Root Canal Vs. Extraction: Which Is Right For You?

If you have an infection or abscess deep in the tooth root, you will often be given a choice between a root canal treatment or an extraction. Both treatments will address the cause of the pain and help you to find relief. But with an extraction, you could be creating more problems for yourself further down the line.

What is a root canal?

A root canal is a treatment carried out of an endodontist. It involves removing the damaged and decayed pulp from inside your tooth before filling the root canals and topping the tooth with a crown.

The tooth will be weakened by decay and by the procedure, so the tooth is often strengthened by placing material inside the tooth before topping it with a porcelain crown.

This treatment is often the last resort before an extraction becomes inevitable. At a certain point, the tooth will be too damaged to save, so if you are offered the option of a root canal, it’s a good idea to get started with the treatment as soon as possible.

When do you need a root canal?

You would need a root canal if you have an infection in your tooth that has spread to the roots. Once the infection reaches the soft pulp in the centre of your tooth, it will become very painful.

A tooth that requires a root canal will typically be very painful and it will be tender when you bite down. You might also have swelling in your face and gums. Your dentist will be able to tell if you need a root canal by X-raying your teeth and looking at the internal structures.

What is an extraction?

When a tooth is too damaged to save – or if the patient opts to not have a root canal – then the tooth will need to be extracted. This is when the tooth is removed from the mouth, roots and all.

The dentist grips the tooth and rocks it in the socket until the tooth comes loose. The tooth is then removed from the socket and the dentist checks that all of the roots are intact.

The socket is left to heal and then the patient will need to decide if they want to leave a gap in their smile or if they would like to choose a restoration option like dental implants, a bridge or denture.

When do you need an extraction?

If the tooth is too far damaged to be saved, your dentist might recommend an extraction. If the tooth is very complex with lots of roots, they might also recommend an extraction. Your dentist will assess the likelihood that the extraction will be successful and present you with these options.

The patient should always have the option to choose an extraction over a root canal if they prefer. Some patients are too afraid of the root canal treatment to consider it, but we would recommend exploring all of your options if this is the case for you.

Can I have an extraction after a root canal?

In some cases, a root canal may fail. If this happens, you may either choose to repeat the root canal treatment or you could opt for an extraction. There is a limit to the number of times a tooth can handle the root canal treatment, so your dentist may recommend stopping treatment and choosing an extraction and tooth replacement.

How can I replace a tooth after an extraction?

If you opt for an extraction, it’s often a good idea to also think about how you will replace the tooth. While you can certainly leave a gap in your smile, this isn’t always the best choice. After an extraction, the surrounding and opposing teeth may struggle due to the lack of support. This can lead teeth to drift out of alignment or become loose.

After an extraction, we recommend replacing the tooth with either a bridge, denture or dental implant. These options have associated costs, so it’s important to think about the cost of the extraction and the restoration together. Patients commonly assume that an extraction is the cheaper option, but this is rarely the case.

How do I decide between treatments?

Choosing the right treatment for your needs should be based on accurate information rather than fear or worries about budget. While an extraction may be cheaper, you also need to consider the cost of restoring the missing tooth to protect the surrounding teeth.

And if you are choosing an extraction because of a fear of the root canal treatment, it’s worth discussing this with your dentist. We can offer dental sedation for very nervous patients so they can access the care they need without fear.

While a root canal might be the last resort to help save a damaged tooth, it’s not always the right choice for patients. If the tooth is very badly damaged and the root canal is likely to fail, you may be better opting for an extraction and restoration. Discuss the options with your dentist if you are confused or have doubts about your choice.

Final thoughts

The choice between a root canal and an extraction is not always a simple one. You need to consider the long-term implications of each treatment and the likelihood that it will be successful.

If in doubt, always speak to your dentist about the options available to you. We recognise that this can be a very difficult decision to make. You will never be rushed into a decision, but if you are offered a root canal as a last resort to save the tooth, it’s usually best not to delay treatment for too long.

Remember that both treatments will achieve the same goal of helping to address your tooth pain, so whichever option you go for, you can at least find some relief.