Clinicians Have Growing Need for Implant Experts

Clinicians Have Growing Need for Implant Experts. Photo Courtesy of Krishnacreations/stock.adobe.com.

he dental implant industry is booming and your laboratory’s business could follow suit. It sounds like an over-the-top marketing tagline, but the rapid growth of implant dentistry (and the burgeoning work it gives labs) is indisputable. According to the American Dental Association, over 5 million implants are placed annually in the United States.¹ The American College of Prosthodontists says 2.3 million implant-supported crowns are fabricated annually.² And these numbers are growing every year.

Although dentures and bridges once were the treatment of choice, the rising popularity of implants means any lab not offering them is squandering opportunities, some professionals say. “The true pioneers in implants made it mainstream in the 2000s,” says Conrad Rensburg, owner and head of the Dental Implant Division for Absolute Dental Services in Durham, North Carolina. “Obviously we did implants before then, but that’s when it really became commercialized. It was a little easier in those early days to get into the space. But today, if you haven’t offered it, you’ve got a lot of catching up to do. And you need to be offering it.”

So how can a lab become the go-to for implants? In a competitive market, a lab must stand out. You need to put in some work, do research, become a resource, and understand—and meet—the demands of clinicians.

“Dentists are looking for lots of things in a lab when it comes to implants,” says Chris Bormes, MICOI, president of Preat, a company in Santa Maria, California, offering dental implant components. “They want treatment planning skills. They want to see knowledge of multiple systems and restoration types. They want their lab to have the ability to problem solve and think outside the box. And of course, they want reliable quality and timely communication.”

Build Relationships

As with any industry, good connections are essential. Building relationships can make the difference between a successful and long-lasting or not-so-successful and fleeting partnership. With so many options available to clinicians, having a solid relationship can set a lab apart.

For example, when clinicians attend a trade show, they are looking at 400 vendors, all saying their products are the best. This can be overwhelming. Instead of the dentist wading through endless options, the lab can—and should—be a resource.

“I think the lab should be who the dentist calls when they are looking for advice about a product or company,” Rensburg says. “A lab can be a true resource, provided they are going to speak up and not play favorites but instead say, ‘Hey, here are the advantages of X over Y,’ regardless of any existing relationships with companies. Being transparent and honest is going to instill trust in dentists.” This means labs must research what options are available on the market and what dentists are looking for in a product or service.

“You need to understand your [clinician], what is being promoted to them, and their pain points,” Bormes says. “In 2017, dental school graduates listed implant dentistry as the key area they are not sufficiently prepared for. This is an opportunity to provide additional value other than just your product.”

Understanding what a clinician is looking for is key. Ask questions like “How can I create more efficiency for your practice? How can I help boost your revenue? How can I support your staff?” Then, Bormes says, the next step is to show them what your lab value proposition is. Whether that involves demonstrating how you can save them chairside time or investing in your relationship via an experience together (such as attending continuing education as a team), building that sense of a partnership is important. Helping clinicians increase their knowledge (and therefore confidence) leads to less stress, higher patient acceptance rates, and, ultimately, more revenue for all parties. “And remember to support the entire dental team, not just the dentist,” he adds. “Make sure your value proposition includes the hygienists, assistants, and front desk staff.”

“Become a resource and invest in your relationship, whether it be providing lunch-and-learns or continuing education to your dentists,” Bormes recommends. “Attend [the] Pankey [Institute], Spear [Education], or Kois [Center LLC] with your [clinicians]. Attend the same study clubs. Be the ‘technicians that know implants’ to these key prospective [clinicians]. You will increase respect and likely pick up new [clinicians] simply by being ‘the resource’ and sharing what they don’t know, whether that be material choice or technology.”

If your lab has the ability and resources, providing free continuing education to dental professionals can also attract attention. This positions the lab as a reliable resource for clinicians. Becoming heavily involved in treatment planning and case troubleshooting generates trust, building a closer relationship.

“It’s critical to provide complex and simple treatment planning,” Bormes says. “You need to be able to help choose the right framework, restorative components, and materials to provide the optimal solution for each patient. Dentists want lab advice on material options, restoration choices, and treatment planning. Understand the [clinician’s] experience level with each implant case and make the level of communication appropriate to provide peace of mind.”

Ultimately, providing support and accessibility is paramount to success. “We identify hundreds of implants and attachments each day,” Bormes says. “People trust us for their difficult cases, so the same professionals will trust our multiplatform prosthetics for their patients. We also strive to be ‘easy to do business with’ via extended hours, multiple ways to connect with us, and a senior technician on staff at all times.”

Stay Abreast of Research and Technology

To provide what a clinician needs, the lab must be expert on the available offerings. This means staying up-to-date and educated on the latest materials, techniques, products, and technology. Otherwise, Rensburg says, a lab becomes obsolete.

“It’s my job to know what kind of zirconia is out there,” he says. “It’s my job to know what kind of implants or restorative options are out there. And the way you do this job is by constantly educating yourself.”

