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markets have been highly penetrated,
such as Korea and Japan. Statistically
speaking, per 10,000 people, they have
more people who need and are getting
implants. So why are we behind? Part
of it is the general dentist population,
who patients go to and trust —
DC: The quarterback.
DT: More like the gatekeeper. The guy
you trust, who does not feel comfortable
doing an implant, so he does a
bridge. And the patient doesn’t question
it, unless the patient is well educated
and realizes there is another
possible route. Today, the Internet is
helping. I’ve said this to my own academy
in periodontology: “Don’t hesitate
to train the general dentist now.”
They’ve been fighting general dentists,
and I’m on record now saying this, as
a teacher: “If people want to learn
something, they’re going to learn it.”
When I at first was not allowed to take
the course that Brånemark gave, I had
to take it as a prosthodontist, not as
a periodontist. But we periodontists
had a will. This was something that
we wanted, and we found a way to
learn. The general dentist who wants
to learn is going to do the same thing.
So why don’t we be the ones to teach
them in a way that is accepted, so they
can decide whether they want to do
implants? They’ll still come to us for
referrals in the more difficult cases,
and even in some regular cases — and
for their mother and their father. What
I’m saying is, if we had penetrated the
market by 50, 60, 70 percent, everybody
would be looking at each other’s
cases, and stealing each other’s cases.
But here’s the key: Because we’ve
only penetrated the market by about 8
percent, there’s such room for expansion,
for the whole pie to grow. And
that’s when everybody will be happy,
including the general dentists who
may want to do something different,
as well as the periodontists, the oral
surgeons and the prosthodontists. The
market will expand for everybody.
The key is to get the word out to the
general dentist and to the patient that
Because we’ve only penetrated the market
by about 8 percent, there’s such room for
expansion … And that’s when everybody
will be happy, including the general
dentists who may want to do something
different, as well as the periodontists, the
oral surgeons and the prosthodontists.
implants are safe and reliable when
done properly. The periodontists,
prosthodontists and oral surgeons can
all do their part, and everybody should
be happy because the pie will grow.
DC: We’ve seen that the metric you mentioned
— the number of implants placed
per 10,000 inhabitants — is pretty common
within the industry. One thing
we’ve noticed is that those countries
with the highest level of penetration are
also the countries where the cost is the
lowest — not only the treatment cost to
the patient, but also the cost of the components,
the materials, the implants. Do
you think there is a direct correlation,
or is this a coincidence?
DT: Well, I think it may be part
coincidence, due to some of these
countries tending to be more
nationalistic from a business standpoint.
Whereas the big companies had market
share in many parts of the world —
often total market share — some places
like Korea, to give an example, began
to develop their own industry, and
they began making their own implants.
So there were Korean companies
making their own implants, and they
were moderately priced — not even
inexpensively priced. Some people in
these countries said, “OK, the quality is
there, I’m Korean, and I prefer to buy a
Korean implant.” So the big companies
lost some of their market share there.
The same thing is happening in Brazil.
Part of that is because it’s inexpensive,
but part of that is a feeling of national
pride in being able to place a Korean or
a Brazilian implant, for example. If you
look at the implant marketplace around
the world, let’s say in Germany — which
is a big implant market, as you know
— one of the German-made implants
is always one of the biggest sellers,
certainly one of the top two or three.
In Switzerland, it’s Swiss implants. In
Sweden, the Swedish implant is number
one. So there’s a bit of a nationalistic
flavor to the implant world.
DC: It’s the World Cup of dental implants.
DT: That’s about right. In the U.S. for
a while, it was that way, too. We were
certainly strong contenders. Americanmade
implants just felt comfortable.
That’s what I think was going on. Of
course the economy today is so difficult,
certainly in Europe. There are
ups and downs in Asia. And in America
now, we are just slowly starting to
come out of the recession. But we’re
getting there. I certainly see that in
my practice. Three years ago, when
we were all about to go over the cliff,
almost literally, people just stopped
spending. You couldn’t tell patients
they needed a full-mouth rehabilitation.
The words just wouldn’t come
out of your mouth. The question was
more, “What do I need now to hold
me off?” They weren’t ready to spend.
– Implant Q&A: An Interview with Dr. Dennis Tarnow – 13