Root Canal Treatment or Extraction, Which is Better?

ROOT CANAL TREATMENT OR EXTRACTION, WHICH IS BETTER?

As practising professionals, our experience would most certainly vote for root canal treatment and keep extractions as the last resort, if everything fails. 

When do we need to extract teeth?

• Severe tooth decay or infection  
• Severe gum disease, which may affect the supporting tissues and bone structures of teeth.
• Treatment of symptomatic impacted wisdom teeth e.g. that are associated with pericoronitis, unrestorable caries or cysts. 
• Prophylactic removal of asymptomatic impacted wisdom teeth. 
• Supernumerary teeth that are blocking other teeth from coming in.
• Supplementary or malformed teeth.
• Fractured teeth.
• Cosmetic: to remove teeth of poor appearance, unsuitable for restoration.
• Teeth in the fracture line of the jaw bone
• Teeth which cannot be restored endodontically.
• Prosthetics; teeth detrimental to the fit or appearance of dentures. 
• Head and neck radiation therapy, to treat and/or manage tumors, may require extraction of teeth, either before or after radiation treatments.
• Lower cost, compared to other treatments. 

  

Orthodontic

• In preparation for orthodontic treatment (braces). Extractions are commonly required before the provision of orthodontic treatment, to create space for crowded teeth to be moved into. The premolar teeth are the most commonly extracted teeth for this purpose.

Aesthetics

• Cosmetic: to remove teeth of poor appearance, unsuitable for restoration

 

INDICATIONS FOR ROOT CANAL TREATMENT 

Signs of requirement for a root canal treatment 

• Severe pain while chewing or biting.
• Abscess on the gums.
• A chipped or cracked tooth.
• Lingering sensitivity to hot or cold, even after the sensation has been removed.
• Swollen or tender gums.
• Deep decay or darkening of the gums.
• Traumatised or/and fractured teeth, if they are desirable
• Intentional root canal treatment in teeth for aesthetics and smile design

HOW DOES RCT SAVE A TOOTH?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.

IS THE RCT PAINFUL?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

RCT ILLUSTRATED

CAN ALL TEETH BE SAVED ENDODONTICALLY?

Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

 

CONCLUSION

If  your dentist feels your tooth can be saved, root canal treatment is the first treatment of choice. If it’s hopelessly damaged or detrimental to oral health, better go for removal.

However, your dentist is the best judge to diagnose correctly and suggest the right course of action.