Give your tooth a second chance!
Deciding between root canal therapy (RCT) or tooth extraction is something we help our patients navigate through on a daily basis. In this website, we’ll look at the indications and contraindications for keeping or pulling a tooth.
What dental problems lead to root canal or tooth extraction?
When you get a toothache – especially a constant throbbing one that doesn’t settle easily, it’s can be a sign that the nerve in your tooth is irritated, inflamed, dying or infected. The tooth nerve or ‘pulp’ sits in the middle of the tooth, surrounded by hard enamel and dentine. This nerve can be affected by trauma or exposure to the mouth which can happen from dental decay, dental trauma, periodontal disease, dental wear and many more.
The pulp can become severely inflamed or start dying. Either of these two scenarios mean the nerve will not heal. Instead, it needs to be completely removed to resolve the toothache properly. Placing a filling on the top of the tooth to seal it up simply won’t work.
So you can either keep the tooth after completing RCT or take the whole tooth out. Let’s look at each of the options:
Why choose root canal therapy?
RCT means cleaning out the nerve in the centre of the tooth, filling up the canal spaces, and restoring the tooth properly for appearance and long-term daily use. Technically the tooth is dead, in the same way your hair, fingernails and toenails are not alive either. A well restored, root-filled tooth can last indefinitely in your mouth, well over 10 years, which tends to be the length of the longest review studies.
Keeping the original tooth is usually considered the best option by dentists whenever possible, because any substitute will be a compromise and have a limited life expectancy of around 10-20 years at most. This is a routine procedure for all dentists to perform, although sometimes in complex cases, a referral to an endodontist – a dental specialist in RCT may be recommended.
Some things to be mindful of with RCT:
- If there’s not enough sound tooth structure left to adequately seal the canals and support a restoration, RCT cannot be done and tooth extraction (EXO) is indicated instead.
- RCT is an intensive, technique-sensitive procedure that can take multiple visits to complete, the cost of the treatment reflects this complexity.
- The best prognosis for a root-filled tooth is when the RCT is completed quickly, not drawn out over months and months, and a solid protective layer is placed over the tooth – often an onlay or crown is placed.
- The risks of RCT are generally small – occasional procedural complications may arise from the treatment, but these are uncommon.