Face 
Dentistry If a tooth is badly damaged, inflamed or infected, you may find yourself considering two very different options:
Try to retain the tooth with root canal treatment – or remove it.
It is understandable to want someone to tell you which is “better”.
But that isn’t really the right question.
The better question is:
What are the reasonable options for this particular tooth, and what would each option mean for me?
Where a tooth is suitable for root canal treatment and can be appropriately restored afterwards, treatment may provide an opportunity to retain your natural tooth.
There are also situations where attempting to retain a tooth isn’t considered appropriate and extraction may be recommended.
The decision needs to be made after the tooth has been assessed.
Root canal treatment treats the inside of the tooth when the dental pulp has become inflamed, infected or damaged.
The affected tissue is removed and the root canal system is cleaned, shaped, filled and sealed.
The NHS explains that root canal treatment is used to treat infection inside a tooth and may avoid the need to remove it.
But the fact that root canal treatment is technically possible doesn’t automatically mean it is appropriate.
The rest of the tooth matters too.
This is one of the most important questions.
There needs to be enough appropriate tooth structure remaining for the tooth to be restored and function afterwards.
Your dentist or endodontist may therefore consider:
Root canal treatment addresses the root canal system.
It cannot make an otherwise unrestorable tooth restorable.
Extraction may be discussed where retaining the tooth isn’t considered appropriate or where the patient chooses removal after understanding the alternatives.
Reasons vary considerably.
For example, there may be:
Your clinician should explain the reason in relation to your tooth, rather than simply telling you that extraction is necessary without explanation.
Retaining natural teeth where appropriate is an important goal of dentistry.
But “natural tooth at any cost” isn’t a sensible rule.
Sometimes the amount or complexity of treatment required, the condition of the tooth or its ability to be restored means that trying to retain it may not be appropriate.
Equally, removing a tooth simply because extraction appears quicker doesn’t take account of what happens afterwards.
The decision needs to consider the whole picture.
Once a tooth is extracted, the next question is:
What happens to the space?
Depending on the tooth and your circumstances, options may include:
Not every missing tooth needs to be replaced, and not every replacement option is suitable for every person.
But if replacement is likely, it should form part of the original decision.
Comparing:
“root canal treatment versus extraction”
without considering:
“extraction plus what happens afterwards”
can give you an incomplete picture.
The immediate cost of an extraction may be lower than root canal treatment in some circumstances.
But the meaningful comparison is not necessarily just the price of those two procedures.
If you plan to replace the tooth afterwards, you also need to understand the potential cost and treatment involved in that.
Ask for the whole treatment pathway to be explained.
At Evolve, specialist endodontic fees will depend on the tooth and treatment required.
If treatment is recommended, the relevant fees will be explained before you decide whether to proceed.
Again, compare the complete pathways.
Root canal treatment may require more than one appointment and the tooth may subsequently need a restoration.
Extraction involves removing the tooth, but replacing it may require further appointments and treatment.
Your dentist can explain the likely pathway for the options available to you.
Fear is real, but it shouldn’t have to make the decision for you.
If your preference for extraction is largely because you’ve heard that root canal treatment is extremely painful, find out what treatment actually involves before deciding.
Root canal treatment is normally carried out using local anaesthetic.
Read: Does root canal treatment hurt?
You may still decide that extraction is right for you.
The important thing is that your choice is based on accurate information rather than somebody else’s frightening story.
This changes the question.
If a previously root-treated tooth develops a problem, possible options may include:
Which of these is appropriate depends on the cause of the problem and the condition of the tooth.
Read: My root canal hasn’t worked – can my tooth still be treated?
It can be useful where specialist endodontic assessment is appropriate.
At Evolve, Dr Alex Brett, Specialist Endodontist, GDC no. 244328, can assess whether endodontic treatment is a reasonable option and explain relevant limitations and alternatives.
That does not mean he will always recommend root canal treatment.
Sometimes a valuable specialist opinion is that further endodontic treatment isn’t appropriate.
You can be referred by your dentist or self-refer directly to Evolve.
Rather than asking only:
“Which would you choose?”
try asking:
Understanding all four areas gives you a much better basis for deciding.
Reality: Retaining a natural tooth can be desirable, but root canal treatment isn’t appropriate for every tooth.
