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Implant Tribune Asia Pacific Edition | 4/2017 IMPLANT NEWS XXXXXXX 19 “Implant failure is a failure for both the dentist and the patient” “A holistic view on medical conditions that includes oral health has not been established in clinical medical practice.” For us, it is important to ensure that patients have the correct in- terdental brushsize. This means that we tell them what size they need. A dental hygienist or perio- dontist usually gives instructions and explains everything. One al- ways needs to determine the cor- rect sizes and give proper instruc- tions. As an implant specialist, what do you think about prevention? There does not seem to be a strong connection between im- plantology and prevention at irst, but just look at the problem of peri-implantitis. One needs to treat peri-implantitis as a bacte- rial problem and thus one must give clear instructions for clean- ing, which involves interdental brushes and mouthwashes. Pre- vention is always the golden rule for any implant. If I do not see good oral hygiene in my patient’s mouth, I do not place the implant. I wait for a couple of months for the oral hygiene to improve. If I consider it acceptable, then I place the implant. How do you deal with implant fail- ure? Implant failure is a failure for both the dentist and the patient. It is a headache for dentists, and in the worst case, patients will not be able to enjoy a beautiful smile. Periodontal treatment and oral hygiene are important before and after every implant placement. Before and after surgery, I usually explain oral hygiene and motivate my patients. Just recently, I placed an implant in an 84-year-old pa- tient. Six months after placement, I have seen improvement owing to interdental brushes. Oral hygiene treatment is mostly taken care of by dental hygienists. Most larger clinics employ at least one dental hygienist and it seems that Dubai citizens make extensive use of them. Is there a good part- nership between hygienists and dentists? There is very good coopera- tion. I am not interested in clean- ing and my dental hygienist is not interested in placing im- plants. We are both happy to do our work. The profession of den- tal hygienist does not exist in some countries, such as in France, where I lived for a long time. There, the dentist cleans and pol- ishes for 10 minutes. Here, our ap- pointments last for 45 minutes. We explain to the patient how to perform the necessary post-oper- ative care. How do you explain it usually? We simply show them how to brush their teeth and interdental spaces properly. If one just pre- scribes a certain toothbrush to pa- tients on a piece of paper without instructing them, they will likely go to the pharmacy and buy a dif- ferent one. If you give it to them, let them try it anrd help them use it correctly, the possibility of the patients buying the correct brush is higher. You completed a programme on individually trained oral prophy- laxis (iTOP). What was your im- pression? I did the iTOP programme a year ago. Although I liked the programme a great deal, we have still seen that not all pa- tients take the time and really apply what they have learnt. Some patients are really moti- vated and sit down with us to learn more about the system. The dentist and dental hygien- ist then work together. In to- day’s fast-paced world, we need to convince patients that they have to take care of individual prophylaxis. For dental hygien- ists and dental students, iTOP gives dental professionals a gradual awareness of how to provide oral hygiene for their patients. I think that iTOP for students will work well for fu- ture dentists. Thank you very much for the inter- view. AD register for FREE – education everywhere – no time away from and anytime the practice – live and interactive – interaction with webinars colleagues and experts – more than 1,000 archived across the globe courses – a focused discussion forum – a growing database of scientifi c articles and case reports – free membership – ADA CERP-recognized no travel costs credit administration Dental Tribune Study Club Join the largest educational network in dentistry! www.DTStudyClub.com ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Dr Iyad Estoiny By Marc Chalupsky, DTI Originally from Syria, Dr Iyad Es- toiny obtained his master’s degree in ixed and removable prostho- dontics in France before moving to Dubai in 1997. An implantologist and general dentist at GMCClinics in the heart of Dubai, Estoiny also focuses on prosthodontics and aes- thetic and laser dentistry. In an in- terview with Dental Tribune, the implant specialist spoke in favour of proper oral hygiene and individ- ual prophylaxis training, two areas of dental care that are essential for long-term implant success. Dental Tribune: You are originally from Syria. How was the dental training at your school? Dr Iyad Estoiny: I received my DDS in 1991 from Tishreen Univer- sity in Syria. There are four dental schools in Syria, along with many practitioners. A number of Syrian dentists have moved to the UAE because of their good dental knowledge. The dental education is still excellent in Syria. Can you summarise the state of oral health in Dubai? As Dubai is a multicultural city, one sees problems from all over the world. Some patients are highly motivated in terms of their oral hygiene, while one has to put in a great deal of effort with some others. In terms of oral hygiene, I have seen that people have started to become aware of dental problems and products. In the last ive years, people have become more focused on beauty and aes- thetics, which in turn has led to a higher interest in healthy teeth. We also have an overwhelm- ingly young population in this country; consequently, there are only a few older dentists here. Eighty per cent of expats are young. This means that one does not see any advanced periodontal problems, but one does increas- ingly see stress-related bruxism, which in turn leads to periodontal problems. How would you evaluate the mar- ket for oral hygiene in this region? The market here is competi- tive and small. We do not sell the products, but give it to patients. If they like it, they can buy it at the pharmacy. This has worked well.