Sometimes a patient asks, “Can you pull a tooth that needs a root canal?” While extraction is sometimes the only option for a tooth, the goal of a root canal is to save the natural tooth whenever possible. 

Please be aware this article is for educational purposes only. It would be best to see a skilled endodontist to learn whether a tooth needs to be extracted or can be saved. Your mouth is as unique as a snowflake. This is why personalized care is so essential! 

When weighing the options between saving the tooth and having it extracted, it helps to consider the pros and cons of each.

About Urgent Dental or Medical Emergencies

Please note that sometimes an infection may progress to the point where it becomes a medical emergency. If you have a fever or severe swelling, seek urgent or emergency care. After the swelling and acute infection are managed, you may need specialized dental care to treat the cause of the infection. This may include either a root canal or an extraction. 

Benefits of Keeping the Tooth

As endodontists, our goal is to save natural teeth when we can. This has a better chance of promoting wellness and good oral health. After all, your natural teeth fit together well, and changing even one tooth can affect that fit, altering how you bite down. We want to help relieve patients who are in pain and preserve the natural teeth and bite whenever possible! 

When a tooth gets extracted, you likely need an implant or to wear a dental appliance. If the space where the tooth was pulled is left empty, the adjacent teeth may shift, causing alignment issues. Also, after an extraction, you may lose some bone density in the jaw unless you opt for implants. Maintaining jaw bone density helps support the structure of your other teeth and keeps you looking younger and healthier. So while you could pull a tooth that needs a root canal, it is often not the best choice for long-term oral health and wellness. 

If you need a root canal, consider seeing an endodontist. According to the American Association of Endodontists, an endodontist typically performs 25 root canals weekly, while a general dentist typically performs around two per week. Given the complexity of the anatomy, an endodontist’s experience and practice matter. 

While many people may be nervous about root canals, a successful one is transformative. Some benefits include:

• Relief from pain and infection
• You keep the natural tooth, so you maintain your natural alignment and bite
• End the risk of the infection spreading to other teeth and other parts of the body
• Maintain existing bone in the jaw

Sometimes, people imagine a root canal will be more painful than getting the tooth pulled. That’s a common misconception and typically not the case at all! Both procedures are performed using local anesthetics, and both can result in inflammation, swelling, and tenderness while healing. Many of our patients are surprised that the root canal isn’t much more painful than a routine filling, and modern-day technology is significantly reducing post-operative pain. If pain is your concern, we encourage you to talk about it with your endodontist. 

A Note About Retreatment for Failed Root Canals

Sometimes, a prior root canal is unsuccessful for one reason or another. The pain and possibly infection persist or come back at a later point in time. In that case, retreatment may be an option. The root canal system is tiny and complex; this means that, for dentists who aren’t experienced in performing root canals, it can be easy to miss a detail in the anatomy. Sometimes bacteria still remains in the tooth, hiding in one of those tiny complex canals, or it finds an opening to get into the tooth, resulting in persistent symptoms and infection. 

Our team knows firsthand the pain and frustration of an unsuccessful root canal. Our founder experienced years of failed dental care, which is one reason we specialize in retreatment. Successful endodontic retreatment made all the difference in her life. Even if you had an unsuccessful root canal, it might be worthwhile to have it looked at by a skilled endodontist to see whether retreatment is an option for you. 

When is Extraction Necessary?

Often a root canal is the best treatment option for a tooth that is badly infected or deeply damaged. Other times, the damage might be too severe, and the best option is to have the tooth pulled instead of a root canal. In that case, extracting the tooth may be the only way to relieve the pain and treat the infection.

Some signs that you may need to have the tooth pulled include:

• Pain, swelling, or infection that persists, despite having a root canal or other treatment
• You have severe gum disease
• The damage to the tooth is so severe that a filling or crown can’t restore it
• There isn’t enough room for the tooth, and it overcrowds other teeth

As endodontists, we consider extraction to be a last resort because of all the benefits of keeping the natural tooth. We encourage you to have an endodontist examine the tooth to confirm whether extraction is your best option. While sometimes it is, other times people are surprised they still have other treatment options. 

If your dentist recommends extraction, it is ok to get a second opinion. 

Your Next Steps to Life Without the Pain

Whether a root canal or extraction is, your best option varies, depending on your circumstances and the damage to the tooth. The best way to resolve it is to see an experienced dentist or endodontist.

We recommend seeing an endodontist since they specialize in saving your natural teeth and performing restorative procedures like root canals. 

As a specialist with a focus on saving teeth, an endodontist is more likely to have the experience to determine your best treatment plan and all of your available options. They are also more likely to have specific diagnostic tools and techniques to assess the full extent of the damage to your tooth. An endodontist would conduct a thorough examination, usually involving imaging, pressure tests, and thermal tests. 

If you’re wondering, “Can you pull a tooth that needs a root canal?” Ballantyne Endodontics wants to give your teeth a chance. If you live in the Charlotte area, contact us today for a consultation or to learn how to request a referral from your general dentist. We combine compassion with today’s best practices to ensure the optimal possible outcome for our patients. Contact us today to schedule your appointment.