Publicity?

There's no such thing as bad publicity (except your own obituary!) Dominic Behan. My Brother Brendan (1963)

Dentistry gets its fair share of publicity, much of it, sadly, dentist bashing, so some UK television viewers may have joyfully watched the two part series on the BBC, The Truth about your Teeth. In this, watchers are treated to the calming and ultra-caring attitude of Dr Serpil Djemal, a Consultant at King's College Hospital, London, who sets the most nervous patients at ease and seems to be able to get them (or at least the ones that we see!) to accept the dental treatment, the thought of which has petrified them for years – all good publicity. One particular patient, Angie, was notable for her anxiety, resorting to superglue to glue in either a loose tooth or a post crown. Either way, it was obvious that this patient needed serious treatment, with extractions being the most obvious solution when we learned that she had lost 90% of bony support. We later learned that Angie had eleven extractions and six immediate implants and the result, once the swelling had subsided, looked great. I am certain that some readers of Dental Update will have had patients attending as a result of the programme, asking for a similar miracle. Still good publicity, until we have to tell our patients that the prognosis of implants is far from 100% at 5 years, indeed that results of a systematic review of the literature has indicated that 65% of implants (with their associated crowns) survive for 16 years,1 and that the prognosis is substantially poorer in patients who have had periodontal disease, even if it has been treated.2 In addition, no reader will be unaware that the prognosis of dental implants has been known for some time to be poorer in patients who smoke,3 as Angie did. So, when will this good publicity turn to bad? – potentially with the onset of peri-implantitis for the patient who (we were advised) spent all of her savings on her treatment, and how can we explain this to patients who ask us for this miracle cure?