Root Canal vs Extraction: A Side By Side Comparison

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

But are there any differences between these two options? Which is better and what can you expect when you undergo each one? Here’s some information to help you understand what a root canal entails, when a tooth extraction might be necessary and how they compare.

What Is A Root Canal?

Root canal
A root canal treatment is a procedure done to save a tooth as a result of an infected or inflamed pulp. The pulp is the center 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.

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 which leads to the pulp being irreversibly damaged.

Dental cavity
• Cracked or broken tooth due to an accident or trauma.
• Repeated dental procedures like filling. This can lead to exposure of the pulp.
• Diseases of the gum


Gum disease

Other reasons you may opt for a root canal treatment are
• The tooth is visible when you smile.

• There is really good bone and gum support around the tooth.
• You can afford to pay for the treatment or you can organize a payment arrangement with your dentist.

• You have already lost many teeth and are finding it hard to chew so you want to salvage what you have left. Also removing more teeth will place extra pressure on the remaining teeth making them more likely to chip and crack.
• You have a medical condition which may prevent you from having a tooth extraction at this stage, for example, if you are taking medications like aspirin which will delay blood clotting or if you have a bleeding disorder.

What is Tooth Extraction?

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

When Do I need a tooth extraction?

There are various reasons for having your tooth or teeth extracted.
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

Root canal and tooth extraction are both procedures which 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.

Comparing these two procedures may prove to be a bit difficult but understanding the pros and cons of a root canal and tooth extraction will help you decide which procedure would be better for you.

Question mark

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 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

Root canal

A root canal treatment is often time-consuming. It takes about 1 to 2 hours to complete while an 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 has 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 a tooth extraction, the procedure is relatively straightforward and is carried out in just one visit.

5. Pain


Root canal therapy is virtually 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 sharp pain which can be managed with an over-the-counter painkiller. For an 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?

When you visit the dental clinic, your dentist will examine your teeth and give you professional advice as to if you require a root canal treatment or a tooth extraction.
These are the things to expect if you need a root canal
1. An X-ray of the affected tooth is taken so as to show where the decay or disease is located.


2. Local anesthesia is administered to the affected tooth to numb it so that no 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.

If the tooth needs to be extracted, your dentist will first numb the area so you don’t feel any pain during the procedure. 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 officially extract the tooth. You will feel some pressure while this is happening.

After your tooth has been extracted, you’ll be told 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.


What Are The Complications of These Procedures?

As the case with any treatment, something may go wrong during or after. The likely complications of these procedures are reinfection of the tooth and pain.

1. Pain

You’re likely to feel some pain in the days following the procedure but it shouldn’t be so bad. However, if some bacteria remains behind, it can grow and result in even more pain.

The pain is relieved by taking analgesics and sometimes antibiotics which will be prescribed by your dentist. If the pain persists or gets worse, make sure you consult your dentist.

2. Re-infection

The tooth can become re-infected due to a number of reasons including –

  • Missed root canals
  • Defective materials
  • Difficult extraction

All of these allow a re-introduction of bacteria into the already treated tooth. this further causes more pain. in the event of a re-infection, another dentist visit is required.

In Summary

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A root canal is often the preferred choice of treatment when compared to an extraction because it works on saving your natural tooth so that it could remain in place in your mouth. 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.

With the help of your dentist and what you have learned here, you could make the right choice that will restore your smile and ensure your teeth and gums remain healthy for a long time.

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Onyeka Mgbemere, BDS

Dr. Onyeka Mgbemere is a graduate of Dentistry and a licensed dentist who is passionate about the promotion of oral health education and prevention of oral diseases. She is currently undergoing her residency program in Oral medicine after spending years working at a Naval hospital. Her hobbies are watching movies and reading.