Dentists are pulling healthy teeth, pushing implants for profit, report finds

CBS News and KFF Health News recently partnered up to produce an in-depth report on a concerning trend of removing healthy, treatable teeth in favor of dental implants in an effort to make more money. Reporters spoke with dental and financial experts, as well as Becky Carroll, a victim of a botched dental implant surgery, to underscore how dangerous this trend can be to patient health.

In response to the story, the American Association of Endodontists (AAE) released a statement in response to the CBS News and KFF Health News report to warn against the practice of unnecessary implants. According to the AAE, dental practitioners engaging in this activity are not only betraying patients' trust but also violating ethical standards.¹

"Every patient deserves comprehensive information about all treatment options, especially those that preserve their natural teeth, which offer a superior foundation for lifelong oral health." The AAE said. "We urge patients to seek second opinions and to be fully informed before agreeing to any irreversible dental procedure...We encourage all dental practitioners to remember that their responsibility is to their patients' health above all else, and to practice guided by the ethical principles of patient autonomy, nonmaleficence, beneficence, justice, and veracity."¹

Dentists are causing irreversible damage

Removing healthy teeth before exhausting all other treatment options significantly impacts a patient's quality of life. However, some patients are not properly educated or are unaware of the risks and life-altering side effects before opting to replace their natural tooth with an implant.²

Luiz Gonzaga, a periodontist and prosthodontist at the University of Florida, shared with KFF News and CBS News: "You don't go to the hospital and tell them 'I broke my finger a couple of times. This is bothering me. Can you please cut my finger off?' No one will do that. Why would I extract your tooth because you need a root canal?"²

And what happens when implants fail? Sometimes, patients don't have enough jawbone left to anchor another set, forcing them to get implants that reach into cheekbones. Not only that, but patients who receive implants risk surgery complications and future dental problems like high susceptibility to peri-implantitis-and any dental issues they may run into down the line will likely have fewer treatment options because their natural teeth are no longer there.²

Implant procedures (and profits) are on the rise

A single implant typically costs a few thousand dollars while full-arch implants are in the tens of thousands. Often, dental insurance does not cover these procedures, so many clinics partner with credit companies to offer patients loans.

Yet, on average, implant sales increased by more than 6% on average each year since 2010. Over 3.7 million implants were sold in the US in 2022, according to a 2023 report.²

Private equity firms are also buying large dental chains, many of which are owned by individual dentists and specialists who offer implant procedures. According to PitchBook, Aspen Dental bought ClearChoice for an estimated $1.1 billion in 2020, Affordable Care (whose largest clinic brand is Affordable Dentures & Implants) was purchased for an estimated $2.7 billion in 2021, and the private equity wing of the Abu Dhabi government bought Dental Care Alliance for an estimated $1.1 billion in 2022.²

The American Dental Association (ADA) reported that private equity deals with dental practices increased ninefold from 2011 to 2021. There is also an additional interest in oral surgery, possibly due to how expensive implants can be.

Clinical Hygiene

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Marko Vujicic, vice president of the association's Health Policy Institute, said: "Some argue this [interest] is a negative thing. On the other hand, some would argue that involvement of private equity and outside capital brings economies of scale, it brings efficiency."²

A cautionary tale

Lawsuits have been filed nationwide alleging that dentists at implant clinics have extracted patients' teeth unnecessarily, leaving patients with misaligned implants, or even unable to chew. Dentists who are heavily pushing for implants may be striving for lucrative income instead of the health of their patients.2

Edwin Zinman, a San Francisco dental malpractice attorney and former periodontist, said: "They've sold a lot of [implants], and some of it unnecessarily, and too often done negligently, without having the dentists who are doing it have the necessary training and experience," Zinman said. "It's for five simple letters: M-O-N-E-Y."

It's important to advise patients to make sure the clinic they're visiting has trained professionals with the proper medical training to perform such procedures. An analysis of over 1,000 clinic websites in major private equity-owned dental chains by KFF Health News and CBS News found that over 70% listed only general dentists and no other specialists. If patients see dentists without credentialing from implant training organizations, their safety can potentially be at risk as implant procedures typically require more formal training to perform these surgeries.²

Furthermore, if implants are a dentist's first suggestion to treating a damaged tooth, the patient should consider getting a second opinion. Prioritizing patient education and preserving natural teeth whenever possible is essential to uphold ethical standards and safeguard long-term oral health.

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