Dental student placing implants

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D1Bound

D1Bound

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I'm curious to know. What schools nowadays are allowing dental students to place (not just restore) implants?
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Midwestern University. AZ for sure. I can't speak for IL, but it's probably the same.
 
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Not at the University of Michigan! You can't even restore an anterior implant. Only posterior single crowns and mandibular overdentures.
 
University of Utah and Creighton allow students to place implants as well
 
At my school you can place an implant or two if you become an "implant honor student." This is only available D4 year and you have to restore 3 implants first.
 
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schmoob said:
I would not trust a new grad to place an implant. You have to crawl before you run.
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That's why they should start their D3 year of dental school. Theory should be taught D2. There is nothing magical about placing implants, but dentists should learn under experts while they're in their training rather than at the holiday inn from an implant manufacturer.
 
yappy said:
That's why they should start their D3 year of dental school. Theory should be taught D2. There is nothing magical about placing implants, but dentists should learn under experts while they're in their training rather than at the holiday inn from an implant manufacturer.
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I disagree. D3 is the time to learn how to drop the box and the absolute most fundamentals in dentistry. Skills like how to predictably deliver a block come way before reflecting a flap, placing an implant, covering, and suturing. It’s too advanced. I can understand a good GPR/AEGD, but no dental school.
 
schmoob said:
I disagree. D3 is the time to learn how to drop the box and the absolute most fundamentals in dentistry. Skills like how to predictably deliver a block come way before reflecting a flap, placing an implant, covering, and suturing. It’s too advanced. I can understand a good GPR/AEGD, but no dental school.
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Completely agree
 
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yappy said:
That's why they should start their D3 year of dental school. Theory should be taught D2. There is nothing magical about placing implants, but dentists should learn under experts while they're in their training rather than at the holiday inn from an implant manufacturer.
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This
 
No reason students shouldn't be able to place implants. It's an easier procedure than most anything else. I did like 10 in school. That doesn't mean I won't seek additional CE to do them on my own
 
gunner4ever said:
No reason students shouldn't be able to place implants. It's an easier procedure than most anything else. I did like 10 in school. That doesn't mean I won't seek additional CE to do them on my own
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Based on these limited responses. Looks like the theory and technique of GPs placing implants is not mainstream at the dental schools.

You mention that it is an easier procedure. Maybe the actual placement of the implant is easy. But what is hard is making the right diagnosis regarding hard and soft tissue, occlusion, esthetics, etc. etc. It's not just about placing an implant. It's how your implant will coexist with the surrounding dentition which will affect it's longevity.

The DSO I work for has "experimented" with GPs placing implants. I work closely with a fellow periodontist. This periodontist along with a couple of OS place most of the implants. From discussions with the Perio .... I've heard many horror stories where the GP placed implant failed and the Periodontist had to bail out the GP. The Perio finally had enough ..... and told his boss' that he would no longer bail out the GP's screw ups. The Periodontist is highly respected at the DSO. At this point. NO GPs are allowed to place implants. The headaches are just not worth it to the company.

On the flip side. During my Private Practice years .... one of the GPs that I worked with .... decided that he wanted to do implants in his office. He was a part time instructor at MidWestern. He went all in. Bought a cone beam machine. Attended all the best implant CE. He worked closely with an oral surgeon. Word was that he was doing a good job with the implants.
 
2TH MVR said:
Based on these limited responses. Looks like the theory and technique of GPs placing implants is not mainstream at the dental schools.

You mention that it is an easier procedure. Maybe the actual placement of the implant is easy. But what is hard is making the right diagnosis regarding hard and soft tissue, occlusion, esthetics, etc. etc. It's not just about placing an implant. It's how your implant will coexist with the surrounding dentition which will affect it's longevity.

The DSO I work for has "experimented" with GPs placing implants. I work closely with a fellow periodontist. This periodontist along with a couple of OS place most of the implants. From discussions with the Perio .... I've heard many horror stories where the GP placed implant failed and the Periodontist had to bail out the GP. The Perio finally had enough ..... and told his boss' that he would no longer bail out the GP's screw ups. The Periodontist is highly respected at the DSO. At this point. NO GPs are allowed to place implants. The headaches are just not worth it to the company.

On the flip side. During my Private Practice years .... one of the GPs that I worked with .... decided that he wanted to do implants in his office. He was a part time instructor at MidWestern. He went all in. Bought a cone beam machine. Attended all the best implant CE. He worked closely with an oral surgeon. Word was that he was doing a good job with the implants.
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Diagnosing most things is hard as a dental student, I would still argue diagnostically a single straightforward implant is easier than most other things. Even if you disagree, just like for everything else in school, there are faculty to help you, so what's the issue?
 
