How do I Choose Between a Root Canal and an Extraction?

Tricia Christensen
Tricia Christensen
People who get a tooth extraction may need to go through several additional surgeries if they want a dental implant to replace the missing tooth.
People who get a tooth extraction may need to go through several additional surgeries if they want a dental implant to replace the missing tooth.

The choice between a root canal and an extraction is dependent on many circumstances, including affordability, dental recommendations, visibility of the affected tooth, success rate, discomfort level, and success rate. Both of these procedures also have to be considered in light of what else is required. Root canals typically are followed by placement of porcelain or metal crowns, especially in adults. After an extraction, patients may either opt to do nothing or get a dental implant, which involves several surgeries.

A tooth extraction may be the best choice to reduce patient pain, or if the tooth can't be saved.
A tooth extraction may be the best choice to reduce patient pain, or if the tooth can't be saved.

Perhaps the biggest factor in choosing between a root canal and an extraction is the patient’s financial situation. Even with insurance, patients can expect to pay significantly more out of pocket for a root canal and crown than a simple extraction. Dental implant surgery is even more costly. Some dentists, oral surgeons, and endodontists may make it possible for patients to pay over time, but many want the total payment upfront. Thus, the choice between a root canal and an extraction may be severely limited by a person’s financial and insurance status in some regions.

A root canal is an invasive procedure that can lead to significant swelling, but it prevents the need for further intervention.
A root canal is an invasive procedure that can lead to significant swelling, but it prevents the need for further intervention.

When a patient can afford the more costly procedure, it certainly helps to get the advice of a dentist. Most dentists prefer saving the existing tooth, and the root canal/crown method achieves this goal. In other instances, the tooth that is broken, painful and/or damaged may already have had the roots scaled and filled or may be dying. It isn’t always possible to save a tooth via a root canal, and an extraction could be preferred to reduce patient pain or because it is the best option.

A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
A root canal involves the removal of damaged nerves and pulp from a patient's tooth.

Some people weigh finances and also weigh the visibility of the tooth when making a decision. If the tooth is in the front of the mouth where it will be noticed as missing, they decide they’d prefer a root canal and crown. Clearly, extraction without replacement will mean there is a visible gap in the mouth. On the other hand, if the choice between a root canal and an extraction concerns a tooth at the back of the mouth, patients might just opt for the extraction alone, since people aren’t likely to notice the missing tooth.

The inclusion of fluoride in drinking water has helped lower the need for tooth extractions in cities throughout the U.S.
The inclusion of fluoride in drinking water has helped lower the need for tooth extractions in cities throughout the U.S.

There are others who base their opinion on the success rate of root canal/crown versus an extraction/implantation. The root canal and crown route has a slightly higher success rate. Extractions alone are successful too, but dental implantations may not last a lifetime and may require replacement.

Alternately, the choice between root canal and an extraction could center on discomfort associated with both procedures. A skilled dentist should be able to make patients comfortable for either procedure, and some dentists even offer sleeping dentistry so patients don’t have to feel what is occurring. Recovery time and length of procedures for dental implantation is much more significant than that associated with root canals and crowns.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

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Discussion Comments

Ruggercat68

I've heard so many stories about root canal pain that I would probably choose an extraction, assuming I even had a choice. I had one tooth pulled while under general anesthetic, and the process wasn't that bad overall. There's a gap, but nobody can see it. My dental insurance would have covered most of the expense of a root canal procedure, but I didn't feel like it was necessary because of the tooth's location.

AnswerMan

Speaking from personal experience, the decision between a root canal and extraction shouldn't be made under duress. Sometimes a tooth can hurt so bad that your only thought is to have it extracted immediately, regardless of any other considerations. When one of my teeth got abscessed, I wasn't thinking about appearances or crowns or the cost of the procedure. I just wanted instantaneous pain relief. I opted for an extraction by an oral surgeon.

While I'm happy that the infected tooth is completely gone, I still miss being able to chew my food normally. I had to get used to pushing food away from that gap. If I hadn't been in so much pain when I saw my dentist, I might opted for a root canal and a crown to replace the tooth.

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    • People who get a tooth extraction may need to go through several additional surgeries if they want a dental implant to replace the missing tooth.
      By: Alexandr Mitiuc
      People who get a tooth extraction may need to go through several additional surgeries if they want a dental implant to replace the missing tooth.
    • A tooth extraction may be the best choice to reduce patient pain, or if the tooth can't be saved.
      By: starush
      A tooth extraction may be the best choice to reduce patient pain, or if the tooth can't be saved.
    • A root canal is an invasive procedure that can lead to significant swelling, but it prevents the need for further intervention.
      By: Vladimir Melnik
      A root canal is an invasive procedure that can lead to significant swelling, but it prevents the need for further intervention.
    • A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
      By: Igor Mojzes
      A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
    • The inclusion of fluoride in drinking water has helped lower the need for tooth extractions in cities throughout the U.S.
      By: vgstudio
      The inclusion of fluoride in drinking water has helped lower the need for tooth extractions in cities throughout the U.S.
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      Antibiotic injections may help prevent infection following a root canal.
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      Patients who undergo a root canal will need to fully recover before eating crunchy foods.