A damaged or infected tooth leaves you with one important decision: save it with a root canal, or remove it with an extraction? In most cases, a root canal is the better choice — keeping your natural tooth protects your bite, your jawbone and your neighbuoring teeth, and it usually costs less over a lifetime. Extraction becomes the right call when the tooth is cracked below the gumline, severely decayed, or so badly damaged that there isn’t enough healthy structure left to rebuild.
That’s the short version. The real answer depends on your tooth, your bone, your budget and your coverage — so this guide walks through both options side by side: the symptoms, the procedures, recovery times, 2026 Ontario cost ranges, and what the Canadian Dental Care Plan does and doesn’t pay for. At Woodbine & Danforth Dental Care, this is a conversation we have most weeks, and patients decide far more confidently once they can see the trade-offs in one place.
Root Canal vs Extraction at a Glance
| Factor | Root Canal | Tooth Extraction |
|---|---|---|
| Goal | Saves the natural tooth | Removes the tooth |
| Visits needed | 1–2, plus a crown appointment | 1 (more if you replace the tooth) |
| Recovery | A few days of mild tenderness | 1–2 weeks for the socket to close |
| Upfront cost | Higher (treatment plus crown) | Lower |
| Long-term cost | Usually lower | Higher once you replace the tooth |
| Effect on the jawbone | Bone is preserved by the root | Bone shrinks where the tooth was |
| Best for | Teeth that can still be restored | Teeth that are beyond repair |
What a Root Canal Actually Does
Inside every tooth is a soft core called the pulp — nerves, blood vessels and connective tissue. When decay, a crack or an old deep filling lets bacteria reach that core, the pulp becomes inflamed or infected. It cannot heal on its own, and the infection eventually works its way out through the root tip into the surrounding bone.
A root canal treats exactly that problem. The dentist removes the infected pulp, disinfects and shapes the hollow canals inside the root, seals them, and then restores the tooth — usually with a crown, which holds the now-hollow tooth together under chewing forces. The root stays anchored in your jaw. As the Canadian Dental Association puts it, the purpose of the treatment is to save a tooth that would otherwise have to be removed.
The tooth stops hurting because the source of the infection is gone. It keeps doing its job because the root is still there.
Signs You May Need a Root Canal
Pulp problems announce themselves in fairly consistent ways. Watch for:
- Pain when you chew or bite down on one particular tooth
- Lingering sensitivity to hot or cold — the ache stays for 30 seconds or more after the drink is gone
- Swelling or tenderness in the gum beside the tooth
- A tooth that has darkened or changed colo\r compared to its neighbours
- A pimple-like bump on the gum that drains, shrinks and comes back — see our guide to what a bump on your gums means
- Deep, throbbing pain that wakes you at night
One caution worth repeating: an infected tooth sometimes stops hurting. That usually means the nerve has died, not that the problem resolved. The infection is still active in the bone. If pain disappears on its own after several bad days, book an exam anyway.
Caught early, a root canal is often the difference between keeping the tooth and losing it. Pain plus facial swelling or fever is different again — that’s emergency dentistry territory, and it needs same-day attention.
What Happens During a Root Canal
Modern root canal treatment has far more in common with getting a large filling than with its reputation. Here’s the sequence:
- The tooth and surrounding gum are fully frozen with local anaesthetic.
- A small opening is made in the top of the tooth to reach the pulp chamber.
- The infected pulp is removed, and the canals are cleaned, disinfected and shaped.
- The canals are filled and sealed so bacteria can’t re-enter.
- A crown — or sometimes a filling on a front tooth — is placed to protect the tooth long term.
Treatment takes one to two visits of roughly 60–90 minutes, depending on how many canals the tooth has. Front teeth typically have one canal; molars can have three or four, which is why back teeth take longer and cost more.
Because the tooth is properly frozen, the procedure itself feels much like having a filling done. The pain patients remember is almost always the infection beforehand, not the treatment.
Root Canal Recovery
Root canal recovery is usually quick and uneventful. Mild soreness or tenderness when biting for a few days is normal and responds well to over-the-counter pain relief. To help it settle:
- Avoid chewing on the treated tooth until the permanent crown is in place
- Stick to softer foods for the first day or two
- Keep brushing and flossing gently, including around the treated tooth
- Call us if pain increases after day three, or if swelling appears
Most people are back to their normal routine the next day. Once the permanent crown is fitted, a root-canal-treated tooth can last for decades — often the rest of your life — with ordinary brushing, flossing and check-ups.
