Restoration Comparison
Dental Implants vs Crowns
When to save a tooth and when to replace it — clinical guidance from Tower Dental's GDC-registered team. Last reviewed April 2026.
The short answer
A crown covers and protects an existing damaged tooth that still has a healthy root. An implant replaces a tooth that has been lost or cannot be saved. The two are not interchangeable — they answer different clinical questions. The right choice depends on whether your tooth can be reliably saved (crown) or needs replacing (implant). At Tower Dental, a crown costs £495-£695 and an implant including crown is £2,380. Crowns are quicker to fit (2 weeks) but have a shorter average lifespan (10-15 years); implants take longer to complete (3-6 months for healing) but typically last 25+ years. The decision should be made on X-rays and clinical examination, not patient preference.
The real question — save or replace?
Most patients ask "implant or crown?" but that is not actually the choice. The clinical question is: can this tooth be reliably saved, or does it need replacing? If the tooth can be saved, the answer is a crown (sometimes preceded by a root canal). If it cannot, the answer is extraction followed by an implant.
The mistake we sometimes see — and which is the most common reason for failed treatment — is crowning a tooth that should have been extracted. A heavily compromised tooth (severe gum disease, fractured root, repeated infections) may accept a crown initially, but if the underlying tooth or root cannot support it long-term, the crown will fail within a few years. The patient then needs the extraction and implant they would have needed in the first place — and has paid for the failed crown on top.
A good restorative dentist will tell you honestly whether the tooth has a good long-term prognosis. If it does, save it with a crown. If it doesn't, replace it with an implant. The wrong answer is to save a tooth that is going to fail anyway.
When a crown is the right answer
A crown is the right treatment when your natural tooth has a healthy, infection-free root, adequate sound tooth structure remaining (typically more than 50% of the crown of the tooth), and good gum and bone support. Specific situations where a crown is the standard recommendation:
- After root canal treatment on a back tooth — the crown protects the now-brittle tooth from fracture under chewing forces
- Heavily filled teeth where the remaining tooth structure is at risk of breaking around a large filling
- Cracked teeth where the crack hasn't extended to the root and the tooth is still vital
- Worn or eroded teeth that need restoring to original height and function
- Cosmetic refinement of a single visibly damaged tooth where a veneer wouldn't provide enough coverage
- Replacement of an old, failing crown where the underlying tooth is still sound
When an implant is the right answer
An implant is the right treatment when the tooth itself is gone, going, or so compromised that saving it is not predictable. Specific situations where an implant becomes the recommendation:
- Tooth already missing — whether from previous extraction, trauma or congenital absence
- Vertically fractured root — these almost never heal and the tooth needs to come out
- Repeated abscesses despite root canal treatment — sometimes the root canal cannot be cleared of infection
- Severe gum disease with significant bone loss around the tooth — the support is gone and the tooth is mobile
- Less than 30-40% of sound tooth structure remaining — there isn't enough tooth left to support a crown reliably
- Failed root canal in a tooth not suitable for retreatment
Implants are also the standard recommendation for replacing a long-missing tooth where a denture or bridge has been used previously and the patient wants a more permanent, more comfortable solution.
Side-by-side comparison
| Factor | Crown (on natural tooth) | Implant + Crown |
|---|---|---|
| Cost (Tower Dental) | £495-£695 | £2,380 |
| NHS available? | Yes (Band 3, £326.70) | Very rarely |
| Treatment time | 2 visits over 2 weeks | 3-6 months total (multiple visits) |
| Surgery required? | No | Yes (under local anaesthetic) |
| Typical lifespan | 10-15 years | 25+ years |
| Bone preservation | Maintains existing bone | Prevents bone loss after extraction |
| Looks natural? | Yes | Yes |
| Can develop decay? | Yes (at margin) | No (titanium doesn't decay) |
| Affected by gum disease? | Yes | Yes (peri-implantitis) |
| Best when | Tooth and root are sound | Tooth is missing or unsalvageable |
The 30-year cost picture
If you compare upfront cost only, an implant is 3-4 times more expensive than a crown. The picture changes when you look at lifetime cost.
A crown lasting 12 years on average means you would need 2-3 crown replacements over a 30-year period. At £495 per replacement, that's £990-£1,485 in total crown costs across the period — without accounting for any complications like recurrent decay or root canal treatment that the natural tooth might develop. If the underlying tooth eventually fails, you then face an additional £2,380 for an extraction and implant. Total possible 30-year cost on a moderately compromised tooth: £3,000-£4,000.
An implant fitted today at £2,380 will, in most cases, still be functioning in 30 years. The crown attached to it may need replacing once at around year 15-20 (£600-£800), bringing the total 30-year cost to roughly £3,000-£3,200. The numbers are closer than the upfront comparison suggests — and the implant has the advantage of not being subject to decay.
This calculation does not justify extracting healthy teeth. It just illustrates that implants are not always more expensive over the long run, and that a crowned tooth with a poor long-term prognosis is the most expensive option of all.
What patients actually find difficult
In our consultations, the implant decision is rarely difficult clinically — the X-ray usually makes the answer obvious. The hard part is psychological. Patients are reluctant to accept that a tooth they have had all their life cannot be saved, and they often press for "any option that keeps the tooth." We understand this — losing a natural tooth is a real loss.
