When experiencing severe tooth pain, you’ll face a big decision about whether to treat your damaged tooth with a root canal or have a tooth extraction performed. Both root canals and extractions can be used to treat severe dental pain and dangerous bacterial infections. However, they follow a very different approach with very different long term consequences.

Most dentists worldwide will recommend saving your natural teeth. Understanding the main differences will help ensure that you make the best choice for your mouth.

What Is A Root Canal?

A root canal is a dental treatment that removes infection from your teeth. This can save your natural tooth. Inside your teeth are soft tissues known as the dental pulp. These contain nerves and blood vessels. When there is deep decay or damage in your teeth, bacteria can enter the inner chamber of your tooth causing inflammation to the nerve and severe pain.

Treatment:

  • Your dentist will drill a small hole into the top of your tooth.

  • They will then use special micro instruments to gently remove the dead or damaged pulp and remove harmful bacteria from the base of your roots.

  • Your dentist will flush the cleaned root canals with anti-bacterial solution. They will then fill the hole with rubber like material.

  • Lastly they will usually fit a porcelain crown on your tooth a few weeks later to protect your tooth and ensure that you can chew with full strength.

What Is A Tooth Extraction?

A tooth extraction involves removing a tooth from the jaw bone. This is done when the tooth has suffered significant damage, deep cracks below the gum line or has suffered severe decay.

Simple Extraction:

– Your dentist will numb the area around your tooth with local anesthetic. They will then gently move the visible part of your tooth using an elevator tool and remove it using dental forceps.

Surgical Extraction:

– If your tooth has broken off at the gum line or is stuck under your gums, your dentist will make a small cut in the gum to safely remove the root.

Healing:

– Your extraction site will form a natural blood clot. This will protect the bone and help new tissues grow over the area in the coming weeks.

Why It Is Almost Always Better To Save Your Natural Teeth

Studies have shown that saving your natural teeth provide much better outcomes. By keeping your natural teeth, you can keep your natural mouth structure.

Natural Biting Pressure:

Your natural tooth root can take the heavy pressure of chewing without any issue. Synthetic replacements cannot recreate the feeling or exact pressure as natural teeth.

Prevent Movement Of Surrounding Teeth:

By leaving a gap in your mouth, your surrounding teeth won’t have support. This causes surrounding teeth to tilt, shift and move into the gap. This will destroy your natural bite.

Jaw Bone Loss:

Every time you chew your food, your natural tooth root will stimulate your jaw bones. If you have your tooth removed without replacing the root, the surrounding jaw bones will slowly shrink.

No Complicated Replacements:

By saving your tooth you don’t have to have complicated surgeries such as dental implants, fixed bridges or removable partial dentures.

Pain During Treatment

Many people fear a root canal. However, with modern dental techniques both options are safe, effective and completely pain free.

During Treatment:

Both treatments involve powerful local anesthetic to ensure that the area is completely numb. You may feel some gentle pressure during your appointment but no sharp pain.

After Treatment:

You will experience very little pain after having a root canal. As the dentist has removed the live nerve, there will be no source of pain. You may feel some gentle sensitivity in the tissues around your root but this will subside within 2-3 days.

You may find that recovering after a tooth extraction can take longer and cause more discomfort. This is because your bone and soft gum tissues will take a few days to heal. You must also be very careful not to disturb the blood clot in your socket.

Costs

When considering the cost of these treatments you must think about long term costs.

Initial Cost:

A tooth extraction will cost less initially than a root canal and crown. This can make them look like the best option if you’re on a tight budget.

Replacement Cost:

Leaving a gap in your mouth will cause serious bite issues and jaw bone loss. Replacing your missing tooth will cost much more with a dental implant or bridge.

Long Term Savings:

With a good crown fitted, a root canal can last anywhere between 15-20 years or even a lifetime. By investing in a root canal you’ll save yourself lots of money over the years by avoiding complicated tooth replacements.

Recovery Time & Aftercare

Depending on what treatment you have, your recovery time will vary.

Root Canal:

Most people will be able to return to work/school and daily activities the next day. You can chew on the other side of your mouth until your dentist fits your final crown.

Extraction:

Soft tissue healing will take 7-10 days. Full bone healing will take 3-6 months.

Dry Socket:

An extraction can cause a dry socket. This occurs when your blood clot falls out of your open socket too early. This causes your raw bone and nerves to be exposed to air and food. This can cause intense pain. A root canal will not cause a dry socket.

When Would A Tooth Extraction Be The Only Option?

Dentists will always try to save your natural teeth. However, there are times where a tooth extraction will be the safest option.

Vertical Root Fracture:

If your tooth has cracked vertically below the gum line into the root there is no way to heal or seal this. Your dentist will need to extract your tooth to relieve your pain and prevent further jaw bone loss.

Extensive Enamel/Wall Damage:

If your tooth has suffered severe decay and lost too much of the natural crown, there will be no way to support a new crown.

Severe Gum Disease:

If your tooth has suffered severe gum disease, the jaw bone will have been destroyed. If your tooth is very loose due to massive jaw bone loss, a root canal will not help stabilize the tooth.

Severe Crowding:

Dentists often extract useless teeth such as impacted wisdom teeth to reduce crowding.

Things To Consider

Have a root canal if:

  • Your tooth has enough healthy structure to support a crown.

  • Prevents your natural bite, jaw bone and surrounding teeth moving.

  • Saves you money long term by not having expensive dental implants/bridges/partial dentures.

Have an extraction if:

  • Your tooth has severe vertical cracking/decay.

  • You’ll need to have an immediate replacement such as a dental implant.

  • Speak to your dentist as soon as possible so they can take 3D digital x-rays to assess your root.

FAQs

Is a root canal more painful than an extraction?

No. Both procedures will involve your mouth being fully numbed. A root canal actually removes the infected nerve causing you pain. This means you’ll feel instant relief. An extraction often causes more soreness as your body will be healing the open jaw bone.

How long will my root canal last?

A root canal with a good crown can last 15-20 years or even a lifetime. As long as you take care of your teeth daily. An extraction will permanently remove your tooth. If you don’t replace it with an implant, your surrounding teeth will move and cause bite issues.

Can I get an infection after a root canal?

Although root canals have a success rate of over 95%, occasionally the crown can come off or new decay can form on the edge. There may also be hidden extra canals in your root. This can cause infection. Most root canals that fail can be retreated easily by your dentist.

What will happen if I have an extraction and no replacement?

If you have an extraction and leave a gap, your surrounding teeth will start to tilt. This will ruin your bite. It will also create difficult to clean gaps. This will cause your gums to suffer from gum disease quicker. Your jaw bone will also start to lose natural bone underneath the gap.

Overall, a root canal to save your natural teeth is the best option. Although an extraction can be a quick and cheap option, you’ll have to replace your tooth which can take a lot of time and money. Book a full check up with your dentist to asses your tooth and choose the best option for a strong healthy confident smile.