Do you have an infected (dead, non-vital, abscessed) tooth? Root canals and dental implants are completely different solutions to the same problem: severe tooth decay (when your existing tooth cannot be repaired with a simple filling). Here’s an overview of each and how to identify which dental treatment is ideal for you.
Root Canal vs Implant: What Is The Difference?
What Is A Root Canal?
A root canal is a treatment for teeth with dead nerves (pulp necrosis); most often this situation arises when decay has extended deeply into the tooth or through trauma to the tooth (car, bike, skateboard accident). This treatment is also known as endodontic treatment. Root canal treatment essentially mummifies your tooth such that it can be retained and restored, hopefully providing you with a pain-free useful addition to your dentition. Root canal treatment involves cleaning out the inside of the tooth (pulp chamber), removing both nerve tissue and blood vessels that would otherwise supply the tooth with sensation and vitality respectively.
The cleaned hollow tooth pulp chamber is then refilled with material (often rubber and glue) to try to prevent the tooth from becoming reinfected again. Once the root canal treatment is complete, usually over a number of separate visits to the Dentist, the tooth is usually left to completely heal for 6-12 months before a permanent restoration can be applied to the top of the tooth. During this time the root canal treatment may remain tender to bite on.
Ultimately, your Dentist will suggest that a full crown (like a finger thimble) covering the entire top of the tooth is necessary to protect the tooth for the future. This is because root canal treated teeth become brittle (due to the removal of their blood supply) and have a much greater risk of fracture under normal bite forces. If a fracture occurs, then quite often it will result in the need for the entire tooth to be removed (and probably replaced with an implant supported tooth).
What Is a Dental Implant?
Dental implant surgery is a treatment whereby the entire tooth (crown and root) are removed and replaced with a titanium implant. Unlike the root canal treatment, the decayed or damaged tooth is removed rather than repaired, such that there is no infected tooth remaining in your jaw after the implant is placed.
Most often the dental implant is placed at the same visit (tooth in an hour; immediate implant placement; all of four; all on six) for removal of the tooth (a single visit as opposed to multiple for the root canal treatment). The implant usually completely comfortable after 24-48 hours. The implant is then left to heal for 2-3 months until it is ready to have the final crown attached to the implant. In some highly visible sites (upper front teeth) a temporary crown will be attached to the implant from the time of insertion (immediate temporary tooth) so that you don’t have to out up with either a denture or a visible gap in your mouth.
In summary, a dental implant replaces the tooth root and the part of the tooth above the gum line, known as a crown, is completely renewed. Root canal treatments can fail simply because they become reinfected from a residual infection contained with the tooth remnant.
Dental implant surgery usually consists of three stages:
- Tooth removal and implant placement (immediate implant placement). This stage will sometimes include creation of a temporary crown (or multiple crowns in the form of a bridge) to be attached to the implant on the same day. After 1-2 days, the implant is usually completely comfortable and settled. This stage can be performed comfortably under either local (awake) or general (asleep) anaesthetic.
- The implant is tested to ensure it has properly attached to the jaw bone (implant integration assessment). This stage is performed 2-3 months after stage 1 and is comfortably performed without anaesthetic. The implant success rate is 97-98% (very likely to be successful).
- The implant crown is attached to the implant. Once again, this stage is usually performed comfortably without anaesthetic. This final dental implant crown looks and feels no different to your other teeth and works just like your natural teeth.
When Is A Root Canal Necessary?
A root canal should only be considered when:
- The patient is made fully aware of the costs associated with treatment and completely aware of other treatment options. Patients may feel that keeping their own tooth (at all costs) is in their best interests, however the cost of implant treatment is often equal to or less than the cost of root canal treatments.
- The patient is made fully aware of the longevity of treatment. Up to 50% of root canal treatments will fracture over the first ten years, and quite often this will be a terminal event for the tooth. Implant treatment is likely to outlast the root canal treatment, thus providing patients with better long term value.
- The patient is made fully aware of the stages involved with treatment. Root canal treatment will only be offered to awake patients, it will tale multiple visits to complete and the healing will take longer. Implant treatment is complete after three stages and can be performed under either local (awake) or general (asleep) anaesthetic.
When Are Dental Implants Advised?
Implant replacement of a tooth should be considered whenever a tooth has limited structure above the gum line or has fractured or decayed to the gum line. Patients under 18 years of age (patients that are growing) may require root canal treatments for teeth to hold the tooth space open until a dental implant replacement can be considered (after growth ceases).
Implant placement is best to be performed immediately once the tooth has been removed. In this manner, the patient only has a single procedure (and thus a single recovery period). Without immediate placement, the jawbone that once held your tooth root will slowly begin to shrink and may require a separate procedure to rebuild the lost bone (bone graft procedure). Also, the teeth opposing the one removed and either side of the gap will shift in an attempt to replace the missing tooth, causing crooked teeth.
Dental implants are the best long term solution for the treatment of a broken or dead tooth, that can’t be fixed with a simple filling. Once placed, dental implants can last for decades since they are impervious to decay.
Root Canal Procedure vs Dental Implant Procedure
Root Canal Procedure Steps
- Your dentist will take an X-ray to find out the extent of the infection and amount of tooth structure remaining above the gum line.
