Question

Root Canal Therapy

Are there alternatives to a root canal?

A Answers (29)

  • ADe Vizio, DMD, Dentistry, answered on behalf of Colgate
    Although there are alternatives to root canals, they are much more drastic. The most common - and oldest - alternative way of dealing with a decaying tooth is removal. This has the obvious disadvantage of leaving a gap in the teeth in addition to being far more traumatic to the mouth than the less invasive root canal. Once the tooth has been removed, the gap should be filled as soon as possible with a bridge or denture. If the gap is not filled, the position of other teeth in the jaw will begin to shift, producing an irregular bite.
  • AMark Burhenne, DDS, Dentist, answered
    The best alternative is extraction and then placing a dental implant. In some cases this a more predictable outcome than doing the root canal. Most dentists are taught to preserve the tooth as all costs. Make sure the root canal that you and your dentist are planning is straightforward and has a good prognosis. Don't gamble by allowing "heroic dentistry" to be performed in your mouth. Before considering the root canal, always ask for the predicted outcome of both the root canal and the dental implant. That way you will have made an informed decision that better serves your oral health for the long term.
  • AJeff Campbell, Dentistry, answered

    Absolutely! I just answered that question 5 minutes ago for a patient who has a lower right first molar that either needs a root canal or have the tooth removed and an implant placed. Occasionally, as time goes by, even with a crown in place the root canal treated-tooth will break due to stress and brittleness and require extraction. Implants have great success and have a 98% prognosis over 10 year studies. However not all patients are candidates for implants. Fortunately today we have much better predictability due to CBCT scans that are inexpensive 3-dimensional x-rays that tell us how much bone is available and exactly where to place the implant.

  • ASally Kashani, DDS, Dentistry, answered

    Yes definitely!

    If you DO need a root canal, the one thing you shouldn't do is ignore it, especially if there are no symptoms. You may not feel pain now but symptoms may pop up suddenly and be very painful. Also the longer you have the infection, the more bone loss you will have around your teeth.

    Your options are: Extract the tooth and consider replacing it with a dental implant, a removable denture, or a bridge.

    Dental implants are a good alternative. It is not uncommon for patients to get an extraction of a tooth that needs a root canal and replace it with an implant immediately or in a few months. This may be a more reasonable approach for teeth that have a lot of decay and are missing a lot of tooth structure. 

  • ALucia Yau, DMD, Dentistry, answered

    Yes. Depending on a number of factors such as bone level, portion of healthy tooth left, patient preference, and finance, the dentist may suggest an alternative to root canal treatment. Extraction (taking out the tooth) is sometimes the answer. 

  • AGeorge Felt, Dentistry, answered
    1. Extract the tooth
    2. Live with the problem

    The basic question you need to answer is: "Do I want to keep the tooth?" If the answer is yes, then root canal therapy (RCT) may enable you to correct whatever problem threatens you with loss of that tooth. RCT is not usually the whole treatment for any problem - but, it is often a necessary starting point. Back teeth generally also need to be restored with a crown, and may need a "core buildup" or "post and core." Front teeth may or may not need these treatments. Some teeth need other treatment before the restorative work can be done properly. Some teeth are better off being treated by extraction; root canal therapy is not always the best choice. The many factors that contribute to making a wise treatment decision are beyond the scope of this forum. Ask your dentist to discuss the pros and cons of your treatment options so you can make an informed decision that relates to your personal situation.

  • ARobert Csillag, Dentistry, answered

    If a tooth is infected and is to be saved, a root canal is the only available treatment. Usually a root canalled tooth will need to be restored via a crown. If one chooses not to have a root canal performed on a tooth, the tooth can be extracted and replaced with a dental implant. In most cases, in my opinion, if a tooth can be saved with a good prognosis, that is the treatment of choice.

  • AArnold Liebman, Dentistry, answered

    The rationale for having a root canal is that there has been damage to the pulp (nerve) of the tooth. This occurred from either bacteria entering the pulp from tooth decay or trauma sustained to the tooth from injury.