If you have no experience with implants why does it matter if you're a dental student or a dentist? You're still starting at the same point whether or not you have more letters behind your name. Personally I would rather place them for the first time with the safety and teachings of the school rather than out on my own.

And this is coming from the least cowboy person there is. I'm very cautious in everything I do and don't jump into things without really know and understanding. But this argument that placing an implant as a dental student is a magical forbidden thing makes zero sense to me
 
gunner4ever said:
If you have no experience with implants why does it matter if you're a dental student or a dentist? You're still starting at the same point whether or not you have more letters behind your name. Personally I would rather place them for the first time with the safety and teachings of the school rather than out on my own.

And this is coming from the least cowboy person there is. I'm very cautious in everything I do and don't jump into things without really know and understanding. But this argument that placing an implant as a dental student is a magical forbidden thing makes zero sense to me
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You make good points. And I get why you think it’s beneficial to do some implants in school.

For me it’s more of a principle thing. Dentists should be able to do extractions, fillings, crown and bridge, and endo and do it well. These foundations and skills start in dental school and start with diagnosis, treatment planning, and hand skills. As someone who was recently around dental students, it was shocking how bad they were at all of these (not all obviously). So to hear students should be able to place implants when they don’t even know how to do the GP basics sounds foolish. Even if you have completed all your requirements, do more crowns, RCT’s, extractions. That’s what you need to be able to do to be a good dentist at first. You can refer implants out at first while you are getting started. You need to be as proficient at extractions, restorations (direct/ indirect), and simple endo as you can.
 
gunner4ever said:
Diagnosing most things is hard as a dental student, I would still argue diagnostically a single straightforward implant is easier than most other things. Even if you disagree, just like for everything else in school, there are faculty to help you, so what's the issue?
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gunner4ever said:
If you have no experience with implants why does it matter if you're a dental student or a dentist? You're still starting at the same point whether or not you have more letters behind your name. Personally I would rather place them for the first time with the safety and teachings of the school rather than out on my own.

And this is coming from the least cowboy person there is. I'm very cautious in everything I do and don't jump into things without really know and understanding. But this argument that placing an implant as a dental student is a magical forbidden thing makes zero sense to me
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I think that’s exactly why. Implants are more than just place screw in bone. It’s not a surgical procedure, it’s a restorative procedure with a surgical component. Occlusion needs to be factored in, esthetics, etc. Is it going to subcrestal? How will it be sutured? What suture will be used and what technique?
These are all skills above and beyond that of a student who takes 2 hours for an MOD.
 
Implant placement requires pre-requisites that most dental students don’t have.

- good local anesthesia
- flap design and creating a clean incision to bone
- lifting a full thickness flap
- virtual implant planning with the CBCT
- creating an osteotomy in the proper location with good angulation, avoiding anatomical dangers
- suturing

I’ve taught very very few dental students who I would have any confidence creating a clean flap and being able to suture it closed. I’ve seen lots of GPR/AEGD residents who struggle with flaps.

Could we hold their hand through it all? Sure, but at that point, they’re basically an assistant. Most schools don’t have the time or faculty available to dedicate to students like that.

Also, most things in dentistry can be cleaned up or redone. Preps, dentures, Endo. When an implant goes in poorly, it’s not so easy to have faculty fix things. And I don’t think dental schools can swallow the costs of a bunch of wasted implants.
 
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RollingDDS said:
At Loma Linda you can place an implant or two if you become an "implant honor student." This is only available D4 year and you have to restore 3 implants first.
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I was set to do this at Loma Linda before I graduated but COVID hit and stopped everything I had planned. I felt like I would have been very prepared at that time to place an implant in this "honors program" because the faculty would have helped with the difficult parts of planning it and holding my hand through those steps. As far as the surgery goes I had already done some OMFS externships and so I was a little more advanced in that aspect. The point being that I definitely think there are appropriate situations where dental students can place implants but I like that at Loma Linda we had to earn it and have the faculty trust that the students they let do it could be trusted to learn and listen etc.
 
FutureDent020 said:
You make good points. And I get why you think it’s beneficial to do some implants in school.

For me it’s more of a principle thing. Dentists should be able to do extractions, fillings, crown and bridge, and endo and do it well. These foundations and skills start in dental school and start with diagnosis, treatment planning, and hand skills. As someone who was recently around dental students, it was shocking how bad they were at all of these (not all obviously). So to hear students should be able to place implants when they don’t even know how to do the GP basics sounds foolish. Even if you have completed all your requirements, do more crowns, RCT’s, extractions. That’s what you need to be able to do to be a good dentist at first. You can refer implants out at first while you are getting started. You need to be as proficient at extractions, restorations (direct/ indirect), and simple endo as you can.
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Placing an implant is easier than all of those procedures
 
gunner4ever said:
Placing an implant is easier than all of those procedures
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Maybe so, but there is one sticking point. When (not if) a medicolegal issue arises .... for basic general procedures .... you will be judged by your GP peers.
With implants ..... your peers will be specialists who trained for years to become proficient in implants.

