Is it time for your patient to get an implant or should they get a root canal? It is important to have an answer to this question from a patient investment stand point and from a medical history standpoint. However, the answer to this question requires a thorough examination and conversation.

Here are a few things to consider when talking to your patient about whether they should get a root canal or a dental implant.

Patient history

Dr. Edward Harsini is the owner of Smile Dental Clinics in Phoenix.

When examining a patient one of the first things we need to consider is if the patient needs a root canal or a retreat of a root canal. Retreatments have a success rate of about 60 percent, patients should be well aware of this statistic. If the Root canal fails again in few years a patient’s investment is wasted.

During the examination of your patient look at the health of the root and the health of the bone around the tooth, also does the tooth have a post. Having a post, it is a clear indication of lack of clinical crown.  Open apexes, also complicate success rate.

A history of diabetes could also be a significant factor in your recommendation of implant vs. root canal. Patients with a high A1c are not candidates for implants. Their healing capacity is poor, and their immune system is more likely to be compromised.

Also if the patient is on Bisphosphonate or any medication because of bone loss, they are not candidate for Implants, root canal treatment would be preferred.

Patient history is a strong indicator of which procedure will produce more success. 

Invest in your mouth

When it comes to getting a root canal or implant it is important to help the patient understand that whatever procedure they decide, needs to be thought of as a long term investment in their mouth. 

It is important that we educate the patient on the best course of action. Also let the patient know the pros and cons of different procedures.

If the patient thinks of their procedure as a long term investment, then they are less likely to be spooked by short term cost and think about the benefit of saving money later on by preventing extra treatment and saving themselves from long-term pain down the line.

Save your natural teeth if possible

Let the patient know that if you can save their natural teeth that is always the best option; however, be honest with your patients and recommend an implant if needed.

Natural teeth are the best option; however, it 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 out perform dental implants.

Deciding between dental implants and a root canal can be a stressful time for patients, but a through examination and conversation about the best course of action can make all the difference in the world.


Dr. Edward Harsini is the owner of Smile Dental Clinics in Phoenix, Ariz. He graduated from the University of Missouri-Kansas City Dental School in 1998. He is certified by UCLA Aesthetic Continuum, the 3M Imtec Mini Dental Implants and GRU/AAID Maxi-Course Implant Dentistry.