What Can I Do Instead of a Root Canal?

Reviewed on 3/3/2022
Dental model of a root canal
Dental treatment alternatives to a root canal include direct pulp capping, pulpotomy, pulpectomy, endodontic retreatment, endodontic surgery, tooth extraction, dental implants, bridges, or dentures.

For those with an infected or decayed tooth, there are several treatment alternatives available instead of having a root canal. These include the following dental procedures:

  • Direct pulp capping
    • This is a procedure used to treat exposed vital pulp with dental material to help promote dentin repair and to maintain vital pulp
    • Calcium hydroxide and mineral trioxide aggregate are the most commonly used pulp capping materials
    • The tooth is filled after the pulp capping materials are applied
  • Pulpotomy
    • This procedure is performed on a tooth that is still alive, where there is still blood flow and the tooth still responds to temperature and sensation 
    • The pulp that sits within the main part of a tooth, above the gumline (coronal pulp) is removed from a tooth
    • Often performed in baby teeth with pulp damage, but may also be done on permanent teeth with trauma or cavities that reach the pulp
  • Pulpectomy
    • In contrast to a pulpotomy, this procedure is done on teeth that are no longer alive
    • Removes the pulp from all parts of a tooth, including pulp in the roots
    • Removal of all the contents of the tooth's inner chamber, and cleaning of the entire root canal to protect it from further infection
  • Endodontic retreatment
    • The tooth is reopened and the filling materials that were placed in the root canal during the first procedure are removed 
    • The tooth is examined for additional canals or new infection
    • Infection is removed, canals are cleaned and shaped, and new filling materials are placed
    • The opening is sealed with a temporary filling and once the tooth heals, a new crown or other restoration is placed on the tooth to protect it
  • Endodontic surgery
    • Can help find small fractures or hidden canals that had not been detected on X-rays during the initial treatment
    • May also be used to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth
    • The most common procedure is an apicoectomy or root-end resection
    • Local anesthesia is used and the gum tissue near the tooth is opened to see the underlying bone and to remove any inflamed or infected tissue, and to remove the very end of the root
    • A small filling may be placed to seal the end of the root canal and sutures may be needed
    • The bone will heal around the end of the root within a few months
  • Tooth extraction and dental implants, bridges, or dentures
    • Tooth extraction is a last resort; it is better to try to save the tooth
    • If extraction is needed, dental implants may be considered to help you bite and chew properly, to keep healthy teeth from shifting, and to help maintain appearance
    • Dental bridges or partial dentures may also be an option

What Is a Root Canal?

A root canal is a type of dental treatment used to eliminate bacteria from an infected root of a tooth. 

Root canals are used to save a tooth that is infected or decayed due to: 

  • Cracked teeth that result from injury or genetics
  • Deep cavities
  • Issues from previous fillings

The top layers of the tooth are hard layers called enamel and dentin, and within those layers is soft tissue called pulp that contains blood vessels, nerves, and connective tissue. The pulp helps the roots of teeth grow during their development, but fully developed teeth can exist without the pulp because surrounding tissues provide teeth the nourishment they require.

In a root canal, inflamed or infected pulp is removed and the inside of the tooth is cleaned and disinfected, then filled and sealed. 

What Are the Complications of a Root Canal?

Most of the time, with proper care, the tooth that had a root canal treatment will last for a lifetime. However, in some cases, the treated teeth may heal improperly, causing pain or disease months or years after treatment and a root canal procedure may not be an option and other treatments will be considered. 

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Reviewed on 3/3/2022
Image Source: iStock Images