Myths about root canal treatment: Pulling a tooth is a better option than having root canal.

Some people may be tempted to have a tooth extracted rather than salvaged by way of having root canal treatment. This seemingly simple and inexpensive choice, however, may prove to be a very poor choice in the long run.

If a tooth is removed, its neighboring teeth will tend to shift towards the vacant space, sometimes significantly. A change such as this can lead to problems with chewing, aesthetic concerns or jaw joint function. Alignment changes can also create food traps or make it so your teeth are more difficult to clean. If so, you will be placed at greater risk for developing problems with tooth decay and gum disease.

Root canal treatment offers a predictable solution.

When you dentist deems it appropriate, having root canal treatment performed for your tooth can be an excellent choice. Alley (2004) found a success rate for root canal treatment to be in excess of 90%. When the treatment was performed by a root canal specialist (an endodontist), this rate rose to 98%. By choosing to save the tooth you have opportunity to go with your status quo, as opposed to creating a change that, as describe above, can lead to subsequent difficulties.

A root canalled tooth's permanent restoration plays an important role.

It is important to understand that your root canal therapy is only a part of the total treatment that will be required for your tooth. The permanent restoration that is place on (or in) a tooth (such as a dental crown or filling) after its endodontic treatment has been completed plays an equally important role in providing for a successful long-term fix. When considering endodontic therapy as an option, you must figure in the cost and amount of appointment time needed for both of these procedures together, not just the root canal treatment by itself.

Extracting a tooth and having it replaced can be a suitable choice.

Electing to have an extraction instead of root canal treatment can be an appropriate choice if you plan to have the missing tooth replaced. If this is the approach that you choose, here are so of the different ways a missing tooth can be replaced.

» Removable partial dentures.

Of all of the options available, replacing a tooth with a removable partial denture is probably the least favorable one. Compared to the tooth that it replaces, a partial will be cumbersome and might be considered to be a "mouth full." Its removable nature may be found to be a nuisance and over the long term it can create a wedging or "loosening" effect on the wearer's teeth. The cost of a partial might be less than that of having root canal treatment. But other than that, most people would probably prefer to have their original tooth instead of wearing a removable partial denture.

» Dental bridges.

Placing a dental bridge is another way by which a dentist can replace a missing tooth. When a bridge is made, the teeth on either side of the missing tooth space are trimmed (just like for a dental crown). This means that replacing one tooth involves making irreversible changes with two other, previously uninvolved, teeth. It's unlikely that the cost of a dental bridge will be less than restoring a tooth with root canal treatment. And although a dental bridge is cemented in place and therefore feels solid like a natural tooth, the patient will find this artificial tooth more difficult to clean (especially floss).

» Dental implants.

A dental implant can provide an end result that is fairly similar to having one's original tooth, but this treatment approach is not as cost-effective as salvaging a tooth with root canal treatment. Our topic "Placing a dental implant or having root canal treatment: Which is the best choice?" discusses the advantages and disadvantages of this option in detail.