Saving Badly Diseased Teeth More Trouble Than It's Worth

In recent years, it was common practice for dentists to perform repeat root canals and other procedures in an effort to say teeth compromised by extensive decay, gum disease, and bone loss. Recently, the American Academy of Implant Dentistry has said that this no longer necessary and patients should skip the dental heroics and opt for long lasting dental implants.

Dentist and spokesman for the AAID, John Minichetti, claims, “There really is no justification for undergoing multiple endodontic or periodontic procedures, and enduring the pain and financial burden, to save a diseased tooth. The days are over for saving teeth till they fall out. Preserving questionable teeth is not the best option from both oral health and cosmetic perspectives.”

Losing a tooth can be a difficult decision but patients must also be aware of the oral health and cosmetic implications of preserving questionable teeth. Though patients initially resist losing their natural teeth, they often recognize that the best outcomes occur from extracting them and inserting implants – which look and function like natural teeth.

Recent evidence has found that root canal procedures have a higher failure rate than dental implants. In some cases, root canals can fail because abscesses occur, and oral surgery is required to clean the infected area. A study published in the Journal of Oral Implantology showed that single-tooth dental implants are 98.5 percent successful after seven years and there was no discernable bone loss in all the implant sites. In comparison, first time root canals have a 5% failure rate and much higher rates following repeat procedures.

Saving badly decayed teeth can also result in unfavorable cosmetic results, according to Minichetti.  He adds, “Periodontal procedures to save decaying natural teeth can require raising the gum line and exposing teeth roots to anchor a new crown. The crown needs something to hold onto, so you have to push the gum tissue up with unfavorable cosmetic impact.”


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