Female dental patient holding jaw in pain, seated in chair talking to dentist.

Root Canal vs. Extraction: Which Dental Procedure is Right for You?

Neglecting dental care can severely affect your oral health and overall well-being. Despite the resilience of teeth, poor dental care can cause cavities, gum disease, and tooth decay. When left untreated, these dental issues can lead to serious health complications and significantly impact your quality of life.

Root canal therapy and tooth extraction are two standard dental procedures for treating damaged teeth. While each approach has its advantages and disadvantages, determining the most appropriate treatment requires considering several factors.

This article will briefly overview the root canal and extraction procedures, highlight the differences, and offer guidance on choosing the proper dental procedure for your needs.

Overview of Root Canal Procedure

A root canal treatment is a dental procedure to salvage a badly damaged tooth that would otherwise require extraction. It involves the removal of the infected or inflamed pulp tissue from inside the tooth, followed by a thorough cleaning of the root canals and filling.

The pulp, a type of soft tissue containing nerves, connective tissue, and blood vessels, can become infected or inflamed for various reasons, including: 

  • Tooth decay: Oral bacteria can reach the pulp and cause an infection when a cavity is left untreated for an extended period
  • Cracked enamel: A fissure or crack in a tooth can serve as an entry point for oral bacteria, potentially resulting in an infection of the pulp
  • Periodontitis: Advanced stages of gum disease can result in receding gums, exposing the roots and potentially leading to a condition called pulpitis, which is an inflammation of the pulp
  • Injury: A traumatic injury to the tooth can cause severe damage to the pulp, leading to inflammation. Additionally, if the enamel is compromised due to the injury, it can expose the pulp to oral bacteria, increasing the risk of infection.

Pros of Root Canal Treatment

Root canal treatment has several benefits, they include: 

  • Restores tooth functionality: A root canal treatment not only restores the functionality of a damaged tooth but the crown or filling that is placed during the procedure also strengthens the tooth, allowing it to withstand the forces of chewing
  • Relieves pain: Inflammation or infection of the pulp can lead to unbearable pain. However, extracting the damaged or infected pulp can provide relief to the patient and avoid the need for continuous pain medication.
  • Saves the natural tooth: A root canal treatment can help preserve the natural tooth and prevent the need for extraction. While tooth extraction may be necessary in some cases, restoring and preserving a damaged tooth is often the best option for your oral health
  • Prevents the spread of infection: If the infected pulp is not removed, there is a risk of the infection spreading through the jawbone. Opting for a root canal preserves the affected tooth and prevents potential oral health complications. 

Cons of Root Canal

While root canal treatment is a safe procedure with a high success rate, it has some potential downsides. These include: 

  • Cost: The cost of a root canal treatment can vary, but it can become quite expensive, mainly if the tooth requires additional procedures like crown placement or post insertion
  • Discomfort: After undergoing a root canal treatment, it is common to experience some discomfort as your tooth heals. Nevertheless, you can alleviate any pain or discomfort by following a proper aftercare routine
  • Tooth weakness: While a root canal treatment can restore tooth functionality, it may weaken the treated tooth since the procedure involves removing a significant amount of tooth structure.

Overview of Tooth Extraction

Tooth extraction is a dental procedure that involves removing a tooth from its socket in the jawbone. A dentist usually carries out this procedure while you’re under either local or general anesthesia, depending on the complexity of the operation.

Though tooth extraction is considered a last resort by most dentists, it may be necessary in the following cases: 

  • Impacted wisdom teeth: If you are experiencing pain or other oral complications due to impacted wisdom teeth, your dentist may suggest tooth extraction as a solution. 
  • Severe tooth decay: If a decaying tooth cannot be salvaged through standard dental treatments such as fillings, crowns, and root canals, extracting the tooth may be the only option
  • Advanced gum disease: Tooth extraction may be unavoidable if gum disease has caused significant damage to supporting bone and tissue around the tooth, causing it to become loose. 
  • Overcrowding: If you have overcrowded teeth, your dentist may suggest extracting one or more teeth. This will create the necessary space for your teeth to align correctly 

Pros of Tooth Extraction

Although tooth extraction is considered a last resort, it has various benefits, including:

  • Prevention of oral health complications: Sometimes, extracting a tooth is the only way to prevent severe oral health problems caused by advanced gum disease, tooth decay, or impaction from worsening and affecting nearby teeth and gums.
  • Long-term oral health benefits: Extracting a tooth that’s causing severe pain or compromising nearby teeth can lead to long-term oral health benefits by reducing the risk of future dental complications
  • Pain relief: Tooth extraction can provide pain relief especially if the affected tooth is impacted, severely damaged or can’t be treated using restorative dental treatments
  • Correction of orthodontic issues: Tooth extraction can be helpful in orthodontic cases like overcrowding by providing space for proper alignment of teeth

Cons of Tooth Extraction

Despite being a safe and effective dental procedure, tooth extraction has various disadvantages. They include: 

  • Teeth misalignment: After tooth extraction, adjacent teeth can shift towards the gap altering the facial structure and causing bite problems.
  • Pain: You may experience pain and swelling after tooth extraction. However, you can manage these symptoms by following the proper post-operative care instructions.
  • Bone loss: A significant disadvantage of tooth extraction is the potential jawbone deterioration following the procedure. This bone loss may lead to weakened jawbone integrity and affect your facial structure.

