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.
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).
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:
A root canal should only be considered when:
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.
You will need more than one visit to complete the entire root canal treatment.
First Stage
Second Stage
Third stage
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.
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.
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.
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.
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?
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.
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.