As Dr. V likes to say, the best teeth are the ones you’re born with. No restorative material can compare. Sure, there are plenty of good options for when a tooth must be repaired or replaced. But no dental restoration or prosthesis can last forever. Your natural teeth – properly taken care of – can and should (barring accident or injury) last a lifetime.
…comes as no surprise.
According to the study , published recently in JADA, the 15 year loss rate for implants may be as high as 33%. For natural teeth? At most, 13.4%.
Of course, part of the survival rate for natural teeth also depends on their overall condition. The loss rate of “questionable” teeth can be nearly as high as that of implants and even higher for “hopeless” teeth in patients with chronic or aggressive periodontitis (advanced gum disease). But even these teeth may be retained with adequate care.
The results of this systematic review show that implant survival rates do not exceed those of compromised but adequately treated and maintained teeth, supporting the notion that the decision to extract a tooth and place a dental implant should be made cautiously. Even when a tooth seems to be compromised and requires treatment to be maintained, implant treatment also might require additional surgical procedures that might pose some risks as well.
The authors also note a critical point: “A tooth can be extracted and replaced at any time; however, extraction is a definitive and irreversible treatment.”
This recommends a conservative approach. First, do what you can to improve the health of the tooth and supporting structures. If that fails, extraction may be the best option.
As for replacing that tooth? In our office, implants – metal or otherwise – are a non-option. Just as with mercury amalgam, we find that their risks far outweigh any benefits. (For more info, follow the “when it comes to implants” links above.)