Root Canal vs. Extraction and Implant: Which to Choose (2022)

Sometimes, a tooth can become so severely damaged or infected that your dentist might discuss a couple of different kinds of treatment plans with you. The first is a root canal, and the other is a dental extraction followed by an implant, which is an artificial tooth designed to replace your damaged tooth.

As you speak with your dentist about how to proceed, you’ll need to consider the costs and the benefits.

For example, after an extraction, you might need an artificial tooth, or implant, or possibly a bridge or partial denture to fill that gap along your gumline. You’ll also need to keep in mind that extraction may create some risks and side effects down the line. But if the damage isn’t quite that severe, it may be possible to save the tooth with a procedure like a root canal and a crown.

It may be helpful to understand the differences between a root canal procedure and a dental extraction and implant. Both procedures aim to address the damage in your mouth, but they achieve it in different ways.

Root canal

Perhaps a more accurate name for this process is actually “root canal treatment” or “root canal therapy.”

First, your dentist will numb the area by your tooth with a local anesthetic injection. Next, they’ll make a small opening in the top of your tooth.

(Video) Root Canal Vs. Extraction and Implant: Which Is Right For You?

Using special tools, they will remove any soft tissue, or pulp, that’s become inflamed or infected down inside the pulp chamber and root canals of your tooth. This leaves some empty space, which your dentist will fill with a type of biocompatible material called gutta-percha. Then it’s time to seal off the opening at the top of your tooth, often with a temporary filling.

A week or two later, you’ll return to your dentist’s office, so they can remove the temporary filling and put a crown or other type of restoration on top, if necessary.

Sometimes, the crown is created during the same appointment, and you don’t have to worry about returning.

Extraction and implant

If your tooth is so diseased or damaged that it cannot be saved, even with a root canal procedure, it may be time for an extraction coupled with an implant or other replacement option.

A simple extraction usually involves your dentist administering local anesthesia and using a tool like forceps to remove the tooth. Or you may have to undergo a surgical procedure, which requires general anesthesia. With surgical extraction, your dentist will cut into your gum and may remove some bone around your tooth, as well as the tooth itself.

However, you might not be able to get a dental implant to permanently fill that gap in your smile for at least several months. The timing of the placement of the implant can vary, according to a 2019 study published in the Journal of Cranio-Maxillo-Facial Surgery.

Some people can get an implant, which resembles a screw, immediately after an extraction, but many people need to wait for proper bone healing before the implant. The wait is typically 1 to 4 months or longer. Additionally, you may need to wait several months for the implant to become integrated into the bone before the replacement tooth or crown can be placed on top of the implant, according to the American Dental Association.

How to decide which is best?

A number of factors must be taken into account, such as the restorability of the tooth, the esthetic demands, and the cost-to-benefit ratio, according to an implant position statement from the American Association of Endodontics. But many experts believe that it’s better to save the damaged tooth if possible.

Prolonging the life of a tooth may delay or remove the need for an implant later

If you can save a damaged tooth with a root canal, it may prolong the life of the tooth. It could even eliminate the need to install an implant later on.

A 2009 review of research on the differences between root canal therapy and implants found that nonsurgical endodontic treatment had very high success rates, in terms of the affected tooth’s functionality several years later. For example, one large study found that more than 94 percent of the teeth studied were functional 3.5 years after the root canal treatment.

A root canal may be less expensive

A root canal procedure may be significantly cheaper, as extraction and an implant may not be covered by your insurance.

According to CostHelper, the estimated cost of a root canal with insurance coverage ranges from about $250 to slightly over $1,600. The cost can vary depending on the type of tooth that’s affected, your insurance plan, your location, and the type of dental professional performing the procedure. It can also cost significantly more if you also need a crown on top of the tooth that requires the root canal.

Meanwhile, the cost of a simple tooth extraction might not be that high, but you may need a surgical extraction. And the cost of a surgical extraction may be quite a bit higher. Add in the additional cost of just one implant, and you could be looking at a bill of at least $4,000 to $10,500, depending on your specific situation.

