How Does My Dentist Decide between a Root Canal and Tooth Extraction?

Tooth extraction or root canal

Tooth restoration options vary from person to person.

When your tooth becomes infected, your options for treatment become limited. In most cases, the choices are either a root canal or a tooth extraction. Sometimes, you’ll be able to decide between the two, but there are other instances when your dentist will strongly recommend one over the other.

But what exactly determines the best option for treating your tooth infection? There are various factors involved, and some of them supersede personal preference. 

Whether it’s the level of decay, the severity of the infection, or the strength of the remaining tooth, your dentist will need to carefully assess the situation to determine how best to restore your smile.

The Stages of Tooth Decay

Tooth decay is the precursor to tooth infection. In order for your dentist to know whether your tooth is salvageable through root canal therapy or if it will need to be extracted, they first need to assess which of the following stages of decay the tooth is in:

1. Demineralization

In its earliest stages, tooth decay is only detectable by white spotting that appears where the enamel has begun to wear away. This stage is easily treated, even without fillings.

2. Enamel Decay

If demineralization goes untreated, the white spots will begin to turn brown. This is a sign that the tooth enamel is decaying and cavities are forming.

3. Dentin Decay

Beneath that protective layer of enamel lies a part of your tooth known as dentin. Once the decay has reached this part of the tooth, you’ll begin to feel an increase in sensitivity to hot and cold. This level of decay can often be fixed with a filling, but if it’s significant enough, it may require a crown.

4. Damaged Dental Pulp

The dental pulp is a collection of tissue, blood vessels, and nerve endings in the innermost part of your tooth. Once decay has reached that deep, only a root canal can fix the issue and maintain the natural tooth.

5. Dental Abscesses

With your inner tooth now exposed, bacteria can make their way in and cause an infection. That infection can lead to a dental abscess, which is not only severely painful but dangerous to your health. It’s this level of tooth decay that often warrants an extraction over a root canal.

Signs of an Abscess and Infection

Seeing your dentist regularly for preventive treatment is crucial in avoiding the unpleasant circumstance of deciding between a root canal and tooth extraction, but if it’s too late and you’re already experiencing significant decay, keep an eye out for the following symptoms:

  • Severe pain in your tooth, jaw, neck, or ear
  • Increased sensitivity to hot or cold
  • Painful chewing
  • Swelling in the affected area
  • Bitter taste in your mouth
  • Foul odor in your mouth
  • Pus around gums
  • Fever

If you’re experiencing one or more of these symptoms, speak with your dentist right away. Dental abscesses can quickly spread infection to your jaw, head, neck, and more.

The Root Canal Procedure

If your dentist tells you that your tooth can be saved with root canal therapy, then you can generally expect to undergo the following process.

First, your dentist will numb the area with a local anesthetic, then drill a small hole into the infected tooth.

Next, they’ll remove the infected dental pulp and clean out and disinfect the various tiny canals within the inner tooth.

Then, they’ll fill the now empty inner tooth with a biocompatible material called “gutta-percha.”

Finally, your dentist may provide a crown to give the tooth extra support and help defend it from further infection.  

What if I need to have my tooth extracted?

If your dentist determines that extraction is your best option, don’t panic; you’re in good company. It’s estimated that around 178 million Americans are missing at least one tooth. Not only that, but there are some great options for addressing tooth loss, including:

Dental Bridges

A dental bridge is a row of one or more false teeth with a zirconia crown on either end. The crowns are fixed to the natural teeth on either side of the gap left by tooth extraction to give the false teeth plenty of support.

Dental Implants

Dental implants can replace your missing tooth with a natural-looking prosthetic that’s fixed to a biocompatible titanium post that has been fused to your jawbone for an unmatched level of stability and support.


Dentures are a cost-effective way to replace multiple missing teeth at once. They’re a prosthetic device that can either be removable or fixed into your mouth permanently with the help of dental implants.

Save your smile with the help of Valley Dental Clinic.

Tooth decay and infections can not only be a metaphorical pain, but they can cause literal pain as well. If you need a root canal or tooth extraction to restore your smile’s health, Valley Dental Clinic can help. Visit us online to schedule your appointment today.