Is Root Canal Treatment Expensive?

A Check on how expensive is root canal treatment

Tooth pain is a reality for many of us, but it doesn’t have to hurt your wallet either. Emergency dental care may be expensive if you haven’t been regular with your oral check-ups ( at least twice a year). However, if you need a root canal treatment to fix a sore tooth, first, you need to understand the various factors and a general rundown for root canals to get an idea about how much it will ultimately cost you.

In the past, whenever a damage or decay-like situation happened to a tooth, the only treatment option was to have it extracted. Root canal therapy is turning out to be an extremely beneficial option because it allows for most teeth to be saved and remain functional within the mouth itself. 

Everyone should be aware that our teeth do not really need pulp to function properly once they are fully formed. The pulp provides the tooth sensation to hot or cold stimuli, but in a healthy mouth, it isn’t required for the tooth to remain functional.

Understanding root ranal treatmentr

Endodontic, Root canal or root canal treatment treats the pulp of the inflamed, infected, or dead tooth. When an endodontist performs a root canal, they remove the dental pulp and fill and seal all the canals and the pulp chamber to prevent bacteria from reentering. All our teeth roots have at least one canal, but some have more than one root canal. 

Endodontics is a specialty dentistry that deals specifically with the tooth pulp and tissues surrounding the tooth’s root. Therefore, root Canal Treatment should preferably be done by an endodontist instead of a general dentist. In addition, endodontists have multiple years of specialty training after dental school to focus exclusively on root canal treatments. 

Another reason is that if a general dentist discovers later that a particular tooth is complicated or the root canal is done for the second time, your dentist may refer you to an endodontist.

Why should you opt for root canal treatment?

Please understand that you are probably already a candidate who needs a root canal treatment by the time you feel pain or any other symptoms that alert you to visit a dentist. 

However, there are specific symptoms that you should keep in mind. 

  1. Pain along with some sensitivity for hot or cold stimulus. Notably, heat sensitivity, instead of cold, is a symptom that is very specific to a tooth requiring root canal treatment. The pain could progress to a severe generalized headache. In case of a dead or abscessed tooth, the pain would be felt when a person chews food or puts pressure on the tooth. These could lead to swelling of the cheek, jaw, or throat. A swelling means you need to go to the emergency care of a dental hospital. A root canal could be masquerade into many types of toothaches. Therefore it is best to get a thorough examination with pulp vitality testing by a licensed dentist for a proper diagnosis. Jaw pain, upper teeth pain during sinus congestion, gum disease can all feel like root canal pain.
  2. Infection / Endodontic Abscess – An abscessed tooth requires a root canal at all costs. The pus pocket that forms around the end of the dead tooth gets infected with bacteria and sometimes resembles a pimple outside the gums. A patient may even notice pus draining or feel a persistent bad taste/bad breath in his mouth. The abscess left untreated could infect the bone and could lead to severe consequences. The antibiotics may provide temporary relief from the infection. Still, to remove the root cause of the problem, root canal clearing out all the dead tissue and bacteria inside the pulp chamber and root canals are very important.
  3. Cavities – Tooth decay extending deep into the tooth and reaching the pulp needs to be treated to avoid further damage to the tissue. Only a dentist could rule out if the tooth decay is completely taken care of in cases where the patient fails to notice any pain.
  4. Fracture/Trauma – The tooth could get damaged and nerve severed at the end of the root due to fracture or trauma. Suppose a tooth has fractured so that not much tooth structure is left above the gum line for a dental crown or any other restoration. In that case, a root canal may be the only option, so your endodontist could place a post down the tooth’s canal to help retain the restoration.
  5. Resorption – Resorption is a condition whereby the tooth structure dissolves away as a reaction to injury, trauma, tooth replantation, or aggressive tooth moving during orthodontic treatment. External root resorption is when the defect starts from outside the root and goes inward. While internal resorption is when the tooth dissolves from the middle or inside and progresses towards the outside. Resorption usually causes no pain and can only be diagnosed during dental X-rays. 
  6. Repetitive dental procedures – Dental procedures do put significant stress on a tooth. Repeated procedures like drilling may cause inflammation of the pulp. If it is reversible, your dentist will recommend a different procedure.

How much does a root canal cost?

The cost of root canals varies depending on several factors like location, delay in getting the treatment, status of the past root canal treatment, and any other complications that may arise during or after the treatment. (Read on to know more about them). 

Molars, for example, have more canals that need to be treated and filled, so they may turn out to be more expensive. Most dental insurance plans cover root canal treatment. The actual amount that your dentist charges could vary greatly. 

A root canal is definitely less expensive than a dental extraction and the subsequent cost of a bridge, a crown, or a post and an implant.

