Are Dental Implants Better Than Root Canals?

When you’re told that a badly damaged or infected tooth may need root canal treatment or removal and replacement, it’s natural to have questions.

You might wonder:

Which one lasts longer?
What does each treatment involve?
How long does recovery take?
Should I try to save my tooth, or have it removed and replaced?

It can be tempting to think of dental implants as an “upgrade” from a natural tooth, but the two treatments have very different purposes.

Root canal treatment aims to treat infection or damage inside a tooth so the natural tooth can remain in place. A dental implant, on the other hand, is used to replace a missing tooth after the natural tooth has been removed or is already absent.

Which treatment may be appropriate depends on factors such as the condition and restorability of the tooth, the surrounding bone and gums, your general and oral health, and your individual circumstances.

Let’s look at what each treatment involves and some of the factors a dental professional may consider when discussing your options.

Quick Answer: Are Dental Implants Better Than Root Canals?

Not necessarily.

If a damaged or infected tooth can be successfully treated and restored, root canal treatment may allow you to keep your natural tooth.

A dental implant may be considered when a tooth cannot be predictably restored or has already been lost.

Situations where removal of a tooth may need to be considered include:

• Severe structural damage
• Certain significant tooth or root fractures
• Advanced loss of supporting tissues
• Persistent problems with a previously treated tooth where further treatment is not considered appropriate

There isn’t one treatment that’s right for everyone.

The appropriate option depends on an assessment of the individual tooth, surrounding tissues, your health and other clinical factors.

Understanding the Difference

Although root canal treatment and dental implants may both form part of managing a badly damaged tooth, they work in completely different ways.

What Is a Root Canal?

Root canal treatment is used to treat infected or damaged pulp tissue inside a tooth.

During treatment, a dental professional may:

• Remove infected or damaged pulp tissue
• Clean and shape the root canal system
• Disinfect the canals
• Fill and seal the root canals
• Restore the tooth with a filling or crown, depending on the circumstances

The aim is to treat the affected tooth while allowing it to remain in your mouth.

Root canal treatment may require more than one appointment.

What Is a Dental Implant?

A dental implant is used to replace a missing tooth.

The implant itself is usually a titanium screw that is placed into the jawbone where the root of the missing tooth was located.

Once the area has healed sufficiently, an artificial tooth, such as a crown, can be attached to the implant.

Dental implant treatment is usually completed in stages and may take several months.

Why Might Preserving a Natural Tooth Be Considered?

Where appropriate, treating and retaining a natural tooth can avoid the need for extraction and subsequent tooth replacement.

Whether a tooth can be retained depends on its individual condition.

Factors a dental professional may assess include:

• How much healthy tooth structure remains
• The extent of decay or damage
• Whether there is a crack or fracture
• The condition of the bone and gums supporting the tooth
• Previous treatment
• Whether the tooth can be adequately restored after root canal treatment

A dental professional can assess these factors and discuss the available options, including the potential benefits, risks and limitations of each.

Keeping the Existing Tooth

Root canal treatment removes infected or damaged tissue from inside the tooth while retaining the tooth itself.

After treatment, the tooth is restored to help protect it and restore function.

Depending on the tooth and how much structure remains, this may involve a filling or dental crown.

Different Treatment Pathways

Root canal treatment and dental implant treatment involve different procedures and treatment timelines.

Root canal treatment generally involves cleaning, disinfecting, filling and sealing the root canal system, followed by restoration of the tooth.

Implant treatment may involve:

• Removal of the tooth, if it is still present
• Healing following extraction
• Implant placement
• Healing while the bone integrates around the implant
• Placement of the final restoration

The exact number of appointments and treatment time vary between individuals.

Considering the Surrounding Bone

Following tooth removal, changes can occur in the bone where the tooth was previously located.

Dental implants are placed into the jawbone and can provide support for an artificial tooth.

The amount and quality of available bone are among the factors a dental professional will assess when determining whether implant treatment may be suitable.

When Might Root Canal Treatment Be Considered?

Root canal treatment may be an option when the pulp inside a tooth has become infected or damaged and the tooth can still be restored.

Possible reasons for root canal treatment include:

Deep Decay

Tooth decay can sometimes extend far enough into a tooth to affect the pulp.

If the tooth can be adequately restored, root canal treatment may be used to remove the affected pulp tissue and retain the tooth.

Dental Trauma

Dental injuries can damage the pulp inside a tooth.

