Save a failing tooth or pull and replace it
When a tooth is badly decayed or cracked, you can often save it with a root canal and a crown, or pull it and replace it with an implant or a bridge. Saving the natural tooth is usually the cheaper path and keeps the root and bone. Pick the tooth to compare the real costs and how long each option lasts.
Saving vs replacing a tooth
The upfront price vs the full price
Pulling the tooth is cheaper on the day, at about $150 for a simple extraction, versus about $2,600 for a molar root canal plus the crown that comes after. But an extraction isn't really a fix, it's a trade. Replace the tooth with an implant and the total passes $4,000, a bridge lands similar or higher, and if you just leave the gap, the neighboring teeth drift while the jawbone shrinks. The tool above prices every path for your tooth, including how long each one lasts.
Why dentists push to save the tooth
Because nothing really replaces a natural root. A saved tooth keeps its root in the bone, which keeps the bone alive and the neighboring teeth in place, and a root canal plus crown usually holds for 11 to 20 years, often longer. Every replacement, no matter how good, is still a substitute: implants are excellent ones, bridges are decent, and a gap isn't a replacement at all. Money-wise, saving the tooth is usually the cheapest path that actually ends with a working tooth.
Pain and recovery, compared honestly
The fear here points the wrong way. A modern root canal feels a lot like getting a filling, and the endodontists' professional association reports that people who choose root canals are far more likely to call the procedure painless than those who choose extraction, because pulling a tooth takes real force and leaves a surgical wound. Recovery goes the same way: most people are back to normal the day after a root canal, while an extraction site means gauze, swelling, food restrictions, and several days of care while the socket heals.
When extraction is the right call
When there just isn't enough tooth left to save. A crack below the gumline, decay through the root, or bone loss around the tooth can make a root canal a bad investment, and only a dentist looking at the X-ray can make that call. Wisdom teeth are their own thing, almost always pulled instead of treated. If your dentist says the tooth isn't restorable, the real decision shifts to which replacement, and the tool prices those too.
The real cost of leaving the gap
The extraction fee now, plus problems that pile up later. Teeth next to a gap tilt into it, the opposing tooth over-erupts, the bite shifts, and the jawbone under the gap shrinks within the first year, which means a future implant would need grafting. For a molar nobody sees, some people accept the gap, but for a visible or chewing tooth it's the most expensive cheap option in dentistry. The tool includes it for honesty, not as a recommendation.
Common questions
Does insurance cover extractions?
Usually, as basic work, commonly at 70 to 80 percent after the deductible. The replacement afterward is covered separately and a lot less generously.
How long does a saved tooth last?
A root canal plus crown holds for 11 to 20 years in large population studies, and a tooth that makes it through its first decade usually just keeps going.
What if I cannot afford either option right now?
Tell the dentist, because an infected tooth left alone only gets more dangerous and more expensive. Most offices can stage the treatment, set up a payment plan, or handle the infection first while you sort out the rest.