Differences Between Root Canal and Tooth Extraction

Root canals and tooth extraction are dental procedures to fix damaged teeth and improve oral health. However, their distinct differences make them ideal for specific dental problems. Here’s a detailed comparison of the two procedures:


Although both procedures involve some level of invasiveness, tooth extraction is typically considered more invasive than root canal treatment. It’s important to remember that root canal treatment is a restorative dental procedure designed to save a damaged natural tooth, while extraction involves completely removing the tooth.

Additionally, root canal treatment is a relatively straightforward procedure that remains consistent regardless of the tooth’s location or damage it has sustained. In contrast, complex tooth extraction procedures may require a more invasive approach than standard extractions.

For instance, in the case of an impacted wisdom tooth, your dentist may need to remove portions of the jawbone and break the tooth down into smaller pieces before extraction. This process can be quite painful and may require general anesthesia.

Recovery Time

Post-operative care routines significantly affect the recovery time for both root canal treatment and tooth extraction procedures. However, root canal therapy typically involves a shorter recovery time due to its ability to restore the damaged tooth’s functionality while strengthening it in the long term. 

In contrast, tooth extraction is a more invasive procedure that may require several weeks for the extraction site to heal fully. Adherence to proper post-operative care routines is important to avoid complications and promote a speedy recovery.


Root canal procedures are usually less expensive than tooth extractions. Although the location and extent of damage or infection can affect the complexity of the root canal, root canal procedures are generally straightforward and predictable.

On the other hand, the cost of a tooth extraction can vary significantly depending on whether it is a simple or surgical procedure. Surgical extractions, which may  involve incisions, bone removal, and a high level of dental expertise, cost more than standard (simple) extractions.

Long-Term Effects

Successful tooth extraction and root canal procedures can improve your overall oral health. However, a root canal may weaken the treated tooth, leading to an increased risk of fracture and reinfection that may necessitate further treatment or extraction. That is why a crown is generally recommended after a root canal procedure. A crown will minimize the risk of a fracture following a root canal procedure. 

On the other hand, the gap left by a missing tooth after extraction can cause oral health complications such as bone loss and shifting teeth. To counter this, your dentist may recommend replacing the missing tooth using a dental implant, bridge or partial.

Factors That Can Affect The Choice Between Root Canal Therapy and Tooth Extraction

As mentioned, root canals and tooth extraction are effective dental procedures used to treat specific oral health conditions. Your dentist will consider the following factors before recommending either of the procedures:  

  • Location of the tooth: The location of the affected tooth can affect the choice between a root canal and tooth extraction. For example, a root canal is the better treatment option for a visible front tooth since extracting it will ruin the aesthetics of your smile. However, extraction may be a viable option for back molars that are difficult to see.
  • Severity of the infection: While root canal therapy is an effective restorative treatment, it may not successfully treat a severely damaged or infected tooth. In such cases, extraction may be the only treatment option.
  • Oral health goals: Your dentist will consider your oral health goals before recommending a treatment option. For example, they may recommend an extraction if you’re willing to consider dental implants or partials. However, a root canal procedure is your best bet if you want to preserve your natural teeth at all costs.
  • Cost: While prices for both procedures can vary, root canals are generally more expensive than tooth extraction. Moreover, you should consider the cost of additional dental procedures if you intend to replace the missing tooth with a dental bridge, partial or implant.

Aftercare and Recovery

To prevent complications and ensure a speedy recovery, following the post-operative aftercare routine recommended by your dentist is essential. Below are some useful tips for standard aftercare routines following root canal and tooth extraction procedures:

Root Canal Aftercare Routine


  • Avoid smoking cigarettes since tobacco products delay healing and can lead to severe dental complications
  • Maintain proper oral hygiene but brush your teeth gently using a soft-bristled toothbrush to avoid irritating the treated tooth.
  • Contact your dentist if you experience severe pain, tingling in your lips or discharge from the treated tooth.
  • Wait until you have a permanent crown placed before chewing with the treated tooth.
  • Apply an ice pack to the outside of your cheek near the treated area for 10-15 minute intervals to reduce discomfort and swelling.
  • Take any prescribed pain medication as directed by your dentist.

Tooth Extraction Aftercare Routine


  • Avoid smoking, spitting forcefully, or drinking through a straw for at least 24 hours.
  • Apply an ice pack to the outside of your cheek near the extraction site for 10-20 minute intervals at least twice daily for the first 48 hours after the procedure.
  • Don’t dislodge the protective blood clot that forms over the extraction site, which can lead to complications. 
  • Take pain medication as directed by your dentist.
  • Contact your dentist immediately if you experience persistent bleeding, severe pain, tingling in your lips or neck, and discharge from the extraction site.
  • Maintain your dental care routine by brushing and flossing regularly, but be gentle to avoid irritating the extraction site.

Root canals and tooth extraction procedures address serious dental complications. However, both procedures involve different levels of invasiveness and have varying long-term effects on oral health. Root canal therapy can preserve the natural structure of your teeth and prevent further damage, while extraction may be necessary in cases where a tooth cannot be saved. 

Ultimately, the decision of which procedure to pursue should be based on a thorough evaluation of your dental needs and the advice of your dentist.