Depending on the type and severity of the injury, root canal treatment may form part of managing the damaged tooth.

Not every cracked or injured tooth requires extraction, so a clinical examination is important.

Infection

An infected tooth may be associated with symptoms such as:

• Toothache
• Swelling
• Sensitivity
• Pain or tenderness when biting

However, an infected tooth does not always cause obvious symptoms.

Root canal treatment aims to clean, disinfect and seal the root canal system.

Restoring the Tooth

Root canal treatment is only one part of managing the tooth.

Afterwards, an appropriate restoration is generally required to protect the remaining tooth structure and restore function.

Depending on the tooth and its condition, this may involve a filling or crown.

When Might a Dental Implant Be Considered?

Sometimes a tooth cannot be adequately restored or has already been lost.

In these circumstances, a dental implant may be one of the options considered for replacing the missing tooth.

Severe Structural Damage

If a tooth has extensive decay, damage or loss of tooth structure, it may not always be possible to restore it predictably.

A dental professional will assess how much healthy tooth structure remains and whether an appropriate restoration can be provided.

Root Fractures

Certain fractures involving the root of a tooth can significantly affect whether the tooth can be retained.

The location and extent of the fracture are important, so assessment and appropriate imaging may be required before treatment options can be determined.

Advanced Gum Disease

Periodontal disease can damage the tissues and bone supporting the teeth.

If a tooth has lost substantial support, its prognosis may be affected.

Any active gum disease also needs to be considered when assessing whether dental implant treatment is appropriate.

Problems Following Previous Treatment

A tooth that has previously received root canal treatment can sometimes develop further problems.

Depending on the circumstances, options may include:

• Root canal retreatment
• Endodontic surgery
• A new restoration
• Extraction

The appropriate approach depends on why the previous treatment has developed problems and whether the tooth remains restorable.

Success and Longevity: Which Treatment Lasts Longer?

There isn’t a simple answer.

Both root canal-treated teeth and dental implants can function for many years, but outcomes vary between individuals.

Factors such as the initial condition, quality of treatment, restoration, oral hygiene, smoking, general health and ongoing maintenance can all influence long-term outcomes.

Root Canal Treatment

Root canal treatment can allow an infected or damaged tooth to remain functional.

Long-term outcomes depend on several factors, including:

• The condition of the tooth before treatment
• The anatomy of the root canal system
• How effectively the tooth can be treated
• The quality of the final restoration
• Ongoing oral hygiene and dental care

No dental treatment can be guaranteed to last for a particular length of time.

Dental Implants

Dental implants can provide a long-term option for replacing missing teeth, but they also require ongoing care.

Possible complications can include:

• Inflammation of the tissues around an implant
• Infection
• Bone loss
• Damage or wear to the restoration
• Mechanical complications involving implant components

An implant cannot develop tooth decay because it isn’t a natural tooth, but the tissues surrounding an implant can still develop disease.

Regular maintenance remains important.

Which Option Feels More Natural?

A root canal-treated tooth remains your natural tooth, although the pulp tissue inside it has been removed.

The tissues surrounding the root remain capable of providing sensation associated with pressure and biting.

A dental implant is different.

An implant is attached to the jawbone and does not have the periodontal ligament found around a natural tooth.

Both root canal-treated teeth and implant-supported restorations can provide useful function, but they are biologically different.

Individual experiences can also vary.

Recovery Time: How Do the Treatments Compare?

The recovery and overall treatment timeline differ between root canal treatment and dental implant treatment.

Root Canal Recovery

Some discomfort or tenderness can occur following root canal treatment and usually improves as the area settles.

The time required to complete treatment depends on the tooth and individual circumstances.

More than one appointment may be required, and the tooth may subsequently need a permanent filling or crown.

Your dental professional can advise you about eating, oral hygiene, pain relief and returning to normal activities following treatment.

Dental Implant Recovery

Dental implant placement involves a surgical procedure.

Following implant placement, you may experience:

• Swelling
• Bruising
• Pain or tenderness
• Some bleeding from the gums

The implant then requires time to integrate with the surrounding bone.

This healing process commonly takes a number of months, although the exact treatment timeline varies.

Further treatment is then required to attach the final crown or other restoration.

Longevity: Which Lasts Longer?

Neither treatment has a guaranteed lifespan.

Root Canal Longevity

A root canal-treated tooth can remain functional for many years.

