It's one of the most common dilemmas in dentistry: your tooth is badly decayed or infected. Should you get a root canal treatment (RCT) to save it, or just get it extracted? Here's an honest comparison.
What Is a Root Canal?
RCT removes the infected nerve (pulp) from inside the tooth, cleans and seals the canals, then caps the tooth with a crown. The tooth stays in your mouth — dead but functional.
When Is RCT the Better Choice?
- The tooth structure is mostly intact — enough tooth remains to support a crown
- The tooth is in a visible area — front teeth affect your appearance
- You want to avoid replacement: Keeping your natural tooth means no bridge or implant needed
- The tooth is strategically important: Molars that bear chewing load, or teeth that anchor a bridge
When Is Extraction Better?
- The tooth is severely broken — not enough structure to support a crown
- Advanced gum disease: The bone around the tooth is too far gone
- Cracked root: A vertical root fracture makes RCT pointless
- Wisdom teeth: Impacted or problematic wisdom teeth are usually extracted, not treated
- Cost is a major constraint: RCT + crown costs ₹8,000 – ₹20,000 vs extraction at ₹500 – ₹5,000 (but you'll eventually need a replacement)
The Hidden Cost of Extraction
Extraction seems cheaper, but consider what comes after:
- Gap problems: Adjacent teeth shift, opposing teeth over-erupt, your bite changes
- Bone loss: The jawbone shrinks where the tooth was — this happens within months
- Replacement cost: An implant (₹25,000 – ₹65,000) or bridge (₹9,000 – ₹36,000) will be needed eventually
In most cases, saving the tooth with RCT costs less in the long run than extracting and replacing it.
The Honest Answer
A good dentist will always try to save your tooth first. Extraction should be the last resort, not the default. If a dentist immediately suggests pulling a tooth without discussing RCT, consider getting a second opinion.
At our clinic, we follow a conservative-first approach: we recommend extraction only when saving the tooth is genuinely not feasible or would compromise your overall dental health.