Reality: The extraction itself may be relatively straightforward, but you also need to consider the effect of losing the tooth and whether replacement is appropriate.
Reality: Specialist assessment may establish that treatment is inappropriate or that another option should be considered.
If you’re unsure whether further endodontic treatment is appropriate, you can arrange an assessment with Dr Alex Brett, Specialist Endodontist.
Self-referrals and dentist referrals welcome.
Speak to our team about an endodontic assessment
Or download:
Your guide to root canal treatment – what it means, what to expect and understanding your options
For independent patient information, see the NHS guide to root canal treatment.
Electric or manual toothbrush - which is better?
It`s one of those dental questions where almost everyone has an opinion.
But does buying an electric toothbrush automatically mean you`re doing a better job?
Richard tackles the question.
Whichever toothbrush you use, how you brush matters enormously - so don`t panic if there`s nothing rechargeable sitting beside your bathroom sink.
Now we`re curious...
Clear aligners or fixed braces - which is better?
Which is better - clear aligners or fixed braces?
Neither.
At least, not until we know more about you.
The right orthodontic treatment depends on your teeth, what you`d like to change, your lifestyle and a number of clinical considerations.
For some people, clear aligners can be a great option. For others, fixed braces may be more appropriate.
So rather than starting with:
“Which braces do you want?”
We`d much rather start with:
“What would you like to change about your smile?”
Swipe through to understand some of the differences.
💚 £338 raised for Macmillan Cancer Support! 💚
We had such a lovely time at our Macmillan Coffee Morning last week. ☕🍰
A huge thank you to everyone who popped into the practice, enjoyed a slice of cake, had a chat and made a donation. It was wonderful to see so many of our patients, friends and members of the local community getting involved, and we were genuinely touched by everyone’s generosity.
Together, you helped us raise an amazing £169.
And we’re delighted to share that Carol has very generously matched every pound raised, bringing our final total to…
🥁 £338 for Macmillan Cancer Support! 💚
Thank you to our brilliant team for baking, organising and keeping the cake table well stocked, and to every single person who helped make the day such an enjoyable one.
Days like this remind us just how lovely the community around Evolve really is. 💚
#MacmillanCoffeeMorning #MacmillanCancerSupport #Portishead #EvolveDentistry #PortisheadCommunity
Being shortlisted for Team of the Year means a lot to us, but not because of the trophy.
It’s because dentistry is never the work of one person.
It’s the nurse who notices you’re nervous before you’ve said a word. The reception team member who remembers the conversation you had last time. The clinician who takes time to explain something again. The person behind the scenes making sure your visit runs smoothly.
Those small things happen every day at Evolve, and they only happen because people care about the experience we create together.
So being a finalist gives us a lovely excuse to say something we probably don’t say often enough: we’re incredibly proud of this team.
#PrivateDentistryAwards #TeamOfTheYear #DentalTeam #EvolveDentistry
You might notice a familiar face missing from Evolve for a little while… 💚
Carol is heading to Zambia with SmileStar, a dental charity providing free dental care to communities with limited access to treatment.
In this video, Carol shares a little more about where she’s going, what she’ll be doing while she’s there and why she wanted to be part of the trip.
It’s going to be a very different couple of weeks away from the practice, and we’re incredibly proud to see Carol giving her time and skills to support SmileStar’s work.
We’ll be sharing a little more from her trip when we can, but for now, we’ll let Carol tell you all about it in her own words. 💚
Safe travels, Carol. We can’t wait to hear all about it when you’re home!
#EvolveDentistry #SmileStar #Zambia #Dentistry #Portishead
🍰 Come and join us today! 💚
Our Macmillan Coffee Morning is in full swing at Evolve Dentistry, and we’d love to see you!
We’ve got plenty of delicious homemade cakes waiting for you, so pop in, say hello, grab a slice (or two!) and help us raise money for Macmillan Cancer Support.
We’ll be serving cakes right through until 5pm today, so there’s still plenty of time to come down.
📍 Evolve Dentistry, Portishead
🍰 Cakes until 5pm
💚 Everyone is welcome
Come hungry! 😋
#MacmillanCoffeeMorning #MacmillanCancerSupport #Portishead #PortisheadCommunity #EvolveDentistry
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