Often this question is asked by a patient who is struggling to make a significant investment in their natural tooth that is significantly compromised.  The answer depends on many factors.  As a dentist in the Niagara and St. Catharines area, I try to help my patients in making the best decision for themselves.  I can provide insight and guidance but ultimately the decision to restore a tooth or extract it lies firmly on the shoulders of the patient.  It is your tooth and I cannot force you to decide what is best for you.  The patients in my practice have an active role in the decision-making process for any treatment we provide.  We feel that is the best way to treat our patients by empowering them to make the appropriate decisions for themselves.

If your tooth has extensive decay and there is little tooth structure remaining to restore the tooth above the gum line, it will be a challenge to restore this tooth.  Most likely, the tooth will require root canal treatment AND gum surgery to expose more of the natural tooth to allow it to be properly restored.  Even with this treatment, the prognosis for the tooth may not be good.  I have concern recommending treatment if it may not last long term (greater than five years).  This treatment sequence is invasive and expensive.  Also, it may take time for the soft tissue to heal so there is no quick fix here.  Ultimately, the long-term prognosis will dictate what I will recommend for my patient.  Often, when the prognosis is guarded at best, I will discuss with the patient the possibility of extraction and replacement with a dental implant.  This might be a better option in the long run and you may get more value for your money overall.  But there is some risk with dental implants as well.

Extracting a compromised tooth is never an easy decision.  However, there are many tooth replacement options available for patients today.  I believe the standard of care for tooth replacement is a dental implant.  A dental implant is a titanium post that is placed in the jaw bone, becomes fused to the bone and then a crown is placed on top of the implant.  It is like having your natural tooth again.  Dental implants can last a long time if properly maintained and often will be a better long-term option for a patient.  However, they can be expensive and require possible multiple surgeries.  Furthermore, the bone in the area needs to be of sufficient quantity to allow placement.  If there is inadequate bone, further surgery maybe required to augment the bone in the area with grafting.  This can add to the cost and complexity of the treatment.  While dental implants are impervious to getting cavities, they can still fail for many reasons.  Patient home care needs to be good and if there are excessive biting forces on the implant through clenching or grinding that can be harmful as well.  Dental implants can last a lifetime if managed well by the patient and dental team.

In summary, a lot of factors will play a role in the decision-making process whether to save a tooth or not.  Often, there is no clear-cut choice and the best that Dr. Vlahos can do is present all the relevant information to the patient and allow them to make the best decision for themselves.  He will take the time to discuss your situation with you, listen to your concerns and together make a decision that is best for you.  If you a similar problem in your mouth, please feel free to contact Dr. Vlahos at 905-937-4673 (or email: [email protected]) to set up a free consolation to discuss your situation.  Dr. Vlahos and his team will be more than happy to do this for you!