Root Canal vs. Tooth Extraction: Which Is Right for You?

When a patient sits in my chair with a badly damaged or infected tooth, one of the first questions they ask is: "Should I just pull it?" It's a fair question. Both root canal therapy and extraction are viable treatments — but they lead to very different long-term outcomes. Here's how I help patients decide.

The Case for Saving Your Tooth (Root Canal)

Your natural teeth are, frankly, the best teeth you'll ever have. No implant, bridge, or denture can perfectly replicate the feel, function, and strength of a healthy natural tooth. A root canal removes the infected nerve tissue inside the tooth while preserving the outer structure. Once restored with a crown, the tooth can last a lifetime.

Here are the advantages of choosing a root canal:

• Preserves your natural bite — neighbouring teeth don't shift or drift into the gap
• No need for replacement — you avoid the cost and complexity of implants or bridges
• Looks and feels natural — with a well-made crown, no one (including you) will know the difference
• Faster overall treatment — one to two visits versus the months-long implant process

When Extraction Makes Sense

There are situations where a tooth truly cannot be saved. If the tooth is cracked vertically below the gum line, if it has lost the majority of its structure, or if severe gum disease has destroyed the supporting bone, extraction may be the more practical option. We never recommend pulling a tooth if it can be predictably saved — but sometimes it's the honest answer.

After an extraction, you'll need to think about replacing the missing tooth. Options include dental implants (the gold standard), bridges, or partial dentures. Each comes with its own timeline, cost, and maintenance requirements.

The Cost Question

Many patients assume extraction is cheaper. And in the short term, it is — pulling a tooth costs less than a root canal plus crown. But when you factor in the cost of replacing that tooth later (an implant in Canada can run $3,000–$5,000+), a root canal is almost always the more economical choice over a lifetime.

My Recommendation

At Dr. Muller Dentistry, we always try to save the tooth first. I'll give you an honest assessment based on x-rays and a thorough exam. If a root canal can predictably save the tooth for another 15, 20, or 30+ years, that's what I'll recommend. If the tooth is beyond help, I'll tell you that too — and we'll discuss the best replacement options together.

If you're dealing with a damaged tooth and not sure which route to take, come see us at our St. John's office. We'll take the time to explain your options clearly so you can make the decision that's right for you.