What are the advantages of root canal therapy vs tooth extraction and implant?

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Specialist Endodontist
Endodontic Care
BDS (Otago), DClinDent (Otago)

Comparing root canal therapy (or endodontics) with tooth extraction and implant is like comparing a real limb with an artificial limb. It’s a no-brainer. 

Unfortunately, the fallacies tend to drown out the facts when it comes to weighing up the relative merits of these treatments. I would like to clarify some of these fallacies to give you a clearer understanding.

Fallacy no. 1: “I would rather get an implant now as I will eventually have to get one anyway.”

Both root canal therapy and a dental implant could have the same success rate. This means ideally they both would last 15 to 20 years, if not more. If a root canal–treated tooth fails, then one can always have an implant. However, if an implant fails, then each new implant that is placed has a lower success rate. Nothing is forever. In theory, by keeping your own natural teeth longer (with root canal treatment), you are buying yourself time before needing to opt for an implant. This means that the tooth in question can be managed and maintained for longer.

root canal therapy

Fallacy no. 2: “The success rate for dental implants is the same as for root canal–treated teeth.”

Yes, maybe.

If all studies are critically analysed then one can see a pattern. When it comes to root canal treatment, there is a clear distinction between success (no disease) and failure (evidence of disease). With dental implants, “success” (retention of implant with no disease) is often confused with “retention” (meaning the implant may still be in the mouth despite having disease, which does not equate to success). Often this simple truth is skewed to make implants seem more appealing. Hence what you read on the internet can be misleading.

Implant success can also be dependent on a lot of host factors – such as the site of the implant, quality of bone, immune system, condition of the gums, smoking history and medications being used. Root canal treatment is a lot more forgiving and it has very few factors working against it.

The age of implant placement is also critical. Often the human body can continue to grow until the age of 25 (if not more!). An implant placed in a growing individual may have a compromised cosmetic appearance later in life if continued eruption or jaw growth occurs.

Finally, it can be more challenging to make a dental implant look as “natural” as a real tooth.

Fallacy no. 3: “Implant technology is new, so it must be a better treatment.”

Not necessarily. New is not always better. Because root canal treatment has been practised since the eighteenth century, it is one of the most exhaustively researched treatments in dentistry. Implant technology has been around only since the late twentieth century and we clinicians are still refining this technology as longer-term data becomes available. 

Fallacy no. 4: “The cost of an implant would be the same as root canal therapy.”

No. The cost of root canal treatment is often half that of a tooth extraction combined with an implant. However, it can come close to par if a posterior tooth is being treated as such teeth often require crowns for structural protection. 

tooth extraction

Fallacy no. 5: “I spent a lot of time and money getting a root canal treatment and it failed anyway.”

Just because one tooth failed doesn’t mean they all have to. Root canal treatment is a delicate treatment the outcome of which depends in part on the knowledge and skill of the operator. Also, different teeth in the same mouth have different outcomes according to the location, size of the filling and extent of the infection. 

What would dentists choose for themselves?

At the end of the day, the majority of dentists would fight tooth and nail (quite literally) to save their own teeth through root canal treatment, if possible, rather than getting an implant. That says it all.

So seek the professional opinion of a specialist endodontist at Smile Solutions before considering tooth extraction for an implant. 

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