What are the alternatives to having root canal treatment?

- This page outlines the options you have and compares their advantages, disadvantages and costs.

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Link to Implant as an Alternative animation.
Link to Dental Bridge as an Alternative animation.

There is no other type of dental procedure that's directly comparable to having root canal therapy. No other treatment can be used to salvage a tooth that has the kinds of problems that it remedies.

Because of this, not opting for root canal means that your tooth will need to be extracted.

That doesn't, however, mean that you have to remain toothless. As outlined below, a replacement can always be made via the use of a dental implant, dental bridge or removable partial denture.


What are your options if you decide not to have root canal treatment?

Option #1 - Delay your procedure.

This option, of course, isn't really an "alternative." But it may offer a way for your tooth to be saved.

We've listed this option first because we want to make it clear that, in most cases (per your dentist's recommendation), salvaging your tooth usually makes the wisest choice.

A tooth abscess.

A tooth abscess.

When might this approach be used?

This is the type of plan you might go with if your procedure's cost, or finding the time to schedule it, is the obstacle.

!! But, as we discuss here, this is not an option that should ever be chosen on your own. It should only be opted for after consulting with your dentist because otherwise you place yourself at risk. Infected teeth are thoroughly unpredictable and can flare up at any time.


Option #2 - Have your tooth extracted.

While simply having your tooth pulled may seem to be the cheapest and easiest fix, this option may turn out to be the worst, and possibly most expensive, choice over the long haul.

That's because having even just a single tooth removed can start a chain of events that results in significant changes with your mouth.


Option #3 - Tooth extraction and replacement.

Choosing tooth extraction over root canal treatment can make an appropriate choice if you plan to have the lost tooth replaced.

As outlined below, there are a number of ways to do this. They include placing a dental implant, dental bridge or removable partial denture.

Make sure you know what you're getting.

While an extraction-and-replacement approach can make a good plan, be sure to ask your dentist a lot of questions about what your replacement tooth will be like.

Saving your tooth via root canal treatment is a way of preserving the status quo. In comparison, any type of replacement tooth will, at least in some way, be different than what you have now. Make sure you know what you're getting before you make a decision.

A comparison of endodontic therapy and a dental implant.

Having treatment vs. a dental implant.

#3a - Extraction + Dental implant placement.

Just a few decades ago this option didn't even exist. Nowadays it's so often the choice being considered that we've dedicated a page specifically to this topic: Dental implant or root canal, which makes the best choice? (success rates)

... as compared to root canal treatment.

  • A root canal approach can likely be completed within a shorter overall time frame than this one (which typically requires some months of healing).

    Start to finish, root canal therapy and the creation and placement of whatever type of final restoration is needed should be able to be completed within 30 days or so.

  • Some people may notice subtle differences between their implant and the natural tooth they could have saved. This can include things like the way it's explored by their tongue, the way it accumulates debris or is cleaned. For most people, however, these issues should be minor.

... as compared to other replacement techniques.

  • A dental implant is the most natural-like type of replacement tooth. The implant itself serves as the new tooth root. A dental crown is then placed on the implant for proper function and appearance.
  • As compared to other tooth-replacement techniques, placing an implant does not involve making changes with neighboring teeth (see below for a comparison).

... cost comparison.

  • Using our dental procedure costs index, we estimate that an implant approach (extraction + implant placement + implant abutment + dental crown) would cost roughly 50% more than a root canal one (molar root canal + dental post and core + dental crown - This is the most expensive scenario possible).
  • In regard to the above calculation, the implant cost would be the same for replacing any tooth. In comparison, molars have the highest root canal fee. Additionally, not all teeth will require a post and core, or possibly even a dental crown.
  • For a scholarly evaluation of this topic, use this link: Which is the more cost-effective, root canal or an implant?
  • If a dental plan or insurance is involved, check to see what procedures are covered. For example, some policies may not cover dental implants.

A comparison of endodontic therapy and a dental bridge.

Having treatment vs. a dental bridge.

#3b - Extraction + Dental bridge placement.

A dental bridge is another way to replace a missing tooth. Until implants came into vogue, it was usually considered the preferred method. A dental bridge spans the space of a missing tooth.

... as compared to root canal treatment.

