The rise of the dental cartel?

Perhaps I am becoming an agony aunt (uncle really), but I recently seem to see and hear about patients who have been offered treatment about which I am suspicious, ‘Voleurs’ being an example a year or so ago.¹ In that regard, I recently saw a patient who had been advised that his UL7 required extraction: surprisingly, it was minimally filled and his dentist advised that its root was fractured, that the tooth required extraction and arranged a consultation with what the patient was told was a dental implantologist (no such person – there is no specialist list for dental implants!) who confirmed that the tooth required extraction, followed by placement of a dental implant. I arranged for this patient to see a specialist endodontist, who confirmed that the tooth did indeed require extraction, but never mentioned the word implant. My conversation with that patient started thus: there is no rule in the dental rulebook that states that a tooth that is lost, automatically requires replacement, notwithstanding whether that is by a denture or an implant. In this patient's case, when I examined the occlusion opposite the UL7, it was clear that teeth opposing the UL7 would be in a stable position occlusally (ie the opposing tooth was not likely to overerupt) if and when that tooth was lost. There, therefore, seemed little or no need for an implant, given that the patient had a functioning 27-tooth dentition.