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Root Canal vs Extraction: Which Option is Right for You?

Experiencing tooth pain or damage can be uncomfortable and worrying, leading to crucial decisions regarding your dental health. This discomfort often necessitates choosing between two common dental procedures: root canal treatment or tooth extraction. 

Understanding these options is pivotal, as each has its benefits and considerations. A root canal aims to preserve the damaged tooth’s natural structure, while an extraction removes the tooth altogether. 

Making an informed choice addresses the immediate issue and impacts your long-term oral health. Therefore, it’s essential to fully understand both procedures to decide which one aligns best with your needs and health goals.

Root canal vs Extraction

Root canal therapy is a dental procedure that involves removing the damaged pulp of a tooth, cleaning and disinfecting it, and then filling the infected pulp and sealing it. This is done to save a tooth that is severely decayed or infected. The primary purpose of a root canal is to relieve toothache, save the tooth from extraction, and preserve the natural structure, enabling it to remain functional in the mouth.

On the other hand, tooth extraction is completely removing a tooth from the mouth. This procedure is typically considered when a tooth is too damaged or decayed to be repaired or when further oral health complications need to be prevented. An extraction aims to alleviate discomfort, prevent the spread of further infection anywhere and make way for further dental treatments if necessary.

Root Canal: When is it Necessary?

A root canal becomes necessary under several common conditions relating to a tooth’s health and functionality. Understanding these reasons can help you recognise when it’s time to see your dentist and discuss the possibility of a root canal procedure

  1. Severe Tooth Decay: When tooth decay penetrates the outer layers and reaches the inner pulp, it can cause an infection that a root canal aims to remove. 
  2. Repeated Dental Procedures: Teeth that undergo multiple dental procedures might need a root canal due to repeated stress and potential pulp infection.
  3. Cracks or Chips in the Tooth: These can provide a pathway for bacteria to reach the pulp, leading to infection, discomfort, and a root canal.
  4. Deep Fillings: Very deep fillings can sometimes reach close to the pulp, causing inflammation and necessitating a root canal.
  5. Trauma to the Tooth: Even if a tooth doesn’t show visible cracks or chips, trauma can damage the pulp. A root canal might be needed to save the tooth.

Symptoms That Might Point to a Root Canal Need

Recognizing the symptoms that suggest needing a root canal can help you seek timely dental advice and treatment. These symptoms include:

  • Persistent Pain: A constant or intermittent toothache could indicate tooth pulp problems.
  • Sensitivity to Hot and Cold: If this sensitivity lasts long after the hot or cold stimulus is gone, it might indicate that a root canal is needed.
  • Swelling Around the Tooth: In pain, swollen gums near the tooth can indicate infection.
  • Discoloration of the Tooth: If a tooth becomes discoloured (darker), it can be due to internal tooth issues.
  • Pain When Eating or Touching the Tooth: This can indicate that the tooth’s root or pulp is damaged or inflamed.

Root Canal Procedure

The root canal procedure is meticulously carried out to ensure the tooth is saved with minimal discomfort to the patient. Here’s a friendly and informative step-by-step breakdown:

  1. Anaesthesia: The procedure kicks off with the administration of local anaesthesia to numb the affected area, ensuring you feel no pain during the procedure. It’s a straightforward step designed to keep you comfortable and relaxed.
  2. Access Creation: Once the area is numb, your dentist will create a small opening on the tooth’s surface to access the damaged pulp. This is done with precision and care to preserve as much of the tooth structure as possible.
  3. Pulp Removal: After creating the access point, the dentist delicately removes the infected or inflamed pulp from within the tooth. This step is crucial, as it eliminates the source of pain and infection.
  4. Cleaning: After the pulp has been removed, the next step is thoroughly cleaning the interior of the tooth (the root canals) to ensure no debris or bacteria is left behind. This exhaustive cleaning process ensures the area is perfectly prepared for the filling material.
  5. Filling: Once the tooth is cleaned, it’s time to fill the empty root canals. A biocompatible material, usually gutta-percha, fills the space, sealing it from future infections or contaminations.
  6. Restoration: The final step involves restoring the tooth’s functionality and appearance. This might involve placing a crown or other restorative solution on the tooth to protect and restore it to its natural shape and function. The aim is to save the tooth and ensure it can stand up to the rigours of daily use.

Root Canal Aftercare

Proper aftercare following a root canal procedure is instrumental in ensuring a smooth recovery and the long-term success of the root canal treatment. Here are some guidelines to help you through the process:

General Aftercare for the First Few Hours

  • Do: Keep the treated area clean, avoid eating until the numbness wears off to prevent accidental biting of cheeks or tongue, and rest as much as possible.
  • Don’t: Engage in strenuous activities or consume hot beverages, as these can exacerbate swelling and discomfort.