  • A dental bridge is more tedious to maintain than a natural tooth. Dental floss must be used to clean its underside.
  • A root canal approach can be expected to be completed within a slightly shorter overall time frame than this one. (1 month vs. 1 1/2 to 2)

    That's because a dentist will usually want to wait at least 30 days after an extraction for bone healing to take place before creating the permanent bridge for that space.

... as compared to other replacement techniques.

  • When a bridge is made, the teeth on either side of the missing tooth's space are trimmed (just like for a dental crown). In some cases, this may mean that otherwise perfectly healthy teeth may need to be altered. (Dental implants don't pose this problem.)
  • Like a dental implant, a bridge is fixed firmly in place and is not removable. (Compare to removable partial denture below.)

... cost comparison.

  • Using our fees index, we estimate that a dental bridge approach (extraction + 3-unit bridge) would cost roughly 25% more than a root canal one (molar root canal + dental post and core + dental crown - This is the most expensive scenario possible).
  • In regard to the above calculation, the bridge costs would be the same for replacing any tooth. In comparison, molars have the highest root canal fee. Additionally, not all teeth will require a post and core, or possibly even a dental crown.
  • If a dental plan is involved, an evaluation of its benefits and possible restrictions needs to be evaluated before a decision is made.

#3c - Extraction + Removable partial denture.

A removable partial denture is an appliance that has one or more artificial teeth attached to it. When it's slipped into place, they fill in the spaces of missing teeth.

... as compared to root canal treatment.

  • It should be easy to imagine how wearing a removable appliance is different than having your own natural tooth (which is what you have if you opt for root canal). People certainly do, however, adapt to wearing partials.
  • A root canal treatment approach can be expected to be completed within a slightly shorter overall time frame than this one. (1 month vs. 1 1/2 to 2).

    That's because a dentist will usually want to wait at least 30 days after an extraction (so to allow for jawbone healing) before creating a removable partial for that tooth's space.

... as compared to other replacement techniques.

  • A dental bridge or tooth implant is firmly fixed in place, a removable partial denture is not. This is a big difference.
  • Over the long term, a partial may create a wedging and loosening effect on the wearer's teeth. This is not an issue with a bridge or implant.
  • Removable partial dentures typically arch around and grasp onto teeth on both sides of a person's mouth (left/right). They're designed this way because it improves their retention and stability. That means, as compared to a bridge or an implant, wearing one can seem like a mouthful.
  • For all of these reasons, most people would probably prefer having a bridge or implant than a removable partial denture.

... cost comparison.

  • Using our dental costs index, we estimate that a removable partial denture approach (extraction + cast partial denture) would cost roughly 30% less than a root canal one (molar root canal + dental post and core + dental crown - This is the most expensive scenario possible).
  • In regard to the above calculation, the partial denture costs would be the same for replacing any tooth. In comparison, molars have the highest root canal fee. Additionally, not all teeth will require a post and core, or possibly even a dental crown.
  • If a dental plan is involved, an evaluation of its benefits and possible restrictions should be evaluated before any decision is made.


It may be possible to delay your treatment until a more favorable time.

In those cases where a tooth requires endodontic therapy, it's always best to go ahead and make plans to have it performed sooner rather than later.

In some cases, however, a patient's travel plans, other scheduling conflicts, the need for other dental work, or else financial considerations may make this impossible.

Your dentist may be able to temporize your tooth.

Treatment delays can sometimes be accommodated. Your dentist may be able to temporize your tooth by performing the initial steps of root canal treatment (the ones that can make it so your tooth feels better and its behavior is more predictable).

  • This temporization stage needs to be considered just that, a temporary alternative. Your dentist will need to outline for you what time frame they consider appropriate before your treatment must be resumed.
  • Your dentist must also discuss those precautions you need to take, and explain the signs and symptoms that may indicate that changes are occurring within your tooth and attention is required.
  • Temporization is never a first choice but rather a make-do one.

Only delay treatment after discussing matters with your dentist.

You should never make a decision to delay root canal treatment on your own. You must discuss this matter with your dentist. That's because:

  • Any tooth that is in need of root canal treatment, but has not yet received it, is not predictable.
  • A tooth could remain asymptomatic for an indefinite period or, at the other extreme, flare up (cause pain, produce swelling) at any time.

Even in those cases where a tooth remains quiet, the infection associated with it could cause damage to surrounding bone tissue. Also, teeth that have more established infections can be less responsive to treatment (have a lower success rate).

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