Root canal or extraction: what happens if I just pull the tooth?
Comparing the two paths
| Root canal treatment + crown | Extraction | |
|---|---|---|
| Keeps your own tooth | Yes | No |
| Visits | Usually 3–4 (root canal, then crown) | 1, plus replacement visits if you replace the tooth |
| Cost on the day | Higher | Lower |
| Cost over time | Root canal + crown | Extraction + replacement (implant, bridge or denture), if replaced |
| Surgery | No | Yes, minor; more if an implant follows |
What happens if a tooth is removed and not replaced
- The teeth on either side can tip into the gap, opening spaces that trap food.
- The opposing tooth can drift towards the gap, changing your bite.
- The bone where the tooth was shrinks over time, which can make an implant harder later.
- Chewing shifts to the other side.
A gap is not always a problem. Losing a wisdom tooth, or sometimes a second molar at the very back, may not need replacing. Your dentist can tell you whether a particular gap is likely to matter.
When keeping the tooth makes the most sense
- The tooth has enough sound structure to hold a crown, and the gum and bone around it are healthy.
- You take bisphosphonate or other anti-resorptive medicines, have had radiotherapy to the head and neck, are immunocompromised, or have poorly controlled diabetes. These raise the risks of extraction and implant surgery.
- It is a front tooth, where a gap is visible.
When extraction is the better choice
- A crack runs down into the root.
- Too little tooth is left to restore, even with a crown.
- Severe gum disease has destroyed most of the supporting bone.
- The tooth is not needed for chewing or appearance, such as a wisdom tooth.
Replacement options if the tooth is removed
An implant, a bridge or a removable denture. See implant, bridge or denture?
Costs at Toothsmith
Root canal treatment: $500 front tooth, $650 premolar, $1,000 molar; the core build-up and crown are quoted separately. A single-tooth implant including the crown is $3,200, of which the $1,950 surgical visit is MediSave-claimable. Root canal treatment, crowns and extractions are CHAS-claimable for eligible cardholders (CHAS). See also root canal treatment and dental implants.
Frequently asked questions
Is it better to save a tooth or get an implant?
When a tooth can be predictably restored, keeping it is usually preferred. Implants are a good replacement when a tooth cannot be saved, but they involve surgery and their own maintenance.
Is extraction cheaper than a root canal?
On the day, yes. Over time, if you replace the tooth with an implant or bridge, extraction plus replacement usually costs more than root canal treatment and a crown.
How long does a root-canal-treated tooth last?
A well-restored root-canal-treated tooth can last many years. A crown on back teeth, good cleaning and regular checks make the biggest difference.
Can I decide later?
A tooth with an inflamed or infected nerve needs treatment of some kind. Waiting risks the infection spreading or the tooth breaking down further, which can rule out keeping it.
Questions about your teeth?
Book a check-up. You will hear what we find, the options and the fee before anything is done.