Root Canal vs Extraction: Which Is Better?

If you have visited your dentist because of severe toothache, you may have been given the option of either saving the tooth by doing a root canal treatment or extracting the tooth.

There are differences between these two options.

What Is A Root Canal Treatment

A root canal treatment is a procedure done to save a tooth as a result of infected or inflamed pulp. The pulp is the central part of the tooth that houses the blood vessels and nerves that supply the tooth. This procedure is performed to save a tooth instead of removing it. It is also known as endodontic treatment.


What is Tooth Extraction?

Tooth extraction is the removal of a tooth or tooth roots with minimum damage to the surrounding tissues.

When Do I Need A Root Canal?

You may need a root canal if the pulp of your tooth has become infected or inflamed. This can be caused by any of the following reasons.

  • Extensive tooth decay that leads to irreversible pulp damage.
  • Cracked or broken tooth due to an accident or trauma.
  • Repeated dental procedures like filling. This can lead to exposure of the pulp.
  • Gum disease

Other reasons for a root canal treatment are:

  • The damaged tooth is visible when you smile.
  • There is really good bone and gum support around the tooth.
  • You have already lost many teeth and can’t afford to lose another one.
  • You have a medical condition that may prevent you from having a tooth extraction.

When Do I Need a Tooth Extraction?

Sometimes your dentist simply can’t save your tooth, and it needs to be removed. This is usually the case if you have really bad cavities that compromises too much of your tooth’s structure such that it is too weak to repair.

If your tooth has a very bad fracture, extraction may very well be the only option. A tooth with a crack that extends down below the gum line also needs to be extracted.


Root Canal vs Extraction

A root canal and tooth extraction are both procedures that are used to treat teeth that are damaged or infected and cannot be saved by a simple filling. They are not exactly pleasant procedures but at the end of the day, one of them has to be done.

Understanding the pros and cons of each one will help you decide which procedure would be better for you.

1. Cost

While the initial cost of a root canal may be higher, tooth extractions often lead to long-term costs. When you get a tooth extracted, you’ll be required to get the missing tooth replaced because the gap that is left behind after a tooth is extracted could become problematic later in the future.

The cost of getting the replacement tooth usually costs the same or even more than a root canal treatment.

2. Alignment

Aside from aesthetics, a gap in your teeth that’s left after an extraction creates an imbalance in the structure of your mouth. With a missing tooth, the other teeth close to it gradually move to take over its place so a tooth replacement tooth is necessary. The types of tooth replacement options are dentures, bridges, and implants.


Choosing to do a root canal treatment may be a better option because the tooth is saved and the structure of the mouth is not distorted. It restores your ability to bite and chew comfortably, prevents jawbone degeneration and other side effects of missing teeth.

3. Time

A root canal treatment is often time-consuming. It takes about 1 to 2 hours to complete while extraction takes about 20 to 30 minutes to complete. This is in the case of a simple extraction.

A root canal takes a longer time because it is a complex treatment so proper care and attention have to be taken to prevent treatment failure. Keep in mind that if the extraction is difficult or is a surgical extraction, it could take a longer time.

4. Dental Office Visits

In the case of a root canal treatment, multiple visits to the dental clinic are usually required. For tooth extraction, the procedure is relatively straightforward and is carried out in just one visit.

5. Pain

Root canal therapy is almost painless due to modern techniques and anesthesia. According to the American Association of Endodontists, patients who choose root canal treatment are six times more likely to describe it as painless when compared to patients who opt for tooth extraction.

After a root canal treatment, it’s normal to feel some pain for a few days after the first visit. This pain can vary from a dull ache to a sharp pain that can be managed with an over-the-counter painkiller.

For extraction, the pain felt afterward can be more depending on the type of extraction and this pain may last up to a week. There may also be an associated face swelling.

6. Success Rate

Root canal treatments have a high success rate with results that last a lifetime when compared to tooth extraction. To determine the success or failure of root canal treatment, the most reliable method is to compare new X-rays with those taken prior to treatment.

What Should I Expect During A Root Canal?

These are the things to expect if you need a root canal:

  1. An X-ray of the affected tooth is taken to show where the decay or disease is located.
  2. Local anesthesia is administered to the affected tooth to numb it so that minimal pain is felt during the procedure.
  3. An opening is made on the tooth and the diseased pulp is removed.
  4. The tooth is then filled with a root filling material and sealed off with cement.

What Should I Expect During A Tooth Extraction?

  1. Your dentist will first numb the area so you don’t feel much pain during the procedure.
  2. A lever-like instrument (known as an elevator) is first used to loosen your tooth then another instrument (called forceps) will then be used to extract the tooth. You will feel some pressure while this is happening.
  3. After your tooth has been extracted, you’ll be told to bite on a piece of gauze for up to 45 minutes to stop the bleeding and allow the blood to clot. Also, a set of aftercare instructions will be given to you.


A root canal is often the preferred choice of treatment when compared to tooth extraction because it saves your natural tooth. However, a root canal may not always be an option, depending on the damage on the tooth.

If a tooth is far too compromised, your dentist might recommend an extraction, followed by a tooth replacement.

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