Should You Extract a Painful Tooth? Place an Implant? Have a Root Canal or Crown?

Should you extract a painful tooth? Place an implant? Have a root canal or crown?
Dr. James Martin Kahal Dentist Laguna Woods, CA

Dr. James Martin Kahal D.D.S. is a top Dentist in Laguna Woods, California. With a passion for the field and an unwavering commitment to their specialty, Dr. James Martin Kahal D.D.S. is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr. James... more

This topic comes up every day in my practice, and I wanted to share the decision-making process that dentists go through to recommend the appropriate treatment. First, we must find out what is causing the pain.

Is it periodontal (the gums)? Is it endodontic (the inside or nerve of the tooth)? Is it a fractured tooth? Or could it be decay above the gum or decay below the gum? Could it be a combination of any of the above?

If the tooth is fractured above the gum, we can usually restore the tooth with a crown and possibly a root canal (endodontic procedure). If the tooth is fractured vertically below the gum, it usually means the tooth will need to be extracted and restored with an implant and implant crown. The same goes for decay.

When decay is under the gum and it extends to the bone it is very difficult to restore the tooth traditionally, and we will recommend extraction and the implant restoration protocol. When the inside of the tooth is the source of pain and we can identify which tooth it is, we will recommend root canal treatment (endodontics) and possibly a crown.

Back teeth with root canals need to be crowned, and front teeth sometimes do not have to be crowned after root canals. If the pain is coming from the gums, it can be as simple as removing debris that is stuck or doing some sort of gum treatments to resolve the issue.

As you can see, the decision tree is a complicated one that that has many solutions. A prudent dentist will consider all the signs and symptoms before recommending any treatment.