Aftercare for the First Few Days

  • Pain Management: It’s common to experience some discomfort. Your dentist may recommend over-the-counter pain relief medications to help manage this.
  • Eating and Drinking: Stick to soft foods and avoid chewing directly on the treated tooth until any temporary crown or root canal fillings have been replaced by a permanent one. Avoid extreme temperatures and spicy, crunchy, or sticky foods.
  • Oral Hygiene: Resume brushing and flossing gently around the treated area, ensuring good oral hygiene is maintained to prevent infection.

Long-term Aftercare

  • Pain Management: Any post-procedural discomfort should subside within a few days. If it persists, report it to your dentist.
  • Foods and Drinks: Once fully recovered, there are no specific restrictions. However, maintaining a balanced diet will contribute to overall dental health.
  • Oral Hygiene: Consistent oral hygiene practices are crucial. If the treated tooth remains a bit tender, consider using products designed for sensitive teeth.

Do’s and Dont’s

  • Attend regular dental check-ups and cleanings to ensure the health of the treated tooth and surrounding gums.
  • Don’t neglect proper oral hygiene; continue brushing twice daily and flossing daily.

Tooth Extraction: A Last Resort

While root canal therapy serves as a heroic measure to save an ailing tooth’s structure, there are circumstances where tooth extraction morphs into the most prudent course of action. This could be when the tooth’s damage extends well beyond what root canal treatment can mend. Examples include:

  • Severe Decay: When decay ravages a tooth to an extent where the structure remaining is insufficient for restoration, extraction may be advised. This is often the reality when decay reaches deep into the tooth, compromising its integrity.
  • Advanced Gum Disease: Periodontal disease can lead to tooth loosening by eroding the supporting bone structure and gums. Extraction might be the only viable solution in advanced cases where the tooth’s support is critically undermined.
  • Extensive Damage or Fracture: Teeth that are severely cracked, fractured, or broken, especially those where the damage extends below the gum line, are sometimes beyond saving with root canal therapy and must be extracted.
  • Tooth Crowding: Occasionally, orthodontic treatment plans require the removal of one or more teeth to address crowding and properly align the remaining teeth.
  • Failed Root Canal Treatment: While rare, there are instances where a root canal might not achieve the desired outcome, leading to the decision to remove the tooth to protect dental health and alleviate pain.

Tooth Extraction Procedure

Asian male patient reclining with open mouth and dentist examining his teeth

Understanding the tooth extraction procedure can alleviate your apprehensions about the process. Here’s a friendly, step-by-step guide to what you can expect:

  1. Consultation and X-Ray: Your dentist will first conduct a thorough examination of your tooth and take an X-ray. This helps plan how to remove the tooth and anticipate potential complications.
  2. Anaesthesia: To ensure comfort and minimize pain during the extraction, your dentist will use a local anaesthetic to numb the area around the tooth to be extracted. If you’re particularly anxious, discuss other sedation options with your dentist.
  3. The Extraction: Once the area is numb, the dentist will use specialized tools to gently rock the tooth back and forth until it is loose enough to be completely removed. The goal is to extract the tooth as safely and swiftly as possible.
  4. Caring for the Socket: After the tooth is removed, your dentist will clean the socket (the hole where the tooth was) to remove any debris and may place a gauze pad in the socket to help stop bleeding. In some cases, a few stitches may be necessary.
  5. Post-extraction Care: Your dentist will provide specific instructions on how to care for your mouth after the extraction, including managing swelling and discomfort and promoting healing. Following these instructions closely is crucial to avoid complications such as infection or dry sockets.

Tooth Extraction Aftercare

 While the healing process can vary from person to person, there are some general guidelines that most people should follow after a tooth extraction:

General Aftercare for the First Few Hours

  • Bleeding Management: It’s normal to experience some bleeding. Bite gently on a gauze pad over the extraction site for 30-60 minutes. If bleeding continues, replace the gauze and apply pressure again.
  • Swelling Management: Apply an ice pack to the cheek near the extraction site to reduce swelling. Use it for 15 minutes on and then 15 minutes off for the first 24 hours.
  • Rest: Limit your activities for the day. Elevating your head with extra pillows when lying down can help reduce bleeding and swelling.

Aftercare for the First Few Days

  • Pain Management: Pain and discomfort are normal but manageable. Follow your dentist’s advice on taking over-the-counter pain relievers. If prescribed, take any antibiotics to prevent harbouring an infected tooth.
  • Eating and Drinking: Choose soft and cool foods like yoghurt, pudding, and applesauce. Drink plenty of water, but avoid using a straw for the first 24 hours, as the suction can dislodge the blood clot in the socket.
  • Oral Hygiene: Do not brush or floss next to the extraction site for the first 24 hours. After this period, gently rinse your mouth with warm salt water several times daily to reduce swelling and soothe the area.

