Why Get a Root Canal if You Can Get an Implant?

With the advent of the implant are root canals a thing of the past? What are Endodontists saying about this??

Doctor Answers 15

Your own tooth is worth saving

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As a general dentist who both performs root canals and places dental implants I have a unique perspective.  I always try to save teeth.  I think there’s nothing better than having your own teeth.   A root canal is a fairly routine and painless procedure.  The dental crown can be placed several weeks after your root canal and the work can last for many years.

Implants are terrific but they do require a bit more work.   You may have to wait ~4 months for the bone to heal after taking a tooth out, and then another 4 months before a crown can be placed on the implant.  Although dental implants are painless, they do require a minor surgery of first taking the tooth out and then placing a dental implant into bone.   I advise my patients to avoid any surgery unless it’s absolutely necessary. 

Although dental implants are highly successful , studies show ~96% of the time,  sometimes they do fail.   In which case they need to be replaced, which uses up more of your time and possibly incurs more expense.

Of course there comes a point where it’s no longer worthwhile to save a tooth, in which case dental implants are a terrific option.   I always give my patients all the options.  But I advise them to do what’s easiest, least expensive, and most predictable.  Good Luck!

Manhattan Dentist

Endodontic treatment vs dental implant

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Root canal therapy still exists and is a predictable treatment for the teeth with good bone support, enough of remaining tooth structure and when saving the tooth is important for occlusion. If the situation with the tooth is compromised, it is severely decayed, has periapical changes and periodontal disease - dental implant becomes more predictable option. Usually before considering the endodontic treatment and invseting the money in it the patient should ask his dentist about all possible risks and benefits, get the information about the overall tooth prognosis. Opened and clear communication between the patient and the doctor is essential in choosing right type of treatment.

Dental implant or root canal

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If a tooth has a very good prognosis by performing a root canal and a proper restoration, then it should be the treatment of choice. If the prognosis is poor or it requires significant number of procedures to save and there are structural compromises, then extraction followed by implant should be considered as the treatment of choice. When appropriate, and performed by skillful endodontists, root canals can be very successful. It is best to do predictable dentistry, and not heroic dentistry.

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 7 reviews

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Implants vs Root Canal

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Your question is a good one.  It all comes down to predictablility.  In the past, dentists did everything they could to save a tooth but with the advent of dental implants that has changed.  No dentist likes to extract a tooth unecessarily.  If a tooth is in need of a root canal and has good bone support and adequate tooth structure remaining to restore the tooth then I feel that root canal therapy is appropriate.  However, if the tooth is compromised, has a failing root canal or requires a heroic effort to restore, then consideration must be given to the implant since its success rate, in that case, is more predictable.  Be sure to discuss all of your options with your dentist before making any decisions.

Gary Nack, DDS
Philadelphia Dentist

Dental Implant or Root Canal?

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As dentist we always try to be as conservative as possible when performing treatment.  A root canal is the most conservative treatment the majority of the time.  Root canals have well over a 90 percent success rate and are many times a wise choice of treatment.  In cases where a tooth would require a post and core or the retreatment of a past root canal, it is my opinion that a dental implant would give a better long term prognosis.  There is a place and time for both of these procedures and a well trained dentist will always discuss the pros and cons with you of your particular situation. 

Great question!

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Believe it or not there are more and more Endodontists ( root canal specialists) who are placing dental implants.  Why?  Because they can be very good judges of when a tooth is not worth saving and are a very trusted colleagues of the many dentists who are not comfortable with dental implants.

I am a general dentist who has been placing and restoring dental implants for nearly 30 years.  I also do many root canals on a daily basis but sometimes a judgment call based on experience needs to be made as to the long term prognosis for a tooth.  If the tooth is either too broken down, periodontally involved or the root canal faces being retreated, a dental implant may be the better choice.

If you can save a stable tooth, do it!

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Even though implants are an extremely successful treatment option I would recommend you try and save your tooth with a root canal assuming that the dentist thinks that the prognosis of the tooth is favorable.  Maintaining what you have is the more conservative approach.

Dan Haas, DDS
Toronto Dentist

A good tooth is still the best.

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Let me start by saying that I am a fan of both root canal treatment to save teeth and implant treatment to replace missing or hopeless teeth.  Some teeth cannot be saved.  They may have a root fracture, or decay that makes them unrestorable, or maybe they are periodontally involved to the point that there is not enough bone to hold the roots in place.

If however there is enough good healthy tooth structure remaining I feel that nothing is as good as a good tooth.  Teeth are anchored in the jaw bone by roots which are attached by a ligament.  This periodontal ligament acts as a shock absorber of sorts for  your teeth.  It also contains nerves which feedback information when you are chewing so you will know if you are chewing too hard or not hard enough, ... this is called proprioception. 

Implants are fused to the bone in a process called osseointegration.  There are no nerve endings or ligament around an implant to give you that information. 

This is the main reason that I like teeth and recommend root canal treatment over implants whenever it is possible.   

Martin Frankel, DDS
Toronto Dentist

Root canal vs. implant.

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The success of root canal treatment is about 90-95%, the success of dental implants is 80-95% over 10 years.  With similar success rates it really depends on the situation.  Well done endodontic treatment saves the tooth and in the future implant therapy is quite easy.  However failed implants are a complex situation that requires multiple surgeries to address.  There is nothing better than a natural tooth and our focus should be to save teeth.  Having said all that I still have patients that do not want root canals because of bad previous experiences or beliefs, we do our best to educate and replace teeth with the most biocompatible ceramic implants.

Dan Hagi, DDS
Toronto Dentist

Root Canal or Implant

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Saving a tooth will always be my approach to a case when it is possible. Extraction is usually my last resort. Of course we must consider the patients over all oral health and condition of his remaining teeth and gingiva. There are cases where by saving a tooth with a root canal, we are only prolonging something inevitable, for example, someone with severe periodontitis. It is important that we educate our patients, listen to what their expectations and goals are, and then chosing the best option for the patients long term oral health. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.