- After numbing the tooth, the dentist will cover the tooth with a sheet of rubber, called a rubber dam, which will help keep your tooth dry.
- The tooth nerve chamber is opened (with a drill) to access the pulp chamber inside.
- To eliminate all bacteria, they will clean the inside of your tooth, removing the damaged nerve and pulp tissue with circular files.
- Repeat stage 4, until infection is proven to be resolved.
- The tooth pulp chamber is completely filled with a rubber based product (such as gutta-percha) to protect against future infection.
- Once the root canal has settled (6-12 months), the tooth will be capped with a restorative crown.
You will need more than one visit to complete the entire root canal treatment.
Dental Implant Procedure Steps
- The Specialist Surgeon will apply a numbing paste to your gums, followed by a long-acting local anaesthetic. Alternatively, you may opt to be placed under general anaesthetic (asleep).
- The Specialist Surgeon will expertly remove your damaged tooth with minimal intervention techniques to retain the bone investing the tooth (this also means that your recovery is faster with less pain and swelling). Placement of the dental implant (immediate placement) then proceeds.
- The surgeon will reshape the bone and gum tissue surrounding the implant and suture the wound with dissolving stitches.
- The implant rapidly settles completely over 24-48 hours and remains comfortable beyond that time.
- Local anaesthetic usually not needed.
- Your Specialist Surgeon will remove the abutment (a small cap that is attached to the top of the implant) and test the implant’s strength of connection to the jawbone. 97-98% of the implants placed will be successful. This confirms that the implant is a suitable as a secure base for your new tooth.
- The Specialist Surgeon will use a state of the art intraoral 3-dimensional scanner (digital planning – no impressions are needed) to accurately capture the position of the implant in relation to existing teeth as well as the colour of the teeth next to the implant. This data file is then used to create a custom made tooth crown which fits your bite perfectly and matches the colour of your natural teeth, to harmonise your smile. This process is fast and comfortable
- Three to four weeks after the 3-dimensional scanning is completed, your new dental crown will be ready to attach to your dental implant.
- Since this procedure is pain-free, it doesn’t require any anaesthetic.
- Your Specialist Surgeon will check your dental bite and provide instructions on how to care for your new implant retained teeth.
Your Specialist Surgeon will advise you of the simple measures required (tooth brushing and flossing just as you would do for your existing teeth) to maintain the implant’s health.
Regular checks with your dentist (at least once a year) are also a great way to ensure that the implant remains healthy.
Root Canal vs Implant Health
Advantages of Root Canals
Having a root canal means that some of your natural tooth is retained. Losing a tooth is concerning for some patients, such that they will choose root canal treatments to ensure that their tooth doesn’t get removed. However, the tooth structure remaining is weakened by the root canal treatment and may result in early failure of the tooth, thus necessitating removal.
Disadvantages of Root Canals
Unfortunately, root canals are not always successful. If even the smallest amount of bacteria remains after cleaning, it may be packed back down into the tooth with the filling and begin to multiply again. If this happens, another root canal may be suggested. Unfortunately, re-treatment of existing root canals is very difficult and may result in further tooth structure weakness. A weakened tooth may even break during the chewing, leading to the need for tooth extraction.
Root canals are also not a one-time only treatment. Since the caps or crowns placed to seal the tooth after the root canal have a lifespan of about 7–10 years, having one root canal means committing to multiple replacements over a lifetime.
Advantages of Dental Implants
A dental implant will replace your painful, infected tooth with a realistic-looking tooth that is free standing (it doesn’t rely on connection to adjacent teeth or result in damage to surrounding teeth). The implant fuses directly to the jaw bone, and being made from titanium are extremely durable, often lasting for many decades. Dental implants provide superior comfort compared to other replacement teeth options. Dental implant surgery is comparable in cost to a root canal treatment with a 97-98% chance of success.
Disadvantages of Dental Implants
A dental implant is artificial, and therefore cannot perceive temperature or bite pressure (neither can a tooth that has been root canal treated).
Dental implant surgery does sound scary and painful, but in reality it can be performed comfortably and easily either awake (local anaesthetic) or completely asleep (general anaesthetic) if you prefer?
Will I Need A Dental Implant After My Root Canal?
Sometimes a root canal will not be successful in controlling or treating the tooth infection. Unfortunately, if a root canal treatment fails multiple times, this can weaken the tooth further, resulting in the need to extract the tooth and invest in a dental implant to permanently fix the problem. Patients who have had one or more unsuccessful root canal treatments will often opt for a dental implant rather than trying a third or fourth root canal.
Final Thoughts: Root Canal vs Implant
Ultimately, the decision whether to have a root canal vs a dental implant comes down to your individual needs and preferences. With a root canal, you’ll preserve your natural teeth. However, this treatment is less successful over the long term and you will likely need to have a re-treatment of root canals every 7-10 years following the original root canal. Dental implants have a similar cost to root canal treatment, but have a higher success rate. You’ll have a stronger tooth that looks and feels natural, for a longer period of time.
Wondering whether to save a tooth or pull it? If you have any questions about root canals or dental implants, get in touch with the surgical specialists at Dental Implant & Specialist Centre today on (07) 5503 1744.