When a tooth is badly damaged there are usually two roads: treat the inside and keep it, or take it out. Patients often assume the second is the cheap, simple option. Sometimes it is. Often it is the start of a longer and more expensive story.
Here is what is actually being weighed.
How much tooth is left
This is the first question and frequently the only one that matters. A root canal treats the inside of the tooth, but the outside still has to be strong enough to hold a crown afterwards. If decay has gone below the gum on several sides, there may not be enough left to build on, and treating the inside of a tooth that cannot be restored is money spent twice.
Which tooth it is
A front tooth is visible, has one root, and is comparatively straightforward. A back molar does most of the chewing, has several roots and more anatomy inside, and takes longer. Both are treatable. The time, and therefore the cost, differ.
What happens to the gap
This is the part that gets skipped. Take a molar out and the tooth above it slowly drops, the teeth either side lean in, and the bite changes over a few years. Replacing it later with an implant or a bridge costs more than the root canal and crown would have. So “just take it out” is often the more expensive answer with a delay built in.
There are cases where extraction genuinely is right. A tooth that is cracked down the root cannot be saved. A wisdom tooth causing trouble usually does not need replacing at all. A tooth that has already had a root canal that failed may be better out.
What a root canal is actually like
It has a reputation it has not deserved for about thirty years. The tooth is fully numb, the treatment relieves the pain rather than causing it, and most patients tell us afterwards that the anticipation was the worst part. What a root canal visit involves here is on the root canal page. Soreness for a couple of days afterwards is normal.
What to ask
If a tooth is in trouble, these four questions will get you a clear answer from any dentist:
- Is there enough tooth left to restore if we treat it?
- If we take it out, what would replacing it involve and cost?
- What happens if I do nothing for six months?
- What would you do if it were your tooth?
The last one is the useful one. Ask it.
If you are in pain now, do not sit on it waiting for a decision. Call us and we will see you.