Replacing Missing Teeth: Dr. Darshan Parikh Explains Dental Implants and Why They Matter (Part-1)

Dr. Darshan Parikh: My name is Dr. Darshan Parikh, and I am based in Pune, where I was born and brought up. I completed my undergraduate dental education at Nair Hospital Dental College, Mumbai, which is regarded as one of the leading dental training institutions in the country.

From my school years, I have been deeply involved in sports. Physical activity has always been an integral part of my life. I have been running half marathons consistently for nearly twenty years now. I started during my internship, and this coming January will mark my twentieth consecutive half marathon in Mumbai. It has become an annual ritual for me.

Alongside my clinical practice in Pune, I have been actively involved in continuing dental education, particularly in the field of implant dentistry. I underwent advanced training at IFZI, the International Training Center for Dental Implantology in Germany. For the past three to four years, I have been conducting part of this training program in India and then taking dentists to Germany to complete the remaining curriculum.

I run my own general dental practice in the heart of Pune city and enjoy all aspects of dentistry, from pediatric care to complex full-mouth rehabilitations. Over the last few years, implant dentistry has naturally become one of the key focus areas of my practice.

Dr. Darshan Parikh: This is an important question, and I think it is something many professionals often overlook. A large part of my approach comes from my background. I studied in a very sports-oriented school and played several sports at a competitive level, including basketball, swimming, softball, and handball. Physical activity was always part of my routine.

That said, during dental school, especially in demanding departments like prosthodontics, our schedules were intense. We would reach college early in the morning and often stay until late evening. My level of physical activity went down a little bit in the third and final year, which are quite heavy academically. However, having a strong sports foundation and getting the opportunity to be trained for half-marathons helped me return to a disciplined routine later.

We focus a lot on our profession, but we neglect our health, and what we don't realize is that health is what we really need. Health truly is wealth. If you are healthy, you can work productively for a longer period. Dentistry is physically demanding, and over the years, I have experienced neck and back issues, like many clinicians, in the last 20 years of my practice. We made necessary ergonomic changes, such as modifying the dental chair and using loupes, but physical fitness remains essential.

To answer your question, both motivation and discipline play a role, but discipline is far more important in the long run. Motivation can fluctuate. Discipline ensures consistency. Today, it is no longer about achieving faster times or personal records. It is about showing up regularly and doing the work.

This mindset applies equally to clinical practice and learning new skills. Consistency, discipline, and showing up every day are what ultimately lead to meaningful progress.

Dr. Darshan Parikh: It’s very interesting to frame the question this way. Over the weekend, at the study club that we attended, one of the lecturers said that peri-implantology is going to become a specialization in itself in the future. 

For the general public, a dentist is simply a doctor who treats teeth, and people usually visit a dentist only when they are in pain or discomfort. This is true even across the medical fields. Patients rarely seek care unless there is a problem.

An implantologist, in simple terms, is a dentist who replaces missing teeth using dental implants. Implantology is not a standalone specialty. A dentist becomes an implantologist by acquiring the scientific knowledge and clinical training required to place implants safely and restore teeth over them.

Implant dentistry has two major components. One is the surgical aspect, which involves placing the implant in the bone. The other is the prosthetic aspect, which involves placing the tooth over the implant. An implantologist should have a sound understanding of both. Dentists from various backgrounds, such as oral surgery, periodontics, prosthodontics, or general dentistry, may practice implantology if they are trained appropriately.

Dr. Darshan Parikh: This is a very good question and I cover this in my IE101, which is the foundational level implant training that we do. This is a very relevant concern. Implant dentistry is unique because patients often come without complaints related to missing teeth. Usually we treat the issue patients come with. However, the procedure of implant placement itself involves pain and temporary discomfort, both during the surgical and prosthetic phases. This makes it especially important not to push implants unnecessarily.

My first responsibility is always to address the patient’s chief complaint, usually pain. Once that is managed, my role shifts to education. I explain what is missing, why it matters, and what the available options are, whether it is a removable denture, a bridge, or an implant. If the patient is receptive, I guide them toward the option that is most suitable for their age, bone quality, and long-term oral health. For example, in a younger patient with good bone support, an implant may preserve bone and prevent future complications better than other options.

Visual aids are extremely helpful for making the patient realise the seriousness of the situation. Photographs, scans, or digital models allow patients to understand the consequences of missing teeth, such as bone loss, tilting of adjacent teeth, or supre-eruption of opposing teeth. At the end of the day, education is our duty. The decision must remain with the patient. If they choose to proceed, that is good. If they do not, that must be respected. Our role is to inform clearly and honestly.

Dr. Darshan Parikh: The most common challenge I encounter is simple lack of awareness. Many patients do not even realize that a tooth is missing. They are able to eat, function, and live comfortably, so they do not perceive the absence of a tooth as a problem that needs attention. In such cases, the issue is not resistance, but ignorance. The second concern arises when there is no pain associated with the missing tooth. If a patient has come to you with pain in one area and you start discussing a missing tooth elsewhere, it can feel disconnected from their primary concern. Trust cannot be built instantly in such situations. Over time, your role is to gently draw their attention to the missing tooth and explain its relevance to overall oral health, rather than forcing the conversation in a single visit. Another major barrier is fear, often driven by hearsay. Many patients have heard negative stories from friends, relatives, or neighbours about implants failing or causing complications. In most cases, they do not know what actually went wrong or why. This fear is closely linked to lack of understanding and misinformation.

As patients become more aware, newer concerns emerge. They begin asking practical questions: How long will the implant last? Is there a warranty? What happens if something fails? These are valid questions and should be addressed transparently.

The way to handle all of this is not by selling implants, but by basing recommendations on proper diagnosis. We do not promise implants to every patient. We first assess whether the patient is a suitable candidate, how many implants may be needed, and what the long-term implications are. These decisions are supported by clinical findings and diagnostic parameters, which are explained clearly to the patient.

One of the most effective tools in building trust is documentation. Showing patients your own treated cases (real clinical photographs and follow-ups) creates far more confidence than generic animations or stock images from the internet. When patients see results from your own practice, the treatment feels real and relatable. With time, as you document more cases and gain experience, confidence naturally grows, both for the clinician and the patient. That confidence, combined with honest education, is what helps overcome these initial misconceptions and fears.