Long-term Aftercare

  • Oral Hygiene: After 24 hours, be careful around the extraction site and resume brushing and flossing. Keeping your mouth clean aids in healing and prevents an infected tooth.
  • Foods to Eat/Drinks: Gradually reintroduce more solid foods as you feel comfortable. For a few days, continue to avoid extremely hot or hard, crunchy foods.
  • Managing Swelling: Swelling typically subsides after 48 hours. Continue using ice packs for the first day and switch to warm, moist heat to help resolve any remaining swelling.
  • Activity: Avoid strenuous activities for a few days, as they can increase bleeding and affect the formation of clots, which is essential for healing.

Key Differences of Root Canal vs Extraction

Feature Root Canal Extraction
Objective Aims to repair and save a tooth that’s damaged but recoverable. Eliminates a tooth that’s beyond repair.
Process Involves intricate steps, including the removal of infected pulp, canal cleaning, and sealing. Can range from straightforward removal to surgical extraction, which might need an incision.
Duration Typically requires more time compared to an extraction. It is usually faster to complete than a root canal.
Anesthesia Local anaesthesia is common, with sedation as a possible addition. Local anaesthesia is used, with the possibility of general anaesthesia for more complicated cases.
Tooth Retention Keeps the natural tooth intact. Leads to the loss of the tooth.
Durability A tooth treated with a root canal can endure for many years with appropriate care. Lifespan varies based on the chosen replacement method, such as a bridge or implant.
Recovery May involve a slightly longer recovery time and the chance of post-treatment sensitivity. Recovery is typically swift, though it necessitates adjusting to the absence of the tooth.
Cost Generally incurs a higher initial cost than extraction. Initially less costly, yet subsequent tooth replacement can significantly increase expenses.
Long-Term Considerations Additional treatments may be necessary over time. Replacement solutions like bridges or implants might be needed for functional and aesthetic restoration of the missing tooth.

Factors to Consider When Making Your Decision

When choosing between a root canal and extraction, it’s essential to heed your dentist’s advice based on factors like pain tolerance, budget, and the preference to save the tooth. General dentists usually prefer preserving natural teeth, which benefits long-term dental health. It’s important to understand the costs of both options, including any future expenses. 

Root canals often cost more initially than extractions due to their complexity and materials. However, extractions may lead to further costs for tooth replacement options like a dental implant, bridge, or denture, which also require ongoing maintenance.

Insurance coverage for these procedures varies, so patients should review their plans carefully to grasp the coverage extent, including deductibles and co-payments. Despite the higher initial cost of a root canal, saving the natural tooth can be more economical and healthier in the long run. Discuss treatment options thoroughly with your dentist and check your insurance to make a decision that suits your needs and budget.

Which option is Right for You? Root Canal or Extraction

Asian male dentist and female nurse standing above and holding tools for dental examination

Determining the right course between a root canal treatment and extraction often boils down to the dentist’s expert assessment of your tooth’s condition. Your dentist is your best ally in this decision-making process, providing guidance based on thoroughly examining your tooth’s health, overall dental health, and personal preferences. 

A root canal procedure aims to preserve the tooth’s natural function and appearance. This option is especially beneficial if the primary goal is to maintain your natural smile and ensure the tooth continues to contribute to the overall structure of your mouth, preventing neighboring teeth from shifting. On the other hand, extraction is considered when a tooth is beyond repair. It can relieve pain more immediately and might be more cost-effective upfront.

Ultimately, the right dental choice balances preserving natural teeth when possible while considering your dental treatment plan’s health, functional, and aesthetic outcomes.


Choosing between a root canal and tooth extraction involves weighing costs, health impacts, and long-term dental outcomes. Consider pain management, oral hygiene, additional costs for dental replacements after extractions, and dental insurance coverage. It’s essential not to decide in isolation. 

Consulting with your dentist is crucial. Their expertise and knowledge of your dental needs will help guide you to the best decision for your health and goals. Heeding their advice is key to managing your dental health confidently.


What hurts more, tooth extraction or a root canal?

The severity of pain can vary depending on the individual’s pain tolerance and the complexity of the procedure. Due to its invasive nature, a root canal can generally cause more discomfort during and after the procedure, but this can be managed with local anaesthesia.

How long does a root canal take?

A root canal typically takes one to two hours, spread over one or two appointments. The exact duration depends on the tooth’s complexity and potential complications that may arise during the procedure.

Does dental insurance cover root canals or extractions?

Many dental insurance plans offer some coverage for root canal therapy and tooth extractions, although the extent of this coverage can differ. It’s essential to examine your dental insurance benefits closely and consult your dentist to make an informed decision based on your coverage level and personal preferences. 

Is It Important to Keep Your Natural Tooth?

Preserving your natural tooth through a root canal can have numerous benefits for oral health. It maintains the integrity and function of your mouth, preventing shifting and potential problems from the affected tooth to the neighbouring teeth.  

Explore the possibility of saving your natural tooth!

Let Us Help You in Taking Care of Your Dental Health

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