You are in the chair, a tooth is cracked or infected, and you are being asked to choose between saving it and replacing it. You have maybe ten minutes and no way to research it.
Here is the version you would have wanted to read beforehand.
Dentistry’s default is to keep the natural tooth when it has a reasonable long-term outlook. A natural root preserves the bone around it, keeps the neighbouring teeth where they are, and transmits the sensation of biting in a way nothing artificial fully reproduces.
That is a default, not a rule. There are teeth that should come out, and keeping one past the point of usefulness costs money and time and frequently ends in an extraction anyway — with less bone left than there was at the start.
So the real question is not which treatment is better in general. It is whether this tooth has enough structure left to be worth rebuilding.
The infected or damaged pulp inside the tooth is removed, the canals are cleaned and shaped, and the space is sealed. The outside of the tooth — the part you chew with — stays yours.
What patients often do not realise is that the root canal is rarely the end of it. A back tooth that has had a root canal is more brittle and usually needs a crown to survive normal chewing. When you compare prices, compare root canal plus crown against the implant, or you are not comparing like with like. Details of the procedure itself are on our root canal treatment page.
The tooth and its root come out. A titanium post is placed into the jawbone to take the root’s place, bone grows around it over several months, and a crown is fitted on top.
This is a longer timeline than most people expect. Healing and integration take months, not days, and in some cases a bone graft or a sinus lift is needed first, which extends it further.
This is the scenario patients in West Palm Beach complain about most and understand least.
A root canal is done. Some years later the tooth becomes painful again. Now there are three paths: retreat it, perform a surgical procedure at the root tip, or extract and place an implant. Each costs money. If retreatment is attempted and does not hold, you have paid for the original treatment, the crown, the retreatment, and then the extraction and implant anyway.
That is not an argument against ever retreating a tooth — plenty of retreatments succeed and last. It is an argument for asking a blunt question when it comes up: what is the realistic outlook for this specific tooth if we retreat it, and what does it cost me if it does not work?
The immediate price comparison usually favours root canal and crown. The ten-year comparison is less obvious and depends almost entirely on whether the restored tooth survives.
A rough way to frame it:
Which means the question underneath the question is: how confident is the dentist that this tooth survives? That is the thing to ask directly, and the answer should be specific to your tooth rather than a general statement about success rates.
For balance, because this gets skipped when implants are being sold.
The jawbone that held a tooth root begins to resorb once the root is gone. That is why a tooth missing for years often needs grafting before an implant can be placed — the bone to hold it has partly disappeared. An implant placed in good time preserves bone that a bridge or a gap does not, which is a real argument in its favour, but it does not change the fact that extraction starts a clock.
Implants are also not maintenance-free. The gum and bone around an implant can become inflamed and lose support in a process comparable to gum disease around a natural tooth. Implants need the same hygiene and the same check-ups. Anyone presenting an implant as a permanent solution requiring nothing further is overselling it.
If the answers are specific to your scan and your tooth, you are getting good advice. If they are generic, ask for the images to be put on the screen and explained.
On a borderline tooth, a second opinion is reasonable and most dentists expect it. It is particularly worth getting when one practice can only offer one of the two options — an office that does not place implants and an office that does nothing else both have a natural pull in one direction.
Palm Beach Institute of Dentistry performs both root canal treatment and implant placement in the same practice, which at least removes the referral incentive from the recommendation. Dr. Etemad has placed more than 5,000 implants since 2007 and also restores teeth that are worth keeping.
Bring the tooth, the X-ray or just the question. A consultation includes 3D imaging and a written plan that says which option we recommend and why.
This article is general information and is not dental advice for your situation. Whether a tooth can be restored depends on clinical and radiographic findings specific to that tooth and can only be determined at examination. Pricing shown is current at the time of publication and applies to a standard single implant; extraction, bone grafting and sinus lift are quoted separately. Candidacy for treatment is determined at a clinical consultation. This article is not a guarantee of treatment, outcome or specific results. Individual results vary.
