Dental Implants = More Visits Than Root Canals

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A new study addresses the growing controversy among dental health professionals regarding the best course of treatment when evaluating between a root canal or dental implant procedure. Researchers evaluated the success and failure rates of teeth treated with a root canal (endodontically treated teeth) or extracted and replaced with a dental implant. While the findings concluded that the success rate of each treatment was similar, the data showed that significantly more dental implants required additional treatment or surgical intervention after the procedure compared to endodontically treated teeth (12.4 percent versus 1.4 percent, respectively).

"Many dental professionals today are faced with the dilemma of whether root canals or dental implants are the best option for their patients," said lead investigator James Porter Hannahan, D.M.D., of the University of Alabama at Birmingham, Birmingham, AL. "While the success of both procedures is similar, saving the natural tooth through a root canal rarely requires follow-up treatment and generally lasts a lifetime; implants, on the other hand, have more post-operative complications and higher long-term failure rates."

Research has shown that poor oral health and tooth loss may lead to serious medical conditions, such as heart disease, stroke, diabetes and even certain types of cancer. Given this connection, taking the right steps to prevent tooth loss can be important for maintaining better overall health.

"Considering these results in light of the growing body of evidence on the impact of oral health on overall health, it is imperative for dental professionals to partner with endodontists who have advanced training in examining whether a natural tooth can be saved through root canal treatment," said Dr. Louis Rossman, an endodontist and president of the American Association of Endodontists(AAE), the dentists who specialize in root canals. "While implants may be an appropriate solution for people with missing teeth, endodontic treatment should be the first choice for restoring a compromised tooth."

Because of the increasing popularity of dental implants, patients may not realize the long-term implications of the procedure or that root canals may be healthier and less complicated in the long-run. Dental professionals should ensure they explain to patients the differences between each procedure.

Dental implants require extracting the tooth followed by multiple surgeries to insert a metal post in the jaw and affix a porcelain crown to the post. These surgeries often can take three or more visits over the course of several months to complete and can be time-intensive and costly. During root canal treatment, the source of tooth pain --inflamed pulp-- is removed and the inside of the tooth is then cleaned, filled and sealed. Today, most root canals can be completed in one visit and are virtually painless. In fact, root canals restore and save an average of 17 million teeth each year.

When considering treatment options, the AAE emphasizes that decisions must be based on factors other than outcome, such as case complexity or the patient's individual health and preferences. To assist dental professionals and their patients in determining the most appropriate treatment, the AAE has formal guidance on treatment planning, which includes evaluating various risk factors and other implications associated with root canal and implant treatment. Risk factors can include smoking, bone quality and estrogen levels -- for example, women with lower estrogen levels may encounter more treatment failures with implants.