When should a tooth be extracted and an implant placed?

My answer to the question is:  IT DEPENDS.

I have placed and restored hundred of implants during the past 35 years.  At the same time, I have restored thousands of natural teeth.  Both treatments are successful if properly executed.

Each patient’s dental situation is unique and individual.  There are  many treatment options but there is only one accurate diagnosis.  The first step is to obtain records that include radiographs,  clinical exam, a dental history (decay rate and periodontal status) as well as a medical history.

A careful assessment of the tooth in question must be completed.  Is the tooth restorable or is the damage so severe that the tooth is non-restorable and an implant is a better choice?   A CBCT (Cone Beam CT) gives a 3D view of the bone and damaged tooth and is often extremely helpful.

After a complete diagnosis is made, a discussion with the patient must take place.  Do they feel strongly about maintaining their existing tooth or is an implant an acceptable option?  The advantages and disadvantages of each treatment option are discussed.  Alternative treatments and the risk of no treatment will also be reviewed.

Often it is possible to restore a natural tooth, but only if heroic and costly efforts are made.  The long-term prognosis might still be questionable.  Other times, an existing tooth with less damage can be repaired/restored, and maintained with excellent prognosis.

IT DEPENDS . . . .