Dental Implant or Root Canal – Cost and Value Comparison

Although I am considered a dental implant specialist by a credentialing board and my peers let me first start by saying that saving your natural teeth is my FIRST priority.

Dental implants are fantastic, but they are a close “second” to your natural teeth. The question is more about “restorability” of your remaining tooth when deciding whether to have a root canal and keep your tooth, or to extract it have a dental implant replacement.

A root canal is a procedure to treat a dead or dying tooth. It is usually a result of a deep cavity touching the nerve or coming very close to the nerve. Some root canals are done to save a tooth that has suffered trauma like a hit to the mouth from a bike accident.

The inside of the tooth and roots are hallowed out and the nerves removed.  This leaves the tooth weak, brittle and prone to fracture so a crown or onlay is made to “cap” over the tooth. A crown or onlay prevents your tooth with a root canal from breaking. So the crown is EQUALLY important as the root canal.

A crown or onlay’s longevity is mostly based on how much of your own tooth remains. So if your tooth had a huge cavity that went under the gumline and then a root canal, you have very little tooth structure left. A tooth post or build-up does NOT add strength to the tooth. It just gives the crown a bit more to grab onto.

Too often I see root canals done on near hopeless teeth.  They have a crown made on a hopeless tooth, and it falls out or fails very prematurely.

That to me is just not right. You may have invested $2000 -$3000 for the root canal, crown, post and build up only to have it extracted in just a few years!

When your tooth is badly damaged, the cost of a dental implant makes a lot more sense than having a root canal and crown on your tooth that does not have a good long-term prognosis.

Can the really bad tooth in this picture be predictably saved?


It is better to extract it and place an implant which is far cheaper in the long-term than a root canal and crown. If the tooth is savable with a root canal for the long-term, that is what I would do in my own mouth or my family’s mouth.

A dental implant placed by me has a 99% success rate as opposed to a root canal on a very compromised tooth that may only have a 40-50% survival rate at 10 years!

If your tooth is restorable, by all means have the root canal. If not, the cost of a dental implant makes more sense in the long term. It does not cost that much more for something that will probably last your life.

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13 thoughts on “Dental Implant or Root Canal – Cost and Value Comparison

  1. Ginny

    There’s a kind of tragedy here, emotionally and financially. I will say I have been “the victim” of the lack of interest in the dental patient and just another project for the technician/dentist. About every three years I vave spent thousands only to have that work undone and the next “project” needed. My mouth has become a money pit. Now I’m at the end of the line, only alternative left is a mouth full of implants and fake teeth. They came up with another half-assed ,very expensive option that is destined to fail. Trust in a professional has been broken! Patient education is the answer. Go on line and look up the “cascade” of dental failure so to make intelligent choices while you can!

    1. RamseyAminDDS Post author

      I’m so sorry to hear about your troubles. Patient education is the answer just like you said. I am a proponent of teaching dental preventive care as a mandatory common core within elementary schools.

      This is the only way dental disease can be prevented. Many patients “brush and floss” but unfortunately do not do it very well. Many others bathe their teeth in acidic juices and sodas, smoke marijuana and tobacco, eat too much sugar, and take prescription medication that dry the mouth out.

      These lifestyle habits make everything fail over time including dental implants, crowns, fillings, root canals , etc.

      Of course I am not implying you’re doing this.

      Be sure to see the very best dentist that you can. They will have a genuine interest in seeing you succeed for the long-term.

      very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  2. Karen T.

    Hello. I had a sinus infection about 6th ago. It was so bad ended up in a hospital for pain. They gave me the strongest antibiotics, anti inflamatory shot and another for pain. The sinus infection was healed but then I noticed a lump just beneath my my right nostril (literally under it). It seems to be affecting my front right tooth. My dentist said the lump is most likely an bases and that I need a root canal before it gets worse. Could I have damaged the nerve for that tooth by pressing too hard on it trying to relieve the pain of the sinus infection? Could it be something worse growing there causing the tooth to die? I am afraid I will have this root canal, spend the money and discover the cyst is actually something else and IF I get that removed, my tooth will return to health. I have a business and my appearance is extremely important as it is in the beauty industry.

    1. Ramsey Amin DDS

      Hello Karen,

      I am assuming you had a 3-D scan done in a dental office to evaluate pathology and abscesses around your teeth???

      The sinuses do not connect all the way up to the front Center incisors. Pressing on them would not have caused this damage most likely. If you have a dead tooth, do the root canal and spare yourself the need for a dental implant.

      The abscess is something pathological, that it needs to be removed and the specimen sent off for histologic assessment under microscope by pathologist. Yes there are tumors that occur in the mouth that look like abscesses but most of them are just abscesses

      3d scan

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  3. Danyelle

    When I was eight, I fell and ended up with a root canal in my left front tooth. Now, I am 46 and I has an infection in that tooth. I went to a specialist today and he told me that he could redo the root canal but if there is a fracture, I would need an implant. He said it was a 50/50 chance of needing an implant if there ended up being a fracture when they go in to redo the root canal. What should I do?? I am so very upset and scared!
    Thank you

    1. Ramsey Amin DDS

      If you end up needing a dental implant, make sure you seek out the best person to do this. Upper front dental implants are considered the most difficult dental implant to do in the entire mouth. You would be best served by a veteran dental implant specialist who can treat your tooth from start to finish. This means that all procedures would be done by the same person all the way through.

      He would not be seen by different dentists or a dentist that just comes in once a month to your dentist’s office.

      How to Choose an Implant Dentist

      Good luck!!!!!

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  4. JoAnn Bentley

    This is a big help. I was afraid that an implant I had 4 years ago may need a root canal, as it has that rotten feeling and metal feeling. Knowing that there’s no root does ease my mind. It may still be a problem but at least it’s not an abcess.