Extraction of Tooth vs. Root Canal: which is a better option?
I went to the dentist because I was experiencing pain in the back of my jaw. According to the dentist, one tooth needs to be extracted and the tooth in front of it (bottom molar) is infected and needs a root canal. I was wondering if an extraction (and then maybe a dental implant at a later date), rather than a root canal, would be another option. I do not have the money to pay for a root canal and crown especially when there is a possibility it will not work. How successful are root canals as compared to extractions, and what are the cons of extraction as it is a back tooth? Maybe I will not even have to get an implant here at a later date?
See also: - Implant close to root canal tooth: thoughts?
4 Comments on Extraction of Tooth vs. Root Canal: which is a better option?
New comments are currently closed for this post.
Jack Binder, DDS
2/14/2013
If a tooth can be saved without heroic dentistry, it should be saved, rather than extracted. By "heroic dentistry", I mean procedures that were created to extend the life of a severely compromised tooth. When I went to dental school, implants were not predictable, and were not taught to dental students. Very creative dentists figured out ways to preserve compromised teeth, often for many, many years. These sophisticated procedures took time and money, and sometimes did not last. In 2013, it is much more common to extract a severely compromised tooth and replace it with an implant and crown. It is more predictable, and often less expensive, depending on how compromised the tooth is. However, if all your molar needs is a root canal and crown, it's not severely compromised. These are proven procedures that have a very high rate of success and should last a very long time. It is also a less expensive solution. So if the tooth is salvageable via routine dentistry, you should save it.
Loyd Dowd DDS
2/14/2013
I used to do root canals on every tooth no matter how infected it had been or for how long. Over the years I learned that the longer a tooth has been infected, especially when you can see blunting of the root end, the less chance it has for a root canal to be successful long term. I feel that when the cementum is dissolved off of the root end it exposes the porous dentin. No matter how well you fill the major canal all the way to the apex there's no way to remove the porous dentin at the apex, which I feel is a repository for bacteria. What I do now is an apico and retrofil when I have a patient who really wants to keep the tooth that's showing a significant periapical radiolucency, especially if I see blunting of the apex. I do this in addition to the root canal therapy itself and have found it very effective long term. I prefer to recommend extraction and implant placement when I see a significant periapical radiolucency especially with apical blunting of the root.
Trevor Knowles DMD
2/14/2013
Dr. Binder is correct. Both implants and and root canals can be predictable and long lasting restorations, although both options do have a possibility of failure. He is also correct that a root canal and crown is typically a more affordable option.
In way of explanation, a severely compromised tooth would be a tooth with decay so extensive that it approaches the level of the bone. This situation may require additional "heroic" procedures to restore the tooth. Those procedures increase the expense of the treatment and result in less bone supporting the tooth. Your dentist will be best able to evaluate your x-rays and determine if an adequate amount of stable tooth structure exists above the level of bone.
It is important to keep your back teeth. The force of chewing is distributed primarily on your back teeth, and the tooth you are indicating is the largest in your mouth. When you lose back teeth, that force is absorbed by your front teeth. They are not designed for that function and will, over a number of years, chip and wear.
Best of luck!
Dr shyam mahajan Aurangab
3/15/2013
It will be good if you give your x ray with your question .I agree with Dr Travor & Dr Loyd .that natural tooth should be saved as much as possible , if it remains 1.without any infection ,2. it is efficiently used for chewing & 3. has long life.
Removal & implant can always be done if the tooth does not remain as par above three things.
In India root canal & crown is much cheaper than implant.
