Root canal treatment has a reputation it no longer deserves as a procedure and entirely deserves as a bill. Understanding how it is priced -- and that the crown afterwards is a separate and often larger cost -- is what stops people from starting a treatment they cannot finish.
What the treatment does
When decay or a crack reaches the nerve inside a tooth, the tissue becomes inflamed or infected. Root canal treatment removes that tissue, cleans and shapes the canals inside the roots, and seals them. The tooth stays in place and keeps functioning; what is removed is the living tissue inside it. Modern treatment is done under local anesthetic and the discomfort during it is generally comparable to having a filling. The pain people associate with root canals is almost always the pain of the infection that made it necessary.
Front teeth and molars are different prices
Price scales with the number of canals. A front tooth typically has one and is the cheapest. A premolar usually has two. A molar has three or four, sometimes with complex anatomy, and costs the most, often close to double a front tooth. Retreating a tooth that has had a root canal before costs more again. Treatment by an endodontist -- a root canal specialist -- generally costs more than by a general dentist, and is worth it for difficult cases; ask your dentist whether yours is straightforward enough for them to do.
The crown is the part people forget
A back tooth that has had a root canal is brittle and usually needs a crown to stop it fracturing. The crown is a separate procedure with a separate fee that can equal or exceed the root canal itself, and it often includes a build-up or post. When you compare "root canal versus extraction" you must compare the full root canal plus crown against the extraction, or the comparison is meaningless. Ask for both figures on the same written estimate. Ask too how long you can safely wait between the root canal and the crown, because a temporary filling left too long can lose the tooth you just paid to save -- but the answer is measured in weeks or months, which sometimes buys the time you need.
When extraction is the reasonable choice
Extraction is a legitimate decision and sometimes the better one: when the tooth is cracked below the gum line, when too little tooth structure remains to hold a crown, when the tooth has already been retreated and failed, or when the total cost is simply out of reach. A dentist should be able to tell you the realistic success rate for your tooth specifically rather than in general. What is not a good outcome is starting a root canal, running out of money, and leaving a temporary filling in place indefinitely. If that is the likely path, say so before starting, and discuss extraction instead.
Where root canals cost less
Dental schools offer root canal treatment at substantially reduced fees, including through their graduate endodontics programs, where the work is done by dentists already qualified and now specialising. Appointments are longer and take more visits. Community health centers vary: some do root canals under the sliding scale, some limit endodontics to front teeth, and some refer them out. This is one of the services most worth asking about by name before you attend, since a clinic that cannot do molar root canals will send you elsewhere after you have paid for an exam.
