Root Canal versus Extraction

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Pros and Cons

Root canal therapy and extractions are two ways a dentist can treat a damaged or infected tooth. Read about what they involve and which option is best for you.

Being informed will help you make the right decision but ultimately you should always listen to the advice of your dentist.

Wherever possible saving your natural tooth is usually the best option but there are occasions when the tooth cannot be saved – when there is too large a cavity or where there is a severe fracture, for example. However, it is worth asking your dentist if the tooth can be saved with endodontic treatment (root canal therapy) and, if so, the chances of its success.

What is Root Canal Therapy (Endodontic Treatment)

Root canal therapy is used to save a tooth that is damaged, diseased or contains non-vital (dead) pulp. Pulp is the centre of the tooth which is made up of living connective tissues and cells but can become infected – and very painful – when bacteria from your mouth reaches your pulp due to a crack or deep cavity.

Root canal therapy involves the dentist or endodontist removing the diseased pulp from the root canals and cleaning and disinfecting the inside of the tooth before refilling it with a rubber like material called ‘gutta percha’.

To protect the tooth following root canal therapy your dentist will advise a crown, or at the least a filling, to cover the tooth. Two or three visits may be required to complete the treatment. Modern advances in dental technology and modern anaesthetics means that root canal therapy should not cause pain, but relieve it, as the infected pulp which caused the pain in the first place is removed.

It has a high success rate when performed correctly and when it is protected with a crown (85-95%) but does rely on you maintaining excellent oral health practices.

What is Extraction

When a tooth has a hopeless prognosis and can’t be saved, your dentist will advise you to have an extraction which is the removal of the tooth from its socket.

During treatment, local anaesthetic is used to block feeling so you should not feel pain though you will feel pressure and hear some cracking and crunching. There will be some discomfort afterwards, the level of discomfort depends largely on how difficult it was to remove the tooth. Usually the discomfort subsides a few days after extraction.

In 3-5% of extractions, a painful condition called dry socket can develop 3 or 4 days after the extraction has taken place. Dry socket is when a blood clot doesn’t form in the socket or gets dislodged and the underlying bone is exposed to air and food. It can be extremely painful and the risks increase if you smoke, drink alcohol or rinse and spit a lot in the days after the extraction. Drinking through a straw also increases the risk of dry socket as it forms a suction which can dislodge the blood clot. If you experience intense pain three to four days after your tooth was extracted, see your dentist who can flush the area and prescribe you painkillers. The condition can last 5-6 days.

Another aspect to think about is if you choose to extract the tooth you will need to replace it with either a bridge, implant or partial denture so you may want to try to save the tooth with root canal if you can.

First step, as always, is to visit your dentist!