Other types of dams made of rock can be just as durable. They are usually inherently safer. Fish can move upstream. They appear more natural. Essentially, a ramp rock serves the same function as a natural river. Depending on the availability of rock locally, they can be more expensive than low-head dams.
A kind of dam called a "step dam" eliminates the re-circulating currents below the dam, but only allows better fish passage if coupled with a lower-angle side channel, or fish ladder, which can double as a "boat chute" for adventurous canoeists and kayakers. This type of dam is a possible safety improvement where flooding concerns are highest.
Alternatively good portage trail can reduce the temptation people sometimes have to "shoot" low-head dams.