When you’re suffering from severe tooth pain or an infection, your dentist may recommend either a root canal or a tooth extraction. While both treatments can relieve pain and address the underlying problem, they have very different long-term implications.
If you’ve undergone treatment and are now wondering whether the right decision was made, you’re not alone. In some cases, a tooth may be extracted when it could have been treated. In others, a root canal may be attempted when extraction would have been the more appropriate option.
In this guide, our specialist dental negligence solicitors explain:
- The differences between root canal vs extraction
- When each treatment is normally recommended
- Red flags that indicate your dentist made a clinical error
- When the wrong treatment could amount to dental negligence
Root canal vs extraction: What’s the difference?
Both procedures are designed to treat damaged or infected teeth, but they achieve this in different ways.
A root canal aims to save your natural tooth. During the procedure, the dentist removes infected or damaged pulp from inside the tooth, thoroughly cleans and disinfects the root canals, then seals the tooth to prevent further infection. In many cases, the tooth is then protected with a crown.
A tooth extraction removes the tooth completely. Once the tooth has been removed, the gap may be left to heal naturally or replaced later with a bridge, denture, or dental implant.
As a general rule, dentists will usually try to preserve a natural tooth wherever possible. Tooth extraction is usually a last resort when the tooth cannot be saved. The decision between root canal treatment and extraction will depend on many factors including the condition of the tooth, the remaining tooth structure and its restorability, periodontal health and the tooth’s likely prognosis.
When is a root canal usually the right choice?
A root canal may be recommended when the inside of the tooth has become infected or inflamed, but the tooth itself is considered restorable and can still be saved.
Common reasons for needing a root canal include:
- Deep tooth decay reaching the dental pulp
- Infection caused by untreated cavities
- Trauma or injury to the tooth
- A cracked or fractured tooth affecting the nerve
A successful root canal can allow you to keep your natural tooth while treating the infection within the tooth and relieving pain.
However, root canal treatment isn’t suitable for every tooth. If the damage is too extensive, there isn’t enough healthy tooth structure remaining, or the long-term prognosis is poor, extraction may be recommended as the better option.
When is tooth extraction the better option?
In some cases, removing the tooth might be the most appropriate course of action.
Your dentist may recommend an extraction if:
- The tooth is severely broken beyond repair
- There is extensive decay that cannot be restored
- Advanced gum disease has left the tooth loose
- The tooth has split below the gum line
Following an extraction, your dentist should discuss whether replacing the missing tooth is advisable and explain the available options.
Do dentists ever choose the wrong treatment?
Although dentists use clinical judgement when deciding between root canal vs extraction, mistakes can happen.
Examples include:
- Extracting a tooth that could have been successfully treated with a root canal
- Attempting a root canal on a tooth that should have been removed
- Failing to properly diagnose the cause of the problem before recommending treatment
- Not taking appropriate X-rays before making a treatment decision
- Failing to explain the available treatment options and their risks and benefits
Every case is different, and there is rarely only one acceptable treatment approach. However, your dentist should assess your condition carefully and recommend treatment that meets an acceptable professional standard.
Red flags to be aware of
There are a few potential signs that could warrant further investigation into whether treatment decisions were appropriate for your circumstances:
- No diagnostic X-rays were taken prior to extracting your tooth
- You were not informed about alternative treatment options prior to extraction, such as a root canal (lack of informed consent)
- A root canal instrument fractured in the canal and your dentist failed to inform you of the complications
- You suffered severe, ongoing nerve damage following an extraction that was not clinically necessary or the risks were not appropriately explained
- Your dentist proceeded with a root canal despite the tooth being considered unrestorable
Could the wrong treatment amount to dental negligence?
Not every poor outcome is caused by dental negligence. Both root canals and tooth extractions carry recognised risks, and complications can occur even when treatment has been carried out appropriately.
However, the wrong treatment decision may amount to dental negligence if your dentist failed to provide care that met an acceptable professional standard.
Examples could include:
- Failing to properly diagnose the condition of the tooth
- Missing signs that the tooth could have been saved
- Extracting a tooth that did not need to be extracted
- Performing a root canal despite obvious signs the tooth was unrestorable
- Failing to obtain informed consent by not discussing reasonable treatment alternatives
To bring a successful dental negligence claim, it generally needs to be shown that:
- Your dentist owed you a duty of care
- That duty was breached because the treatment fell below an acceptable standard
- The breach directly caused you avoidable injury or financial loss
An independent dental expert would usually review your records to determine whether the treatment decision was appropriate.
What should I do if I think I received the wrong treatment?
If you’re concerned that the wrong decision was made, it’s important to seek a second opinion from another dentist as soon as possible.
They may recommend further X-rays or examinations to assess the condition of the treated area and identify whether any corrective treatment is needed.
If you believe your treatment fell below an acceptable standard, you should also keep copies of:
- Dental records
- X-rays or scans
- Photographs
- Receipts for additional treatment
- Details of how the treatment has affected your daily life
These documents can be valuable if you later decide to investigate whether you have a dental negligence claim.
If you believe you received the wrong treatment and this has caused you avoidable harm, get in touch with the Dental Law Partnership for a free, no-obligation assessment. Our specialist dental negligence solicitors can help determine whether you may have a valid claim.