The treatment is less invasive

You might not think of a root canal as noninvasive, but it is less invasive than a surgical dental extraction. With surgical extraction, you may need intravenous anesthesia, as well as local anesthesia, and your dentist has to cut into your gum to remove the tooth — and possibly some bone around it.

(Video) Root Canal vs. Tooth Extraction: What’s the Right Choice?

It’s much quicker than going through the implant process

When you get a root canal, you might have to go back to your dentist’s office a week or so later to get a crown. But other than that, the process can usually be completed in one office visit. By contrast, the extraction and implant process may take several months or longer.

The recovery period is shorter

It can take several months for your mouth to heal from an extraction­ — and that does not include the time it will take for your mouth to heal and regrow bone around the implanted tooth. Meanwhile, the typical recovery period for a successful root canal is usually just a few days.

Other factors may reduce the success of an implant

Some other factors can reduce the likelihood of success of extraction and implant.

For example, research published in 2009 suggests that smokers are more likely than nonsmokers to experience failure of an implant. And a 2005 clinical study suggested that both tobacco and alcohol use can have a negative effect on implant outcomes, causing bone loss.

Just as there are some benefits for opting for a root canal over extraction and implant, there are also some risks to consider.

A root canal might weaken the tooth

Your dentist has to drill down into your tooth to remove the diseased or inflamed pulp. If the tooth is already very fragile, this process could further weaken it. And if the root canal is done on one of the back teeth (whether the molar or premolar), it should have a crown placed to protect the tooth from the forces of biting down and to support the remaining tooth structure.

(Video) Root Canal VS Dental Implant

The tooth may fail, anyway

If your tooth is weakened, or the damage is very extensive, choosing a root canal might not be enough to address the damage. The tooth may not survive, and you may wind up getting an extraction anyway.

Depending on the state of your tooth, you may not have the option for a root canal and crown. Your tooth might have sustained so much damage that the best way to stop the deterioration is extraction and then replacing it.

There may be other possible procedures, depending on your situation.

As a 2021 study in the British Journal of Oral and Maxillofacial Surgery noted, some research is showing success with dental implants installed through impacted teeth or residual roots, rather than a complete extraction. However, your dentist needs to assess your tooth and discuss the specifics of your situation in detail with you.

Takeaway

(Video) Root Canal Treatment vs Tooth Extraction. Which one is better?-Dr. Shahul Kamal Asif|Doctors' Circle

Speak with a dentist about the short-term and long-term risks and benefits of both procedures and explain what your goals and priorities are. Generally, when an existing tooth can be saved, it’s viewed as the more beneficial procedure.

FAQs

Should I choose root canal or extraction? ›

In most cases, root canal therapy is a better way to treat an infected tooth than an extraction. However, there are exceptions, such as if the tooth has suffered extreme damage. Your dentist will carefully analyze your oral health before making a treatment recommendation.

Is extraction and implant better than root canal? ›

If you've got longevity in mind, know that dental implants can last you for much longer than a root canal and crown. They have a low failure rate and can last decades with good care. With a root canal, you may still end up with your tooth failing or needing to replace crowns after five to 15 years.

What hurts more dental implant or root canal? ›

The extensive procedure for a root canal treatment and the soreness after each procedure with mild discomfort for a few days makes the root canal a more painful treatment. A dental implant only involves pain when the effect of the anesthesia wears off when the tooth to be replaced by an implant will be removed.

Can I ask for extraction instead of root canal? ›

In general, tooth extractions are cheaper than root canals, and they can be performed by general dentists as well as endodontists. Many people choose extraction instead of root canals simply because of the cost. However, getting a dental implant to replace your natural tooth can cost a lot of money.

Why you should not get a root canal? ›

Root canal dangers for long-term health

Studies have shown that there is a link between gum disease and serious chronic health conditions such as diabetes, heart disease, osteoporosis, respiratory disease, and cancer, and emerging evidence has shown that root canals pose the same health risks.

