Sometimes a tooth becomes infected, inflamed and painful and requires root canal treatment to solve the pain and infection and save the tooth.
I am often asked, “Why not just get rid of this tooth and get an implant?”
Both root canal procedures and conventional implants have their place in addressing the issue of a badly damaged and infected tooth, but first we must understand the basics of these treatments.
Root canal treatment
The aim of root canal treatment is to clean the canal system and reduce the number of bacteria in the tooth to a level where problems such as pain are eliminated. Then the canal system is filled so that bacteria will find it more difficult to colonise. For a restorable tooth, the success rate can be 90 per cent or higher. Root canal treatment has come a long way over the past forty years. In the past, it has been the subject of many horror stories but these days the procedure is comfortable and can often be completed in one visit by one of our specialists. Most teeth should then have a crown fitted.
To replace a missing tooth, or a tooth with a hopeless prognosis, a titanium implant is placed into the bone and a fixed crown attached to mimic the lost tooth. The end result should look, feel and perform just like a natural tooth.
The aim of both of the above procedures is to provide the patient with a functional tooth, whether the base of that tooth is natural (root canal treated tooth) or prosthetic (titanium implant).
So which is the best?
There is no best treatment as such, but there is probably a “best” treatment for your particular case. Core Dental’s specialist endodontists and general dentists can advise you on the pros and cons of each to help you decide which is right for you. There are many factors at play, such as a tooth having little remaining tooth structure, or previous root canal treatment of the same tooth diminishing the long-term prognosis. In terms of general health, certain issues such as diabetes, smoking and osteoporosis can reduce the long-term success rate for dental implants.
My general advice to patients is to try to keep what they have. With the high success rate of root canal therapy and specialist care, you can often expect a root canal and crowned tooth to last ten years or more. By contrast, once you have extracted a tooth there is no going back!
If a tooth is restorable I will always advise my patients to have an examination and a discussion about the prognosis of that tooth, either with me as a general dentist or with one of our specialist endodontists if the tooth is more complex.
If a tooth is more broken down and has suffered a significant loss of structure, the long-term prognosis reduces and an implant may be a better solution. Again our specialist team are best qualified to advise you on your particular case. The success rate for dental implants has also shot up over the past few decades and the results available these days are truly amazing.
In summary, think “conservative”: try to keep what you have! But if that’s not possible, don’t despair. Root canal treatment is not the only option.
Dr Simon Hampton
General DentistDIS, BSc (Hons), BDent (Syd)