Our honest position is that we will always try to save a tooth that has a reasonable long-term prognosis, even if it means more conservative work for us. But if the tooth will fail anyway, recommending a crown to delay the decision by a few years is not in the patient's interest. It costs the patient money for treatment that won't last and can sometimes make the eventual implant more complex (because of bone loss in the intervening period).
Bottom line
Implants and crowns are not alternatives to each other for the same problem — they are appropriate for different clinical situations. A crown saves a tooth that can be reliably saved. An implant replaces a tooth that has been lost or cannot be saved long-term. The right answer for any specific tooth depends on the clinical picture, not patient preference.
If you're facing this decision, an honest consultation with full X-rays and a written treatment plan is the right starting point. Call 01253 353759 or request a consultation for an honest second opinion.
Frequently Asked Questions
Can my tooth be saved with a crown, or do I need an implant? +
This is the single most important question and the answer is genuinely tooth-dependent. A crown can save a tooth that has lost up to 50-60% of its structure but still has a healthy, infection-free root and adequate gum support. If the root is fractured below the gum line, severely infected and not responding to root canal treatment, or surrounded by significant bone loss from gum disease, a crown is no longer a reliable option and extraction with implant replacement is usually the better long-term choice. The decision is made on X-rays, clinical examination, and sometimes a CT scan — not on patient preference. We always discuss both options when both are clinically valid.
Which lasts longer, an implant or a crown? +
Implants generally last longer than crowns when comparing like-for-like. A well-placed implant in a healthy mouth typically lasts 25+ years and many patients keep their implants for life. A crown on a natural tooth typically lasts 10-15 years before needing replacement, primarily because the underlying tooth root continues to age, the cement bond can weaken, or recurrent decay develops at the crown margin. However, crowns can be replaced relatively easily; implant replacement is more involved if the implant fixture itself fails. Across a 30-year horizon, an implant usually requires fewer interventions than a crowned tooth.
How much do implants and crowns cost compared? +
At Tower Dental Blackpool, a single dental implant including the crown costs £2,380 — this includes the titanium fixture, abutment, and the porcelain crown that goes on top. A standalone crown on a natural tooth costs around £495-£695 depending on material (porcelain-fused-to-metal, full-zirconia, or hand-layered porcelain). The implant is roughly 3-4 times the upfront cost. However, if a tooth that should have been extracted is crowned and then fails 5 years later, the patient will end up needing an implant anyway — at which point they have paid for both treatments. This is why getting the initial decision right matters.
Is the implant procedure painful? +
Implant placement is performed under local anaesthetic and is typically less painful than a difficult extraction. Most patients describe the placement appointment as comfortable — pressure but no sharp pain. Post-operative discomfort lasts 2-5 days and is managed with standard painkillers. The longer aspect of implant treatment is healing time: 3-6 months for the bone to integrate with the titanium fixture before the final crown can be fitted. During this period a temporary tooth is provided for visible areas. A crown procedure on a natural tooth is shorter (2 visits over 2 weeks) and usually involves less post-operative discomfort.
Can I get an implant on the NHS? +
Implants are very rarely available on the NHS. They may be funded only in exceptional clinical circumstances — for example, severe trauma, congenital absence of teeth, or specific reconstructive cases referred to specialist hospital departments. For the vast majority of patients seeking implants, private treatment is the only realistic route. Crowns, by contrast, are available on the NHS under Band 3 (£326.70 in England as of 2026), although the NHS specifies the material and shade — meaning back-tooth crowns are typically metal, and front-tooth crowns are a basic porcelain-fused-to-metal. Premium materials like full-zirconia or layered porcelain are private-only.
What if I'm grinding my teeth — does that affect the choice? +
Bruxism (tooth grinding) damages both crowns and implants but in different ways. Crowns can chip, fracture or come loose under heavy grinding forces. Implants can suffer from biological complications (bone loss around the fixture) under excessive force, and the crown attached to an implant can fracture. The treatment for both is the same — a properly fitted nightguard, reduction of caffeine and stress where possible, and in some cases muscle-relaxant injections. We screen every patient for grinding before recommending either treatment, and a nightguard is included with most implant cases.
Can I have a crown on a tooth that's had a root canal? +
Yes — a crown is the standard recommendation after root canal treatment on a back tooth. Root-canal-treated teeth become brittle over time because the internal blood supply is removed, and a crown protects the remaining tooth from fracture. The crown should typically be fitted within 6-12 months of the root canal to give the best long-term outcome. If a root-canal-treated tooth fractures despite a crown, the tooth is usually no longer salvageable and an implant becomes the next option.
How do I decide which is right for my tooth? +
The honest answer: see a dentist who is willing to discuss both options, and get a proper clinical assessment including up-to-date X-rays. The right decision depends on factors that cannot be assessed remotely: how much sound tooth structure remains, the health of the root and surrounding bone, the strength of your bite, your gum health, and your willingness to undergo a 4-6 month healing process for an implant versus a 2-week timeline for a crown. At Tower Dental we always present both options where both are valid, with itemised costs for each, and we don't push patients toward the more expensive treatment when a crown would do the job.
Further reading from trusted UK sources
- NHS — Dental implants
- General Dental Council — Standards for the Dental Team
- Royal College of Surgeons — Faculty of Dental Surgery
Related at Tower Dental
Get an honest second opinion
A £40 consultation (normally £150) with X-rays and a written treatment plan covering both options where applicable.