Which hurts worse root canal or extraction? ›

In addition, healing from an extraction takes longer and is often more painful than healing from a root canal, and pulling the tooth means even more dental procedures and healing time to replace it later. Still, pulling the tooth might be right for some situations.

Can you get an implant years after extraction? ›

Whether or not you've stayed a long time after having your teeth extracted is not a reason not to undergo dental implants. So it doesn't matter the number of years you've spent; 3, 5, 10 or any number of years past, you can still get your dental implant surgery.

When is it too late for a root canal? ›

Root Canals Aren't Possible with Severe Infection

If the deepest layers of the pulp become infected, it may be too late to save the tooth. In addition, if a large portion of the tooth is lost and a crown cannot be placed on what's left, root canal treatment is no longer a viable solution.

What happens if you have a tooth pulled and don't replace it? ›

After you undergo a tooth extraction, you will need to replace the missing tooth or teeth. If the teeth are not replaced, the bones in your mouth can weaken and lose density. Other teeth also might shift, and you might experience trouble eating. Fortunately, you have several replacement options for missing teeth.

Can I get an implant instead of root canal? ›

Root Canals: How to Know What's Right. Your dentist might not always give you a chance to choose between the two, but you can make the decision for yourself in some cases. A dental implant can be a better option for those who have an active lifestyle or want to avoid having another procedure in the future.

Can you have a crown without having a root canal? ›

Getting a crown doesn't always require a root canal and vice versa. However, in some instances, you might require both treatments. If your tooth is beyond repair, your dentist might recommend extracting it. Later, you can use dental implants, bridges, or dentures to replace the lost teeth.

What is the life of dental implants? ›

Many patients are surprised to learn that, when properly cared for, dental implants can last for around 25 years.

What are the disadvantages of root canal? ›

Con – treatment might weaken the tooth

It is possible for a tooth to become weaker after a root canal. Dentists must drill through the tooth to get to the pulp, and additional decay might need to be removed. If the tooth is too weak to function, the dentist will add a crown to it.

What can you do instead of a root canal? ›

Alternatives to root canal treatment
  • Direct pulp capping. Direct pulp capping is a type of dental procedure that can be used to treat severe damage or decay that exposes the pulp. ...
  • Pulpotomy. A pulpotomy is a procedure in which the pulp is removed. ...
  • Tooth extraction. Tooth extraction is when an entire tooth is removed.
22 Apr 2021

Do teeth break during extraction? ›

Broken teeth

It is also possible that the tooth broke during the extraction procedure, potentially leaving a tiny portion behind. If a significant portion of the tooth is missing, the remaining part may be hard to grab or manipulate with dental tools.

Why do dentists always want to do root canals? ›

Why are root canals necessary? Root canals are a simple procedure that are recommended to save damaged, natural teeth and prevent the need for dental bridges and implants. Root canals are necessary when the pulp, or soft tissue, inside the tooth becomes inflamed or infected, which could lead to an abscess.

Why are people afraid of root canal? ›

While any dental procedure can sound painful at the onset, many people balk at the thought of getting a root canal because it requires dealing with infected nerves at the root of a tooth. This site sounds deep and invasive, and already painful to begin with.

Does a root canal weaken the tooth? ›

A root canal may save a tooth from further infection, but it does not save the tooth from weakening. Coupled with tooth decay, a root canal procedure weakens the tooth by reducing the amount of healthy tissue within it.

What happens to the nerve when a tooth is pulled? ›

Nerve injury

Although far less common than dry socket, injury to sections of a nerve called the trigeminal nerve is another possible complication of wisdom tooth removal. It can cause pain, a tingling sensation and numbness in your tongue, lower lip, chin, teeth and gums.

How many days does it take for a tooth extraction to heal? ›

About 3 days after your tooth extraction, your gums will begin to heal and close around the removal site. And finally, 7-10 days after your procedure, the opening left by your extracted tooth should be closed (or almost closed), and your gums should no longer be tender or swollen.

