One of the questions I'm asked most goes something like this: "If the tooth might not last, wouldn't it be easier to take it out and have an implant?"
It's a fair question. Implants work very well and sound like a permanent fix. But if your own tooth can be saved, that's usually the better choice. Here's why, and when I'd say the opposite.
The short answer
I'll always try to save your own tooth first. Nothing we can make feels or works quite like the real thing. But not every tooth can be saved, and sometimes an implant is the better long-term choice. It depends on the tooth, and on you.
Why I try to save the tooth first
Your own tooth feels natural when you bite and chew. A root canal clears the infection from inside the tooth, so you get to keep it.
Implants are very successful, but they aren't perfect. The gum around them can become infected, and occasionally they fail. If we can keep your own tooth going for another ten or fifteen years, you may not need an implant until much later in life, or at all. And if you do need one later, you'll have had extra years with your own tooth, and the implant will still be there as an option.
When an implant may be the better option
A root canal only works if the tooth can be built back up afterwards. I'll suggest an implant when:
- There isn't enough tooth left. If decay or breakage has destroyed too much of it, there's nothing strong enough to rebuild on.
- The root is cracked. A crack in the root usually means the tooth can't be saved.
- The tooth's chances aren't good. Some teeth can be treated, but probably won't last long, such as a tooth that's already been treated several times, or one with gum disease around it. Spending time and money on a tooth like this isn't always the right call.
I'll always tell you honestly how likely a tooth is to last. Sometimes the answer is "this one isn't worth saving," and that's fine.
What about leaving the gap, a bridge or a denture?
These are all options, and some people prefer them. Each has its downsides:
- Leaving the gap costs nothing now, but over time the teeth around it can shift and change your bite. A gap at the back can also make chewing harder.
- A bridge attaches a false tooth to the teeth either side. It's quicker than an implant, but the teeth next door often need to be filed down to hold it. If one of them has a problem later, the whole bridge can be affected.
- A denture is the cheapest way to fill a gap. But it comes in and out, and many people find it less comfortable than a fixed tooth.
How I check your tooth
Before recommending anything, I'll examine the tooth, check the gum and bone around it, and take X-rays. For trickier cases, I can take a 3D scan here at the practice. This gives us a clear picture of whether your tooth can be saved.
If an implant is the better choice, I'll explain why and talk you through the next steps.
What it costs
A root canal at our practice is £935, or £1,100 if the tooth has had a root canal before. Most back teeth will also need a crown afterwards to protect them, which is £940. A single implant, including the crown, starts from £2,500, though the cost can be higher depending on your situation. You can see our full price list on the Chalfont Dentist fees page, and you can spread the cost with 0% interest-free finance through Tabeo.
So, root canal or implant?
If your tooth can be saved, keeping it is almost always the best place to start. If it can't, an implant is a great option, and I'll help you decide which one is right for you. If you've been told a tooth needs to come out and you'd like a second opinion, get in touch. You can also read what root canal treatment is really like.
