Dr. Darshan Parikh: Definitely the IFZI program. I had already undergone my implant training and was exposed to more complex procedures starting around 2013, 2014, and 2015. During that phase, I was attending almost everything I could - ISOI conferences, ITI study clubs, and any other lectures that were happening, whether online or offline, wherever they were being conducted. That continuous exposure was ongoing. About three years later, I did my IFZI training, and that genuinely changed my approach not just to implant dentistry, but to dentistry as a whole. The biggest shift came from focusing on the smaller, often overlooked aspects of clinical practice. Things like workflow optimization, patient positioning, operator positioning, organization of the operatory - these details make a massive difference in how efficiently and predictably you work. Because my practice is not exclusively implant-focused and a large part of my time is still spent doing general dentistry, I was able to adopt and integrate these principles across all procedures, not just implants.

We were always practicing what you could broadly call four-handed dentistry, with an assistant helping out. However, from around 2018 onwards, there was a conscious shift. I started formally training my staff, putting clear protocols in place, and moving toward six-handed dentistry as the standard. Today, six-handed dentistry is the norm in my practice, even for something as basic as scaling. When it comes to implant procedures, the setup becomes even more structured. We move into what is essentially eight-handed dentistry. That includes me as the operator, two sterile assistants assisting chairside, and one floater managing instruments, materials, and overall workflow. This level of organization has significantly improved efficiency, reduced fatigue, and enhanced consistency in outcomes across both surgical and non-surgical procedures.

Dr. Darshan Parikh: I see digitalization already happening across the entire spectrum of implant dentistry, from the planning phase right through to execution and restoration. Even something as routine today as a CBCT is part of this digital shift. More importantly, our ability to plan using CBCT data has improved significantly. We can now visualize scans in three dimensions far more accurately, which directly improves diagnostic precision and surgical planning. The next step we are actively looking to incorporate into our workflow is intraoral scanning. We have consciously held off for a long time, but ideally, the future workflow should involve creating a complete digital dataset. That means taking an intraoral scan, acquiring a CBCT, and then merging these two datasets. This gives a very accurate representation of both the intraoral situation and the underlying bone anatomy. With this combined data, you are far better prepared, whether you are planning a guided surgery or even a freehand procedure, because your understanding of the case is far more precise.

When it comes to guided surgery, robotics is clearly emerging as a major development, but these advancements come with very high price points. For example, the Yomi robotic system currently costs a little over one crore rupees. Is that something a dentist like me can realistically invest in if I am placing one implant a week? No. But in a large hospital or institutional setup where 8–10 implants are being placed daily, investing in robotics for potentially better outcomes may make sense. So, yes, the field is definitely moving in that direction.

This naturally leads to the broader question that is being asked across many professions; if AI and robotics continue to advance, what happens to clinicians? Will dentists eventually be replaced? That is an interesting discussion, particularly for the surgical side of dentistry, but for now, technology remains an adjunct rather than a replacement.

On the prosthetic side, digital workflows are already well established. Most modern labs are using scanners, 3D printing technologies, and milling systems. Restorative materials, whether zirconia for definitive restorations or PMMA for long-term provisionals, are increasingly being fabricated through fully digital workflows. This part of implant dentistry has already embraced digitalization to a large extent.

Going forward, I see these technologies becoming more commonplace as adoption increases. With wider adoption, price points will inevitably come down. Just like CBCT, what was once available in only one center across an entire city is now widely accessible. As a result, costs have dropped as well. A scan that once cost ₹2,000 now costs closer to ₹1,000 in many places. Better access, lower costs, improved planning, and more predictable outcomes ultimately translate into better results for patients.

Dr. Darshan Parikh: I think the pace at which dentistry is progressing, implant dentistry is something that will need to be taught at the BDS level. At the end of the day, implants are a part of dentistry. There is nothing inherently special that says implants can only be performed by someone who calls themselves an “implantologist,” especially since we do not have a single, standardized curriculum that defines implantology as an independent specialty. Within implant dentistry itself, there are multiple layers and directions of growth. Some clinicians focus on soft tissue management, others on hard tissue augmentation, some go on to perform advanced procedures like zygomatic implants. These are all extensions within the same field. Naturally, this means that continuing education will always remain essential, because no single course can cover everything. That is true for every branch of dentistry.

If you look at how dentistry has evolved, procedures like composite restorations and root canal treatments have become routine. Nobody today says that only an endodontist can perform a root canal. The orthodontic fraternity is currently going through a phase of transition with the rise of aligners. There is a lot of debate within the profession. The orthodontists are expressing concerns about general dentists providing aligner therapy. Similarly, the oral and maxillofacial surgeons are debating who should practice cosmetology, and professional bodies are issuing statements. We see these discussions frequently, even on platforms like LinkedIn.

