One of the most common decisions for dental patients who are faced with treating a decayed or fractured tooth is between a root canal and placement of a dental implant. Not every patient will be a candidate for root canal treatment and not every patient will be a candidate for an implant-based crown or bridge. Each treatment plan recommendation will be based on each patient’s needs and dental circumstances.
For those of you who are faced with this decision, where either a root canal or an implant are equally viable treatment options, here a couple of main things to consider when deciding which treatment to pursue.
The two main considerations are cost and long-term results.
A root canal is quite obviously less expensive than placement of an implant. A root canal can range from $600 in a front tooth to $1000 in a molar, while an implant can cost $1000 each or more. In both cases there is usually an extra charge for IV sedation if the patient so chooses (although placement of an implant is commonly done under IV sedation).
The main advantage to an implant-based restoration over a root canal is the quality of the results. A root canaled tooth can predictably last about 10 years before needing to be permanently replaced (usually with an implant). This lifespan may be less if the root canaled tooth is being used to support a pontic (bridge) or crown. The lifespan also depends on the skill of the dental specialist performing the root canal treatment. Missed canals or inter-operative complications (eg: instrument separation) can compromise longevity. Sometimes tooth decay is found to be more extensive than anticipated or tooth fractures or perforations are discovered during the root canal, which can also affect long-term results. In some cases, the root canal may need to be redone or an apico-ectomy performed to fully resolve the issue, increasing the cost to beyond that of an implant-based restoration.
By contrast, once properly integrated, an implant can last 30 years or more, and performs and looks just like a natural, non-root-canaled tooth.
For most patients the percentage of success in either a root canal or implant placement procedure is almost the same (95% versus 95-98% respectively), so the choice will ultimately (likely) come down to price, and the extent of the damage or rate of decay affecting the tooth or teeth being treated. It should be noted though that root canal treatment is generally viewed as an intermediate step. It is assumed that, at some point in the future, an implant-based restoration will be necessary.