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Root Canal or Implant


                                                                                                                                                               Root Canal or Implant?

So you have a tooth with a big problem such as decay into the nerve or a crown has come off.  Your dentist tells you that you can save the tooth by having a root canal treatment or tooth extraction and that the best way to replace it is to have an implant placed. How you decide which treatment is best for you?

30 years ago a dentist would have done any possible treatments to save a tooth (unless the patient preferred extraction for economic reasons).  The surgical techniques used then are done less frequently now because implants are available. Additionally, if a tooth is badly broken down it is more commonly extracted now. There are pros and cons to both implants and root canal treatment:

Root Canal “Pros”

-the root of the tooth is already in place,  is in ideal shape, and a natural substance

-start to finish, a root canal, filling, and crown can be done in less than a month

-there is no need to use a removable false tooth during the process

-there is no risk of post-operative bleeding or other extraction complications

Root Canal “Cons”

-the natural root and tooth can later decay or fracture

-the root canal treatment can fail and get reinfected

-all teeth that have had root canals must have a permanent filling or “core” placed and most of them will also need a crown

Implant “Pros”

-implants never decay

-implants are less likely to fracture

Implant “Cons”

-implants can sometimes be placed the day a tooth is extracted but in most cases there is a better outcome if a bone graft is placed after the extraction and then several months of healing are allowed to take place

-a removable partial denture or “flipper” is often worn for four to eight months during healing

-implants are round and do not mimic the shape of the natural tooth so it can be more difficult to get a natural looking crown on top of the implant

-an implant can still break, crack, or get a gum infection

-people who have taken certain types of medications, such as bisphosphonates, are not good candidates for implants. Diabetics and smokers have a higher rate of implants loss.

Let us know if you have any questions about root canal treatment or implants. We can help you decide which treatment option is best for you.

Corporate-run Dental Offices

“Corporate Dentistry” – or dental practices under the control of dental management companies, are increasing in number. How do they differ from traditional dental practices?

People in Colorado are aware of some of these dental chains – that begin with a “C” or a “P”, for instance. Others are not so obvious – they may have an unique name, but still are part of a large organization. These offices usually have the following:

– dentist owns only part or none of the business

– dentist is under pressure to make a profit

– new, younger dentists go through the practice with a high turnover, so you don’t always know who you will be seeing

– high cost dentistry in high volumes are usually expected of the dentists

– some of the practices do not employ dental hygienists to cut costs, and use unlicensed assistants more to compensate

– practice managers often have no dental background, but have a say in what treatment is done

– some practices are for children, because a general dentist can see a high volume of kids covered by Medicaid and it is lucrative

We have provided a link to a presentation from Columbia University Dental School specifically about this type of practice. Below the link we have printed negative comments from the dentists who participated for this project.

Link for the negative comments below:

Negative comments from dentists who worked for dental management companies:

•”Very few have any ethical standards; profits are main goals, a “good” doctor is only one who makes lots of production, regardless of patient satisfaction.” ~ 2yrs DPMC

•”Most of my concerns stem from no autonomy in managing the office. I would like it run a certain way, corporate runs it another. We need to share our office space with general. Budgets restrict what I am able to do.” ~ 3yrs DPMC

•”These institutions should be banned by the ADA. They are unethical in what they do and their services are below standard of care.” ~ 2yr DPMC

•”On the whole, dental corporations are very money oriented. I have witnessed many scenarios where the office managers without a dental degree dictated what treatments (usually the more expensive ones) were need by the patients.” ~ 1yr DPMC

•”I think they are entities more focused on making money rather than patient care. The practitioners I know including myself have only been able to work for these large companies for under a year due to the high stress and burn out rate.” ~ 2yr DPMC

•”’Practice Manager’ dictating treatments and not the treating dentist. / They never know when to refer and the quality of work, when I see it, is horrendous. These recent graduates are pressured into performing too many procedures and unnecessary work is often being performed and the patient care is substandard, in my opinion.” ~ 0yrs DPMC

•”They are destroying dental field.” ~ 0yrs DPMC


•”Chains are ruining the quality of care patients deserve. They are mills to make a quick buck. Chains are ruining private solo practitioner practices.” ~ 0yrs DPMC

•”Though I have no real personal experience to draw from, I automatically assume a negative bias about dental management companies. I assume that quality of care will be compromised, I assume that production and profit will drive patient care and that I won’t have control over my treatment planning.” ~ 0yrs DPMC

    Our advice – if you are a patient of a “corporate ” practice and are given a surprising treatment plan, go get a second opinion! Try to find a dentist who is a full owner of his or her practice and seek their advice before you proceed with the plan.

10 Resources for Free and Reduced Fee Dentistry in Metro Denver

denver dentists

Photo credit: Larry Johnson








Not everyone has dental insurance or money to pay for dental care, especially with jobs disappearing.

If you have a dental problem and no insurance, what can you do? Well, you can cancel the cable TV, skip the acrylic nails and cut your own hair (hair and nails grow out, teeth don’t!).

If you still can’t afford traditional dental care, there are other alternatives. There are so many options for dental care for children, I will save those for my next column.

Here are some resources for adults:

1) Barter.
Place a Craigslist add offering to provide your skills in exchange for dental care.

2) Attend the Colorado Mission of Mercy (COMOM) event, which occurs during one weekend each fall. The Colorado Dental Association has sponsored the COMOM, which provides free dentistry to hundreds of people on a first-come, first-serve basis. The location changes each year, in 2014 it will be in Henderson, CO. Get there early and bring a book, you will have to wait in a queue. You won’t get a new set of veneers, just the basics are provided – but the price is right.

3) The University of Colorado School of Dental Medicine provides discounted dental care. There are even residencies to train dentists to become orthodontists and periodontists (gum specialists). Be patient, getting into the system can take awhile. (This is a state institution run by state employees). Dental students tend to work at a slower pace, but everything is done by the book.

4) Denver Health has a dental clinic at their main campus, and an oral surgery residency there provides services such as removal of wisdom teeth. They have 2 other affiliated clinics referred to as “Eastside” and “Westside”. Treatment is provided on a sliding fee basis, for residents of Denver County.

5) Tri-County Health provides discounted dental care to people over age 55 who reside in Arapahoe County.

6) Colorado Coalition for the Homeless has a dental clinic at 21st and Champa, for qualifying homeless people.

7) Inner City Health Center has 2 clinics, one at 3800 York Street, and another called New Hope Dental at St. Anthony’s Central Hospital . Dental treatment is provided on a sliding fee basis.

8) Community College of Denver has a dental hygiene program that provides cleanings and x-rays at reduced cost at the Lowry Campus.

9) Medicaid. While Medicaid provides comprehensive dental care for children, adults are not so fortunate. If you qualify for both Medicare and Medicaid and have certain health conditions, dentistry is provided through the Colorado Access Plan.

10) Your Dentist. If you have a cavity or broken tooth and can’t afford major treatment, ask your dentist if there is a temporary or “provisional” option to stop decay and stabilize the tooth for several months. Sometimes a temporary crown can keep you chewing and smiling while preventing abscesses.

For more information see these websites: