6. If a Tooth Has Had Root Canal Treatment, Is It a Dead Tooth?

Root Canal Treatment does not kill a tooth. Even though root canal treatment removes the pulp tissue from inside the tooth, the tooth is by no means “dead.” Following successful endodontic treatment, the tooth continues to receive its blood supply and nourishment from the surrounding tissues and the supporting bone. The body’s immune system continues to recognize an endodontically treated tooth as viable and healthy, just as it recognizes any other normal non-treated tooth. An endodontically treated tooth generally requires a protective crown and, once this restoration has been completed, the tooth continues to function as an integral component of the dental arch. A tooth that has had root canal treatment and has been properly restored is no more susceptible to fracture, decay, or gum disease than any other tooth.

  1. What are the alternatives?

The only alternative to RCT is the extraction of the problematic tooth. It is wise to consider all of the implications of losing a tooth before having it removed. The decision should not be made hastily or because the tooth is painful. If pain is present and the dentist thinks that the tooth can be saved, the discomfort can first be relieved and then the alternatives explored.

RCT may not always be able to repair your tooth with root canal treatment. This may be the case if your tooth is very seriously damaged by decay or injury, or if you have gum disease meaning that your tooth isn’t well supported. Extraction of the tooth may be recommended instead.

It’s important to have root canal therapy done quickly. The bacteria will travel down the canal to the root and into the jawbone. If this happens, the pain of your toothache will spread to your jaw. Even more important, the infection can cause your jawbone to deteriorate and weaken the structure that holds your teeth.

The discussion about tooth replacement alternatives after extraction can be complex because each individual situation is unique and, at times, various specialists may need to be consulted. When considering the alternatives for replacing a missing tooth, a few of the major factors to consider are the long-term predictabilities of the various alternatives, the overall chair time involved in treatment, the esthetic results, the effects on the adjacent and opposing teeth, and the costs.  We advise removing teeth as a last resort natural teeth are the ones best suited for the mouth.

Not replacing the extracted tooth is a poor choice in most situations. Leaving a space after extraction can lead to long-term problems with teeth shifting and tipping, destabilization of the biting system, and esthetic changes in the profile of the face. Financially and psychologically, this could turn out to be the most costly choice over the lifetime of the patient.



After considering and weighing all of the consequences of extraction and all of the alternatives for tooth replacement, in most situations it becomes obvious that well-performed RCT with a protective restoration is the best treatment of choice.

  1. What Is the Cost of Root Canal Treatment?

There are many factors that affect the cost of RCT. Each patient and tooth presents a different set of circumstances. Generally, the cost of root canal treatment is directly related to the chair time necessary to perform the treatment as well as to the costs of the staff, training, and technology that the dentist has available when performing the procedure. There are many factors that influence the amount of chair time necessary to treat any particular tooth:

  • The position of the tooth in the mouth
  • The number of roots and the number of canals within these roots
  • Root curvatures and the length of the roots
  • The presence or absence of calcifications within the root canal space
  • Special dental considerations. For example, it may be more difficult for the dentist to work through an existing crown or a bridge than to work on a tooth with only a small previous filling. Also, some teeth may have been severely broken down by past dental disease and these may have to be “built-up” before root canal treatment can even be started so that an aseptic field can be established and maintained during treatment.

In addition to the chair time involved for treatment, other factors are also taken into consideration when determining a fair fee for root canal treatment:

  • The cost of technology. Dentists who use state-of-the-art technology for certain procedures have invested in computer digital radiography, ultrasonic, and specialized training courses for themselves and for their staff. Those patients who benefit from them share the costs of these items.
  • The costs of the dental office overhead include staff, rent, and supplies in addition to many other expenses. These costs vary significantly in different areas of the country.
  • Fees vary among practitioners due to differences in their endodontic treatment philosophies, which in turn dictate the chair time required, the materials selected, and the technologies utilized.

In conclusion, there can be marked discrepancies in the fees charged for root canal treatment by different dentists. Ultimately, the best value for care is treatment that is done once and works over a period of many years. Conversely, the most expensive dental treatment is the treatment that may cost less initially but does not work predictably and needs to be redone one or more times. The wise dental consumer does not make a treatment decision on the basis of cost alone.





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