Implantology, being a surgical discipline, should still be introduced at the undergraduate level, not with the expectation that every BDS graduate must start placing implants but to create awareness. India has a massive population and a huge unmet need. Early exposure allows a student to understand what implant dentistry involves and then decide for themselves whether they want to pursue it further or not. Importantly, not pursuing implants does not make anyone a lesser dentist. You can build a very fulfilling and financially viable career focusing purely on scaling, restorations, and conservative dentistry. If you are exceptionally good at composite work and can charge ₹5,000 per filling, doing three or four high-quality restorations a day already puts you in a very comfortable position. Work five days a week, have your coffee, and still lead a balanced, happy life.

Ultimately, it comes down to identifying your niche. Dentistry today offers multiple pathways. The better you become at any one area, and if that aligns with your personal and professional goals; you should absolutely pursue it with full commitment.

Dr. Darshan Parikh: For dentistry in general, as we discussed earlier, there is definite scope. However, it often comes with certain trade-offs, especially early in your career. For instance, if you choose to move to a smaller town, you may have to compromise slightly on lifestyle, like fewer entertainment options, and social outlets, which might feel important when you are younger. That said, from a purely earning potential perspective, dentistry still offers solid opportunities, particularly in underserved areas. As a profession, dentistry must uphold certain minimum standards, not just in terms of income and pricing, but more importantly, in the quality of care delivered. You cannot justify charging ₹2,000 for a scaling and then delivering substandard treatment. Patients today are informed, and expectations are higher. The only sustainable way forward is to raise your own standards. Continuous learning and self-improvement are non-negotiable. There is no shortcut to becoming better at what you do unless you invest in yourself. In fact, that investment in education and skill-building will likely give you better long-term returns than most financial investments people talk about today.

Specifically for dentists who want to get into implant dentistry, the same principle applies: do not compromise. Avoid the mindset of completing a short, two-day certificate course or a company-sponsored program and assuming that you are now fully equipped to place implants. Implant dentistry, even in its simplest form, is multifactorial. It involves biological, mechanical, prosthetic, and patient-related considerations. Superficial training can put both you and your patients at risk. The approach should be to learn properly and keep learning. Especially in the first few years, attend every credible program you can, listen to different perspectives, and expose yourself to good-quality education. I remember that immediately after graduating, I would sometimes walk out of implant lectures because at that stage I was more focused on endodontics and prosthodontics. I invested heavily in hands-on training in those areas, and in hindsight, I consider it good fortune that I trained under some of the best clinicians in the world for those disciplines.

When I eventually decided to get into implant dentistry, after running my own clinic for a few years, I carried forward the same philosophy. Over time, implants became more than just another procedure; they became a genuine area of interest and passion, eventually even leading me into teaching.

So, for anyone looking to enter implant dentistry, the message is clear: do not compromise on training. Attend as much high-quality education as you can. Be willing to spend on good programs. Learn from clinicians who not only teach well, but who are also doing consistently good clinical work. That foundation will define the quality, confidence, and longevity of your implant practice.

Dr. Darshan Parikh: One important point is that just because you want to start implant dentistry does not mean that every patient automatically becomes an implant candidate. Case selection is fundamental. You must be able to objectively assess whether a particular patient is suitable for implant therapy, both locally and systemically, and also from a behavioral and maintenance perspective. Second, your foundational knowledge and preparation must be solid. Completing an implant course does not mean you should immediately start placing implants indiscriminately. You should begin cautiously, applying the knowledge you have gained in a responsible manner. There is no need to rush. Implant dentistry rewards patience and careful decision-making far more than speed.

For your initial cases, ideally the first 5 to 10, it is strongly advisable to work with support. This could be a senior clinician or a trusted colleague whom you can rely on. There is a significant difference between sending a CBCT to a senior and asking, “I’ve planned this case, is this okay?” versus involving them more actively by saying, “This is the case, this is the data. Can you come over and assist or guide me during the surgery?” The latter approach provides real-time learning, confidence, and patient safety.

Another effective model is a buddy system with a peer at a similar experience level. You assist each other during surgeries; today you help in my case, tomorrow I help in yours. For this to work well, your clinical philosophy and thought processes should be reasonably aligned so that communication is clear and decisions are consistent. This shared learning approach can significantly reduce stress, improve outcomes, and accelerate your clinical maturity.