Question: What criteria govern the addition of a product to your clinical armamentarium?
Gary Alex, DMD; Gregg Helvey, DDS; V. Kim Kutsch, DMD
Dentists are continually bombarded with marketing ads for “new,” “improved,” and “better” products and materials. It is often difficult to tell fact from fiction and if the “new” product is really that much better than the “old” product. It is not uncommon to buy the “new” product only to find that it is shortly replaced by an even “newer and better” version of the same product. Most dentists have a closet somewhere full of obsolete products that “seemed like a good idea at the time.”
Dental manufacturers are under intense pressure to produce and market “new” materials and products to remain competitive in the fickle dental marketplace. The problem is there is often little or no controlled clinical testing of these products before their introduction and it is often the patients who wind up as the clinical testers of materials. So how should dentists decide what materials to buy and use?
While not perfect, many reputable publications and websites offer an objective, relatively unbiased evaluation of dental materials and products. Listen to speakers and opinion leaders you trust and respect knowing they also have their own bias and sometimes a financial interest in a product they recommend (that hopefully is disclosed). Be suspicious of “testimonials” used in marketing advertisements. Those giving testimonials often have an agenda that has nothing to do with the actual clinical effectiveness of the product.
The manufacturer counts. Some dental companies have truly earned their reputations for integrity, quality, and honesty regarding their products and general interaction with the dental community.
Is the product something you really need? Unless there is a compelling reason for doing so, stay with what works. Be aware of current and future trends in dentistry and start thinking about dental materials and products accordingly. Dentistry is changing so quickly it is easy to be suddenly left with an office full of antiquated materials and products. Be cautious but open to change, new ideas, new products, and new materials. To quote the poet Alexander Pope: “Be not the first on whom the new is tried, nor yet the last to lay the old aside.”
After 33 years of clinical practice I have seen my share of the “latest and greatest” products come and go. There are a number of factors that should be considered when incorporating a new product into one’s practice. The risk/benefit ratio for the patient is certainly a major concern along with the scientific data (especially the source of the data: independent versus manufacturers) and the track record of the manufacturer. Dentists (as well as the patients) have been, without their knowledge, field testers for a long list of short-lived dental products. Are the claims made by the manufacturer realistic and how do the promises compare to similar products?
Who is making the product is another consideration. Is it actually made by the manufacturer or by another company and “private labeled?” There are a number of products with a different manufacturer’s label that are made by the same company. Where the product is made is another factor that could affect the accessibility and quality of technical support. Sometimes when a product is made outside the United States, an answer to a technical question may not be readily available. Critical situations occur, for example, when a patient is in the chair and a technical answer is necessary in a timely fashion but the answer heard over the phone is, “we are away from our desk and we’ll get back to you.”
Another factor to consider is the technical difficulty of the product not only for the clinician but also the staff. Will the use of this product require extra training for the staff and how easily can other staff become cross-trained? Our competitive nature might compel us to be the first to have the newest product or technique on the block, but using some caution and waiting for clinical evidence may prove to be prudent.
Dentistry is changing at a rapid pace and new products are being introduced at an unheralded rate. Clinicians are challenged with wading through this maze of products and promises and making sense of it for the benefit of our patients. Whenever I am evaluating new technologies, materials, or techniques, I always begin with one question: Will this new product improve the treatment outcome for my patients? Will it provide the stable, successful, and predictable treatment outcome I am looking for? That’s the starting point; of course, the more scientific evidence there is to validate the claims being made, the better. But the reality for our market today is that a material may have only a 2-year life expectancy before it becomes obsolete. You’re not going to get to see 15-year clinical trials in that environment. I want as much good scientific evidence as possible, but the truth is, most of the 10-year clinical research today is actually being done on the public. I want to know if the treatment outcome is not improved, is it as good as my current system, but with improved patient comfort or significant time savings? Does it provide the same treatment outcome but with an improved experience for the patient? If it’s a material or technology, I want to know who is distributing it and providing ongoing support for the product. How long before it will become obsolete? If it is an expensive technology, does it have a reasonable return on investment, and will I be able to upgrade it as improved versions become available? I also look for the recommendation of colleagues who have had clinical experience with the product, how is it working for them? Does it live up to its claims? By taking a little time and asking the right questions, focusing on treatment outcomes, clinicians can make sound decisions on new products to include in their clinical armamentarium.
About the Authors
Gary Alex, DMD
Dr. Alex is the co-director of the Long Island Center for Dental Esthetics and Occlusion in Huntington, New York, and has a private practice in Huntington, New York.
Gregg A. Helvey, DDS
Dr. Helvey is an adjunct associate professor at Virginia Commonwealth University School of Dentistry in Richmond, Virginia, and has a private practice in Middleburg, Virginia.
V. Kim Kutsch, DMD
Dr. Kutsch has a private practice in Albany, Oregon.