Root Canal vs. Tooth Extraction: Making the Right Choice

Has your dentist recommended a root canal treatment? Not sure if you prefer root canal therapy over a tooth extraction?

It's normal to feel nervous about getting a dental procedure, but this guide will help you make an informed decision that puts your dental health first. We'll explain the differences between a root canal treatment and a tooth extraction, why a dentist may recommend them and the health impacts of each treatment.

Dental procedures can cause anxiety, especially when you’re not sure what different treatments do. Having mild to severe pain is a signal that something is amiss, but even intense pain doesn’t always mean that you have to lose a tooth.

Are you wondering if you should opt for a tooth extraction instead of a root canal? What kinds of dental issues require a root canal therapy or a complete removal of an infected tooth?

If you’re fretting that both choices will involve severe pain and surprise costs, you’re not alone. Modern dentistry uses state-of-the-art therapies that minimize discomfort both during a root canal treatment and after. Having a dental professional carefully explain what to expect, in both the short-term and long-term goes a long way to easing anxiety. It’s important to understand the differences in both treatments, and how each process varies in short and long-term costs.

Root canal procedures are not the same process as tooth extractions. Both treatments are designed to treat dental pain, severe tooth decay, and protect the natural tooth structure, but they are used in different circumstances.

The Basics – What Each Procedure Involves

What is a Root Canal?

A root canal's primary aim is to save an infected or decayed tooth. A root canal treats infections inside the tooth, when inner soft tissue, called the pulp, becomes infected. An inflamed pulp is unlikely to heal on its own, and if left alone, could cause extensive decay.

During a root canal procedure, the dentist makes a small opening in the tooth, in order to gain access to the infected pulp. The interior of the problematic tooth is cleaned and disinfected of the diseased pulp.

Next, the space is filled and sealed with a dental material called gutta-percha. An oral surgeon will place a temporary or permanent filling (such as a dental crown for protection) over the tooth. A healthy tooth can be saved with a root canal therapy, because it treats just the small part of inflamed pulp. This treatment allows you to retain your natural tooth, which in turns maintains your natural smile’s appearance.

What is a Tooth Extraction?

A tooth extraction is what it sounds like: An entire tooth is removed from the socket in the jawbone. A dentist will recommend a surgical extraction when the entire tooth is too damaged to save or repair. Teeth can be extracted due to severe decay, infection, or overcrowding. Wisdom teeth can become impacted, and are often removed.

Pros and Cons: Root Canal vs Tooth Extraction

The pros of going with a root canal include:

Keeping your natural tooth:

As noted, keeping your natural tooth preserves your jawbone, your natural smile and the alignment of the teeth.

Helps with chewing: Keeping your tooth maintains normal chewing function.

Aesthetics: You won’t have a gap in your smile.

Quick recovery time: Getting a root canal is similar to getting a filling, in terms of mild discomfort and recovery process. Most patients resume normal activities within one or two days after their dental treatment.

The cons of getting a root canal include:

Appointments: Depending on the severity of the case, more than one appointment may be necessary.

Cost: Depending on the case, a root canal can be more expensive upfront than an extraction.

Potential future issues: There’s a small risk that if fillings are not properly sealed, an infection can return.

The pros of getting a tooth extraction include:

Immediate relief: Removing a source of infection typically reduces discomfort, even intense pain.

Cost-effective: Depending on the case, an extraction might cost less than a root canal. Costs will also be impacted by insurance coverage.

Quick procedure: Typically, an extraction can happen in one visit.

The cons of getting a tooth extraction include:

Bone loss: Missing teeth can impact the jawbone’s health and deterioration over time.

Shifting teeth: The remaining teeth may shift towards the gap, and impact the bite.

Aesthetics: A gap may impact the look of your smile, and by extension, your confidence.

Replacements required: Tooth extraction leaves behind a permanent gap, which needs to be addressed with a prosthetic replacement.

While individual cases will vary, a root canal tends to have a short recovery time and preserves the natural tooth. A tooth extraction is a more invasive surgery, which will cause swelling and a longer recovery process. Once a tooth is extracted, you’ll need a replacement option like an implant or a bridge. Without prosthetic devices, the teeth can shift, prompting changes in the jaw, such as a misaligned bite.

Recovery and Aftercare

Root Canal Recovery Duration

Most patients recover within a few days.

Mild Discomfort: Mild soreness is reported, and is often treated with over-the-counter pain relievers.

Care: Avoid chewing on the treated area until it’s fully healed.

Tooth Extraction

Initial healing from the surgery will take about one to two weeks. Complete bone healing may take months.

Discomfort: Swelling, bleeding and mild pain in the first days are common.

Care: A dentist will provide detailed care instructions, which may likely including avoiding activity and eating soft foods.

When to Get a Root Canal

Your dentist will recommend a root canal therapy if:

The natural tooth is still savable

The infection is limited to just the pulp and has not cause extensive tooth damage

The tooth structure is mostly intact

Saving the natural tooth maintains chewing, the shape of the jaw, and general appearance.

When a Dentist Recommends Extraction

Unfortunately, sometimes a tooth can be too damaged or decayed to be repaired. A dentist will recommend removing a tooth when

The tooth is infected and not manageable via a root canal

The tooth is fractured, especially below the gum line

There is bone loss around the tooth

There is severe tooth damage

Alternatives to Know: Implants, Bridges, and Dentures

When teeth are removed, patients will need to consider dental prosthetic devices, such as implants, bridges and dentures. This means that a tooth extraction isn’t really a short term choice. But rather, a tooth extraction changes the mouth permanently, and requires new tools (and additional costs) to restore appearance, maintain chewing ability and keep the teeth from shifting.

The options for prosthetics include:

Dental implants: A titanium post is surgically added to the jawbone, then topped with a crown. Implants are durable and will function like natural teeth.

Dental bridges: A false tooth is anchored to neighboring teeth. This process is less invasive than an implant, but may require adapting or changing adjacent teeth.

Dentures: These are full or partial removable teeth that fill in the gaps in the smile.

Each prosthetic device will vary in cost, maintenance and replacement fees, which can accumulate over the years. Your dentist can advise on which makes the most sense for your smile and your lifestyle.

Frequently Asked Questions

Q. Is a root canal painful? 

Given modern dentistry techniques and advances in anesthesia, [ link to What to Expect blog ] root canals are similar to getting fillings. Most patients report feeling relatively mild discomfort during the process.

Q. How long does a root canal take? 

This depends on the severity of the case, but a root canal typically takes one to two hours. It may require two visits, depending on the tooth.

Q. Do I have to replace a missing tooth? 

Leaving a gap in the smile means that the remaining teeth may move around. This can result in new areas of crowding, a change in appearance, bite issues and even jawbone loss. Dental experts advise that replacing missing teeth is key to maintaining good oral health.

Q. What are the risks to tooth extraction? 

There are always risks to surgical procedures, including infections, swelling and bleeding. Following aftercare instructions will minimize risks. Long-term risks to tooth extraction including shifting of the teeth, if the gap is not addressed with some kind of prosthetic device, either permanent or removable.

Talk to a Dentist You Trust

Feeling anxious about how to treat pain in your mouth? Trust Tend’s top-rated staff to explain your options and create personalized treatment plans. Only a clinically-trained dental professional can diagnose the best way to treat that mystery tooth pain.

Choosing a root canal or tooth extraction will have an impact on the health of your smile for years to come. Don’t put off an exam, in case it’s an infection that can spread and get worse.

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