Natural Tooth vs An Implant, Making the right choice

Dental Implant

The past week has been unique for me in terms of clinical work.
The patients I saw were divided between one half who wanted dental implants and the other asking me to save their natural tooth.

The common factor with these patients was either a bad, painful tooth or had undergone a root canal done at some point in life, that was now getting infected and failing.
It’s a common practice in most dental offices to extract the bad tooth or failing root canal and replace it with an implant. However, as a trained Endodontist (Root Canal Specialist ) and Restorative Dentist, its often a tough decision to take and go ahead on extraction without giving it a second chance!

So, here’s a quick guide on when to go ahead and take the decision to extract or introduce an implant.

What does a failing Root Canal Mean?

A previously treated Root Canal that is associated with swelling, pain, discomfort or tenderness may be on its way to failing. However sometimes, it may be a silent infected tooth that may have absolutely no symptoms.These may be detected on routine radiographs and may warrant treatment.

Will Repeat Treatment Work?
With advances in Dentistry we now have greater understanding of the tooth, better equipment to diagnose a problem, and high powered magnification for better diagnosis. This makes the Root Canal Treatment more predictable with very high success rates.

Yes,the procedure is more tedious and time consuming but saving the natural tooth is worth every bit the effort.

Routine Threats to Our Natural Teeth :

Tooth Decay: This is by far the most commonly encountered problem. The degree of damage can vary from simple tooth destruction to a badly damaged tooth structure.
Tooth Fracture : The degree and location of the fracture are important factors that will decide on whether to extract the tooth or save it
Gum Disease : Gum Disease leading to bone loss and associated weakening of teeth is extremely common
Age related loss: Tooth loss and bone destruction caused by age

In most of the above cases the natural tooth can easily be salvaged making it a great long term solutions against Dental Implants.

When are Implants a Better Choice?

There are however some situations when the natural teeth cannot be saved at all and its in these cases that extraction and replacement with implants may be a better choice.

Severely infected root canals that fail to heal
Variant root anatomy
Fractured tooth which may be split into half
Severe gum infection with mobile teeth
Badly decayed tooth with no tooth structure

In these cases extracting the damaged or mobile tooth and replacing it with an implant is a better long term solution

Why Implants and Not A Bridge ?

Can last for years, if done well
Can be used as a fixed or removable option
Can be used to replace multiple teeth
Maintain the jaw bone and facial contour
Does not require the adjacent teeth for support
Not prone to decay

While It’s true that dental implants can look (and function) more like natural teeth as opposed to any other tooth replacement system, the subjective value of keeping your “own” teeth is something thats not measurable. There are similar procedures like a Four Titled Implant. You can read more here,

In the final analysis it would be helpful to discuss this with your dentist who will explain the options, listen to your concerns, and help you take the best informed decision.

I hope this overview has made it easier for all my readers who were faced with such a dilemma of natural vs implant.

Till next week then, take care and keep smiling.

Dr Shail Jaggi

Dr Shail Jaggi

Dr Shail Jaggi is a passionate dentist with specialisation in cosmetic dentistry and endodontics. She manages an Advanced Microscope Enhanced Practice – Dentalwiz dealing with all aspects of dentistry. Dr Jaggi is recipient of ‘Outstanding Dentist Of The Year -2015’. Dr Jaggi writes every Wednesday on Pune365.
Dr Shail Jaggi