Why Saving Natural Teeth Should Always Be the Goal in Modern Dentistry

Technology and techniques in dentistry have come a long way over the past 20 years. Today, we can save natural teeth and tooth structure far more effectively than in the past. Thanks to modern equipment, bonding techniques, and biomimetic principles, teeth that once would’ve needed to be extracted and removed can now often be restored predictably and conservatively.

With advancements in bonding and restorative materials, we no longer need to drill away the majority of a tooths structure in order to place a crown. Instead, we only remove the decayed or damaged portion and replace it with a bonded porcelain filling. This approach restores strength without sacrificing healthy tooth structure. It’s not only healthier for the nerve—because there’s less trauma from drilling—but it also helps the tooth last longer by preserving what gives it its natural strength.

The traditional approach to crowns often involved removing over 50% of the tooth, then covering it with a hard material to protect it. The problem is, these full-coverage crowns can pop off when eating sticky foods, and the remaining tooth (which has been shaved into a small nub) is more prone to fracture—sometimes at the gum line, rendering it non-restorable.

By using modern adhesive dentistry in everyday practice, we can offer healthier, longer-lasting, and less invasive treatments. These techniques reduce post-op sensitivity and help avoid complications.

In addition, today’s technology allows us to save teeth that were previously considered non- restorable. We can now restore teeth with minimal structure left above the gumline—something that wasn’t possible before. And this matters, because keeping a natural tooth—even if only for a few more years—is always better than placing an implant too soon.

Why Delaying an Implant Can Help

Every time a natural tooth is extracted and replaced with an implant, some bone is lost. Even when an implant is perfectly placed, we typically lose about a millimeter of bone every five years. That’s because the body is better adapted to preserve bone around a natural tooth (due to the presence of the tooths ligament and natural blood supply) than around a dental implant.

So even if a tooth has to be extracted down the line, saving the tooth for even another 5 to 10 years keeps the bone healthy for that duration. If the implant had been placed earlier, several millimeters of bone would have been lost in that same period—making future treatment more complicated.

The longer we can delay the implant, the longer the implant will last when we finally need it—and the fewer complications we’ll face due to bone loss.

Why Some Patients Are Pushed Toward Extraction and Implants

Unfortunately, not all dental offices prioritize tooth preservation. Some practitioners may be more aggressive in recommending extractions and implants. This can be due to several factors:

• Insurance limitations: Some insurance plans don’t cover conservative, tooth-saving treatments, leaving patients feeling like extraction is their only option.
• Surgical bias: Dentists with a stronger surgical background may not have the training, tools, or technology needed to save the tooth, so they default to extraction and implants.

As a patient, one simple question can help you identify whether a dentist is focused on saving your teeth: Do they bond their restorations?

Dentists who use bonded, adhesive techniques (sometimes referred to as biomimetic dentistry) are typically better equipped to preserve natural teeth. Dentists who do not, often don’t have the equipment or training to save a more compromised tooth.

The Importance of Second Opinions

One of the most empowering things a patient can do is seek a second opinion—especially if a treatment plan feels aggressive or rushed. Dental treatment is irreversible and cannot be undone, so it’s important to make decisions with full understanding.

This is especially true in offices that accept in-network or HMO insurance plans. While many excellent dentists accept these plans, the reimbursement model can make it difficult for office to prioritize conservative care. Especially in California where the dental insurance coverage is so poor, it can prevent dental offices from being able to offer more conservative treatment options. Sometimes, the financial model favors extractions and implants simply because it’s the only financially viable option for the office.

That said, getting a second opinion doesn’t mean you have to switch providers. You can always return to the original office for treatment. But a second opinion gives you perspective, especially if it’s from a dentist who practices minimally invasive dentistry.

Cost Isn’t Always What It Seems

Many patients assume that in-network care is always less expensive. But that’s not always the case. We’ve seen patients who were told they needed multiple implants, when in fact, their teeth could be saved with bonded porcelain restorations. Even though the per-procedure cost might be higher at an out-of-network office, the overall cost could be lower because fewer procedures are required.

Great dental care is available both in-network and out-of-network. What matters most is the philosophy of care—whether your provider is trying to save your natural teeth, and whether they have the tools and training to do so.

Bottom Line

Modern technology has allowed us to save teeth and preserve natural structure in ways that were not possible a generation ago. If you’re ever concerned about losing a tooth or feel that a proposed treatment plan is too aggressive, it’s worth consulting a provider who practices minimally invasive or biomimetic dentistry. You may find that there are better, more conservative options available—and your natural teeth might just thank you for it.

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