We thank Dr Ramachandra for the comments regarding our paper on dental implant tourism. The main issue facing implant tourism is accountability,1 which can differ significantly from country to country. Regulation of training, however, is similar in some ways as this also differs from country to country with no global uniform standards. However, market forces related to dental implant companies wishing to sell their products with short courses on implant management occur in many countries throughout the world. The underlying issue that this letter addresses is the scope of dental implant management in general dental practice and whether the undergraduate or postgraduate dental degree provides the training for a dentist to undertake implant treatment. This issue is difficult to assess as dental school curricula in regards to implant training can vary significantly even within the same country, let alone between different countries.
We agree that basic implant dentistry is now the realm of the general dental practitioner. Recently, an attempt has been made to address the issue of regulation at a dental school level in Australia. In 2010, a consensus document was created with representatives from all the major dental schools which defined the guidelines for implant education, not only for dental students but for general dental practice as well.2 This was followed up by the publication of key competencies of implant management at the graduate dentist level.3 Such education has already started to be implemented into the dental curriculum with the Melbourne Model dental degree incorporating dental implant treatment planning as part of its curriculum. Guidelines have also been established for those graduate dentists wanting to undertake further training and gain competencies in implant dentistry procedures to facilitate the provision of dental implant treatment options at a general dental practice level.4
Although one would expect postgraduate training in such specialities as oral and maxillofacial surgery, periodontics or prosthodontics to provide adequate training for dental implant management, even these courses or training programmes should undergo a level of clinical governance and audit to maintain standards and quality. We have published such outcomes in late 2009 of the training programme in Victoria.5 Not only do such audits allow assessment of quality but they also have given us valuable feedback allowing implementation of improvements. The programme is scheduled to be re-audited soon.
Suboptimal dental care, though, can occur in any country throughout the world. Regulation of standards in implant dentistry will probably aid the quality of treatments performed. Nonetheless, regulation still cannot address the main issue of accountability with dental implant tourism nor can it provide compensation and management of complications for those who have had suboptimal treatment.