When a tooth can be saved, a root canal is usually the better long-term choice: you keep your natural tooth, and you avoid the cost and time of replacing it with an implant or bridge. Extraction makes more sense when a tooth is too broken, cracked below the gumline, or lacks enough bone support to be restored. A dentist decides with an exam and x-rays.
Root canal: saving the tooth
A root canal removes infected or inflamed tissue from inside the tooth, disinfects it, and seals it. Most back teeth then get a crown for strength.
- Pros: keeps your natural tooth and bite; usually one or two visits; no gap to replace.
- Cons: a crown is often needed afterward; not possible if the tooth is too damaged.
Extraction: removing the tooth
- Pros: fast; removes the source of infection; lower cost up front.
- Cons: leaves a gap; replacing the tooth with an implant or bridge adds cost and time; bone in the area can shrink over time.
How the decision is made
Dr. Tran looks at how much healthy tooth structure is left, whether there is a crack below the gumline, the health of the surrounding bone and gums, and your goals and budget. He’ll show you the x-rays and walk through both options before you decide. That’s the “Advise, Educate, Inform” approach AEI Dental is named for.
Common questions
Is extraction cheaper than a root canal?
Pulling a tooth usually costs less up front. But replacing the missing tooth with an implant or bridge, which is often recommended to keep neighboring teeth from shifting, typically costs more than saving the tooth.
Is it OK to leave a gap after an extraction?
For some back teeth it may be acceptable, but gaps can let neighboring teeth tilt and the opposing tooth drift, which can affect your bite over time. Ask your dentist whether replacement is recommended for your situation.
Last updated November 13, 2026 · AEI Dental, Katy, TX