Medically Reviewed by Dr. Jason Steinhubel, DDS on September 9, 2026
When a tooth is severely infected or damaged, a root canal is usually the better option for saving it, while extraction is reserved for teeth that are cracked below the gumline, have lost too much supporting bone, or are too compromised to rebuild. The right choice comes down to how much healthy tooth structure remains and whether the surrounding bone and gum tissue can still support it over the long term.
At All Smiles Dentistry in Lake Stevens, we take pride in helping patients think through that decision carefully rather than rushing toward extraction by default. Dr. Jason Steinhubel has been serving this community since 2004, and his focus on restorative dentistry in Lake Stevens has always centered on one guiding principle: keeping your natural teeth whenever it’s truly possible.
What a Root Canal Actually Involves
A root canal gets a bad reputation it doesn’t deserve. Think of the procedure less like a dramatic surgery and more like a deep cleaning, one that happens inside the tooth rather than on the surface. When the pulp, the soft tissue at the core of your tooth, becomes infected or inflamed, the goal of a root canal is to remove that damaged tissue, clean the canals thoroughly, and seal the tooth so it can continue functioning normally. During the procedure, your dentist numbs the area, opens a small access point in the tooth, removes the infected or dying pulp with fine instruments, and fills the empty canals with a biocompatible material before sealing the tooth.
Recovery from a root canal is typically milder than most patients expect. In fact, post-treatment soreness is often less significant than what follows a routine filling. Once a dental crown is placed to protect the treated tooth, most patients return to normal biting and chewing without issue. Research published through the National Institutes of Health found that root canal-treated teeth showed a 97% survival rate at 10 years, a strong indicator of how reliable the procedure can be when performed well and followed by proper restoration.
When Tooth Extraction Makes More Sense
There are situations where saving a tooth simply isn’t feasible. If a tooth is fractured below the gumline, has suffered extensive bone loss from advanced periodontal disease, or is structurally too compromised to restore, extraction may be the more practical path. The same applies when keeping the tooth would put the surrounding teeth or tissue at risk. Some extractions are straightforward and quick, while others, such as a tooth broken at the gumline, require a more involved surgical approach, which your dentist will explain beforehand so there are no surprises.
It’s also worth understanding what comes after extraction. Removing a tooth without replacing it can allow neighboring teeth to shift and the jawbone beneath it to gradually deteriorate. That’s why extraction is rarely the end of the conversation. Replacing the missing tooth with a dental implant is often the recommended next step, though the process takes time, multiple appointments, and a higher overall cost compared to saving the original tooth.
Comparing the Two Options
Both treatments carry legitimate benefits, and neither is universally superior. Consider a few key points:
- A root canal preserves your tooth, which means no bone loss, no shifting, and no need for a replacement prosthetic.
- Extraction followed by implant placement is often a longer, more involved process, though implants are an excellent long-term solution when extraction is truly necessary.
- In terms of discomfort, root canals are frequently more comfortable in recovery than people anticipate, especially with today’s local anesthesia and sedation options.
- Cost varies by case, but saving a tooth with a root canal procedure is often more economical over time than extraction paired with implant placement, and flexible financing can make either option manageable.
Every case is different. The right choice depends on the condition of the tooth, the surrounding bone and tissue, your overall health, and your long-term goals for your smile. Patients who are anxious about cost should know that payment plans through CareCredit and Cherry financing can spread either treatment into manageable monthly amounts, so cost alone rarely has to decide the outcome.
Weighing Comfort and Common Concerns
A lot of hesitation around root canals comes from outdated stories rather than the modern reality of the procedure. Anesthesia and technique have advanced enough that most patients describe the experience as comparable to getting a filling, not the ordeal older generations remember. Our guide to what a root canal actually feels like breaks down exactly what to expect if you are nervous about the appointment itself.
Extraction, by contrast, tends to involve a more noticeable recovery window immediately afterward, along with the added step of planning a replacement tooth. Neither procedure should be chosen out of fear of the other. The better question is which one gives your mouth the healthiest outcome for the years ahead.
