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April 12th, 2012

With the advent of new technologies, dental implants that replace missing teeth have become very reliable and quite common.  In fact, implants have become the standard of care in many situations.  This has led to new decision making when faced with the prospect of a damaged tooth.
In the past, we went to great lengths to save any tooth since, once it was lost, the only way to replace it was with a fixed or removable bridge.  A fixed bridge depends upon the teeth on both sides of the now empty space and these usually need to have crowns made to anchor the bridge.  These teeth often don’t require crowns, so the treatment is more invasive than we would like.  If there are not teeth on both sides of the space, then a removable appliance (partial denture) was the only available route.  Many people do not like the prospect of that hardware in their mouths.
When a tooth has had major damage done, then it usually needs a crown and may require  root canal treatment if the nerve is damaged.  This can lead to a healthy restored tooth that will function for a lifetime.  But there may be other considerations.  What if there is periodontal disease around the tooth, or internal fracture lines that may indicate future failure of the treatment?  These may point to the rationale for taking the tooth out and placing a single tooth implant.
The options for restoring the teeth and maintaining optimal dental health are constantly changing.  Your dental team will always advise you of your options and discuss the best course of treatment for you.
As with many treatment options, cost is a factor.  When considering a tooth that needs root canal treatment along with a filling core and post to support a crown, the cost is almost the same as an extraction and implant placement.  Having the implant done removes the risks of further decay and gum disease but it is definitely a more invasive process.

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