This means the workday doesn’t end at 5 pm. For Rensburg, clocking out of the office means spending time reading articles or sitting in continuing education—for both technical and clinical sessions. Rensburg says he probably spends more time in clinical courses than technical, because it is important to understand what happens on the clinician’s side. For example, if a lab technician has never been chairside with a guided-surgery case, they cannot know what could go wrong and do not see a patient’s discomfort, or understand how making a mistake at the bench relates back to the chair.

“I think a lot of lab techs like to limit themselves to just technical, because of course that’s what you’re going to be doing, but you have to understand what a clinician is dealing with to be able to help them,” Rensburg says. “If you learn from clinicians, you can be a resource to other clinicians.” Rensburg and Bormes agree that you cannot gain this knowledge without participating in continuing education events, classes, or conferences.

“Attending education events is very important,” Bormes emphasizes. “Ideally, a noncommercial course will provide ideas, tips, or techniques, and is a great way to remain current and motivated.”

This is critical in the rapidly evolving world of implant fabrication. New technologies and improvements are frequent, so it is important for labs to stay current. For example, Bormes says, in the 1980s the biggest development in implant fabrication was the angled tissue extension abutment. More recently, it has been the angled access channel. Both developments allow the patient to have a reasonably priced, esthetic, retrievable, and strong screw-retained restoration, often eliminating the need for painful, expensive bone augmentation and lowering the risk of peri-implantitis from cement. Although this technology is now common, not understanding it (or other improvements that hit the market) can hurt a lab. This makes knowledge and flexibility imperative.

“We all strive to have each surgery be prosthetic-driven, but often the surgeon must place where bone is,” Bormes says. “These combined technologies allow for fixed or removable cases with up to 60º of angle correction.”

Continuing education is not only a chance for technicians to learn; it presents a good marketing opportunity as well. “I recommend technicians who come back from a course send a note to their dentists informing them of the course they attended, what they learned, and inviting them to a lunch or meeting to discuss,” Bormes says. “It all goes back to being that invaluable resource.”

To be that all-encompassing resource, labs need information about companies, products, and materials. Being limited to a single company or product line can limit a lab’s capabilities and hurt its ability to offer a range of services. Although you may have companies you work more closely with, keeping an impartial and open mind about which offerings are the most effective for a specific indication is important. Not only will this allow a lab to provide superior services, but it will also build faith with clinicians who will trust that you are recommending the best product and not just promoting a company with which you may have ties.

“You will obviously build closer relationships with some companies over others,” Rensburg reiterates. “But a clinician needs to trust that when they ask you a question or what you think about a product, you will speak your mind truthfully and not play favorites just because you have a relationship with a company or rep. Instead, you should be honest and say, ‘Hey, these are the advantages, this is what I like or don’t like, and this is what I think you should do.’ This will build trust while also providing the best restorations.”

“Don’t be a ‘Brand X only’ lab,” Bormes agrees. “Learn multiple platforms. The value implant segment is the fastest growing in the United States. For example, in Europe, the value segment is expected to account for 60% of units placed by 2024. You never know when the surgeon is going to change brands, or a new patient presents with a system the doctor is not familiar with. It’s the same as with restoration types (ie, not every crown should be cemented porcelain fused metal or screw-retained ceramic): Be familiar with the indications and contraindications for many restoration types to be that resource for your clients.”

Labs can provide multiplatform prosthetic offerings by branching into multiple brands and restoration types. A lab that is a 1-stop shop can provide the widest selection of implant parts and attachment solutions for fixed and removable restorations. Because not all patients are the same, not being tied to 1 implant brand allows labs to provide clients with the best restorative parts for each patient. “In the end, an implant is an implant,” Bormes says. “The patient only cares about the restoration.”

In-lab technology can also increase a lab’s appeal to dentists. When the return on investment warrants it, Bormes recommends that labs have a scanner. Until it makes financial sense to bring printing or milling in-house, labs should outsource their work. Technology can be a huge driver for labs—and for implant companies—so both need to constantly innovate and not fall behind the other available options.

But technology alone will not market a lab. Although having the latest in technology may seem like a huge value add, it may not matter if the lab is lacking elsewhere. Even if the lab has the latest, greatest gadgets, it will not be cutting edge without reliability and knowledge.

One example is digital dentures. When they emerged, many in the industry were skeptical and did not believe they could be high quality. Many clinicians were hesitant to trust in the new technology, even though digital dentures can be esthetic, functional, and stronger than those made by hand. From the lab standpoint, digital dentures are faster and cheaper but still deliver a better product, saving time and money. But none of that really matters if the clinician does not have the information to trust in the technology—information the lab should be able to provide.

“I think it really doesn’t matter what technology a lab uses,” Rensburg says. “I think what gives labs a marketing ability is understanding the technology. If a dentist hears about a new material, he should feel confident that he can call me because he trusts I will already know about it. Yes, if a lab doesn’t embrace new technology, it will eventually become obsolete—but only if you are scared of it instead of immersing yourself in the knowledge and understanding of it. You do have to continually innovate to drive your company forward, because otherwise you can’t offer the latest innovations. But you need to know what you’re doing.”

