When a tooth is badly decayed or infected, patients usually face two paths: save the tooth with a root canal, or remove it with an extraction. Both are routine, both relieve pain — but they lead to very different futures for your smile and your budget. Here’s how our dentists help Lake Worth and Fort Worth patients decide.
Rule of thumb: save the tooth when you reasonably can
Dentistry has a strong bias toward keeping natural teeth, and for good reason. Your natural tooth root stimulates the jawbone, holds neighboring teeth in place, and chews better than any replacement. A root canal removes the infected nerve tissue inside the tooth, disinfects the canals, and seals them — the tooth stays in your mouth and, once crowned, can last for decades. Modern root canals are done with effective numbing and feel much like getting a large filling; the procedure’s painful reputation is decades out of date.
When a root canal is usually the right call
- The tooth has enough healthy structure left to support a crown.
- The infection is contained inside the tooth or at the root tip.
- The tooth is visible when you smile, or it’s a key chewing tooth.
- You want to avoid the follow-on costs of replacing a missing tooth.
At Northwest Family Dental, a root canal is $899, and most treated teeth also need a crown ($899) to protect the now-brittle tooth — so a saved tooth typically runs about $1,798 all-in. That’s a real investment, but it’s a one-time cost for a tooth that can serve you for many more years.
When extraction makes more sense
- The tooth is too far gone. A crack that runs below the gumline, decay that has consumed most of the tooth, or severe bone loss around it can make the tooth unrestorable — a root canal would only postpone the inevitable.
- Repeated failed treatment. A tooth that has already had a root canal and reinfected may be better removed and replaced.
- Wisdom teeth and crowding. Some teeth simply don’t have a useful future in the mouth.
- Budget today. A simple extraction is $199 and a surgical extraction is $249 at our office — far less up front than root canal plus crown.
The hidden cost of the “cheaper” option
An extraction only stays cheaper if you don’t replace the tooth — and for most teeth, you should. A missing tooth lets neighbors drift, changes your bite, and the jawbone under the gap begins to shrink within months. Replacement options range from partial dentures to a dental implant, and those costs usually exceed what the root canal would have been. When we recommend saving a tooth, it’s because the math — and the biology — usually favor it over a five-to-ten-year horizon.
How we decide together at your exam
The choice comes down to one clinical question: can this tooth be restored predictably? We answer it with an exam and X-rays, then walk you through what we see — how much solid tooth remains, where the infection sits, and what each path costs now and later. If you’re not sure about a recommendation you’ve received elsewhere, we’re happy to take a look and give you a straightforward second opinion. New patients pay $129 for a first visit that includes an exam, X-rays, and a cleaning ($79 for exam and X-rays only).
In pain now? Don’t wait
An infected tooth doesn’t heal on its own, and waiting narrows your options — teeth that could have been saved with a root canal often become extractions after months of delay. Dr. Claudia Appiah and Dr. Brijesh Patel treat toothaches for families across Lake Worth, Fort Worth, Azle, and Saginaw. Call (817) 237-3232, book online at dental4.me/northwestfamilydental/1, or reach us through our contact page — we’ll find the source of the pain and lay out both paths clearly, so you can choose with confidence.
This article is for general information only and is not a substitute for a professional dental examination.