Root Canal vs Extrac­tion: When to Save a Tooth and When to Remove It

On the one hand, there is a chance that your root canal could fail, and then you’ll be right back where you started. On the other hand, extraction is permanent, and you should ideally have a restoration plan in place before you move forward to avoid damage to surrounding teeth as a result of the gap.

If you’re stuck between a root canal and an extraction, we have some advice that can help you to determine which is right for you. At every stage in the treatment plan, you will be in charge and you’ll have the final say. All your dentist can do is to advise you on the best course of action, but they cannot make the decision for you.

Root canal explained

When there is an infection in the inner part of the tooth, this can lead to painful swelling and inflammation. When this happens, your dentist can perform a root canal treatment. You’ll be completely numb throughout treatment, but you might experience some discomfort if there is an active infection.

They start by drilling into the top of the tooth. Next, they will use small tools to remove the soft pulp tissue from the centre of the tooth. When it is clean, they’ll fill it with dental cement and top it with a crown to offer support and protection. The pain goes away once the infection tissue is removed.

Extraction explained

If a tooth is too badly damaged, or if the patient would prefer, then an extraction might be performed. In most cases, it’s better to do everything we can to save the natural tooth, but sometimes this is unavoidable.

We start by numbing the area and then grip the tooth with dental forceps. Your dentist will rock the tooth back and forth in the sock to loosen its roots. The tooth might break apart during this procedure and your dentist will need to extract the tooth in smaller portions.

After this procedure, you might need a dental implant, a bridge or a partial denture to help restore your bite.

Still not sure which treatment is right for you? Here are some questions you should ask yourself when choosing between a root canal or extraction:

Have you tried a root canal before?

If you’ve already tried a root canal and the procedure has failed, you might consider extracting the tooth. Once a root canal has failed once, there is a good chance that the tooth has become more badly damaged. Repeating the treatment increases the risk of it failing once more.

Is the tooth important for your bite?

Some rear molars are less important, so you could get away with extracting the tooth and not replacing it. This would be the case for the rear molars and the wisdom teeth. These can generally be removed without having a huge impact on your oral health.

Do you want to save the tooth?

This is important to consider, as some patients would much rather remove the tooth and deal with the gap than consider going through a long procedure like a root canal. There’s nothing wrong with deciding that you’d rather have a bridge than save the natural tooth.

Is the root system complex?

Teeth will have between one and three roots, and these can be difficult to navigate. If you have been referred to another service for the procedure, this could indicate that the treatment will be more complex and lengthy. Nervous patients might use this opportunity to skip the long treatment and choose the extraction.

What does your dentist advise?

If your dentist thinks there is a chance to save the tooth, it’s often better to follow this advice. However, if they are concerned that the tooth is too badly damaged, they might recommend an extraction to save you the discomfort. Ultimately, the final choice is with you, but your dentist will be there to help guide you.