ROOT CANAL OR IMPLANT?

Root canal.  The word itself tends to make patients grimace, but root canals have a good place within dentistry.

Quite often people will come to me requesting an implant over a root canal.  They state reasons such as a previous root canal that failed, a root canaled tooth that fractured, or a bad story heard from a friend regarding a root canal that they had done. 

However, a properly done root canal can be highly successful.  Its hard to provide you, the reader, an exact percentage of success, but the numbers range between 85% and 97%.  There are lots of reasons as to why they might fail.  Some of these include: complications such as re-infection or fracture due to failure of crowning (capping) the tooth after the root canal was completed, missed canals during the procedure, or stubborn bacteria that simply won’t allow the root canal procedure to heal.

If I evaluate a tooth that I feel can be fixed, I usually encourage this avenue.  Nothing that we (dentists) can do for you can replace what mother nature has given to you as well.  Also, keeping the tooth preserves the option for an implant when it truly becomes necessary, and the tooth must be extracted.

Unfortunately, there are times root canals will not be advised, and the tooth must be extracted.  Reasons can include: root fractures, decay that is extensive enough it renders the tooth non-restorable, teeth that have been re-treated multiple times, and the presence of concurrent periodontal (gum) disease.  In these situations, implants might be placed at the same time as the extractions, but at other times, your dentist might recommend waiting for healing to occur after the extraction.  Sometimes a bridge or denture might be advised, rather than an implant.  All of these options are a discussion for another Dental Digest article.

One item that requires clarification is what must be done for each procedure.  When you perform a root canal, you are keeping the tooth.  When you perform a dental implant, the tooth is removed.  Both the implant and the root canal require “studs” or “posts.”  In the case of the root canal, a “post” is oftentimes placed into the tooth.  With the implant, the “implant” or “fixture” is placed into the bone.  To some of you this may be obvious.  However, to many patients, this is a rather confusing topic.

What I cannot advise you on is who should perform your root canal.  That is between you and your dentist.  Endodontists are root canal specialists: these are dentists who have continued their studies for 2 or more years beyond dental school.  They have advanced training in the field of endodontics (root canals), and have well developed skills and advanced equipment.  All of these will allow for a highly successful diagnosis, followed by highly skilled treatments.  However, your general dentist may also have highly developed skills, knowledge, and equipment to allow for the same results.

So, in conclusion, I encourage you not to be too quick to rule out a root canal if your dentist advises this.  Just be sure to follow through with his or her recommendations once the procedure is completed, such as a crown.  Remember, keeping your tooth is almost always a better option than the alternative: an extraction followed by a dental implant, bridge, or denture.

Please remember, additional information regarding this, and other topics, is available on our website.

About the author:  Dr. Ira Goldberg has been a dentist for 25 years, and maintains an extremely well-respected practice in Succasunna, NJ.  He performs general dentistry procedures, cosmetic procedures, as well as dental  implant procedures.  He is a Diplomate of the American Board of Oral Implantology / Implant Dentistry, a Fellow of the Academy of General Dentistry, and a Scholar of the Dawson Academy for Complete Dentistry.  He is also a lecturer in the field of implantology.  For a free consultation, please call his office at (973) 328-1225 or visit his website at www.MorrisCountyDentist.com

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