What happens if a bit of root is left after extraction? ›

Generally if the tooth nerve is not infected when the root is fractured off, the root can be left behind safely-especially if the root is less than 2mm in length. It is sometimes safer to leave the root behind than to chase after it. The root remanent may then get embedded in the bone and remain indefinitely.

What is the downside of dental implants? ›

Dental Implants Require a Surgery for Placement

The complication rate is just an average 5 to 10%. The risks and complications you are taking for dental implants include infection, damage to other teeth, delayed bone healing, nerve damage, prolonged bleeding, jaw fractures and more.

Can you get a temporary tooth while waiting for an implant? ›

The dentist may decide to place a temporary bridge in the patient's mouth while waiting for implant supported dentures. This does as the name implies. A bridge will bridge the gap in the person's mouth.

Can you do extraction and implant on same day? ›

The short answer is it is possible! The long answer is implants can only be placed sometimes at the time of extraction. This is known as an 'immediate implant placement' but it can only be performed when the condition of the tooth allows.

Does extraction of tooth change face shape? ›

This area is not directly attached to the basal jawbone. Therefore, when the teeth are removed, there is really no change to the shape of your jaws.

When is a tooth too decayed to save? ›

Extraction is usually necessary when the decay is too pervasive to stop and/or the gums are too infected to offer support and structure to your teeth. In these cases all the affected teeth will have to be extracted.

How do you know if it's too late to save a tooth? ›

You might see pus around your tooth, and you'll notice your gums pulling away from contact with the tooth. Your gums might swell, and that swelling could extend to your face and neck, too. At this point, your tooth will likely have to be removed.

What is the cheapest way to replace missing teeth? ›

A partial denture will usually be the cheapest dental restoration available, with a dental bridge (and the corresponding adjacent tooth crowns) priced somewhere in between dental implants and dentures.

What do dentists do with extracted teeth? ›

The teeth are placed in a hazardous waste container and then incinerated once it's picked up at the dental office. The CDC has different guidelines for teeth containing metal fillings. Because the metal might release toxic fumes during incineration, they need to be sent to a specialized recycling center instead.

Do I need a bone graft after tooth extraction? ›

A bone graft is usually necessary after a tooth extraction since the bone can start to melt away. This can cause your facial features to sag, so a bone graft can help provide needed structure and support.

Is a dental implant worth it? ›

In many cases, the cost of treatment is just slightly higher than that of more traditional dental procedures. Dental implants are also a permanent replacement for lost teeth, making them a cost-effective option in the long run. And a good investment for individuals who want to avoid dental problems in the future.

How many tooth implants can be done at once? ›

How many dental implants can you get at once? The answer really is that you can have as many dental implants as you have teeth that need to be replaced. However, each patient has individual needs and Dr. G can make a professional decision regarding the most appropriate dental care for your oral health.

How often do root canals fail? ›

As mentioned above, only about five percent of root canals fail, and sometimes it is not actually a “failure.” In cases, of teeth that have more than one root, it is possible that only one root was infected and filled.

What happens if I don't get a crown after root canal? ›

What happens after? A root canal often weakens the outer tooth. Because a big part of the tooth's structure is removed during a root canal, the outer tooth is likely to crumble if it is not reinforced with a crown.

Can I wait a month to get a crown after root canal? ›

Typically, you may be able to delay getting the crowns for 1-2 months but beyond that point, they risk breaking.

What happens if you wait too long to get a crown? ›

But if a patient delays in getting a crown in a reasonable amount of time, eventually the decay will reach the inner layer of a tooth where the pulp and nerve reside. Then a root canal is necessary to remove the infected nerve.

What celebrity has dental implants? ›

6 Celebrities Who Have Dental Implants
  • #1: Ed Helms. Well-known for his roles in “The Hangover” movie series and “The Office,” Ed Helms' gapped grin in the former wasn't makeup or movie magic! ...
  • #2: Nicolas Cage. ...
  • #3: Mike Tyson. ...
  • #4: Christie Brinkley. ...
  • #5: Steven Tyler. ...
  • #6: Chris Rock. ...
  • About the Author.
12 Jan 2022

Can your mouth reject an implant? ›

Strictly speaking, your body can reject a dental implant. But, the good news is that it is very rare. Dental implants are the most adaptable and durable replacement for teeth roots, with up to 98% of the success rate.

