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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.

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

  1. I had a root canal on a lower molar almost 5 years ago. ( it is Jan 7, 2019 now) The roots are infected with some pain recently. The pain comes and goes it seems. the One who did the root canal refers me to an entodontist. I heard the 2nd time has less of a chance of success, should I consider an implant- spend a little more and not worry about this all happening again in a few more years? My tooth has a gold crown, he says I can keep the crown if I have this re-done. I guess they drill down through it and plug it.

    1. It really depends on the long term prognosis of each. Sometimes the root canal is the better option. Each Sirius unique

  2. My sister age 16 has her tooth 🦷 #9 cracked badly where it’s cracked horizontally close to the gum line. The specialist said root canal will be ok for maybe 10 years or less or should we look into implant?

  3. Doc my daughter #15 tooth need a root canal with a crown the dentist never spoke about an implant option she is 16 , should we consider an implant for better long term results?

  4. My husband has a crack on tooth number 30. There is no infection. He is being told me an implant is better to get rather than a root canal. Is it due to the crack? I would think the tooth could be saved with a root canal, but he was told since it’s the last molar it won’t sustain. Thoughts? Also, how does a tooth just crack?

    1. Teeth crack all the time!! My own tooth broke! If it is a bad crack, a root canal will only delay the inevitable. Sorry 😐

  5. I just had my # 11 tooth, which is a crown, break off. My dentist said it took most of my remaining tooth with it and has recommended either a bridge,$400, an implant $2700, or a root canal and post $400. I don’t know what to think. My crown is about 8 years old and most of my teeth are crowned. I am thinking of the bridge but he would take off both side teeth which are crowned

    1. If you are referencing the upper left canine tooth in the American tooth numbering system that is a super important tooth. It is the cornerstone of the upper arch. This is best replaced with a dental implant rather than connecting to weaker teeth on either side to replace it.

  6. I had a root canal with subsequent crown done on my front right tooth recently. The crown was placed approximately 3 weeks ago. During the procedure, the dentist informed me that the tooth had significant decay, however he said he had removed all that prior to placing the crown. A post was added to my tooth to provide extra stability. However, now, less than a month after having the crown placed it seems loose, and I am beginning to wonder whether or not my dentist made the right decision in placing the crown in the first place. Not once was the option of a dental implant suggested to me as an alternative. I am now suspicious that my tooth was perhaps too far gone to be saved and that the dentist should probably have recommended an implant over the root canal and crown (he even said he would recommend the crown as the tooth was very susceptible to fracture given how much had to be removed). I have now spent around $3000 having this tooth fixed, and will be very disappointed if I now find that I need an implant at further cost to myself, given that I have already maxed out my insurance for this year.

  7. I need two root canals and just had two done . I have maxed out my insurance and am running out of money and am on severe pain everyday. Is there any other alternative?

    1. Unfortunately it’s either root canals or extractions. Not much in between for teeth that are that far gone. 🙁

  8. Hello, I have crowns on every tooth in my mouth that are as old as 20+ years. I have spent the cost of a small home on my mouth over the years. I am now in the stage of teeth failing and having to get root canals. I spent over $4000.00 to have a back molar done and gold crown put on by a specialist in Endodontics. The tooth has never stopped hurting 1 1/2 years out. I have complained to the Endo DDS the entire time with nothing done to correct it so far. I am now facing another painful tooth, tooth # 24 and it to has to be done by the specialist per my regular DDS. My problems were/are I have very very tiny teeth with almost zero enamel. This was not caused by lack of care or foods. I was born with a 110% overbite and ground my teeth on top of having a major enamel or the lack of issue. When they originally put in the crown, the lower front teeth had very little to hold a crown and I was worried. Now that I must attempt to have it redone with a root canal, I honestly dont see what could hold it together. I dont know what to do. Should I have it pulled and be toothless in the front or try to save it with zero guarantee for the Endo DDS? My regular DDS said they should be able to save the crown and drill on the back side. I think the minute it touches a drill it will pop off. Also the pain is so bad unlike anything I have ever had. It hurts all the way down my chin and under my chin. No pain meds though because all us people out hear who are not drug addicts have to suffer because of those who misuse. I cant take Ibu. allergic and eating enough tylonel to stop my liver.

    1. Lower front teeth with root canals are weak because that is a naturally thin root.
      It sounds like saving it would be a basketball shot from half-court… Not likely to make it in.

  9. I had root canal treatment done on my back molar 7 months ago. Now the crown is broken. Is this normal? Is there any sort of life expectancy for a root canal? I believe I would now like the tooth to be extracted. Would it be better to return to the dentist who did the now broken root canal? Is it reasonable for me to expect the dentist to extract his failed handy work gratis? Or would it be better to see a different dentist?

    1. It would be best to return to the original dentist. From your comment it is difficult for me to decipher if you just chipped porcelain which would be minor or did the whole crown break off indicating there was not too much tooth that remain to even make a crown in the first place.

      Oftentimes root canal teeth are saved at too much of a cost ending with premature failure.

      Very Respectfully,

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

      1. thank you. I went to a different dentist who told me the whole crown was broken off and the tooth was split in two. He extracted the tooth and also scraped some of the bone away in case of any infection. Today, one day after surgery, I feel great! No pain! Miles better than after receiving the root canal treatment which pained me for over a week afterwards.

  10. I developed an infection on a tooth that had previously gone through a root canal because I did not place a crown after the root canal treatment. The infection grew large and needed drainage. I am currently on antibiotics. The dentist is charging me around $3000 for a root canal and crown in a week. Does this price sound right? I am paying out of pocket. Also, I live in Georgia and I have heard that it should not cost this much.

    1. That is within range for treatment done by a good dentist. Quality and experience is what you are paying for.

  11. I am upset because I got a root canal and buid up and crown inOct 2012 (not by this doctor) and Dec 2015 the whole thing fail off. I am left with tooth decay on what is left of the tooth that still there. When I was told that the crown will protect the tooth.

    I call my dentist and they told me there is nothing they can do if the tooth has decay but pull it…..WHAT after thousands of dollars and 3 years later you want pull my tooth and then want me to pay thousands of dollars to have implants put in. Are you serious???? Why did I go through all of that????

  12. 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. 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

  13. 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. 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

  14. Hello,
    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. 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

      1. I am in a similar situation (8yrs old, school event at roller rink lead to root canals of both front teeth), one now infected 25yrs later and dentist said 50/50 chance of success redoing root canal. I feel more confident with this decision after reading your blog, the above post, and your comment. Thank you!

  15. 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.

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