Edward Harsini, DDS.
Educating the patient on the best course of action is important. Also, let the patient know the pros and cons of the different procedures. I tell my patients that saving their natural teeth is always the best option if possible. However, I recommend an implant if that is what the patient needs.
Natural teeth are the best option, but the decision depends on the factors that we mentioned above. Implants play a very important role in helping a patient recapturing lost chewing surfaces. However, natural teeth if healthy and strong will outperform dental implants.
Here are some things to consider when talking to your patients about whether they should get a root canal or a dental implant.
A patient's history is a strong indicator of which procedure will produce more success.
When examining a patient, one of the first things to consider is whether the patient needs a root canal or a retreatment of a root canal. Retreatments have a success rate of about 60%. Patients should be well aware of this statistic. If the root canal treatment fails again, their investment is wasted.
“A patient's history is a strong indicator of which procedure will produce more success.”
During the examination, look at the health of the patient's root and the bone around the tooth. I remind myself to check if the tooth has a post. Having a post is a clear indication of a lack of clinical crown. Open apexes also can complicate the success rate of treatment.
Does your patient have diabetes or a history of diabetes? Patients with high hemoglobin A1c levels are not candidates for implants. Their healing capacity is poor, and their immune system is more likely to be compromised.
Also, if patients are on bisphosphonate or any medication because of bone loss, they are also not a candidate for implants. I recommend root canal treatment for these patients.
When it comes to deciding on treatment, it is important to help patients understand that, whichever procedure they decide on, they should think of it as a long-term investment in their mouth.
If patients think of their procedure as a long-term investment, then they are less likely to be shocked by the short-term cost. I try to help my patients consider the long-term benefits of treatment, such as cost-savings from not needing additional treatment and pain reduction.
Deciding between dental implants and a root canal can be stressful for patients, but a thorough examination and conversation about the best course of action can make all the difference in the world.
Edward Harsini, DDS, is the owner of Smile Dental Clinics in Phoenix.
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