The dental implant: first or last option?

I read with interest the title of the forthcoming Dental Update seminar: The Dental Implant: First or Last Option. This seems to address an important question in dentistry today.

Dentists of my age (qualified 1971) never thought that we would see the day when trying to save a tooth was not the best option. Whereas peers would nearly always consider providing ‘heroic’ restorations admirable, there is now the possibility that some would consider it foolish at best and against the patient's best interest at worst; and they could be right! On the other hand, there is a suspicion that sometimes patients are disadvantaged by the reluctance of some clinicians to offer difficult endodontic and restorative solutions, preferring to provide the relative ease of replacement by implant. So there is a difficult balance to be made between the traditional skills of advanced restorative procedures, and the new possibilities of implant-supported dentistry.

In my view, to answer the question ‘What is best for this patient?’ is going to need a lot more evidence than is currently available. But I welcome that the debate has started and, before we get all the answers, let's learn what the right questions are.