Have you ever noticed that fashion and haircuts go in a circle and come back in vogue again?  Well, the same can be said for trends in the health fields.  We see this trend happening in dentistry with root canal treatment versus the placement of implants for restoring a tooth.  In general, dental implants are a very popular, well-advertised treatment.  You can see this in television ads, brochures, and magazine articles.

Our patients trust us as professionals to properly diagnose and recommend treatment that is in their best interest, not ours.  I have run into colleagues who have removed the treatment option of saving a tooth with root canal treatment and will extract and place a dental implant as the only treatment option.

Well, what is old is new again.  The pendulum has swung back to keeping the natural tooth.  Why?  Well as more and more implants are placed, we have accumulated more knowledge on longevity and complications that are arising with this form of dental replacement.  Research shows that implants do not last longer than a tooth which has been properly restored with root canal and a crown.  And the implant treatment is more costly.  A recent article in DENTISTRY TODAY, by Dr. John West DDS, MSD,  states exactly how I feel about this topic.  He states “the implant versus endodontic(root canal) formula is simple:  if the tooth under consideration for treatment has a predictable biologic structure, function and esthetic prognosis, then restore it.”  In other words, teeth with good bone structure are the best nature can offer and we should keep them.  Please understand, I treatment plan dental implants as a treatment option when needed and love the idea of anchoring loose dentures with implants as well as restoring missing teeth.  But, this form of dental treatment should not always be the first option.

I use a simple test to determine whether I should recommend an implant or restore a tooth with root canal treatment.  Simply, I ask myself what would I do for my family?

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