The question of whether it is cheaper to remove a tooth or save it with a root canal is a common dilemma for patients facing severe dental decay or injury. An extraction, the simple removal of a tooth, offers an immediate, low-cost solution to pain. Conversely, a root canal treatment (RCT) is a restorative procedure that cleans out the infected pulp chamber and preserves the tooth structure itself. The choice between these two paths determines the true financial outcome. The answer to which procedure is ultimately cheaper depends entirely on the necessity of replacing the lost tooth.
The Initial Price Tag
An extraction is nearly always the cheaper option when considering only the initial procedure cost. A simple extraction, performed on a tooth that is fully erupted and easily accessible, typically costs between $75 and $250. If the tooth is impacted, broken, or requires the removal of bone, a surgical extraction performed by a general dentist or oral surgeon can range from $180 to $650. A root canal treatment involves complex internal work and is naturally more expensive. The cost depends highly on the tooth’s location and the number of canals that must be cleaned and sealed. A root canal on an anterior (front) tooth generally costs $700 to $1,100. Treating a molar, which can have three or four canals, is significantly higher, often costing $1,000 to $1,800.
The Financial Impact of Tooth Replacement
The initial savings from choosing an extraction are often misleading because a missing tooth almost always requires replacement to maintain long-term oral health. Removing a tooth creates a gap that leads to the shifting of adjacent teeth, bite collapse, and bone loss in the jaw. Replacing the tooth prevents these issues, but it introduces significant long-term costs.
Replacement Options
The most comprehensive replacement is a dental implant, which involves surgically placing a titanium post into the jawbone. The full cost of a single tooth implant, including the post, abutment, and final crown, typically ranges from $3,000 to $7,000. A fixed dental bridge uses adjacent teeth as anchors for a prosthetic tooth. A three-unit bridge to replace a single tooth can cost between $2,000 and $5,000, as it requires crowning the two neighboring teeth. The most affordable replacement is a partial denture, a removable appliance that fills the space, costing between $300 and $2,500. The total bill for an extraction plus replacement will almost certainly surpass the cost of a root canal.
Comprehensive Cost of Tooth Preservation
The cost of a root canal is only part of the total expense for saving a tooth, as the procedure requires a final restoration to succeed. After the infected pulp is removed and the inner chamber is sealed, the tooth is structurally weakened and prone to fracture. The complete cost of preservation must combine the root canal fee with the cost of a permanent protective covering.
The standard restoration is a dental crown, which completely encases the treated tooth to restore its strength and function. Crowns made from ceramic or porcelain materials typically cost between $800 and $2,500 per tooth. This brings the total cost of saving a molar with a root canal and a crown to an estimated range of $1,800 to $4,300. If the tooth structure remains relatively intact after the root canal, a less expensive deep filling or a core build-up may suffice. A core build-up to create a solid base for the crown adds an average of $200 to $500 to the total cost.
Variables That Change the Final Bill
The final amount a patient pays is heavily influenced by factors outside of the procedure itself, particularly dental insurance coverage. Most dental plans use a tiered structure that categorizes procedures and applies different reimbursement percentages. Simple extractions, considered a basic service, are often covered at a higher rate, sometimes 70% to 80% of the cost.
Root canals and crowns are typically classified as major restorative services, for which coverage may drop to 50% of the total cost. This difference in coverage percentage can make the immediate out-of-pocket expense for a root canal feel significantly higher than a simple extraction. Geographic location also plays a role, with procedures in major metropolitan areas often costing more due to higher overhead compared to rural locations. The choice between a general dentist and a specialist is another variable. Specialists may charge higher fees due to their advanced training, but their focused expertise can lead to more predictable outcomes and prevent costly retreatment later.