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When a tooth is severely damaged or infected, you may be faced with a difficult decision — should you try to save it with root canal treatment, or have it removed? Both options can relieve pain and resolve infection, but they lead to very different outcomes for your long-term oral health.
Root canal treatment aims to preserve the natural tooth by removing infected tissue from inside the root and sealing it. Extraction removes the tooth entirely, which may then require a replacement such as an implant or bridge. The right choice depends on the condition of the tooth, the extent of damage, and your overall dental health.
This guide explains the key differences to help you understand your options. The best treatment will always depend on a clinical assessment by your dentist.
| Feature | Root Canal | Extraction |
|---|---|---|
| Purpose | Save the natural tooth by removing infected pulp | Remove the entire tooth from the jawbone |
| Procedure Type | Endodontic — internal cleaning and sealing | Surgical or non-surgical removal of the tooth |
| Pain / Discomfort Level | Minimal — performed under local anaesthesia | Minimal — performed under local anaesthesia |
| Recovery Time | A few days of mild sensitivity | 1–2 weeks for full healing of the socket |
| Impact on Oral Health | Preserves natural tooth, bone, and alignment | May lead to bone loss and shifting of adjacent teeth |
| Cost (at Our Practice) | From £347.50 (member) / £695 per tooth | From £125 (member) / £250 per tooth |
| Longevity / Outcome | Can last a lifetime with proper care and a crown | Permanent removal — may require a replacement |
| Suitability | Teeth with salvageable root structure | Severely damaged, fractured, or non-restorable teeth |
Purpose
Root Canal
Save the natural tooth by removing infected pulp
Extraction
Remove the entire tooth from the jawbone
Procedure Type
Root Canal
Endodontic — internal cleaning and sealing
Extraction
Surgical or non-surgical removal of the tooth
Pain / Discomfort Level
Root Canal
Minimal — performed under local anaesthesia
Extraction
Minimal — performed under local anaesthesia
Recovery Time
Root Canal
A few days of mild sensitivity
Extraction
1–2 weeks for full healing of the socket
Impact on Oral Health
Root Canal
Preserves natural tooth, bone, and alignment
Extraction
May lead to bone loss and shifting of adjacent teeth
Cost (at Our Practice)
Root Canal
From £347.50 (member) / £695 per tooth
Extraction
From £125 (member) / £250 per tooth
Longevity / Outcome
Root Canal
Can last a lifetime with proper care and a crown
Extraction
Permanent removal — may require a replacement
Suitability
Root Canal
Teeth with salvageable root structure
Extraction
Severely damaged, fractured, or non-restorable teeth
Root canal treatment is a procedure designed to save a tooth that has become infected or severely decayed. During the treatment, your dentist removes the infected or damaged pulp — the soft tissue inside the tooth that contains nerves and blood vessels — cleans and disinfects the root canals, and seals the tooth to prevent further infection.
The treated tooth is usually restored with a dental crown to protect it and restore its strength and appearance. Root canal treatment allows you to keep your natural tooth, maintaining your bite, jawbone density, and the alignment of surrounding teeth. The procedure is performed under local anaesthesia and is generally no more uncomfortable than having a filling.
Root canal treatment is suitable for patients whose teeth have become infected or severely decayed but still have sufficient root structure to be saved. It is commonly recommended for teeth with deep cavities, cracked teeth with pulp exposure, or teeth that have developed an abscess. Good oral health and a commitment to aftercare are important for long-term success.
Tooth extraction is the removal of a tooth from the jawbone. It may be recommended when a tooth is too severely damaged, decayed, or infected to be saved — or when keeping the tooth poses a risk to surrounding teeth or overall oral health. Extractions can be simple (for visible teeth) or surgical (for teeth that are broken below the gum line or impacted).
The procedure is performed under local anaesthesia. After extraction, the socket heals naturally over one to two weeks. In most cases, your dentist will recommend a replacement — such as a dental implant, bridge, or denture — to restore function and prevent long-term complications such as bone loss or shifting of adjacent teeth.
Extraction is suitable for patients whose teeth cannot be saved through restorative treatment. It is commonly recommended when the tooth is non-restorable, when infection is too advanced for root canal treatment, or when removal is necessary for orthodontic or surgical reasons. Your dentist will always explore options to save the tooth before recommending extraction.