    Discomfort from biting on the tooth and/or pain from hot or cold liquids are symptoms of root canal therapy. Swelling associated with the tooth is another indication for root canal therapy. In addition, a dental radiograph of the tooth may show pathology such as a lesion associated with the tooth.

    The alternative for root canal therapy under these conditions is extracting the tooth.

  • AStanislav Moline, Endodontics, answered

    When root canal treatment is indicated (needed, doable, restorable), then here are the alternatives, all of which are not very good:

    • Extraction - less expensive on short run, and very expensive long term (need to restore missing space, problems eating, esthetics, etc.);
    • Do nothing - the tooth may eventually become un-restorable, more infected, calcified, which may end up in tooth loss or higher costs;
    • Implant - not really an alternative in cases when root canal procedure can be performed because it is often more expensive, but most important you lose your own natural tooth. Implants are only good when root canal treatment is not possible due to extensive root decay, large fractures, severe calcification; it is not a good alternative if previous root canal treatment did not succeed.

    Make sure that you have an endodontist, a specialist in root canal treatments, to make a final decision. It is like if you have a heart problem, don't you want a cardiologist to take a look?

    Read more on this topic at official AAE website: http://AAE.org/Patients/

    Check out more information on my website: www.EndoWithCare.com/FAQ_for_Patients.html

  • AJonathan Rich, Dentistry, answered

    There are alternatives to a root canal and depending on each separate situation a root canal may or may not be the best option for a patient. For instance in some cases a tooth is too broken down to be restored. If the dentist has determined there is enough tooth to restore a root canal is the best option. If it is un-restorable, an extraction is the other option available. The infected tissue inside the tooth is what is causing the problem. To fix this you must either extract the tooth or do the root canal. If an extraction is chosen the empty space does not have to remain. In fact it is strongly recommended that it doesn’t remain! Leaving an empty space can causing shifting of other teeth around that area. This can cause further problems in the future. Options to replace teeth are implants, bridges and removable partial dentures.

  • ARussell Fitton, Dentistry, answered

    There are always alternatives. It's just that they are most likely not the best alternatives. One option is to not do anything. This is usually not recommended because if you end up with a bad infection or severe toothache you will regret this choice. Another option is to extract the tooth. That solves the problem at hand but then leaves you with choices to make about replacing the missing tooth. If the tooth has enough remaining structure to support a crown then it is much wiser to save the tooth by having the root canal done. All the alternatives to replace the missing tooth all have possible complications that can be more troublesome than just saving the tooth in the first place.

  • AThomas Connelly, Dentistry, answered

    Sometimes there are. It depends on the dentist, and the extent of the problem. Some dentists are ok with trying a very large filling instead of a root canal (although most won't, because the success rate is not high.) The other alternative is removal of the tooth (which then can be replaced with an implant or bridge, depending on where the tooth is and what's around it.)

    Personally, when I recommend a root canal, it's far and away the best option.

  • AWilliam M. Litaker, Dentistry, answered
    A root canal is done to save a tooth when the pulp( the inside part of the tooth) has become infected. The alternative is an extraction(tooth pulling) resulting in the loss of the tooth. It is generally better to save teeth rather than "pulling" them. While the initial investment is more for a root canal, it is less than the cost of later replacing the extracted tooth.
  • AGerry Curatola, DDS, Dentistry, answered

    While a root canal treatment remains the most conservative way to save a tooth with a dying nerve or surrounding dental abscess, the dental scientific literature continues to indicate that extraction and placement of a dental implant, in fact, may be a more predictable and stable alternative treatment. Other, more unorthodox therapies involving herbal (e.g., sage tea compresses) and homeopathic (e.g., hepar sulf.) preparations, remain unproven and with unpredictable success. On the horizon, stem cell therapy is being explored to regenerate diseased teeth.

