Save My Teeth – Root Canal Versus Implants

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Patient Education

Introduction

In situations where a tooth becomes severely damaged or infected, choosing a suitable treatment plan is complex.

Infection of the surrounding bone, potential gum disease, and the strength and condition of the bone and tooth structure are all factors at play. It’s a multifaceted decision that should be guided by your dentist, taking into account your dental history, as well as your personal and financial circumstances.

The decision may well come down to a choice between a root canal or a dental implant.

This blog compares the two, exploring the benefits and drawbacks of each, considering various circumstances and dental histories, and discussing financial, medical and psychological implications.

Root Canal: The First Port of Call

A root canal is a procedure that aims to save the natural tooth.

It involves removing the infected or damaged pulp from the inside of the tooth, cleaning and disinfecting the chamber and canals, then filling and sealing them.

A crown is often placed on the treated tooth to restore its function and appearance, as well as protecting the tooth from breakage as higher forces can be placed on root treated teeth and it may be weaker due to original fillings

A root canal is always the preferred option when dealing with complex infections as it allows the patient to save their tooth. Everyone agrees that preserving the natural tooth structure is important for maintaining overall oral health, function and aesthetics. There are pressure sensors around the root of a tooth that feedback the forces placed on a tooth protecting it and the adjacent teeth from damaging forces.

The natural tooth’s root also helps to stabilise the jawbone, preventing bone loss that can occur when a tooth is extracted.

While we may be considered a little biased, we believe that saving a natural tooth is always the best option.

With that out the way, here’s a cost-benefit analysis:

Benefits

Drawbacks

Preserve the Natural Tooth:

One of the most significant advantages of a root canal is that it retains your natural tooth structure, which is beneficial for oral health, function and aesthetics.

Potential for Future Issues:

Despite high success rates, root canals are not always permanent solutions. The treated tooth can still become reinfected or damaged.

Less Invasive:

Compared to implants, root canals are less invasive, involving fewer surgical procedures and a shorter recovery time.

Fragility:

A tooth that has undergone a root canal may become more brittle over time, even with a crown, they could fracture and break, and may eventually need extraction.

Cost-Effective:

Generally, root canal treatments are more affordable than dental implants, making them a financially attractive option for many patients.

Virtually Painless:

When performed with care, root canal treatment is quick and painless.

Dental Implants: When All Else Fails

A dental implant involves extracting the damaged tooth and replacing it with an artificial one.

The process involves inserting a specialised titanium screw into the jawbone to act as a root, then attaching a crown to this post.

The main downside to implants is that you will lose your natural tooth, including the feeling and feedback that comes with it. Instead, there will be a foreign object in your mouth. On some occasions an implant may be rejected by the bone and then you will either have a permanent space or need to damage adjacent teeth to replace it.

The procedure is also more invasive and possibly more costly than a root canal.

Here’s a cost-benefit analysis for implants:

Benefits

Drawbacks

Longevity:

Dental implants are

designed to be a long-term solution, often lasting a lifetime with proper care.

Invasive Procedure:

Implants require surgery, which involves a longer recovery time and a higher risk of complications compared to root canals.

Strength and Stability:

Implants are incredibly durable and function like natural teeth, providing excellent strength and stability.

Higher Cost:

The cost of dental implants is often higher than that of root canal treatments.

Prevents Bone Loss:

The titanium screw stimulates the jawbone, preventing the bone loss that typically follows tooth extraction. This is, however, a double-edged sword, as implants placed incorrectly can cause bone loss.

An implant however is not immune to bone loss due to gum disease and if the original tooth was lost due to gum disease there is a high probability that this will happen to the implant as well.

Extended Treatment Time:

The process of getting an implant can take several months to a year, from extraction to the final placement of the crown.

Other Considerations

Rare cases: failed root canal resulting in extraction and implant

If a patient presents with a complex dental history, intricate canal anatomy, tiny cracks in the teeth or obstructions in the canals, it may be challenging to thoroughly remove all the infected pulp tissue, increasing the risk of a root canal treatment failure. In rare cases, even retreatment of root canals is not successful.

In this scenario, an implant offers a more predictable and stable solution, removing the root cause of the problem (literally) and providing a more predictable, durable, long-term outcome with minimal future treatment required.

Certain conditions increase the likelihood of root canal failure, including:

Complex Root Structure: Teeth with intricate root systems are harder to clean thoroughly, increasing the risk of leftover infection.
Previous Dental Work: Teeth that have undergone multiple procedures may be more susceptible to failure.
Severe Infection: If the infection has spread extensively, it can be challenging to eliminate it entirely with a root canal.
Fractures: Hairline cracks inside a tooth can grow through a tooth and into the root structure. Bacteria will invade the crack line and it will not be possible to remove these. The bacteria cause progressive bone loss and the eventual demise of the tooth

As you navigate treatment plans, your dentist will discuss these conditions with you. While important considerations, they don’t necessarily rule out a root canal treatment. That is for you and your dentist to decide, taking into account all other factors.

Financial implications

When deciding between a root canal and a dental implant, cost is a significant factor. Root canals typically cost less upfront, but there may be additional expenses if complications arise. In contrast, dental implants have a higher initial cost but often do not require further treatment once completed.

Psychological implications

For many patients, the idea of having a permanent artificial tooth provides peace of mind and confidence. Others may feel apprehensive about the surgical aspects and the idea of a foreign object in their mouth.

In some cases, patients with complex dental histories who have had multiple root canal treatments may become emotionally distressed.

For these patients, the decision to have an extraction and dental implant treatment can bring a huge sense of relief.

Unsure which is best for you?

Here’s a summarised list of factors to consider:

Root Canal Treatment may be better for you if:	A Dental Implant may be better for you if:
You want to preserve your natural tooth and the aesthetics, function and feeling that come with it	You want a durable, lifelong solution that will require minimal future treatment
You’re under the age of 50, thus more likely to retain your natural tooth for longer	You’re older than 50 and more concerned about the long-term durability of your treatment
You need treatment with a quick recovery time	You have a complex dental history. You’ve undergone root canal retreatment or experienced complications with previous root canal procedures, such as severe infection
Your dental history is not complex, and you haven’t had to undergo many root canal treatments	You have a complex root system and cracked or fractured teeth that could easily become infected
You have fear or anxiety about extraction and the placement of a foreign object in your mouth	You can afford higher upfront costs for treatment

Conclusion:

When faced with the decision between a root canal and a dental implant, starting with a root canal is often the preferred approach.

Preserving the natural tooth structure is vital for maintaining overall oral health, functionality and appearance. The natural root allows natural biofeedback and stabilises the jawbone, preventing the bone loss that can follow tooth extraction. Furthermore, a root canal is less invasive than a dental implant, involving fewer surgical steps and a quicker recovery time.

Keeping your natural tooth also preserves your bite and smile, which are essential for proper chewing and speaking. Additionally, root canals are generally more affordable than implants, making them a practical choice for many patients.

However, there are situations where a dental implant may be the better option, especially when the natural tooth is beyond repair or the root canal treatment fails. Implants offer a durable, long-term solution that can mimic the function and appearance of natural teeth, providing excellent strength and stability. They also prevent bone loss by stimulating the jawbone, an essential factor for long-term oral health.

Ultimately, the decision between a root canal and a dental implant should be made in consultation with your dentist, who can evaluate your specific circumstances and guide you towards the best treatment option for your needs.