What percentage of dental implants fail? ›

It's estimated that about 5 to 10 percent of dental implants fail, either shortly after a procedure or months or years later. If you're scheduled to have dental implant surgery, or if you currently have an implant, here's what you need to know about implant failure and other potential complications.

Is it better to extract or root canal? ›

In most cases, root canal therapy is a better way to treat an infected tooth than an extraction. However, there are exceptions, such as if the tooth has suffered extreme damage. Your dentist will carefully analyze your oral health before making a treatment recommendation.

Why is root canal better than extraction? ›

A root canal has a better success rate than a tooth extraction because there are little to no future complications associated with the procedure. Root canals are performed by dentists to clean and restore an infected tooth. There is no need to extract or remove the tooth.

Why do some dentists not do root canals? ›

This includes the type of tooth, shape of the canal system, and current or past injury. While an endodontist can perform the procedure regardless of the circumstances of these aspects, general dentists will typically only do so when the conditions are less complex.

What happens if you need a root canal and don't get one? ›

If a root canal is delayed for too long, the bacterial infection can spread to other areas of the mouth, putting the patient at risk for serious dental problems and other medical conditions. The infection can cause something called a dental abscess, which is a pus filled sac that requires immediate medical attention.

How can I avoid a root canal naturally? ›

Avoidance Tactics: Top 10 Tips to Avoid Root Canal Treatment
  1. Brush twice daily. ...
  2. Floss once daily. ...
  3. Avoid hard foods such as hard candies and lollipops. ...
  4. Weak teeth be wary. ...
  5. Back away from the ice! ...
  6. Wear a mouth guard at night. ...
  7. Wear a mouth guard while playing sports.
13 Jan 2016

Which tooth is hardest to extract? ›

What is the most difficult tooth to extract? Impacted wisdom teeth are wisdom teeth that have failed to erupt properly. They are generally considered to be the most difficult teeth to extract. The higher the degree of impaction, the more difficult the extraction.

Why do dentists not do extractions? ›

Facial Structure: The positioning of your teeth in your mouth may make it difficult for a dentist to perform the extraction without causing discomfort. Things like large sinuses, or limited jaw mobility necessitate an extraction by an oral surgeon.

Is it easier to extract upper or lower teeth? ›

So it will usually take longer to get numb than to get out. However, some teeth are very difficult to remove. Back teeth are almost always more difficult than front teeth. Back teeth have two or three roots (sometimes four) whereas front teeth have one.

What are the disadvantages of root canal? ›

Con – treatment might weaken the tooth

It is possible for a tooth to become weaker after a root canal. Dentists must drill through the tooth to get to the pulp, and additional decay might need to be removed. If the tooth is too weak to function, the dentist will add a crown to it.

Which is better tooth extraction or filling? ›

Tooth extraction is a more appropriate solution when chronic pain from the tooth makes it hard to function normally. The tooth might be too diseased, too weak, or too far decayed, so a filling won't be able to make the tooth better. If a tooth is cracked below the gum line, an extraction may also be a wiser option.

Which is more painful root canal or wisdom tooth extraction? ›

A root canal treatment has a general reputation for being a costlier and more painful procedure. In comparison, tooth extraction may appear to be the lesser of two evils. However, when given the option, a root canal treatment should always be the preferred choice as it serves to retain the natural tooth in the mouth.

Is there a natural alternative to a root canal? ›

Holistic extraction of the entire injured or infected tooth is the safest approach to take if your tooth has decayed significantly. It is also the most popular alternative to a root canal when followed by replacing the target tooth with a bridge, metal-free dental implant, or partial dentures.

