Root Canal vs. Tooth Extraction: Which Is Right for You?

The short answer

If a tooth can be saved and restored, a root canal is usually the first choice, because it keeps your natural tooth in place. Extraction is generally recommended when a tooth is too damaged or too heavily infected to save, or when the bone around it can no longer support it. An exam and X-rays are needed to tell which applies to you.

What a root canal does

Root canals are the thin passages that run from the soft tissue inside a tooth, called the pulp, down to the tip of each root. When an untreated cavity, a deep crack or repeated work on a tooth lets infection reach the pulp, root canal treatment removes the infected tissue, cleans the inside of the tooth and seals it. The tooth is then restored with a filling or, in many cases, a crown for added support.

What an extraction does

An extraction removes the tooth entirely. It stops a source of ongoing pain and can prevent infection from spreading to the gums, the jawbone and neighboring teeth. At our office, our goal is always to keep your natural teeth, so we treat extraction as a last resort. When a tooth truly can’t be saved, we remove it as gently as possible.

How the two compare

• Your natural tooth: a root canal keeps it; an extraction removes it.
• Comfort: the area is thoroughly numbed for both. Modern root canal treatment is usually no more uncomfortable than having a filling placed.
• Visits: a root canal is followed by a final restoration, often a crown. An extraction may be followed by a replacement tooth.
• Your bite and bone: keeping the tooth supports your bite. After an extraction, the bone in that area can shrink, and neighboring teeth can drift into the gap.
• Long-term planning: a saved tooth usually doesn’t need replacing. A removed tooth often does, with an implant, a bridge or a partial denture.

Signs a tooth may be saved

• Enough healthy tooth structure remains to hold a filling or crown
• The surrounding bone and gums are healthy enough to support the tooth
• The infection can be reached and cleaned

Signs an extraction may be the better choice

• The tooth is too decayed or broken to be restored
• Advanced gum disease has left the surrounding bone unstable
• The infection is too extensive to treat with a root canal
• The damage extends into the root in a way that can’t be repaired

Sometimes the answer isn’t obvious from a regular X-ray. Three-dimensional imaging can help when a tooth’s anatomy is unusual or an infection is hard to locate, and we have a PreXion CBCT scanner at our Titusville office for those situations. If your case calls for a root canal specialist, we’ll refer you to one.

If the tooth does come out

Think about what comes next before the extraction, not after. If you may want a dental implant, socket preservation can be done when the tooth is removed. It fills the site with graft material to limit bone loss, which can make implant placement simpler later. A bridge or a partial denture are other ways to fill the gap, and we’ll talk through each one with you.

Don’t wait and see

A lingering toothache, sensitivity to hot or cold that doesn’t fade, or swelling near a tooth all deserve a prompt look. Infections don’t heal on their own, and even if the pain stops, the problem may still be there. Waiting can also narrow your options, because a tooth that could have been saved may no longer be. To be seen in Titusville, call (321) 269-3802. If you have facial swelling with a fever, or trouble breathing or swallowing, call 911 or go to the emergency room.