Dr. Hall,
I am 75 and have always taken care of my teeth. Now it seems like all my old fillings are needing replaced, and one tooth they say has some cracks. I had to have a crown on my upper second molar and they found a cavity and a crack on the first molar, so they want to crown that as well. They seem to do a good job. But I worry, that what if they say I will need a root canal later. I hope not, but after going thru the crown. I am unsure if I should have a root canal. Plus I had a total knee replacement 16 months ago, so that worries me too. I sure appreciate if you could share your thoughts with me. When does it seem better to have a tooth extracted instead of crowns and root canals?
– Sandi from Columbus, OH
(See Dr. Hall’s answer below.)
We thank our advertisers who help fund this site.
Sandi,
You didn’t mention anything about replacing the teeth after having them extracted. You definitely don’t want to lose your upper molars on one side. Even at age 75, your lower teeth can then drift up into that space, which will leave you with a messed-up bite. Even if they don’t you’re going to end up having to chew on just one side. I can’t imagine wanting that.
So let’s assume you’re planning to replace the teeth with dental implants. That will give us something to talk about.
Dental implants have become a very reliable restoration, so you could make a case for having an implant and a crown instead of a root canal treatment and a crown. Root canal treatments on molars can fail, though with the latest technology, done by root canal specialists, they are also very reliable. Implants can also fail. While there is probably less chance that an implant will fail, re-doing the implant is a tricky process involving the time and expense of a couple of surgeries and bone grafting. Cost-wise, the root canal and crown are probably about 2/3 the cost of an implant and crown.
For me, keeping the original equipment that God gave me is always preferable.
So here’s the breakdown comparing the implant and crown to root canal and crown:
Implant and Crown:
- 50% more expensive
- Takes at least 3 months for the implant to integrate with your jawbone
- A little more reliable than a root canal and crown
- In case of failure, more complicated to repair
Root Canal and Crown
- Less expensive
- Can be done in maybe three appointments over two or three weeks
- The root canal can fail, which could require reverting to an implant and crown
- Is more natural, with no artificial fixtures implanted into your bone
Now getting back to your situation, Sandi, I don’t know why you are so worried that these teeth that need crowns could end up needing root canal treatments. You gave me no indication that you have extra sensitivity in those teeth, which would occur if the teeth were at risk of needing root canals. Yes, I guess there is a slight possibility that either tooth could end up needing a root canal, but that is unlikely. Why have a natural tooth removed just because you think there is a chance it could need a root canal? So my advice would be to get the crowns. Then, even if both teeth end up needing root canal treatment (a very unlikely prospect) just get the root canals. That still, in my opinion, is better than replacing the teeth with implants.
– Dr. Hall
Answer goes here
Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.
About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Leave a Reply