Innovating implant dentistry – a team approach

DHContact caught up with Juliette Reeves to get the inside scoop on the importance of team work in the field of implant dentistry and, in particular, the role of dental hygienists and therapists when it comes to achieving long-term success.


DHC: How important is the whole team to the success of an implant practice?

JR: For me, it starts from the point the patient picks up the phone and calls or visits the practice. The reception team needs to understand the implant process in order to answer initial questions or queries from the patient adequately, and to schedule appointments correctly. If there is a treatment co-ordinator (TCO) in the practice, the reception team also needs to understand the treatment stages and work closely with the TCO to ensure a smooth patient journey.

This then follows through to the nurses; having well-trained, experienced implant nurses to assist at the clinical stage and to be able to answer patients’ incidental questions about their treatment is paramount.

Finally, the dental hygiene and therapy team also needs to be conversant with the clinical treatment pathway. The long-term success rate of implant placement relies on excellent aftercare; namely, the monitoring and maintenance of implant patients and early referral when problems are identified.

If everybody on the team is on the same page and understands the process, patient experience is seamless, which is great for everyone – patients and dental health care professionals alike.


DHC: How important is it for hygienists and therapists to have specific training in implant dentistry?

JR: It is critically important to make hygiene and therapy training an integral part of building a successful implant practice. Implant dentistry has evolved dramatically over the last 10 years. What is considered best practice now is different from 10 – or even 5 – years ago. Protocols change, implant systems and prosthetic designs develop, and clinical procedures continue to evolve and improve, making up-to-date training essential. For some, this can be confusing and frustrating. However, it is also exciting to be part of an ever-evolving aspect of dentistry. It is vital for the clinical team to be involved in the process and continue to develop our skills and understanding, particularly when it comes to long-term maintenance and monitoring.


DHC: Do you think all practices ensure that hygienists and therapists receive this type of training?

JR: I think there needs to be a paradigm shift among the profession when it comes to providing implants within a practice. This because, sadly, not all the members of the clinical team are automatically trained in this area. Many dentists see the value of introducing implant dentistry to their practice and therefore are happy to invest in training for themselves. It is difficult to place implants without well-trained implant nurses and, again, investing in nurses’ training is also seen as adding value to the practice.

Sadly, this is often where it stops; hygienists and therapists are often self-employed and are left to undertake training themselves out of a sense of professionalism. This means having to fund the training, travel, time off work, etc. themselves. As we know, the vital measure of a successful implant practice is the long-term results. For longevity, maintaining and monitoring become critical and so training the hygienists and therapists is as much a part of building value into a practice as training dentists and nurses.

What’s more, training the whole practice together adds value to the patient experience in that the support and advice given is consistent across the whole team. The patient feels confident they are in the best hands and are therefore more likely to consider further treatments, as well as recommend the practice to others.


DHC: On that note, how can the whole team work together to ensure success in implant dentistry?

JR: By recognising and respecting the different role each team member plays in contributing to long-term clinical success rates for the patient and the practice. When the implant team is trained together, and clear communication pathways are in place, the patient journey is flawless.


DHC: You are soon going to be presenting a course in association with BioHorizons. Who is it for and what will delegates be learning about?

JR: The course is suitable for hygienists and therapists and GDPs; and if they attend together they can develop the kind of cohesive protocol we’ve been talking about. Communication between the implant surgeon, dentist and hygienist and therapist is so important.

During the day, we will look at the components of implants, including different surface characteristics. We’ll also cover biological configuration of the tissues, as that makes such a big difference to how hygienists and therapists help patients to maintain healthy gums around implants.

The different types of implants that are commonly seen in general practice will be explored, including fixed hybrid restorations and the various methods for maintaining these structures.

How to identify health and disease will then be covered, as will the difference between periodontal and peri-implant disease, and when to refer a case on.

Finally, there will be a hands-on session covering maintenance and monitoring, including probing and debridement, with a look at some 21st century techniques such as air polishing, laser disinfection and probiotics, plus a review of home care products available for designing a bespoke package for the patient.


DHC: While we’re on the subject of 21st century implant dentistry, how do you see it evolving over the next few years?

JR: I think we're going to become more aware and more focused on systemic factors. We are also beginning to see some patients exhibiting reactions to the metals used in implant dentistry. There are ceramic and plastic implants now, and I believe non-metal components will grow in popularity. Another area of greater focus may well be the oral microbiome and achieving a healthy balance of bacteria, rather than providing treatment that kills them off. We sometimes forget that there is a natural balance and that not all bacteria need to be wiped out.

The most important thing to remember for now is that ongoing education is key, if we, as a team, are going to be able to provide patients with the best possible care both now and in the future.


If you would like further details about ‘The Latest Concepts in Implant Maintenance’ course, to be presented by Juliette and held on 13th October inLondon, please visit

Juliette is an award-winning dental hygienist and nutritionist, with over 30 years’ experience. She has a special interest in the treatment of gum disease and the care of dental implants. She is also an Elected Council Member to BSDHT Executive Team.

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