either chose (or were encouraged) to have sedation to help get through it. Looking back, it’s no wonder that this made the surgery more daunting. The very fact that we encouraged sedation made it necessary for a good number of patients.
So, what has changed?
The biggest changes are the peace, quiet and speed of treatment. Historically we created the holes for implants using high speed drills (still most common today) to do so necessitated cooling irrigation which in turn required constant suction. The result was a cacophony of sound - saline pump and suction, spray and choking - not very relaxing!
Today we use a slow drilling technique which requires no cooling saline or constant suction. The result is tranquillity where the only sound is the patient’s choice of music and conversation between a happy team and a relaxed patient.
The need for sedation and the increased anxiety it instils is gone (except for the extremely anxious patient). Patients frequently report that implant placement is a nicer experience than having a filling! Extensive experience improves treatment outcomes but also makes surgery quicker with less local required and less incumbent morbidity. Speedier surgery is also much nicer for the patient.
As a surgical partner we have a vast range of techniques at our disposal many of which have also seen significant improvements. Take sinus lifts as an example. The success of short implants has reduced the times that sinus augmentation is required and reduced treatment time and morbidity. Techniques for gaining vertical height such as the Summer’s technique - involving a mallet which patients hated (a feeling they could remember even after IV sedation), have been replaced with a much less unpleasant Cosci technique where we gently abrade the floor of the sinus (again without high speed drilling and coolant and the roar of suction). A conventional sinus lift is complete in 30- 40 minutes rather than hours - again a much kinder experience.
Bone grafting is another good example. The gold standard was autogenous bone harvested from the mouth but harvesting this bone is the worst part of the procedure - for the patient - extending treatment time and morbidity - and risk!
We now use human allografts with more predictable long-term outcomes and significantly less patient discomfort and complications. Constantly striving to see our treatment from the patient’s perspective has allowed us to challenge assumptions we make about the way we work.
The grateful amazement of patients - our reward.