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Should I Get a Root Canal or an Extraction?

Posted by AllSmiles

I need a root canal or extraction and implant for my lower right first molar. The tooth behind it is missing, too. I can only afford to replace one tooth at a time, so I am replacing the one that shows the most when I smile. My dentist gave me the option of a root canal or an implant. I am a little concerned about the root canal, and if something goes wrong, I will need an implant anyway. Which option makes sense? Peter from Orange, NJ


Thank you for your question.

Dr. Michalski would need to examine your tooth and x-ray to explain precise treatment options, but we will explain some basic principles for saving or replacing missing teeth.

Root Canal or Extraction?

Diagram of root canal therapy for a comparsion of root canal and extraction with a dental implantSaving a natural tooth with root canal treatment makes sense. Your tooth will need a crown to protect it. The American Association of Endodontics (root canal specialists) recommends that you choose root canal treatment over an extraction and dental implant whenever the tooth is savable. Root canal procedures have a 97 percent success rate. Also, when you are missing molar teeth and do not try to save or replace them, you will have difficulty chewing food well enough to digest it properly.

Although a dental implant is a safe, predictable way to replace a tooth, no form of tooth replacement is better than a natural tooth.

Is a Root Canal Painful?

Root canal therapy is not painful when you select an experienced dentist for treatment. A gentle dentist will take these steps to ensure you are comfortable:

  • Explain options for sedation before your procedure date if you have dental anxiety
  • Apply a local anesthetic to prevent you from feeling the numbing injection
  • Numb the root canal tooth
  • Remove the infected tooth pulp, sanitize the tooth, and fill it with a dental material
  • Explain how to minimize your discomfort with medication at home

Schedule a Second Opinion

We recommend scheduling a second opinion with an experienced dentist to discuss your options. Eventually, you will need an exam and x-rays to assess your oral health and get an accurate diagnosis and treatment options.


Rocky Hill, Connecticut dentist Dr. Thaddeus Michalski, sponsors this post.