If you have an infected tooth and have been told you need root canal treatment, you may be in a dilemma to proceed with root canal or just have the tooth pulled and get dental implant. This is indeed a tough decision to make.

There is no easy answer to this dilemma and quite a few factors should be taken into consideration. It definitely requires an expert and experienced dentist to carefully evaluate the condition and advise the patient.

I come across quite a few patients with such dilemma who try very hard to make the right choice. My advice to them is to get as educated and informed as possible can about the issue at hand and consult with the your trusted dentist. Make sure your dentist is fully knowledgeable about both dental implantology and root canal treatments.

Root canal was an important treatment option for many years but has lost popularity since dental implantology has become a mainstream treatment in dentistry.

What is root canal treatment?

Each natural and healthy tooth has one or more tiny canals that contain nerve and blood supply to the tooth. These canals are well protected by the hard outer enamel. A tooth with intact and healthy nerve is a vital tooth. If there is damage to nerve due to decay, fractures, or other reasons, infections develops inside the canal and in the jawbone surrounding the tip of the tooth root.

Root canal treatment is an option that has been used for many years to eliminate such infections. The dentist opens an access to the canal and removes the dead nerve, eliminate the bacteria, and cleans the canal with tiny files. The canals are then sealed with special rubbery material called Gutta Percha.

How effective are root canal treatments?

Root canal is a complex and difficult technique which requires skill, knowledge and experience. Certain dentist are specialized in doing root canals and go through 2 or more years of education and training to become root canal specialist. Such dentists are called endodontist. Endodontists usually limit their practice to root canal treatments only. Obviously, due to their extended training, endodontists perform root canals with higher success rate than general dentists.

Although the short term success rate of root canals may be as high or above 90%, the long term success rate is a subject of controversy. There is certain belief by some researchers and scientists that root canal, no matter how perfectly done, will never eliminate all the bacteria in the infected tooth. they believe there is always some residual bacteria left in the tooth which may leak to other body organs such as brain, heart, and cause substantial health problems. It may also cause secondary infection and root canal failure even 20 or 30 years later. This is quite common in dentistry.

Disadvantages of root canal treatment

• A root canal tooth becomes more fragile and brittle than vital healthy teeth. This makes a root canal tooth more prone to fractures.
• A root canal tooth may get infected again, requiring new root canal treatment and/or possible loss of tooth.
• A root canal tooth develops certain grayish discoloration which may be a major esthetic complication, particularly in front teeth.
• Root fractures are quite common in root canal teeth. such fractures are not treatable and the tooth should be extracted.
• Possible residual bacteria in the tooth after root canal may spread to other parts of the body, resulting in serious health problems.
• Root canal treatment is an expensive procedure. Additionally most, if not all root canal teeth need additional strengthening with a post/buildup and a crown. These procedures may bring the cost to about $2000 to $3000. Spending such amount on a questionable procedure may not seem wise to many people.
• A root canal tooth may develop decay, resulting in additional cost and/or possible tooth loss

The following case represents a failed root canal tooth that was extracted and replaced with an implant tooth

This case is an actual patient of Dr. James Khazian.
The extraction, bone graft, dental implant, and final tooth was performed by Dr Khazian

This molar tooth was previously treated with root canal
The tooth broke due to becoming weak after root canal

The tooth was extracted and bone grafted in preparation for dental implant

Dental implant and final tooth is in place

Are dental implants a better choice than root canal?

To best answer this question we should look at the advantages of dental implants. The following is only a limited list of dental implant advantages over root canal teeth. Dental implants have many other benefits which are out of the scope of this topic.

• Unlike root canal procedure, dental implant is a very predictable treatment approach. If properly done by an expert implantologist, it has a solid 98-100% success rate.
• Unlike root canal, dental implant procedure eliminates the infected tooth and all the bacteria in the jaw bone. It assures a fully sterile outcome with no chance of bacterial spread to other parts of body and possible health problems.
• Unlike root canal teeth, an implant tooth do not decay. Implant teeth consist of titanium, zirconia, and porcelain. The never decay.
• Implant teeth are much stronger than root canal teeth. Implant teeth have a much lower risk of breaking than root canal teeth.
• Considering the risks and possible failures associated with root canal treatment, dental implant may be a much more cost effective.
• Unlike root canals, the implants have a very low possibility of secondary infection. If maintained properly, implant teeth last for decades or possibly life time.
• Unlike root canal teeth, implant teeth will not develop root fractures.

Dental Implant Centers is an all-in one provider of advanced dental implant treatments in San Diego. This means all your implant treatments are done in one office by Dr. James Khazian. You avoid the confusion of seeing several doctors and/or different offices. Your treatment, no matter how complex will be started and finished by Dr. Khazian. To make an appointment for free x-rays and consultation you may call 866-4my-smile (866-469-7645) or click here

2 Dental Implant Locations to serve you: San Diego and North County cities and communities.

North County Office:
Escondido, San Marcos, Poway, Rancho Bernardo to Vista, Oceanside & North County Coastal Communities.

San Diego Office:
Coastal and inland cities including Hillcrest, El Cajon, Chula Vista, downtown San Diego and Coastal Communities.