Choosing Between A Root Canal And A Tooth Extraction

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When the aching, pulsing sensation in your tooth keeps you awake at night and interferes with your work, it is time to do something about your root canal problem. There are two options available to treat a dying tooth: undergo root canal treatment or have the tooth extracted. Both have their advantages and disadvantages but which treatment is right for you?

What's Going On In Your Tooth

The root canal is a hollow space within the tooth. Bacteria in the mouth will enter this space and move through the canal to the nerves and tissue at the base of the tooth. Here, the bacteria will start affecting the nerves to the point where it causes your tooth to ache and eventually become very painful. At this point you definitely want to visit a dentist or endodontist who will most likely present the options of having a root canal or extracting the tooth.

What Happens During a Root Canal

During a root canal procedure, the dentist removes the infected portions of the tooth including blood vessels, nerves, and other tissues by drilling through the top of the tooth and chipping away at the infected pulp. The tooth is hollowed out to remove any bacterial contamination. Then the dentist will fill the pulp of the tooth with a temporary material. At a later visit, the hollow space is filled, the tooth may be shaped, and a metal or porcelain crown is attached to it.

Why You May Want a Root Canal

While a root canal procedure may seem painful (you do get local anesthesia) and a little intimidating, there are many reasons why you may want to opt for this treatment.

  • Your natural tooth is preserved which helps with more efficient chewing.

  • The jaw structure and teeth placement are maintained.

  • Your smile will be more appealing than with a missing tooth, especially if it is in the front of the mouth.

  • The cost is less than the cost of fabrication and maintenance for an implant or bridge that may be needed to fill the empty space left by a pulled tooth.

However... Consider the Risks

  • The longer you wait for the final restoration procedure, the more likely your tooth will become reinfected.

  • There is a possibility that the root of the tooth will fracture during the procedure or that a shaping file could break and get stuck in the root canal.

  • Sometimes it is difficult to get a good seal on the tooth due to the shape of the tooth.

  • A hidden root or extra canal that is in need of treatment could be missed and the procedure may need to be repeated.

  • There are many diseases including arthritis, appendicitis, and nerve damage that are supposedly related to having root canal treatment.

  • Success ranges between 80% to 98%.

Why You May Want Your Tooth Extracted

The alternative to a root canal is to have the tooth pulled. You can choose this as an option or your dentist may recommend it if you have strange anatomy, poor periodontal support, root fractures, or a medical condition that may make root canal treatment unsuccessful. There are some reasons why you may want to have your tooth extracted over a root canal.

  • The cost of having a tooth pulled is less than a root canal.

  • A tooth extraction is a much simpler and faster process.

  • Success for tooth replacement is close to 100%.

However... Consider The Long-Term Effects

  • Other teeth in your mouth will probably shift into the empty space which could cause misalignment.

  • Teeth are necessary to maintain the jaw bone. If you do not fill the space, the jaw bone may decay and a bone graft may become necessary.

  • Even the back teeth are important for providing a surface for chewing. Without them, you could cause excess wear on the front teeth. They also support the muscles that provide structure to the face.

  • Cosmetically and for health maintenance, you may want to have an implant or bridge put in place which significantly adds to the cost, making it more expensive than a root canal.

When choosing which option is best for you, consider the cost but also the long-term effects. If you are able to spend the extra money now, you may save money on additional procedures in the future. With proper treatment you can maintain your smile, enjoy the foods you love, and limit the need for ongoing dental work.