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References

Warreth A, Boggs S, Ibleyou N, El-Helali R, Hwang S. Peri-implant diseases: an overview. Dent Update. 2015; 42:166-184
King E, Patel R, Patel A, Addy L. Should implants be considered for patients with periodontal disease?. Br Dent J. 2016; 221:705-711
Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implant Res. 2012; 23:22-38
Levin I, Ofec R, Grossman Y, Anner R. Periodontal disease as a risk for dental implant failure over time. A long-term historical cohort study. J Clin Periodontol. 2011; 38:732-737
Sousa V, Mardos N, Farias B, Petrie A, Needleman I, Spratt D, Donos N. A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res. 2016; 27:787-844
Ong CT, Ivanowski S, Needleman IG, Retzepi M, Moles DR, Tonetti MS, Donos N. Systematic review of implant outcomes in treated periodontitis subjects. J Clin Periodontol. 2008; 35:438-462
Easson E. Appropriate advertising: advice on selling yourself. DDU Journal. 2019;

Advertising lies

From Volume 46, Issue 7, July 2019 | Pages 605-606

Authors

Article

Readers will be aware that advertising in Dental Update, and elsewhere, is not peer reviewed, but it could be expected that it would contain – mostly – the truth. Why? Because ill-conceived promises for a certain product will ultimately lead to loss of consumer confidence in the company making the claims and will cause the reputation of the company to suffer, and this ultimately will be reflected in a fall in sales. Worse still, if a clinical company is making an erroneous claim regarding the success of a given treatment, while in the short term this may enhance the company's ‘busyness’, aggrieved patients may end up seeking a legal route to recoup their losses.

It was with some anxiety that I could see such a situation mapping out before me as I read an advertorial in a local newspaper while waiting at my opticians for an eye test. There was a stunning before/after set of photographs (Figure 1) with promises, and here I quote ‘If you have been suffering from gum disease, bone loss and unstable teeth, we suggest a revolutionary technique which means that we can provide a new set of teeth fixed in place using dental implants, in just one day’. The advertisement also indicated greater chewing capacity, improved aesthetics and speech, less bone resorption and better quality of life. There was no mention of how long the treatment might last!

Figure 1. Illustration from a local newspaper.

A week later, on a train from London, I read a similar advertorial (Figure 2) from a ‘world leading’ dental implant company at a cost of around £32 per month. Again, there were no claims regarding longevity.

Figure 2. Illustration from a London newspaper.

Surely there is something wrong here? There is recent evidence that up to 30% of dental implants may be affected by an inflammatory reaction in the gingival tissues around them – this being known as peri-implantitis,1 a good reason why the dental implant should be the last, rather than the first option. In addition, King and colleagues,2 when discussing whether implants should be considered in patients with periodontal disease, stated that peri-implantitis and periodontal disease share similar risk factors. Editorial board member, Dr Phil Ower, used the following words during an excellent lecture day which I listened to recently, ‘a perio patient is always a perio patient’.

Readers will be aware that implants do not last forever, and a review of the literature has indicated that 65% of implants (with their associated crowns) survive for 16 years.3 This paper also produced results which indicated 95.6% survival at 5 years and 93.1% at 10 years. Survival of implant-supported fixed dental prostheses (FDPs) was 80.1% at 10 years. Only 66.4% of patients were free of any complications after 5 years, with the most frequent complication being fracture of the veneering material (13%), peri-implantitis and soft tissue complications abutment (8.5%) or screw loosening (5.3%) and loss of retention of the cemented FDP (4.7%). Biological and technical complications were frequent (33.6%).

These papers reported implant survival in patients free of periodontal disease, but the illustrations above clearly show the presence of periodontal disease. Until recently, the most relevant work in relation to this advertising was that by Levin et al,4 which indicated that implant survival was suboptimal in patients with periodontal disease. More recently, a systematic review by Sousa and colleagues5 has provided cast iron evidence over 45 journal pages that implants placed in patients treated for periodontal disease are associated with a higher incidence of biological complications and lower success rates than those placed in periodontally healthy patients. Results from an earlier systematic review6 also indicated that implants do not perform well in patients who have previous or present periodontal disease.

The advertising that I saw is therefore not telling the truth. Patients who accept treatment for their loose, unstable teeth are therefore likely to be disappointed and may resort to legal action. Furthermore, the dentists who placed the adverts may also have to answer to the Advertising Standards Authority who state that all advertisements must be legal, decent, honest and truthful, and that they must not mislead, harm or offend.7 It goes without saying that the General Dental Council might also be interested. Additionally, general dentists may be asked to comment on such adverts by their patients and/or their relatives and friends, so this editorial may help them to respond. It's relatively simple – advertising should not be peddling lies.