I’m 77 and have a dilemma about whether to get a root canal or an extraction and implant. Over the past year, many of my old fillings have failed and need to be replaced. I recently had a crown placed on my upper second molar, and during the procedure, my dentist found a cavity and a crack in the upper first molar next to it. She recommends crowning that tooth, too.
I’m concerned about needing a root canal after going through the process of getting a crown. I’m not sure whether it’s better to wait or consider a root canal now rather than needing one later. When is it better to remove a tooth instead of restoring it with a crown and, if necessary, a root canal? Thanks. Jen from RI
Jen,
Replacing missing upper molars helps maintain a healthy bite. Without replacement, even at 77, the opposing lower molars can gradually move upward into the space. The changes can affect how teeth fit together. Even if the bite remains stable, chewing on only one side of your mouth can place extra stress on the remaining teeth. It makes sense to include a replacement plan whenever extraction is considered.
How Do Implants and Root Canals Compare?
Both dental implants and root canal therapy have strong success records. However, dental implants are predictable tooth replacement options. Root canal treatment is highly successful when performed by a specialist using current techniques.
While implants have an advantage in reliability and rarely fail, treating a failed implant is often considerably more complex than treating a failed root canal. A root canal and crown usually cost significantly less than an implant and crown.
What Are the Advantages of Each Treatment?
Understanding the strengths and limitations of each option can make the decision easier.
Dental Implant and Crown
- Costs about 50% more than a root canal and crown
- Requires at least three months of healing before the final crown is placed
- Has an excellent long-term success rate
- More complex to repair if the procedure fails
Root Canal and Crown
- Usually, it’s the more affordable option
- Can often be completed within several weeks
- Preserves the tooth and surrounding bone
- Carries a slight possibility of future failure that might require an implant
It Tooth Extraction Worth It to Prevent a Root Canal?
Although there is a small possibility that a crowned tooth could require a root canal later, preserving the tooth is a priority. A more conservative approach is to restore the tooth with a crown and address a root canal only if it becomes necessary in the future. Preserving natural teeth whenever possible generally provides the greatest long-term benefit.
The information you provided does not suggest that these teeth are at high risk of needing root canal treatment. There was no mention of increased sensitivity or other symptoms that would raise concern about the health of the dental pulp.
This blog is sponsored by Lowell cosmetic dentist Dr. Michael Szarek, who has advanced training in complex restorative dentistry, and where we are welcoming our new associate, Dr. Andrea Biondo.