Comparing Root Canals and Tooth Extractions: Making the Right Choice

Comparing Root Canals and Tooth Extractions: Making the Right Choice

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A root canal removes infected tooth pulp — the tooth’s inner layer of nerves, blood vessels, and connective tissues — to prevent infection and save the tooth. An extraction involves removing a target tooth from its socket and the jawbone, and is usually used when a tooth is decayed beyond repair or damaged. Both are common, basic procedures at dentist offices. Let’s dive deeper into some factors you can consider when comparing root canals vs. tooth extractions to help you decide which option is better for you.

1. Age and health

Your age and health — both overall and dental — can dramatically impact whether a root canal or extraction is best. If you’re younger and in good health, you may consider getting a root canal, as it is less likely to cause complications. 

Older patients or those with health conditions may opt for extraction instead. Extractions are simpler at first, but you must somehow replace the tooth to avoid bone loss and shifting teeth alignment. Still, this could be a better option than a root canal if it reduces the chance of health complications.

2. Comfort or anxiety with dental procedures

Cutting-edge technology, advanced dental techniques, and a wide range of anesthesia and sedation options have eliminated almost all pain and discomfort from root canals and extractions. Local anesthesia alone numbs the whole area, often reducing the sensation to mere noise and pulling or pushing feelings. That said, tooth extractions tend to cause slightly more discomfort than root canals because the dentist removes the entire tooth. 

Post-op pain and discomfort are also manageable in both cases. Over-the-counter pain meds, careful oral hygiene habits, and following the dentist’s instructions help minimize pain. Still, the post-op pain of a tooth extraction may be slightly worse than that of a root canal.

3. Procedure length and complexity

Although modern dentistry makes procedures virtually painless, many still wonder, “how long does a root canal take?”, along with the time length for an extraction, since being in the dentist’s chair can cause anxiety. Most standard root canals can take 30 minutes to an hour. Severe cases can take 1.5 hours or more. The procedure involves several steps:

  • Applying anesthesia
  • Opening the tooth
  • Removing infected or inflamed pulp
  • Cleaning and disinfecting the tooth interior
  • Filling and sealing the tooth
  • Restoring the tooth

Tooth extractions may be simpler and take less time since cutting open and then sealing a tooth is unnecessary. A standard tooth extraction with no complications can take 20 to 40 minutes. All it involves is applying anesthesia, loosening and extracting the tooth, then cleaning and sealing the wound.

4. Recovery time and post-operative care

Root canal recovery is often shorter than tooth extraction recovery since the tooth remains. You may experience a few days of discomfort that fades with time since only the tooth’s interior needs to heal. Furthermore, since the tooth remains, you can return to regular activities, including eating and speaking, almost immediately after a root canal.


Extractions can take one to two weeks to recover from. This is because the removed tooth’s socket is a larger area than the tooth’s interior and must heal completely before recovery is finished. Extractions also disrupt daily life more. Vigorous exercise, smoking, and eating certain foods could cause complications during recovery. A missing tooth can also make it harder to eat and speak in the long term.

5. Cost

Root canals are generally more expensive than extractions due to their increased complexity. Extractions will cost less since they often require little more than loosening and removing the target tooth. However, extracted teeth must be replaced to avoid shifting alignment and jawbone loss. This can ultimately cost more than a root canal in the long run, whether you get dentures, crowns, or dental implants. That said, factors like location, the dentist’s expertise, and your insurance coverage can impact each procedure’s cost.

The bottom line

Root canals are a little more complex and can cost more upfront. However, they save money in the long run and cause less disruption. Meanwhile, extractions may require more post-op care and necessitate a subsequent tooth replacement procedure. However, they might be the best option for older patients or those with health conditions.

The good news is that modern dental innovations have made both procedures painless, and sedation can help reduce anxiety. Ultimately, your dentist can help you decide what’s best in your case. Speak to your dental professional about each option’s pros and cons for your situation.