Alternatives to Root Canals: Options & Effectiveness

Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Table of Contents

  1. Tooth Extraction
  2. Ozone Gas & Irrigants
  3. Vital Pulp Therapy
  4. Holistic Options
  5. When to Get a Root Canal
  6. References

A root canal is designed to remove infection from the inside of the tooth, eliminate tooth pain, and save the tooth. It has a high success rate and is often able to preserve your natural tooth and last a lifetime.

There are some alternatives to having a root canal, however, including the following:

  • Tooth extraction

  • Ozone gas treatment

  • Irrigants

  • Vital pulp therapy (VPT)

  • Holistic measures

Most of the time, a root canal is going to be the best option for saving your tooth, minimizing infection, and providing the most long-term solution.

Tooth Extraction

When bacteria builds up on a tooth, it can wear down the enamel and cause a cavity. When the infection reaches the pulp, or the inside, of the tooth, it can break down further.

Typically, treatment for tooth decay depends on the level of infection and proceeds in the following order:

  1. Fluoride treatment to help the weakened enamel repair itself

  2. Fillings to remove bacteria and fill the hole

  3. Root canal to clean out infected pulp and place a crown to seal it on top

  4. Tooth extraction when the damage is significant and placement of an implant or dental bridge

A tooth extraction is typically considered the last resort when a tooth cannot be saved through a root canal. While it can effectively clear out a dental infection, a tooth extraction is also more painful, takes longer to heal, and will require further treatment. A dental implant and/or a dental bridge will be needed after the extraction to fill the gap.

The American Association of Endodontists (AAE) states that it is always better to try and preserve your natural teeth than to have a tooth pulled. That being said, there are times when the infection has gone too far, such as when it enters the bone, and tooth extraction may be needed. Your dentist can assess the level of damage and disease to help you decide on the best treatment option.

Ozone Gas Treatment & Irrigants

The infection in the pulp of the tooth can often extend to the microtubules. Ozone gas can get into these tough-to-reach areas and help to irrigate the tooth effectively.

Ozone gas can reach deeper into the bone than a root canal even. It can help to kill bacteria and irrigate waste from deep into and underneath the tooth.

Ozone has antimicrobial properties and can therefore potentially kill strains of bacteria that traditional methods cannot. Research shows that combining ozone gas with sodium hypochlorite (NaOCl) is extremely effective in reducing the amount of bacteria in the area.

Additional irrigants, including calcium hydroxide, can also be used to flush out diseased tissue. This substance is very toxic, however, and will need to be carefully placed with a needle or file. Irrigants used to disinfect during a root canal can cause serious injuries and issues if not placed exactly right.

The use of ozone gas, other irrigants, or a combination of the two to remove bacteria from a tooth is not yet a common practice. There is no guarantee that their use will get rid of the entire infection. It is possible that you will still need a root canal down the line to save the tooth.

Vital Pulp Therapy

Long used to treat dental pulp that has been impacted by trauma (as is the case with infection from a cavity) in teeth that do not yet have fully formed roots, vital pulp therapy (VPT) is gaining traction as an option for adult teeth with fully formed roots.

Vital pulp therapy involves removing some of the pulp without needing to take all of it, like during a root canal. VPT removes the infected pulp while leaving healthy tissue and often places a pulp cap over the pulp. Especially when used on a molar, it can potentially help to preserve the structure of a tooth over a root canal.

You have to meet specific criteria and undergo a thorough prescreening in order for VPT to be effective. Success of the procedure can depend on the ability to seal it off, how much infected tissue is present, how good the blood supply is, and how healthy the rest of your mouth and teeth are.

Vital pulp therapy is a relatively new option for mature teeth. It requires a trained professional with knowledge and skill to screen candidates and then perform the procedure.

Holistic Measures

Holistic, or natural remedies, for a tooth infection often include changes to diet, as some foods are known to increase bacteria.

Diets that eliminate refined foods, sugars, starches, and grain products often claim to help heal and even reverse tooth infection. This is unproven. Once bacteria have reached the inside of the tooth, changing your diet is not going to be enough to eliminate the infection.

After the enamel from the tooth has been destroyed, it cannot be restored. The infection will need to be professionally cleaned out. You can help to repair weakened enamel before the infection reaches the inside of the tooth by making diet and lifestyle changes, however.

These changes can help to prevent dental infection and minimize further damage:

  • Brush your teeth at least two times per day.

  • Floss every day.

  • Stop smoking or other tobacco product use.

  • Drink enough water.

  • Use a fluoride mouthwash daily.

  • Eat a balanced and natural diet with few processed foods.

  • See a dentist regularly for routine checkups and dental cleanings.

When to Get a Root Canal

A root canal is almost always the safest, least painful, and most effective option when it comes to infection that has reached the inner layer of your tooth.

Saving your natural tooth is the best option, as implants and dental bridges will never quite feel like your real tooth or look as good. A tooth extraction should generally be the last resort if the damage is too severe for the root canal to save the tooth.

Talk to your dentist as soon as you are experiencing tooth pain or sensitivity, as it can indicate a problem, such as infection. There are alternatives to root canals, but these are not proven to be as effective long term. If you opt for another treatment option, it is entirely possible that you will end up needing a root canal later, as the alternatives often do not take care of the entire infection.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.