  • AJohn Boain, Dentistry, answered
    Of course, but they are not good. The need for root canal therapy means that there is an infection present or potentially going to be infected, therefore you must remove the offending agent, the tooth. You always have the option of doing nothing, but you risk infection and bacteremia (infection in the blood) that may transport to other parts of the body and also compromise your immune system. Root canal therapy is very successful i.e. 93% over 10 year period. I have had two myself and recommend them in an effort to save your teeth.
  • ARichard Gochman, Dentistry, answered

    There are alternatives to root canal treatment, if it is determined that the nerve is damaged in a tooth, but the tooth is still savable then a root canal would be the treatment of choice. The decision of whether to save the tooth or not is really dependent on the extent to which the tooth is damaged. Most times if root canal is done successfully, and the tooth is then restored promptly and properly, it should last for many years.

    The only alternative when a tooth needs root canal, and you don’t want to proceed, would be to remove the tooth. Then you would have to replace it with either an implant or bridge. Discuss these options with your Dentist to decide which would be best for your particular circumstance.

  • ASaul Miller, Dentistry, answered

    Unfortunately, if root canal is indicated, the only alternative is extraction. If the patient decides to have the tooth extracted, consideration must be given to replacement to avoid shifting and drifting of other teeth and to maintain good bite relationships. If the bite is not maintained facial appearance may be affected. Tooth replacement may also be indicated for cosmetic and esthetic reasons.

    Replacement of a tooth or teeth can be accomplished with a variety of non-removable or removable alternatives, including some that involve implants.

  • APaul Epstein, Dentistry, answered

    The alternative to a root canal is extraction of the tooth as you don't want to leave an infection in your mouth. Most extracted teeth should be replaced so as to prevent tooth migration and changes in the occlusion (bite). Solutions for tooth replacement include implant placement, fixed and removable bridges. 

  • AJerry Gordon, Dentistry, answered

    If a tooth requires a root canal, there is an infection inside the tooth's roots, and the only other alternative is to have the tooth removed. Once a tooth is removed, the jaw will heal or can be built up with a bone graft. To replace the tooth, you would need a permanent bridge (a series of joined crowns placed over the teeth adjacent to the space), an implant, or a removable partial denture.

  • ACarol Wooden, Dentistry, answered

    The alternative to a root canal would usually involve extracting (pulling) the tooth. 

  • ADan Jenkins, Dentistry, answered
    If a tooth is infected the options would be either to have a root canal done or remove the tooth. If the tooth is removed you could either have an implant placed and then have a crown placed or have a fixed or removable bridge to allow you to keep up your chewing efficiency. I would recommend that if you have the tooth removed and do not have an implant placed you should have the dentist place some bone grafting material to preserve the bone level in that area to maintain support for the adjacent teeth.
  • ANed Nippoldt, Dentistry, answered

    The short answer is yes. Before dental implants were available, dentists did the best job they could to help patients keep their tooth as long as possible by doing root canal therapy, even though on some teeth they were pushing the limits of long-term success. With the advent of dental implants, we now have other options. If there is a good chance for long-term success with a root canal and crown or filling, this still may be the best option for you. However, if there is not a sufficient amount of solid root or tooth structure remaining or the tooth has a failing root canal caused by cracks or lateral canals that cannot be objurgated, the chances for long-term success may not be as great and you may want to save your time, energy and money and instead choose to have the tooth extracted and an implant (artificial root) placed. Depending on how many teeth are missing and the location in the mouth, the spaces may be restored with longer-lasting individual implant-supported crowns or bridges or implant-supported dentures. Should you choose not to have an implant, other options may include bridges, partials or traditional dentures.    

  • AAmit Somani, Dentistry, answered

    Once bacteria has infiltrated the nerve of a tooth, the only way to save it is by doing a root canal. If you don't have the time or money to go through with the treatment the only option is to remove the tooth. This is a very unfortunate alternative. As such, it is imperative you don't wait to the point you need a root canal. You would be amazed at how much time and money you could save by taking just a few minutes each day to brush and floss them properly. 

    If you decide to remove the tooth, you can get a removable partial denture (not recommended for replacing only a single tooth), a fixed partial denture (i.e. a bridge), or an implant and crown. There are also cheaper alternatives to replace the tooth that your dentist may be able to offer you.

  • AChris Zaepfel, Dentistry, answered

    It is always best to keep your natural teeth in your own mouth. Sometimes, due to decay or periodontal disease we may lose a tooth.

