No one likes the idea of getting a root canal or a tooth extraction. Unfortunately, the dentist might recommend one of these procedures at some point. It is important to note that while they both address the problem of a severely decayed or damaged tooth, they are not interchangeable. 

A root canal can save a tooth by removing infected or damaged tissue. Dentists will typically recommend this option unless the tooth is beyond repair. Extracting (pulling) a tooth is always a dental professional’s last resort for a variety of reasons. 

Depending on what is wrong with a tooth, one procedure might be more appropriate than the other. But if patients have a choice of which to get, their main questions are usually about the pain, cost, and risks. 

What is a Root Canal Procedure

Dentists typically recommend a root canal procedure when the root or dental nerve layer of the tooth is damaged, decayed, or even dead. This could be the result of an untreated cavity, some type of accident that causes trauma to a tooth. 

The root canal procedure restores the tooth by removing the damaged interior pulp. The process is fairly simple:

Once a local anesthetic is administered, the dentist drills a small hole in the tooth to expose the canal beneath it. Decayed and damaged tissue are cleaned out and the canal is disinfected. The dentist fills the space that is left with a latex-like material called gutta percha.

Finally the dentist caps the tooth with a temporary crown. Once the tooth heals a permanent crown is affixed to the tooth. 

People commonly worry about the pain of a root canal, but most report that it is not as bad as they anticipated. Patients will experience mild to moderate soreness and some swelling once the local anesthetic wears off. This can easily be controlled with over-the-counter pain medication such as acetaminophen or ibuprofen. In rare cases, pain lasts longer than several hours or returns after subsiding. This is unusual and patients should consult their dentist if it happens. 

An Alternative that Might Also Save a Tooth

Inflammation in a previously root-canaled tooth could be a sign of infection. An apicoectomy may be necessary. Apicoectomies, or root end surgeries, are minor, low-risk surgical procedures performed by an endodontist that remove the root tip and the tissue around the tooth. 

This procedure provides another way to disinfect the root canal system when an additional root canal is not advisable. 

When to Extract the Tooth

Tooth extraction is recommended for some of the same reasons as a root canal, though dentists will always do their best to save the patient’s tooth if possible. The following are typical reasons for pulling a tooth: 

• A cavity so severe or large that it takes up most of the tooth. These can not be filled and a root canal is usually impossible. 
• Overcrowding of the teeth in the mouth. Wisdom teeth are often extracted for this reason. 
• When the tooth has experienced trauma and is broken or chipped. 
• Some medical conditions such as chemotherapy or an organ transplant may require a tooth extraction to maintain good oral health. 

Like root canals, tooth extraction is an outpatient procedure done under a local anesthetic. Some circumstances, such as impacted teeth or teeth broken below the gumline may require a general anesthetic. 

Recovery is similar to a root canal. The patient will typically feel some mild pain once the anesthetic wears off. Over-the-counter medications will help.

Comparing Costs

Although dental insurance can help reduce the cost of dental procedures, cost is still a common concern. Dental health is important, so be sure to consider all factors and not just the price when making decisions. 

Root canal costs are typically $700 to $1200, but costs increase in the case of molars. Root canals on molars generally cost around $500 more than a root canal procedure on non-molars. 

Simple tooth extractions are less expensive than root canals, with costs ranging from $75 to $200, though costs may vary due to the type of anesthesia used. Surgical extractions for impacted teeth are much more expensive, with costs typically ranging from $800 to $2,000. 

While it may be tempting to opt for a less expensive extraction rather than a root canal, there could be other problems associated with a missing tooth. Exposed gum tissue is more prone to infection. The remaining teeth may gradually drift over to fill the gap which can cause teeth misalignment. For these reasons, dentists usually recommend replacing the lost tooth. 

Tooth replacement options could be dental implants, dentures, or a dental bridge. Not only do they look better than a gap in the teeth and make it easier to chew and talk. But these dental prostheses can add hundreds or even thousands of dollars to the initial cost of extraction. Sometimes saving the tooth with a root canal procedure is the more economical option.

Risks of Root Canal vs. Tooth Extraction

Both root canal procedures and tooth extractions are both very safe, low-risk treatments for infected and damaged teeth. 

Simple tooth extractions have few complications. Sometimes, a blood clot does not form at the site like it should. If bleeding is excessive or lasts longer than 12 hours, there could be a problem. This condition is called “dry socket” which can be easily treated by the dentist or oral surgeon. 

A root canal is also a low-risk procedure. There is a chance that an abscess can form if some infection is left in the tooth. There is also a small possibility of re-infection after the procedure. In this case the dentist might recommend an apicoectomy. 

Occasionally the structure of the tooth is too weak to withstand the removal of the pulp. The tooth may need to be pulled.

Finally, some patients may have an allergic reaction to the gutta percha. Individuals with latex allergies should let their dentists know before undergoing a root canal, since gutta percha is chemically similar to latex. Dentists will use a non-latex alternative in these cases. 

Is it Time for an Extraction or Root Canal?

Rather than a choice based on pain or price, the decision of whether a root canal or tooth extraction is best is usually a question for the dentist. Your dentist will make a recommendation based upon the specific conditions of your teeth and with your oral health in mind. If they can save your tooth, they will. 

Whenever you are experiencing prolonged tooth pain, it is time to consult a dentist. If you would like to find a dental professional in your area, use our appointment finder to schedule an appointment today.