Maybe in time placing implants will be considered a basic general procedure.
 
2TH MVR said:
Maybe so, but there is one sticking point. When (not if) a medicolegal issue arises .... for basic general procedures .... you will be judged by your GP peers.
With implants ..... your peers will be specialists who trained for years to become proficient in implants.
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I see this statement made all the time here.

Basically, that you're held to the standard of a specialist. But doesn't that just mean that your held to the standard of doing it properly? I don't want to speak out of line here, because I am just a student. But I know tons of GPs who place implants and, based on their status in the community, are doing so to the highest of standards.

There seems to be a lot of implication that GPs are out there offering substandard care on SDN and it's kind of frustrating. No one is advocating for GPs to offer procedures that aren't equipped for, but there are multiple avenues GPs can take to learn to properly learn to offer procedures outside the bread and butter that clearly the regulating agencies have signed off on. It really just feels like a turf war more than valid concern over outcomes.

Do you really think only those with multi year residencies are able to offer implants?
 
ddsquestionsdmd said:
Do you really think only those with multi year residencies are able to offer implants?
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I believe they are better prepared with a higher chance for success with their implants. "You only know what you know". A person who attended a multi-year residency plus years of experience will probably deliver an implant with a higher probability of success.

Now of course. There will be those GPs that are very good at placing implants. And there will be those specialists that are lousy.

As of now. It appears that GP implant placement is not standard curriculum at the dental schools. Maybe some schools. Is there a reason for this? Political maybe? Or that 4 years is barely enough time to learn basic GP procedures.
 
2TH MVR said:
Now of course. There will be those GPs that are very good at placing implants. And there will be those specialists that are lousy.
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At it's core I think this is my view on many of these debates. Rather than making it about GP vs Specialist, so long as it's within the scope of the license, I think it should be about skill and outcomes. Otherwise, it really just comes across as a turf war. I am not saying that GPs should be out there winging it, but my research makes me feel confident there are other routes to doing implants well than just OS or Perio residencies.

2TH MVR said:
Or that 4 years is barely enough time to learn basic GP procedures.
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Sure, but does that mean that the education shouldn't start there? We have the chance to do surgical extractions in D4 from what I have heard, that doesn't mean we should be doing them right out of school. But it's valuable exposure going into a GPR or AEGD isn't it?
 
ddsquestionsdmd said:
At it's core I think this is my view on many of these debates. Rather than making it about GP vs Specialist, so long as it's within the scope of the license, I think it should be about skill and outcomes. Otherwise, it really just comes across as a turf war. I am not saying that GPs should be out there winging it, but my research makes me feel confident there are other routes to doing implants well than just OS or Perio residencies.



Sure, but does that mean that the education shouldn't start there? We have the chance to do surgical extractions in D4 from what I have heard, that doesn't mean we should be doing them right out of school. But it's valuable exposure going into a GPR or AEGD isn't it?
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Don’t forget prosth residency.

And I had excellent exposure to surgical extractions in school. It left me well prepared in practice and I did not do a postgrad residency when I finished. But extractions are different than implants. I didn’t do any in school and I’m glad I didn’t, it allowed me time to get pretty good at exodontia, suturing, and the other basics of dentistry.
 
Placing an implant is super easy, it’s basic carpentry.

The skill is in the planning, understanding the features of the fixture, considerations for restoring, medical management etc. Implants are so well made and the labs can do so much digitally to overcome bad planning/understanding that while the process can seem easy it’s very difficult to truly master
 
We need to ask more of dental education, not less. Clinic hours should be bumped up to 10-12 hours per day, five days per week, in the fourth year. There is no reason dental students should not be learning how to digitally plan and place implants. The alternative is that they do not, then get out and learn from dental supply companies and hacks. There is so much variability in OMS and perio residencies when it comes to implants. There are some programs that barely give them any training or case volume. In practice, some of the worst placed implants have been done by specialists who graduated from these residencies, so going to a residency is not some kind of silver bullet to learning how to place implants. The foundation needs to be set in dental school.
 
ddsquestionsdmd said:
We have the chance to do surgical extractions in D4 from what I have heard, that doesn't mean we should be doing them right out of school. But it's valuable exposure going into a GPR or AEGD isn't it?
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Late to this thread but I think surgical extraction is basic general dentistry skill that you should have done plenty in dental school and be comfortable to do them right out of school. I am thankful that my school's OS curriculum prepared me adequately for those sx EXTs.
 
This is secondhand info so it’s yet to be corroborated, but a D4 at UCLA told me that several of his friends who are students at USC get to practice placing implants.
 
i’ve heard from my D4 friends that they’ve placed quite a few at UNE.
 
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