    In the case of a badly decayed tooth we have the option of root canal therapy to keep the tooth. This requires usually a post and core and a crown. These are preferred if possible, but very expensive.

    In the case of periodontal disease, you usually lose the tooth because of bone loss and infection resulting from the bone loss. The bone loss is a result of the plaque excreting an acid and inflaming the tissue, resulting in the bone loss with subsequent infection.

    Now you are faced with a problem. How am I going to replace the tooth? Without a root canal you can't save the tooth. After the tooth is extracted, you need to look at the bone left in relation to the anatomy and unfortunately the budget to figure what can be done.

    The easiest and time tested, not necessarily the most satisfactory solution, can be what is commonly known as a ‘flipper'. Sounds like a fish doesn't it? It is all acrylic removable partial.

    If the tooth that is lost has a natural tooth on each side the dentist may elect do a bridge. A bridge is a crown on the natural teeth adjacent to the space with a fake tooth that appears as if it were growing out of the tissue. A bridge is the only optional if you have healthy teeth, periodontally.

    The next replacement possibility is an implant. An implant is a metal female structure that is placed in the bone surgically. After it integrates into the osseous tissue, or bone, it is uncovered in such a manner that you can fit a male attachment which appears totally natural.

    Your last option is do nothing at all and just leave the space. Of course this is not desirable esthetically. Functionally it is a disaster of a choice for the patient to make. Teeth stay in a natural alignment in the mouth by the teeth on each side of it. Kind of keeps the tooth standing straight. The height of the tooth is determined by the teeth they bite against. If you lose a tooth the teeth on either side of the space will lean into the space and the tooth opposing the space will grow, or extrude into that area. Kind of confusing but rest assure it will mess up your bite. Possibly giving you TMJ problems in the form of 'popping' or soreness.

    In conclusion,  go to the dentist for care and brush and floss. Keep damage disease under control.

  • AJohn Paul, Dentistry, answered

    There is always an alternative to any treatment, including root canal treatment. The first alternative is decline or delay treatment. This is not necessarily a good choice but it is your choice to make. If you do have an infection in the pulp of your tooth, it will not get better by waiting or just taking medication, eventually you will lose the tooth and some of the bone around it and maybe some teeth near it. In severe cases the infection can spread to your face and neck. People have died from this kind of infection so while delaying treatment is your choice to make, it is not really a good choice. Another choice is to have the infected tooth removed. Then you will have decisions to make on how and whether you will replace the lost tooth.

  • ASupriya Verma, Dentistry, answered

    If a tooth has been diagnosed to need Root canal treatment then that is the only way to save the tooth. There is nothing like your God given tooth and it is always best to try to save teeth when it is possible. The alternative to saving the tooth is to Remove or Extract the tooth. This alternative may be immediately less costly but has many long term consequences that can end up being more costly. 

    Once a tooth is removed then it is important to replace the missing tooth. If the tooth is not replaced, then with time the remaining teeth can shift. The back teeth will lean in towards the missing tooth and the opposing tooth will begin to super-erupt down into the space. Eventually you may end up losing these teeth as well if the one tooth is not replaced. 

     

  • ARandall Lawson, Dentistry, answered

    The only alternative to root canal therapy is removal of the tooth. This might be the preferred choice if the tooth is too badly damaged to be restored to healthy function. Removal should be the treatment of last choice as it has more potential complications and makes it necessary to replace the tooth by either an implant or a bridge. Both are less desirable than your natural tooth.

  • ASteven Inaba, Dentistry, answered

    It's important to know you always have choices, but sometimes only one of those choices makes sense. For example, you can always choose to delay treatment, but unfortunately with dental diseases time is often an enemy because conditions will worsen. Alternatives to root canal therapy include extracting the tooth, delaying treatment, or beginning the first phase of a root canal ("open & broach") to relieve pain.

    While people often think extracting the tooth is better because it's less expensive it triggers a chain reaction of other problems, and can end up being more expensive in the long run. If the tooth is restorable, often times it's best to do what's necessary to save the tooth.

  • AMark Birnbach, Dentistry, answered
    Extracting the tooth is the only alternative.
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