Factors that determine the cost of root canal treatment

  1. Location of the tooth- According to the American Association of Endodontists, one of the main factors is the tooth’s location that needs to be repaired. If the cavity is on one of your front teeth, it may cost less. It is because the front teeth have only one root. Molars, on the other hand, could have up to three roots. More roots mean more work for your dentist and, ultimately, a higher cost of the root canal.
  2. The timing of the treatment- Root canal costs more the longer you wait. If you have been delaying the dentist visit for a while, the repair work of the infected tooth will cost you more. If you visited the dentist as soon as you noticed sensitivity, the infection wouldn’t have spread as extensively, and it would be easier and relatively cheaper for a root canal treatment. Therefore, don’t drag your feet in making a dental appointment and let the situation worsen. Fast action on your part could mean that you could get off with only a filling instead of a crown.
  3. Retreatment for past root canals- Sometimes, you could get the infection in the same tooth that already had a root canal. The procedure would become a little more extensive when your dentist needs to drill to access the infected areas. If there was a filling before and now your dentist feels you require a crown, the costs will likely go up.
  4. Lack of proper guidance and transparency- Some dentists might not be able to guide you through the whole process and, sensing you are not ready to go the whole Root Canal way, might do a temporary fix of the issue with cleaning the canal and filling it. This might cause problems to recur soon, and the total cost of the dental treatment could shoot up. Therefore you must discuss all your concerns ahead of time and work out a solution with your dentist before undergoing any treatment.

Possible problems or complications that may increase the cost during a root canal treatment

While undergoing root canal treatment, you must consider the possibility of the treatment failing or some other complications arising during or after the treatment is completed. Just because a root canal can be performed on a tooth does not make it an ideal treatment choice if these factors are not considered.

  1. Post-treatment fracture- The tooth is hollowed out to a certain degree during a root canal. It is more prone to fracture. Although a crown placed on the tooth somewhat protects it, there are still chances of an undetected crack even though your dentist treated the tooth with a perfect root canal treatment.
  2. If roots are excessively curved- A file could break off inside the canal in excessively curved roots. If it can’t be retrieved, the tooth may get reinfected, and therefore you may need a surgical procedure to finish the root canal treatment.
  3. Narrowing/calcification in the canal- The tooth may become perforated while locating the canal if the pulp canal is difficult to trace due to narrowing or calcification. In severe cases, extraction could be the only option.
  4. Reinfection- if the restoration leaks or the patient is not maintaining good oral hygiene, or the sealing materials are not of good quality, it could cause reinfection. Sometimes there are more than the typical root canals in a tooth, and the treating dentist could miss an extra canal. This could lead to root canal failure. The retreatment means more than two visits or even a surgical procedure (apicoectomy), adding to the cost of the root canal treatment.
  5. Aesthetic considerations- The root canal treatment could cause some discoloration of the tooth in some cases. Since the nerve in the tooth dies, the tooth could become dark yellow, brown, or gray compared to the surrounding teeth. Particularly in front teeth, the teeth need to be treated with internal bleaching or covering the tooth with a veneer or crown.

When is root canal not cost-effective?

The best dentist in the country will always make sure that you get to see your dental problems from every perspective. It is wise to consider all your options and long-term solutions for your dental problems rather than short-term knee jerk arrangements. 

There are certain situations when a root canal may look like a more manageable, cheaper solution than extraction. Still, if it doesn’t work, and you have to go for extraction, later on, the cost and inconvenience will only increase.

Consider taking a second opinion in the following cases to weigh the pros and cons of extraction vs. root canal treatment.

  1. If your tooth has sustained a fracture down the root or a significant portion of the tooth’s crown is broken, it will be wise to consider extraction since the tooth will continue to hurt or be infected even after a root canal is performed.
  2. Lack of healthy tooth structure, if the left-over tooth structure is not enough or is not healthy for a crown to attach to, the root canal treatment is a waste of money. Although, in some cases, a crown lengthening procedure can be performed, such treatment needs to be done by an expert restoring dentist to ensure there are no side effects.
  3. Third molars or wisdom teeth are generally not in a functional position to have a successful root canal treatment. It is wise to consider their extraction rather than preserving it with a root canal treatment.
  4. If a considerable amount of tooth has dissolved away due to internal or external resorption, even a root canal won’t be able to save it. Consider extraction instead.
  5. In the case of multiple root canals, the more the number of canals, the more the number of procedures. After a first few successful root canal treatments, the efficacy of the treatment on such teeth might go down considerably. Ultimately it’s up to the patient to decide to what extent they want to save the tooth or how comfortable they feel with their treatment options.

Many people are unaware that they may need a root canal treatment until they seek a competent licensed dentist. A dental expert can diagnose the underlying cause and deliver evidence-based dental treatment, including root canal treatment when it is needed. 

Every tooth is different and needs to be evaluated on a case-by-case basis. The pros and cons of root canal treatment vs. extraction need to be understood. Both the patient and the dentist should aim to save the tooth, but in the end, it is the long-term benefits that matter. 

A dentist and an endodontist play a critical role in maintaining perspective regarding the condition of your teeth and advise on the success with different treatment options.

head shot of Dr. Warrier

This article is

Medically Reviewed by 

Dr. Smita Warrier

Dr. Smita Warrier graduated dental school in 2004 from Tufts University in Boston. She relocated to Charlotte shortly after and started her practice in Ballantyne in 2007. She is very passionate about dentistry and providing top-notch care to her patients. 

She is a member of the American Dental Association as well as local and state dental organizations. She feels very strongly about staying abreast of the latest technologies and treatment care modalities and dedicates many hours in continuing education. 

She has been an Invisalign certified provider since 2006.

16143 Lancaster Highway,
Suite 101
Charlotte, NC – 28277

704 544 5500

Mon – Thu: 8am – 4:30pm
Friday: By Appointment
Sat – Sun: Closed



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