Does a severe cavity need to be extracted?

Not every severe cavity requires extraction - in many cases the tooth can be saved with root canal treatment and a crown. However, we may recommend extraction when 1) the decay has progressed deep below the gum line into the root, 2) so much tooth structure is gone that even a crown would not stay in place, or 3) the cavity is at a point where the root has split. In those situations, even if we try to save the tooth, it is unlikely to last long. The decision is based on X-rays and a clinical exam to evaluate the prognosis of saving the tooth - so even for a severe cavity, please come in first for a diagnosis.