When an Extraction Is the Better Choice
Dentists work hard to save teeth, but some teeth genuinely can’t be saved, and stretching to keep one can cost you money and comfort for no benefit. Extraction is usually the right decision when:
- The tooth is fractured vertically or cracked below the gumline
- Decay has destroyed so much structure that there’s nothing left to anchor a crown
- Advanced gum disease has destroyed the bone holding the tooth in place
- A previous root canal has failed and retreatment isn’t viable
- A wisdom tooth is impacted, crowding neighbours or repeatedly infected
An honest dentist will tell you when a tooth isn’t worth saving. Paying for a root canal and crown on a tooth that fails in eighteen months is the worst of both outcomes.
The Tooth Extraction Procedure: Simple vs Surgical
Extractions come in two forms, and the difference matters for both recovery and price:
- Simple extraction — for a tooth that is fully erupted and accessible. The tooth is loosened and lifted out. It takes minutes.
- Surgical extraction — for teeth broken at the gumline, impacted, or with curved roots. A small incision is made and the tooth is often sectioned into pieces for gentle removal. This is oral surgery, and it takes longer.
Both are done with local anaesthetic, so you shouldn’t feel pain during the procedure — pressure and movement, yes, but not pain.
Tooth Extraction Aftercare
Healing hinges almost entirely on protecting the blood clot that forms in the socket. In the first 24 hours:
- Bite gently on the gauze pad to control bleeding
- Apply a cold compress to the outside of the cheek to limit swelling
- Rest, and skip strenuous activity, alcohol and smoking
- Do not rinse vigorously, spit, or use a straw — suction is what dislodges the clot
Over the following days:
- Start gentle warm saltwater rinses after the first 24 hours
- Eat soft foods — see our guide to eating after a tooth extraction
- Keep brushing your other teeth normally, avoiding the socket itself
The gum closes over in about one to two weeks, though the bone underneath continues remodeling for months. If you develop severe throbbing pain two to four days afterwards, often with a bad taste, that can be dry socket — the clot has been lost. It’s easily treated, but call us rather than waiting it out. Our guide to recovering after a wisdom tooth extraction covers the same ground in more detail.
What Each Option Costs in Ontario in 2026
Most Ontario dentists price their work with reference to the Ontario Dental Association Suggested Fee Guide, which is updated annually. It is a suggested guide, not a mandatory price list, so fees vary between practices. The ranges below reflect what patients in Toronto typically encounter in 2026:
| Treatment | Typical Ontario range (2026) |
|---|---|
| Root canal — front tooth (1 canal) | $600–$1,000 |
| Root canal — premolar (1–2 canals) | $850–$1,400 |
| Root canal — molar (3–4 canals) | $1,100–$1,800 |
| Crown after a root canal | $1,000–$1,800 |
| Simple extraction | $150–$300 |
| Surgical extraction | $300–$900 |
Two factors drive root canal pricing: which tooth and how many canals. A front tooth with a single canal sits at the bottom of the range; a molar with four curved canals sits at the top. Endodontists — specialists who do nothing but root canals — generally charge more than a general dentist for the same tooth, and complex or retreatment cases are sometimes referred to one.
On paper, extraction is clearly the cheaper option. That comparison only holds if you leave the gap empty, which brings us to the number most people forget.
The Cost Most People Forget: Replacing the Tooth
A missing tooth isn’t a stable end state. The teeth on either side drift into the space, the opposing tooth over-erupts, chewing shifts to the other side, and the jawbone that used to support the root begins to shrink. That’s why an extraction is usually followed by a replacement:
- Dental implant — the closest thing to a natural tooth, and the only option that preserves bone. Typically $4,000–$6,000 all-in for the implant, abutment and crown.
- Dental bridge — fills the gap using the neighbouring teeth for support, which means preparing two healthy teeth. Our guide to bridge types, costs and lifespan covers the options.
- Partial denture — the least expensive route, though removable and less stable than fixed options.
Add a replacement to the extraction and the arithmetic reverses. A molar root canal plus a crown might total $2,100–$3,600. An extraction plus an implant commonly lands between $4,150 and $6,900. Saving the tooth is very often the cheaper path, not just the healthier one.
What Insurance and the CDCP Cover
Most private Ontario dental plans reimburse root canals and extractions at roughly 50–80% once your deductible is met, subject to an annual maximum. Crowns are frequently reimbursed at a lower percentage than the root canal itself, so ask about both.
The Canadian Dental Care Plan (CDCP) has changed the picture for many households. A few things worth knowing before you decide:
- Eligibility is based on adjusted family net income under $90,000, with no private dental coverage. The plan pays 100% of eligible fees under $70,000, 60% from $70,000–$79,999, and 40% from $80,000–$89,999.
