The business of dental implants

 

I have two dental implants, the first of which was done nearly ten years ago. They were both done after a tooth broke and the dentist told me he couldn’t save the tooth. I could have just left the hole, but elected to fill it with an implant, which was done in each case by a maxillary surgeon, not the dentist. So far, I’ve been very happy with the results. What is a dental implant?

“In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use "full-arch" or "All-on-4" implants to replace all their upper or lower teeth -- or all their teeth.”

It looks like dental implants are being done by dentists now. And not for the better:

“Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry's fundamental goal of preserving natural teeth and have become too willing to remove teeth to make room for expensive implants, according to a months-long investigation by KFF Health News and CBS News.”

And it’s not just that dentists are doing unnecessary implants. In many cases, they’re doing them badly:

“Dentists are not required to learn how to place implants in dental school, nor are they required to complete implant training before performing the surgery in nearly all states. This year, Oregon started requiring dentists to complete 56 hours of hands-on training before placing any implants. Stephen Prisby, RDH, executive director of the Oregon Board of Dentistry, said the requirement -- the first and only of its kind in the U.S. -- was a response to dozens of investigations in the state into botched surgeries and other implant failures, split evenly between general dentists and specialists.

"I was frankly stunned at how bad some of these dentists were practicing," Prisby said. "It was horrendous dentistry."

For both of my implants, there was about a two-month wait after the base was installed before the crown—the external prosthetic tooth—was screwed in. In one case, I had a bone graft first, before the base was installed, and that involved another four months before the graft took. In both cases, I saw the image of the base right after it was installed and then after two months when the bone had grown in around the base. Now, it appears that some dentists are doing the whole procedure—tooth removal, base installation and crown installation—in a single procedure:

“Becky Carroll was missing a few teeth, and others were stained or crooked. Ashamed, she smiled with lips pressed closed. Her dentist offered to fix most of her teeth with root canals and crowns, Carroll said, but she was wary of traveling a long road of dental work.

 

“Then Carroll saw a TV commercial for another path: ClearChoice Dental Implant Centers. The company advertises that it can give patients "a new smile in as little as one day" by surgically replacing teeth instead of fixing them.”

This focus on money is being driven in many cases by private equity firms, which are buying up dental practices. While they insist they don’t meddle in clinical decisions, this is just gaslighting. Dentists in these practices know they have to bill at a certain level. It’s the patient who pays the price—literally—since dentistry isn’t covered by regular health insurance.

This ain’t your father’s dentistry, peeps.

 

https://www.medpagetoday.com/primarycare/dentalhealth/112740?xid=nl_mpt_investigative2024-11-06&mh=eb71348a5ff6ae370cc6759bc5dc3300&utm_source=Sailthru&utm_medium=email&utm_campaign=InvestivativeMD_11062024&utm_term=NL_Gen_Int_InvestigateMD_Active