Focus on Quality, Not Quantity

The quickest way to destroy a lab’s relationships—and credibility—is to turn out a subpar finished product. Good relationships with clinicians and reps will not matter if you cannot produce a quality restoration. This means knowing your lab’s capabilities, strengths, and weaknesses, and realizing when a case is not feasible.

“It’s OK to say no to a case,” Rensburg says. “It’s crucial to be able to do that, because if you don’t, you’ll end up looking like a fool. Not all money is worth making—because if it’s a bad case, you’re not really making money anyway, since you’re going to be doing the case 2 or 3 times and wasting bench time.”

Not only can taking the wrong cases waste time and money, but it can hurt reputations. “At the end of the day, the clinician that was trying to take a shortcut or force a case that couldn’t be done will stand up at a dental meeting and tell people how bad the case was and what a bad job you did, even though you initially told him, ‘I don’t think this is going to work,’ ” Rensburg says. “It’s much better to say, ‘Doctor, with all due respect, I’m not going to accept this case because it’s not going to work.’ Otherwise, you will become the villain.”

Although rejecting cases can be difficult for smaller labs with only a few customers, it could make a huge difference in potential growth. When saying no to a case that simply will not work, a lab is not being difficult; it is being smart. In the long run, turning down jobs could lead to more work in the future, because a lab will build a stronger reputation for producing impeccable, high-quality work.

“Ask yourself 2 questions with every case,” Bormes says. “First, would I recommend this to my mom? Second, can I service this restoration in 10 years? It is becoming more important to provide life cycle support for implants.”

Providing life cycle support is a big value add. This ensures that clinicians know your lab can help troubleshoot for the life of the restoration and through all phases of prosthesis life, whether that be a reline, rebase, jump, or simply replacing attachments or screws. Ultimately, this means a longer life cycle for the restoration, a higher-quality restoration, and a happier patient.

“The continued excellence and quality of all implants on the market is one of the greatest developments in implant fabrication,” Bormes says. “With high osseointegration rates, now we can focus on what truly matters to the patient: the restoration. When is the last time you saw implant patients talking about what type of implant they have? As I mentioned, an implant is an implant to patients. Patients care about the quality, esthetics, and functionality of the restoration. They want the confidence of looking good, feeling good, and returning to as much of a normal quality of life as possible.”

Promote Your Expertise

When it all boils down, marketing is all about building relationships. In addition to building relationships, making connections with company representatives and implant reps can rapidly expand a lab’s business. Rensburg says it’s been his biggest business driver over the last 20 years.

“Build relationships with your company reps,” Rensburg says. “I’ll be the first one to admit that my relationships with my clinical implant reps have driven more business to me than any marketing or any speaking engagement because those guys are in the field. They can say to a doctor, ‘Hey, you’ve got an implant case, send it to this lab, this lab knows what it’s doing.’”

To build these relationships, Rensburg recommends getting the representative into the lab and talking about how you can collaborate and support each other. This opens the doors to not only a good relationship with a company representative, but a good relationship with someone who already trusts that representative. Although this does involve some selectiveness in the representatives you work with, he still emphasizes the importance of working with multiple companies and not becoming tied to a single brand.

When it comes to marketing to clinicians, traditional marketing can be ineffective. Unless you are a large lab with a big marketing budget or a brand-name chain, most referrals are going to come through community connections. However, there are ways to build your reputation as an implant resource that will not break the bank.

Bormes cites several primary steps for marketing a lab as a go-to for implant cases. He reemphasizes the importance of being a resource to dentists, completing continuing education, and adds several other tips including the following:

Highlight your best—and toughest—cases on social media.

Show clinicians how you can save them money, but be sure you are making money as well. Don’t be worried about being the lowest price; rather, make sure clinicians understand your value proposition and keep your focus on quality, turnaround time, and partnership. Offer multiple-tier pricing to make services more accessible and appealing. “You should have different price levels for different types of [clinicians] and patients,” Bormes says. For example, one can be using all OEM parts, and the other can be a value price using “multiplatform” (non-OEM) parts. “Many labs have increased profitability by offering tiered pricing,” he says.

Source referrals and testimonials that can promote growth for your lab. Ask a few of your favorite clinicians for a referral to “other dentists like them.” Eighty-six percent of dentists look for another dentist’s recommendation when choosing a lab. Testimonials from current clinicians are important to have on the lab website to highlight your value proposition.

Because there are so many moving pieces and parts, building a lab’s business—and maintaining that business—is no easy feat. Getting those components to move in synchronicity will have positive results.

“What we do is hard,” Rensburg says. “We have to build relationships, we have to be marketers, we have to create a product, we have to control the quality, and then we have to deliver on time. So we really capture every facet of almost every industry out there. It’s a one-of-a-kind industry.”

References

1. Dental implants. American Dental Association. Accessed 9 September 2021. http://www.ada.org/~/media/ADA/Publications/Files/ADA_PatientSmart_Implants.ashx

2. Dye B, Thornton-Evans G, Li X, Iafolla T. Dental caries and tooth loss in adults in the United States, 2011-2012. NCHS Data Brief. 2015;197:197.