- Endodontic treatment requires preauthorization. Your dentist submits the plan and X-rays first, and approval isn’t automatic.
- Coverage leans towards front teeth and premolars. Molar root canals are the least reliably covered category, and in some cases an extraction is approved where a root canal is not.
- The CDCP reimburses against its own fee schedule, which sits below the ODA guide. If your dentist charges the ODA fee, you may owe the difference on top of any co-payment.
That last set of points matters enormously for this decision. If you’re relying on the CDCP for a back molar, the coverage gap between “save it” and “remove it” can be significant — and it is worth finding out before treatment, not after. We’re happy to submit a preauthorization and give you a written estimate so you can compare real numbers.
Five Questions to Ask Before You Decide
When you’re in the chair, these five questions will get you everything you need:
- Is there enough healthy tooth left to hold a crown? This is usually the deciding factor.
- What’s the realistic prognosis if we save it? Ask for a straight answer in years.
- If we remove it, what will replacing it involve — and when?
- What does my coverage actually pay for each option? Including the crown, and including the replacement.
- What happens if I do nothing right now? For an infected tooth, the honest answer is that it gets worse, not better.
Talk It Through With a Dentist on the Danforth
You don’t have to make this call on your own, and you shouldn’t make it from a search results page. An exam and an X-ray tell us how much healthy tooth structure remains, how much bone supports it, and whether the infection has spread — and that’s what actually decides the question.
You’ll find us at 2107 Danforth Ave, Toronto — right at Woodbine and Danforth, steps from Woodbine subway station, serving East York, Danforth Village, the Upper Beaches and Greektown. We’re open evenings on weekdays and Saturdays until 5, and we keep room for same-day emergency visits. Call 416-696-1800 or book an assessment online, and we’ll give you a clear recommendation and a written estimate for both options.
Frequently Asked Questions
Is a root canal better than an extraction?
In most cases, yes. Keeping your natural tooth preserves your bite, prevents neighbouring teeth from drifting, and stops the jawbone from shrinking where the root used to be. Extraction is the better option when the tooth is cracked below the gumline, has too little structure left to restore, or has lost its bone support to gum disease.
Is a root canal or an extraction more painful?
Neither should hurt during the procedure — both are done with local anaesthetic. Afterwards, root canal recovery is generally milder and shorter: a few days of tenderness, versus one to two weeks for an extraction socket to close. Extractions also carry the risk of dry socket, which root canals do not.
Which is cheaper, a root canal or an extraction?
An extraction is cheaper upfront — typically $150–$300 for a simple extraction versus $600–$1,800 for a root canal, plus $1,000–$1,800 for a crown. But replacing the missing tooth with an implant commonly costs $4,000–$6,000, which usually makes extraction the more expensive route overall.
How long does recovery take?
Root canal recovery takes a few days of mild tenderness, and most patients return to normal activity the next day. After an extraction, the gum typically closes within one to two weeks, with the underlying bone remodeling over several months.
Does the Canadian Dental Care Plan cover root canals?
Partially. Endodontic treatment is an eligible service but requires preauthorization, and coverage is strongest for front teeth and premolars. Molar root canals are less reliably approved. The CDCP also reimburses against its own fee schedule, so you may owe a balance in addition to your income-based co-payment.
Can I just leave the infected tooth alone?
No. A pulp infection does not heal on its own. Left untreated it spreads into the bone around the root and can form an abscess, and in rare cases infection spreads to other areas of the head and neck. If the pain stops by itself, that generally means the nerve has died — not that the infection has gone.
How long does a root-canal-treated tooth last?
Often for decades, and frequently for life. The two biggest factors are getting a proper crown placed promptly to protect the hollowed tooth from fracture, and keeping up with routine brushing, flossing and check-ups.
The Bottom Line
If the tooth can be restored, save it. A root canal keeps your natural root in your jaw, costs less over time than extracting and replacing, and — with a crown on top — can last the rest of your life. If the tooth is fractured below the gumline, structurally gone, or has lost its bone support, extraction is the honest answer, and planning the replacement at the same time will save you money and bone.
The only genuinely bad option is waiting. Infected teeth get more expensive and harder to save with every month that passes. Book an assessment at Woodbine & Danforth Dental Care or call 416-696-1800, and you’ll leave knowing exactly which option is right for your tooth — and what it will cost.
This article is for general information and doesn’t replace a professional dental examination. Fee ranges are typical Ontario estimates for 2026 and are not a quote; we provide a written estimate before treatment begins.
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