Root Canal vs. Tooth Extraction: Which is the Better Option?

What Is a Root Canal?

A root canal is a dental procedure designed to save a natural tooth that has been compromised due to infection, decay, or trauma. It involves removing the damaged pulp, cleaning and disinfecting the root canals, and then sealing the space. A crown is typically placed over the tooth afterwards to restore strength and function.

Learn more: Saving Your Teeth Through Root Canal

What Is a Tooth Extraction?

Tooth extraction is the complete removal of a tooth from its socket. It may be recommended when the tooth is too damaged to be restored or if keeping it poses a risk to your overall oral health. After extraction, the gap can be left as-is or replaced with a dental prosthetic like an implant or dental bridge.

Considering extraction for wisdom teeth? What Happens If You Don’t Remove an Impacted Wisdom Tooth

Comparing the Two Treatments

When Root Canal May Be Better

Choosing a root canal is often the better option when the natural tooth structure is still intact enough to be restored. Here are scenarios where root canal therapy is usually recommended:

• The tooth structure is still salvageable: If the crown of the tooth is mostly intact and the roots are healthy, root canal therapy can preserve the tooth.
• You want to keep your natural bite and appearance: Natural teeth maintain proper alignment of your bite and jaw, which artificial replacements may not fully replicate.
• You’re looking to avoid additional procedures like implants or bridges: A root canal eliminates the need for extraction and the costs, time, and healing associated with prosthetic replacements.
• The infection has not spread extensively beyond the tooth root: Localised infections are typically manageable with root canal treatment and antibiotics, without needing extraction.
• You have strong supporting bone and gum tissue: A root canal works best when the tooth’s surrounding structures are healthy enough to support long-term retention.
• You want faster functional recovery: Compared to extraction plus implant placement (which can take months), root canals typically require less downtime and fewer appointments.

Why preservation matters: Saving your natural tooth helps retain the strength and stability of your jawbone. Once a tooth is lost, the bone around it can begin to deteriorate — a condition known as bone resorption — which may lead to changes in your facial profile over time.

When Extraction May Be the Better Choice

While preserving a natural tooth is ideal, there are situations where extraction is the safer or more practical solution:

• The tooth is too damaged or decayed to repair: If the tooth is fractured below the gum line, severely broken, or the decay has destroyed most of the structure, saving it may no longer be viable.
• Advanced gum disease is weakening the supporting bone: Periodontal disease can cause significant bone loss, making the tooth unstable even if the crown is intact.
• You’re experiencing repeated infections despite previous treatment: Teeth that have failed previous root canals or continue to become reinfected may require removal to prevent further complications.
• You’re preparing for orthodontic treatment and need space: In cases of overcrowding or impacted teeth, extractions may be necessary to make room for proper alignment.
• The tooth is causing damage to surrounding structures: Impacted teeth or those growing at odd angles (such as wisdom teeth) can push against adjacent teeth, leading to pain, crowding, or damage.

Important Consideration: While tooth extraction might seem simpler or less costly upfront, it often leads to longer-term dental work — such as dental implants, bridges, or dentures — to restore chewing function and aesthetics, and to prevent the shifting of surrounding teeth.

Missing teeth can also contribute to bone resorption in the jaw and changes in your bite or facial structure. That’s why it’s crucial to have a replacement plan in place after an extraction, especially for teeth that play a key role in chewing or maintaining dental alignment.

What Happens After Each Procedure?

• After a root canal, you’ll likely need a dental crown to protect and strengthen the treated tooth.
• After an extraction, your dentist may suggest options like a dental implant or bridge to maintain chewing ability and prevent bone loss.

Want to learn more about how dental implants work? Visit our Dental Implants Service Page

Final Thoughts: Which Is Right for You?

There’s no one-size-fits-all answer. Root canals are ideal when your tooth can still be saved, while extractions are necessary for teeth that are too far gone. At PKWY Dental, our experienced Singapore orthodontist can help you make the most informed decision for your oral health, comfort, and long-term wellbeing.

A detailed consultation with your dentist — including X-rays and a clinical exam — is the best way to determine which treatment suits your situation best.

Ready to take the next step? Contact us today to schedule your consultation.