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ePaper created 2014-11-23, 21:56:20 | version 1.30.01
I economy found that the average person considers implants too expensive and blames the dentist for the high price.4 Additionally,59%ofthepatientsexpecteda lifetime longevity. A previous study showed that 23% of the patients would not opt for implants at all.5 Anotherstudyassessingtreatmentadvicegiven after tooth extraction by Flemish general dentists in Ghent demonstrated that replacement was not recommended in 42% of cases. Of the remaining cases, 54% opted for a removable appliance and only one-fifth received advice for a single implant crown. It appeared that highly educated patients were more likely to receive a single implant, proba- blyongroundsoffinancialaffordability.Hence,de- spiteevidencethatasingleimplantisthebest,cost- effectivewaytoreplaceamissingtooth,itisseldom advised. It is obvious that other patients’ and clini- cians’ arguments prevail in the decision-making process.6 _What the future brings Given the current economic situation, dental healthcareexpenditurewillprobablyslowdownor even be reduced. With budget cuts and savings deemednecessaryintheEUforthecomingdecade, an insecure situation or the perception thereof by manypatientswillrequiredifficultchoices.Inmany countries, national health or private insurance sel- dom reimburses patients for implant prostheses, leading to large groups of patients requiring re- placementsbutbeingwithoutthemeanstopayfor them.Theremainingpatientscanafforddentalim- plants, but have high and often unrealistic expec- tations regarding the device and are very critical. It is a challenge for clinicians to deal with these economic factors and offer good treatment to as many patients as is feasible. The clinician should advise the patient which treatment option is preferable based on individual risk assessment, but the patient’s preferences, including financial af- fordability,andthelong-termcost–benefitaspects are gaining importance and cannot be neglected._ Editorial note: A list of references is available from the publisher. 30 I implants4_2014 Highly educated patients were more likely to receive a single implant, probably on grounds of financial affordability. Prof. Hugo de Bruyn is Chair- man of the Department of Peri- odontology and Oral Implantology atGhentUniversityHospitalinBel- gium.AspartoftheEAO2014sci- entific programme, he presented a paper on cost-effectiveness. _about the author implants [PICTURE: ©JAMBOSTOCK]