Management of patient’s expectations from implant restorations

Many patients present for tooth replacement with the expectation that implants will fully revert the impairments they experience with tooth loss and that their life will be “as before”. These expectations are fueled by commercial publicity, and enthusiastic testimonies from fellow-patients. Despite the undoubted comfort and functional improvement which implants provide to restorative dental treatments, they sometimes fall short to fully restore oral function and esthetics, especially in challenging anatomical and medical conditions, or in the absence of regular maintenance. Hence before setting off for an implant insertion, a careful anamnesis needs to evaluate the patient’s motivation and expectation and discuss them in view of the results from the clinical and radiological examination. Unrealistic expectations are best corrected at this stage, avoid the impression of an “excuse” once the treatment results fall short. At this early stage, expectations are preferably kept modest to avoid deceit, knowing that a positive surprise later on is always welcome. Communication skills are crucial to extract the patients’ motivation for treatment and knowledge on the possible outcome. The technique of “active listening” by establishing confidence, respect and empathy, thus allowing the patients to express themselves without fear of judgement or pressure, should be applied. Listening beyond words and reading non-verbal signals are also part of this technique, just as re-wording the other’s statements for confirmation. Cognitive impairment may also play a role when dealing with elders. Predicting a treatment outcome requires not only the knowledge of the current scientific evidence, but also clinical experience. Raising unrealistic hopes is bound for failure. In addition to correcting possible unrealistic expectations of patients, it is also important to provide them with “hard facts” regarding the treatment outcome, restoration longevity and the time and financial burden of follow-up care.

After the lecture you will be able to:

• apply the “active listening” technique for patient anamnesis
• screen for cognitive impairment in a dental practice context
• be aware of the functional shortcomings of implant restorations
• adapt a patient management strategy that aims at avoiding deceit