People arrive having already framed this as a choice between two products: crown or implant, pick one. It is an understandable way to think about it, and it is the wrong first question, because the two are not alternatives for the same situation.
A crown saves the tooth you have. An implant replaces a tooth you no longer have. The decision that actually matters comes before either of them, and it is this: can this tooth be saved, and is it worth saving? Once that is answered honestly, the rest follows.
The question that comes first
When I look at a badly broken-down tooth, I am working through a short list, and each item can end the conversation on its own.
Is there enough sound tooth above the gum to grip? This is the one that decides most cases and it is rarely explained to patients. A crown does not simply sit on top of a tooth; it needs to grasp a continuous collar of solid tooth structure around the whole circumference, usually a millimetre or two of height, above the level where the tooth is broken. Prosthodontists call it the ferrule. With that collar, the crown wraps the tooth and holds it together against biting forces. Without it, the crown is essentially balanced on a filling, and the forces of chewing work it loose or split the root, whatever it is cemented with. A tooth broken level with the gum on one side often does not have it, and no amount of skill in making the crown compensates for it.
Where does the break go? A fracture that stays above the gum is usually restorable. One that runs below the gum on one wall can sometimes be dealt with by lengthening the crown or slowly extruding the tooth, though both add time and cost. A vertical fracture running down the root ends it: that tooth cannot be saved by anyone.
Is the root sound and treatable? If the nerve is involved we need root canal treatment first, done properly, before any crown. We do root canals here, under rubber dam.
What is the bone doing? A tooth with severe bone loss from gum disease may be perfectly restorable in the crown sense and still be a poor investment, because the support underneath it is disappearing. We assess and treat the gums before deciding, always.
What did this to the tooth, and is it still happening? Grinding, an unbalanced bite, dry mouth from medication, a diet with constant acid exposure. If the cause is still running, it affects both the crown option and the implant option.
If the answers point to yes, we save it. A crown on your own tooth keeps the root in the bone, keeps the periodontal ligament with all its fine pressure sensing, is finished in two appointments a fortnight apart, and costs a fraction of implant treatment. Your own tooth, kept, is almost always the better outcome.
How implants work at this practice, and what we do not do
You should know this before you read any further, because it changes what we are able to recommend and it is not the arrangement at every practice.
We do not perform implant surgery here. We assess you, plan the case, and refer the surgical placement to an implant surgeon. You then come back to us at 129A Canterbury Road for the part we do: the abutment and the custom crown that goes on top, and the ongoing care of the gum and bone around it. Prosthodontics and complex bite problems are my clinical interest, and the restorative half of implant work is exactly that. We also make implant-retained dentures where several teeth are being replaced at once.
The practical consequence for you is that implant treatment is quoted in two parts. The surgeon quotes the placement; we quote the crown. We set both out in a written treatment plan after your assessment so you see the whole figure before committing, rather than discovering the second half later. Our full approach to this is on the dental implants page.
The principle I work from either way is the simplest option that will actually achieve what you want from the tooth. A tooth with enough sound structure left to hold a crown is usually worth keeping, because nothing replaces a natural root as well as the root itself.
What an implant is genuinely better at
None of the above means implants are second best. Where the tooth is already gone, or genuinely cannot be kept, an implant is usually the strongest option available.
- It stands on its own and does not require cutting down the healthy teeth either side, which a conventional bridge does.
- It maintains the jawbone in that spot. Bone that has no tooth in it resorbs over the years, which is what changes the shape of the face after multiple extractions.
- It cannot get decay.
- It is fixed. Nothing comes out at night.
The trade-offs are equally real. Implant treatment runs over months, not weeks, because the bone needs three to six months to fuse to the titanium post. It requires enough bone to place into, and sometimes grafting first. It involves surgery. And although an implant cannot decay, it can develop peri-implantitis, an inflammatory loss of the bone around it that behaves rather like gum disease and is harder to treat once established. Anyone who lost the original tooth to gum disease is at higher risk of exactly that, which is why we stabilise the gums before, not after.
One more difference people are not warned about: an implant has no periodontal ligament, so it has none of the fine pressure feedback a natural tooth has. You cannot feel when you are overloading it. That matters for grinders, and it is another reason we take the bite and the splint conversation seriously.
The honest comparison
| Crown on your own tooth | Implant and crown | |
|---|---|---|
| What it does | Saves the tooth you have | Replaces a tooth already lost |
| Time | Two visits, about two weeks | Several months of healing |
| Surgery | None | Yes, referred to an implant surgeon |
| Who does what | All of it here | Surgeon places, we restore |
| Keeps the root and ligament | Yes | No |
| Can decay | The tooth under it can | No, but peri-implantitis can occur |
| Affects neighbouring teeth | No | No |
| Cost | One item. Nationally, ADA item 615 averaged $1,678 in the ADA’s 2022 fee survey reported by CHOICE, most commonly $1,250 to $2,100 | Two quotes: surgical placement plus the crown |
The cost line is worth reading carefully. Those crown figures are national averages published as general context, not our fee, and we give you our actual figures in writing before treatment. DVA card holders are treated here, and the DVA schedule from 1 July 2026 sets item 615 at $1,561.45 as an administered fee. For everyone else, we have HICAPS on site so any private rebate is applied on the day, and we are an HCF More For Teeth preferred provider. Crowns and implant crowns normally sit under major dental in extras cover, so waiting periods and annual limits are worth checking before you commit; we will help you do that.
When the tooth has to come out
Sometimes the answer is that it cannot be kept. If that is where we land, we say so directly rather than attempting heroics on a tooth that will fail in eighteen months.
Extractions here, including the difficult ones, are done by Dr Kerry Chen, who handles all the complex surgical extractions in this practice. Getting the extraction done well matters more than people realise when an implant is planned, because how carefully the socket is preserved at the time of removal affects how much bone the surgeon has to place into later.
And an implant is not the only replacement. A bridge uses the teeth either side for support and is finished in weeks rather than months, which suits some situations, though it means preparing two healthy teeth. Dentures, including chrome partials and implant-retained ones, remain the most accessible option when several teeth are missing. Occasionally, for a back tooth with a sound tooth in front of it and nothing behind, the right answer is to replace nothing at all and keep the rest healthy. That is a legitimate plan, not a failure to sell you something.
Where to start
An assessment appointment runs a full hour, and the first ten to thirty minutes is conversation before any instrument is used: what you want to be able to eat, what has happened to you in the past, what you would rather avoid. Then a full examination, gum charting, X-rays, and a written plan setting out the options with costs. Where a scan is needed we use our Medit intraoral scanner rather than impression trays, so there is no material to hold in your mouth.
Call (03) 8838 8820 or book online. We are at 129A Canterbury Road, Blackburn, with on-site parking, and consultations are available in Mandarin, Cantonese, Teochew and Shanghainese as well as English.
Related reading: do you really need a crown, honestly? · how long crowns last and what decides it · why teeth break and chip · our crowns and bridges and dental implants pages.