Root canal treatment saves the natural tooth by removing only the infected pulp inside it. Extraction removes the entire tooth from the jaw. Wherever possible, preserving a natural tooth is generally the preferred clinical approach, as it maintains bone structure and avoids the need for a replacement.
Both procedures are performed under local anaesthesia and should not cause pain during treatment. Root canal treatment may involve mild sensitivity for a few days afterwards. Extraction recovery can involve more noticeable soreness and swelling, typically lasting one to two weeks as the socket heals.
Recovery after a root canal is usually quick — most patients return to normal activities the same day with only mild sensitivity. Extraction recovery takes longer, with the socket typically healing over one to two weeks. Surgical extractions may require a slightly longer recovery period.
A root canal preserves the jawbone, maintains the alignment of surrounding teeth, and prevents bone loss. After extraction, the jawbone in the area can gradually lose density, and adjacent teeth may shift into the gap — potentially affecting your bite and facial structure over time.
After a root canal, the tooth usually needs a crown to protect it — but no replacement tooth is required. After extraction, you will usually need a replacement such as a dental implant, bridge, or denture to restore function and appearance. This adds to the overall treatment time and cost.
Root canal treatment has a higher initial cost — from £347.50 for members (£695 standard) for a front tooth. Extraction starts from £125 for members (£250 standard). However, when the cost of a replacement tooth is included, the total long-term cost of extraction can equal or exceed that of a root canal.
Root canal treatment has a higher initial cost but preserves the natural tooth, avoiding the expense of a replacement. Extraction is more affordable upfront but may require a replacement tooth — adding significantly to the total long-term cost.
| Treatment | Member Price | Standard Price | Notes |
|---|---|---|---|
| Root Canal (Front Tooth) | From £347.50 | From £695 | Saves the natural tooth |
| Root Canal (Molar) | From £447.50 | From £895 | More complex root anatomy |
| Extraction (Simple) | From £125 | From £250 | Visible, fully erupted teeth |
| Extraction (Complicated) | From £225 | From £450 | Broken or partially erupted teeth |
| Extraction (Surgical) | From £325 | From £650 | Impacted or complex cases |
Root Canal (Front)
Root Canal (Molar)
Extraction (Simple)
Extraction (Complicated)
Extraction (Surgical)
Membership patients receive 50% off all treatments. The total cost of extraction may increase significantly when a replacement tooth (implant, bridge, or denture) is required. Your dentist will provide a clear treatment plan and cost breakdown during your consultation.
If your tooth has sufficient root structure and can be restored, root canal treatment is the preferred option — preserving your natural tooth, jawbone, and bite alignment for the long term.
Root CanalIf the tooth is severely fractured, has advanced decay, or the root is non-restorable, extraction may be the only viable option — removing the source of infection and protecting surrounding teeth.
ExtractionKeeping your natural tooth with root canal treatment preserves bone density, prevents shifting of adjacent teeth, and avoids the long-term complications associated with tooth loss.
Root CanalExtraction has a lower upfront cost, but a replacement tooth (implant, bridge, or denture) can make the total long-term cost comparable to or higher than root canal treatment.
Extraction (with caveat)The right choice between root canal treatment and extraction depends on the condition of your tooth and your overall dental health. Our team will carry out a thorough assessment, explain your options clearly, and recommend the most appropriate treatment — book a consultation with a dentist in London to discuss your options.
This article is intended for general educational purposes only and does not constitute personalised dental advice. Individual diagnosis and treatment recommendations require a clinical examination by a qualified dental professional. All treatment outcomes depend on individual clinical factors and cannot be guaranteed. The suitability of root canal treatment or extraction is determined during a clinical assessment. South Kensington Medical & Dental is registered with the Care Quality Commission (CQC) and all practitioners are registered with the General Dental Council (GDC).
Our experienced dental team is fully qualified and registered with the GDC, delivering safe, high-quality care in line with the highest professional standards.
Because our patients deserve nothing less.
At South Kensington Medical & Dental, we are fully registered with the Care Quality Commission (CQC) and our clinicians are registered with the relevant UK regulatory bodies, including the GDC and GMC. Our dentists, dental nurses and medical professionals deliver care that meets the highest clinical, safety and ethical standards, because our patients deserve nothing less.
