Becky Carroll had struggled with dental issues for years—missing teeth, stained and crooked ones—and often hid her smile. Her dentist recommended a lengthy process of root canals and crowns to fix the problems. Seeking a quicker solution, Carroll noticed an ad for ClearChoice Dental Implant Centers, which promised a “new smile in as little as one day” by using implants instead of restorative work. After considering this option, she took out a loan and, in 2021, paid $31,000 to replace her upper teeth with implants. However, what followed was far from a dream experience.
Carroll alleges that her anesthesia wore off during the procedure, leaving her conscious as her natural teeth were removed and implants drilled into her jaw. Afterward, her prosthetics were poorly aligned, making it difficult for her to chew until she could afford corrective surgery. ClearChoice has denied Carroll’s malpractice claims, but Carroll’s experience echoes growing concerns in the dental industry about implant overuse.
Dental implants, used for over fifty years, are a highly effective solution for tooth loss, with millions of implants placed annually in the U.S. alone. However, as the popularity of implants soars, so do warnings from experts about the potential risks. According to an investigation by KFF Health News and CBS News, experts are concerned that some dental providers prioritize implants over preserving natural teeth. Many have encountered patients who were advised to extract treatable teeth to make room for costly implants. Court cases also reveal complications that patients have faced, including pressure to remove teeth unnecessarily.
“There are instances where perfectly healthy teeth are removed,” said William Giannobile, dean of the Harvard School of Dental Medicine, who has witnessed unnecessary extractions firsthand. “Many practitioners favor these high-cost procedures,” he noted, suggesting that financial incentives could drive this trend.
Dentists caution that implants, while resilient, require upkeep and can develop gum or bone infections. Implant specialist George Mandelaris highlights that implant complications can lead to more significant problems than those encountered with natural teeth. “Implants can fail quicker than teeth under similar conditions,” he said, cautioning that patients might believe implants are a one-and-done solution.
Typically, implant surgery entails the extraction of a tooth, placing a metal post into the jawbone, and capping it with a prosthetic crown. More extensive procedures, like “All-on-4” implants, replace an entire arch of teeth. But full-mouth extractions, often suggested for implant procedures, leave little room for future corrective options if an implant fails, as patients lose their natural foundation of bone and gum.
The influence of private equity is also a factor in the implant industry’s boom, according to industry analyses. Major dental chains such as ClearChoice, Aspen Dental, and Affordable Dentures & Implants have expanded implant services. Analysts suggest these chains prioritize profitability, sometimes at the expense of patient care. A 2023 study by the American Dental Association found a significant increase in private equity deals in dental care, particularly focused on high-cost procedures like implants. Critics argue that such investments can lead to overtreatment, especially as more clinics push for costly implant surgeries.
“There’s been a rise in poorly trained dentists performing implants,” said Stephen Prisby, executive director of the Oregon Board of Dentistry. Oregon recently became the first state to mandate hands-on implant training, citing the need for improved standards after multiple investigations into substandard practices.
ClearChoice’s involvement in this field reflects the wider trend. The company, acquired by Aspen Dental in 2020 for over $1 billion, has expanded quickly, establishing “co-location” clinics across the U.S. But Carroll’s lawsuit claims that her first meeting at ClearChoice was with a salesperson, not a dentist. She signed financial agreements before any clinical assessment, an approach she now regrets. “They want to make sure you’re approved for financing before you see a dentist,” Carroll said.
Experts worry that financial incentives are eroding the traditional ethic of preserving natural teeth. Patients increasingly assume implants are the superior solution for dental issues, with little awareness of the downsides. Implant specialist Paul Rosen likens the process to surgery: “It’s not a quick fix, and implants often need as much care as natural teeth, if not more.”
Dental care has indeed transformed, with implant dentistry offering a solution for those with severe tooth loss. However, as dental providers and private equity firms capitalize on the demand, industry professionals urge patients to weigh their options carefully. “When patients ask for implants, they should also ask if there’s a way to save their natural teeth,” said Giannobile. For Carroll, a few more questions might have spared her a painful and costly journey.
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