Signs It Is Time to Talk to Your Dentist
Not every damaged tooth announces itself with obvious pain, so it helps to know the general warning signs worth having checked. Ongoing sensitivity to hot or cold, swelling along the gumline, a tooth that feels loose, or discomfort when chewing are all reasons to schedule an exam rather than wait it out. If a tooth injury or infection ever comes with facial swelling or fever, that combination needs prompt attention, and our emergency dentistry team is set up to see patients quickly rather than making them wait for the next routine opening.
Most patients can return to normal eating and speaking within a day or two after either procedure, with mild soreness that responds well to over-the-counter pain relief. Following your dentist’s aftercare instructions, including any prescribed rinses or a temporary softer diet, gives the treated area the best chance to heal cleanly the first time.
All Smiles Dentistry Can Help You Decide Whether You Need a Root Canal or Extraction
At All Smiles Dentistry, Dr. Jason relies on 3D cone beam imaging, digital X-rays, and intraoral cameras to assess your tooth with a level of precision that a standard exam simply can’t match. Microscope dentistry, one of our more unique capabilities, gives us a close-up view of root structure that helps inform whether a tooth is a good candidate for saving or whether tooth extraction is the safer route. Our approach is never about performing procedures for the sake of it. It’s about giving you honest, thorough information so you can make a confident decision, the same way we walk patients through what to expect during root canal therapy in Lake Stevens before they ever sit in the chair.
If you’re dealing with tooth pain, a suspected infection, or a tooth that’s been bothering you for a while, we’re here to help you figure out what’s actually going on and what your best options are. Our team has served Lake Stevens since 2004, and we would rather spend a few extra minutes explaining the reasoning behind a recommendation than leave you guessing. To schedule a consultation with Dr. Jason and the All Smiles Dentistry team, please contact us today.
Frequently Asked Questions About Root Canals and Extractions
Is a root canal more expensive than an extraction?
A root canal usually costs more upfront than a simple extraction, but extraction is rarely the full story. Once you factor in a replacement tooth such as an implant, bridge, or denture, saving the natural tooth with a root canal often ends up being the more economical choice over time.
Does getting a root canal hurt more than having a tooth pulled?
Most patients report that a root canal feels similar to getting a filling, thanks to modern anesthesia and technique. Extractions are also well managed with local anesthesia, but the recovery afterward tends to involve more soreness than root canal recovery does.
Can every damaged tooth be saved with a root canal?
No. A tooth that is fractured below the gumline, has lost too much supporting bone, or is structurally too weak to rebuild is generally not a good candidate for a root canal. In those cases, extraction followed by a replacement tooth tends to give a more predictable, stable result.
What happens if I choose extraction instead of a root canal?
Once a tooth is removed, neighboring teeth can gradually shift and the jawbone beneath the gap can begin to lose density. Most patients benefit from discussing a replacement option, such as a dental implant or bridge, at the same time they plan the extraction rather than waiting until afterward.
How long does a tooth restored with a root canal typically last?
Research on root canal outcomes has found survival rates around 97 percent at the ten year mark when the tooth is properly restored with a crown afterward. Regular checkups and good oral hygiene both play a role in how long the result holds up.
ABOUT THE AUTHOR
Owner and Dentist, All Smiles Dentistry
Dr. Steinhubel opened All Smiles Dentistry in Lake Stevens in 2004 after completing his Doctor of Dental Surgery degree at Creighton University School of Dentistry and an Advanced Education in General Dentistry residency at Offutt Air Force Base. He is a member of the American Dental Association and the Washington State Dental Association, and he focuses on restorative solutions built around long-term oral health.
Dr. Jason Steinhubel opened All Smiles Dentistry in Lake Stevens in 2004 to give the community he loves a better dental experience. A member of the American Dental Association, he brings a background in forensics, dental assisting, and dental lab work to a technology-forward, family-focused practice built on prevention, education, and comprehensive care under one roof.
View Dr. Steinhubel's full profile