When is a root canal not recommended? ›

Root Canals Aren't Possible with Severe Infection

If the deepest layers of the pulp become infected, it may be too late to save the tooth. In addition, if a large portion of the tooth is lost and a crown cannot be placed on what's left, root canal treatment is no longer a viable solution.

What can you do instead of a root canal? ›

Alternatives to root canal treatment
  • Direct pulp capping. Direct pulp capping is a type of dental procedure that can be used to treat severe damage or decay that exposes the pulp. ...
  • Pulpotomy. A pulpotomy is a procedure in which the pulp is removed. ...
  • Tooth extraction. Tooth extraction is when an entire tooth is removed.
22 Apr 2021

Why do some dentists not do root canals? ›

This includes the type of tooth, shape of the canal system, and current or past injury. While an endodontist can perform the procedure regardless of the circumstances of these aspects, general dentists will typically only do so when the conditions are less complex.

What happens to other teeth after extraction? ›

When a gap is left by a missing tooth, the surrounding teeth have a tendency to shift because that tooth is no longer helping to keep everything in line. Ultimately, teeth may become crooked or new gaps may appear between teeth. Another issue that may occur is super-eruption.

What happens if you have a tooth pulled and don't replace it? ›

After you undergo a tooth extraction, you will need to replace the missing tooth or teeth. If the teeth are not replaced, the bones in your mouth can weaken and lose density. Other teeth also might shift, and you might experience trouble eating. Fortunately, you have several replacement options for missing teeth.

How soon do teeth shift after extraction? ›

How Long Will It Take for My Teeth to Shift? As mentioned, your teeth will shift slightly throughout your life. However, if you have had a tooth or teeth extraction, the surrounding teeth may shift to fill the space. There is no time length when this will occur, as it could happen over a matter of months or years.

Do teeth break during extraction? ›

Broken teeth

It is also possible that the tooth broke during the extraction procedure, potentially leaving a tiny portion behind. If a significant portion of the tooth is missing, the remaining part may be hard to grab or manipulate with dental tools.

How long do teeth last after root canal? ›

How successful is root canal treatment? Root canal treatment is usually successful at saving the tooth and clearing the infection. Around 9 out of 10 root-treated teeth survive for 8 to 10 years. Having a crown fitted to the tooth after root canal treatment is important for improving tooth survival rates.

How long will root canal last? ›

Root Canal Treatment Success Rate

According to this report, 98 percent of root canals last one year, 92 percent last five years, and 86 percent last ten years or longer. Molars treated by endodontists had a 10 year survival rate, significantly higher than that of molars treated by general dentists.

Why do dentists push root canals? ›

Root canals are a simple procedure that are recommended to save damaged, natural teeth and prevent the need for dental bridges and implants. Root canals are necessary when the pulp, or soft tissue, inside the tooth becomes inflamed or infected, which could lead to an abscess.

What happens if you need a root canal and don't get one? ›

If a root canal is delayed for too long, the bacterial infection can spread to other areas of the mouth, putting the patient at risk for serious dental problems and other medical conditions. The infection can cause something called a dental abscess, which is a pus filled sac that requires immediate medical attention.

Can antibiotics avoid a root canal? ›

Although antibiotics will not be effective in lieu of a root canal, your provider may prescribe a preventive course of these medications following your root canal treatment. This is to reduce your risk of developing infection in the bone surrounding the tooth, which prophylactic antibiotics are very effective at doing.

Videos

1. Implants vs. Root Canal
(Island Paradise Dental)
2. Root Canal vs. Dental Implant: Which One Do You Need?
(John Jazayeri)
3. Extraction VS Root Canal Treatment | Which Option Is Better?| Dr Deepika Prakash
(KnowItRight)
4. Let's Break Down a Root Canal vs Tooth Extraction
(Innovative Endodontics)
5. Root canals versus extractions
(BURST Oral Care)
6. 22. Molar teeth: Pain, abscesses Root Treatment or Extraction? ( Why choose a specialist for molars)
(London Dental Specialists)

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