You are in the chair, a tooth is cracked or infected, and you are being asked to choose between saving it and replacing it. You have maybe ten minutes and no way to research it.
Here is the version you would have wanted to read beforehand.
Dentistry’s default is to keep the natural tooth when it has a reasonable long-term outlook. A natural root preserves the bone around it, keeps the neighbouring teeth where they are, and transmits the sensation of biting in a way nothing artificial fully reproduces.
That is a default, not a rule. There are teeth that should come out, and keeping one past the point of usefulness costs money and time and frequently ends in an extraction anyway — with less bone left than there was at the start.
So the real question is not which treatment is better in general. It is whether this tooth has enough structure left to be worth rebuilding.
The infected or damaged pulp inside the tooth is removed, the canals are cleaned and shaped, and the space is sealed. The outside of the tooth — the part you chew with — stays yours.
What patients often do not realise is that the root canal is rarely the end of it. A back tooth that has had a root canal is more brittle and usually needs a crown to survive normal chewing. When you compare prices, compare root canal plus crown against the implant, or you are not comparing like with like. Details of the procedure itself are on our root canal treatment page.
The tooth and its root come out. A titanium post is placed into the jawbone to take the root’s place, bone grows around it over several months, and a crown is fitted on top.
This is a longer timeline than most people expect. Healing and integration take months, not days, and in some cases a bone graft or a sinus lift is needed first, which extends it further.
This is the scenario patients in West Palm Beach complain about most and understand least.
A root canal is done. Some years later the tooth becomes painful again. Now there are three paths: retreat it, perform a surgical procedure at the root tip, or extract and place an implant. Each costs money. If retreatment is attempted and does not hold, you have paid for the original treatment, the crown, the retreatment, and then the extraction and implant anyway.
That is not an argument against ever retreating a tooth — plenty of retreatments succeed and last. It is an argument for asking a blunt question when it comes up: what is the realistic outlook for this specific tooth if we retreat it, and what does it cost me if it does not work?
The immediate price comparison usually favours root canal and crown. The ten-year comparison is less obvious and depends almost entirely on whether the restored tooth survives.
A rough way to frame it:
Which means the question underneath the question is: how confident is the dentist that this tooth survives? That is the thing to ask directly, and the answer should be specific to your tooth rather than a general statement about success rates.
For balance, because this gets skipped when implants are being sold.
The jawbone that held a tooth root begins to resorb once the root is gone. That is why a tooth missing for years often needs grafting before an implant can be placed — the bone to hold it has partly disappeared. An implant placed in good time preserves bone that a bridge or a gap does not, which is a real argument in its favour, but it does not change the fact that extraction starts a clock.
Implants are also not maintenance-free. The gum and bone around an implant can become inflamed and lose support in a process comparable to gum disease around a natural tooth. Implants need the same hygiene and the same check-ups. Anyone presenting an implant as a permanent solution requiring nothing further is overselling it.
If the answers are specific to your scan and your tooth, you are getting good advice. If they are generic, ask for the images to be put on the screen and explained.
On a borderline tooth, a second opinion is reasonable and most dentists expect it. It is particularly worth getting when one practice can only offer one of the two options — an office that does not place implants and an office that does nothing else both have a natural pull in one direction.
Palm Beach Institute of Dentistry performs both root canal treatment and implant placement in the same practice, which at least removes the referral incentive from the recommendation. Dr. Etemad has placed more than 5,000 implants since 2007 and also restores teeth that are worth keeping.
Bring the tooth, the X-ray or just the question. A consultation includes 3D imaging and a written plan that says which option we recommend and why.
This article is general information and is not dental advice for your situation. Whether a tooth can be restored depends on clinical and radiographic findings specific to that tooth and can only be determined at examination. Pricing shown is current at the time of publication and applies to a standard single implant; extraction, bone grafting and sinus lift are quoted separately. Candidacy for treatment is determined at a clinical consultation. This article is not a guarantee of treatment, outcome or specific results. Individual results vary.
Palm Beach Institute Of Dentistry