Its longevity may be influenced by:

• The condition of the tooth
• The quality of the root canal treatment
• The final restoration
• Oral hygiene
• Bite forces
• Ongoing dental care

Some root canal-treated teeth may require further treatment in the future.

Implant Longevity

Dental implants can also function for many years.

However, the implant and the crown attached to it are separate components, and restorations may require maintenance, repair or replacement over time.

Implants can also develop biological or mechanical complications.

Ongoing oral hygiene and professional maintenance are important for both natural teeth and dental implants.

Comfort and Function

Both treatments aim to restore comfortable oral function, but individual outcomes vary.

After a Root Canal

Following treatment and restoration, a root canal-treated tooth can continue to be used for biting and chewing.

The pulp tissue has been removed, but the supporting tissues around the tooth remain.

Some tenderness can occur following treatment, particularly in the early stages of recovery.

After an Implant

Dental implants do not contain the same nerves and periodontal ligament as natural teeth.

However, an implant-supported restoration can provide functional replacement of a missing tooth once treatment and healing are complete.

How a tooth or implant feels can vary between individuals.

Can a Root Canal Fail?

Yes.

Although root canal treatment is intended to treat infection or damage inside a tooth, further problems can sometimes develop.

Possible reasons include:

• Complex root canal anatomy
• Persistent or recurrent infection
• New tooth decay
• Cracks or fractures
• Problems with the restoration

A problem following root canal treatment does not automatically mean that the tooth must be removed.

Depending on the circumstances, further treatment may include:

• Root canal retreatment
• Endodontic surgery, such as an apicectomy
• Replacement or repair of the restoration

A dental professional can assess whether further treatment is appropriate.

Can Dental Implants Fail?

Yes.

Dental implants can also develop complications.

Factors that may affect implant treatment or healing include:

• Infection
• The amount and quality of available bone
• Gum health
• Smoking
• Certain medical conditions
• Some medications
• Mechanical or bite-related factors

If an implant develops complications, additional treatment may be required.

For this reason, careful assessment, treatment planning and ongoing maintenance are important.

Which Treatment Is Right for You?

Rather than asking:

“Which treatment is better?”

A more useful question may be:

“What treatment options are appropriate for this tooth?”

Root canal treatment may be considered when:

• The tooth can still be adequately restored
• Root canal treatment is clinically appropriate
• There is sufficient supporting tissue
• Retaining the natural tooth is considered a reasonable treatment option

Extraction and replacement with a dental implant may be considered when:

• The tooth cannot be adequately restored
• There is extensive structural damage
• Certain fractures affect the prognosis of the tooth
• Previous treatment has developed problems and further treatment is not considered appropriate

These aren’t the only considerations.

Your general health, gum health, available bone, medications, smoking status, preferences, costs and treatment time may also form part of the discussion.

Every case is different.

A dental professional can assess your individual circumstances and explain the potential benefits, risks, alternatives and limitations of the available options.

Common Myths About Root Canals and Implants

“Root canals always fail.”

No.

Root canal treatment can allow an infected or damaged tooth to remain in place, although, like any dental treatment, complications or further treatment can sometimes occur.

“Dental implants last forever.”

No dental implant can be guaranteed to last forever.

Implants can function for many years but require ongoing care and can develop biological or mechanical complications.

“It’s easier just to remove the tooth.”

Not necessarily.

Removing a tooth and replacing it are separate considerations.

If a tooth is removed, replacement options may include an implant, bridge or removable denture. Each option has its own benefits, risks, costs and treatment requirements.

“Implants are always better than natural teeth.”

Not necessarily.

A dental implant is a treatment option for replacing a missing tooth. It is not automatically a better alternative to a natural tooth that can be appropriately treated and restored.

Whether retaining or replacing a tooth is appropriate depends on the individual clinical situation.

Final Thoughts

So, are dental implants better than root canals?

Not necessarily.

The two treatments serve different purposes.

Root canal treatment aims to treat infection or damage inside a tooth so the natural tooth can remain in place. Dental implants are used to replace teeth that have been removed or are already missing.

If a tooth can be treated and restored, root canal treatment may be one option for retaining it. If a tooth cannot be adequately restored, extraction and replacement may need to be considered.

The appropriate treatment depends on your individual circumstances.

A clinical examination and, where appropriate, dental imaging can help a dental professional assess the condition of the tooth and surrounding tissues and discuss the treatment options available to you.