Dr. Lee Sheldon: Not so fast with dental implants.

By Dr. Lee Sheldon, For FLORIDA TODAY 11:10a.m. EDT, October 9,2014

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We have a phenomenon that has hit us in the past several years: the dental implant center. The dental implant center works upon the premise that you are fed up with your teeth, so why not replace them with metal posts called dental implants?

Attached to those posts will be a brand-new set of teeth. The supposition is that the implants are better than your natural teeth. But there is a fallacy in that thinking. While implants are the most predictable long-term replacement for missing teeth, they are still replacements. They are not the real thing.

I place a lot of dental implants. I have created my own dental implant logo. I’ve talked about dental implants in FLORIDA TODAY, on TV, radio, in “Extreme Makeover” competitions, in lectures, and have educated hundreds of dentists in my career on how to restore dental implants. I replace lots of teeth every day with dental implants. But this is neither a commercial for dental implants, nor for my expertise in placing them.

I’m concerned. I’m concerned that a dental modality is replacing a thought process called diagnosis. You’ve heard the word. It’s what you expect from your doctor.

Diagnosis comes from Latin, meaning discern or distinguish. In other words, your doctor is to discern or distinguish the cause of disease. That’s what doctors do, and when they are unable, they refer you to clinics such as Mayo to distinguish or diagnose what the problem is before deciding upon a treatment.

That’s what we expect from medicine. So what about dentistry? Shouldn’t we expect the same level of diagnosis from our dentists as we do from our physicians?

In this column, I once talked about the oral DNA test, which differentiates the periodontal bacteria that cause tooth loss and periodontal disease. It is a phenomenal test, and while I don’t need to use it on every patient, the fact that I have that diagnostic tool has meant that patients who otherwise have been told that their teeth would be lost have kept them, because that diagnosis led to a successful treatment.

We have a very simple test for predisposition to dental decay called the pH test. By placing a strip of paper in the mouth, we can tell if your mouth is acidic. If it is, that would lead to cavities. But if we’re able to help you neutralize those acids, or better yet, find what’s causing the acids, then we can get a handle on the cause of your tooth decay.

While dental implants are the most successful method of replacing teeth, some implants do tend to fail. And it is early diagnosis that will prevent many of these from being lost entirely.

But when you go to a dental implant center, the diagnosis is already made. It’s the patient making the diagnosis by even deciding to go to a dental implant center, where there is only one treatment available.

While we have helped thousands improve their lives with dental implants, I’m also proud of patients like Steve. Steve came to me looking to extract all of his teeth and replace them with implants.

But when I looked at him, I found some periodontal disease, found some decay, helped Steve get control of both, and then worked with his dentist to create a new smile, all without the use of dental implants.

I could have easily extracted his teeth and placed dental implants at twice the cost. But instead, we looked at all the diagnostic and treatment options before making a decision on treatment. And Steve is very happy.

That’s what a periodontist does. A periodontist leads with diagnosis, then proceeds with treatment.

Let’s look at cause — at diagnosis — first. Then you can make an informed decision about your dental treatment.