Root Canal With All Roots Removed: Cost & What Happens
Quick answer
A root canal doesn't remove all roots from a tooth — the procedure cleans out infected or dead nerve tissue inside the canals while keeping your tooth structure intact. If your dentist mentions 'all roots removed,' they likely mean the tooth needs extraction because it's too damaged to save, which costs $300–$800 SGD for a simple extraction or $1,200–$2,500 SGD for a surgical extraction, depending on complexity.
The whole process usually takes 60–90 minutes for a single-root tooth (like a front incisor) and 90–120 minutes for a multi-root tooth (like a molar).
What a Root Canal Treatment Actually Does to Your Roots
When my back molar started hurting, my dentist said I needed a root canal on a tooth with three roots. I thought that meant all three roots would be pulled out, so I was confused when she explained she was actually keeping my tooth and just treating the inside. It turns out most patients have the same misunderstanding about what root canal treatment actually involves.
A root canal doesn't remove your tooth's roots. Instead, it removes the infected or dead pulp (nerve tissue) from inside the root canals — the tiny channels that run through your tooth's roots. Your dentist accesses these canals through the crown (top) of your tooth, cleans them out, shapes them, and fills them with a material called gutta-percha. Your tooth structure, including all the roots, stays in place.
Here's how the procedure works step by step:
- 1Diagnosis: Your dentist takes an X-ray to see how many roots your tooth has and how deep the infection or damage goes inside the canals.
- 2Anaesthesia: Local anaesthetic numbs the tooth and surrounding area so you feel pressure but no pain.
- 3Access and pulp removal: Your dentist creates an opening in the crown of the tooth and carefully removes the infected or dead pulp tissue from inside each root canal.
- 4Cleaning and shaping: Each canal is cleaned, shaped, and enlarged slightly to prepare it for filling.
- 5Filling: The canals are filled with gutta-percha, a rubber-like material, and sealed with adhesive cement.
- 6Restoration: A temporary or permanent crown is placed on top of the tooth to protect it.
The whole process usually takes 60–90 minutes for a single-root tooth (like a front incisor) and 90–120 minutes for a multi-root tooth (like a molar). Most teeth in Singapore that undergo root canal treatment are back molars, which often have 2–3 roots.
When Your Dentist Might Recommend Full Tooth Extraction Instead
I've talked to several people who had their dentist mention extracting a tooth completely — and that's when the phrase 'all roots removed' actually applies. It's a very different scenario from root canal treatment, and understanding the difference before you're sitting in the chair makes a huge difference.
If your dentist says all roots need to be removed, they're not talking about root canal treatment — they're talking about tooth extraction. This happens when the damage is too severe to save the tooth, even with root canal treatment. Common reasons include:
- Severe decay that has destroyed most of the tooth structure above the gum line, leaving nothing to anchor a crown after root canal treatment.
- Root fracture that splits the root into separate pieces, making it impossible to seal the canals properly.
- Bone loss around the roots (advanced periodontal disease) that has compromised the tooth's stability.
- A tooth that has already had a failed root canal treatment and is still painful or infected.
- Root resorption, where the body's own cells dissolve the root structure (this can happen after trauma or in rare cases naturally).
- A tooth so deeply embedded in bone that treatment would damage adjacent teeth or nerves.
If extraction is recommended, your dentist will explain why the tooth can't be saved and discuss replacement options: a dental implant (single tooth replacement at $4,000–$8,000 SGD), a bridge ($2,000–$6,000 SGD), or a partial denture ($800–$2,000 SGD).
Root Canal vs Extraction Costs in Singapore
I didn't realise the cost difference between a simple root canal and an extraction until I actually got the quotes — and then I had to choose between paying more to keep my tooth or extracting it. Understanding what you're actually paying for made the decision a lot clearer.
A root canal treatment in Singapore costs $800–$2,000 SGD at a private dental clinic, depending on tooth complexity. A molar with three roots costs more than a single-root front tooth because it takes longer and requires more careful cleaning of each canal.
Extraction costs are usually lower upfront:
- Simple extraction (tooth visible and easily accessible): $300–$600 SGD at a private clinic.
- Surgical extraction (tooth below the gum line, impacted, or with curved roots): $1,200–$2,500 SGD at a private clinic or specialist oral surgeon.
At subsidised clinics under CHAS (Community Health Assist Scheme), root canal costs are reduced to around $400–$600 SGD depending on your card tier, and extractions may be $50–$150 SGD. However, CHAS clinics typically handle only straightforward cases; complex surgical extractions or root canals on difficult teeth may be referred to private clinics.
Medisave can be used for root canal treatment, but only if the tooth is not otherwise salvageable through other means — in other words, your dentist must document that extraction or other treatment won't work. Medisave withdrawal is subject to annual limits (currently part of your Dental Care benefit if you have one, though this varies by plan). Check your CPF statement or call the CPF Board to confirm your current Dental Care balance.
Success Rates and What Happens if Root Canal Treatment Fails
After my root canal, I spent weeks worried about whether it had actually worked — my tooth still felt a bit tender. I later learned that some discomfort is normal for weeks afterward, and there's actually a range of outcomes when it comes to root canal success, especially with multi-root teeth.
Root canal treatment has a success rate of around 85–95% for teeth treated for the first time, according to endodontic studies published in major dental journals. Success rates are lower for teeth that have already failed treatment once (around 60–80% on retreatment) and for teeth with curved, calcified, or very complex root systems.
If your root canal fails — meaning infection returns, pain persists, or the tooth eventually darkens or becomes loose — you have two options:
- Retreatment: Your dentist reopens the tooth, removes the old filling material, cleans the canals again more thoroughly, and refills them. This costs $1,200–$2,500 SGD at a private clinic and takes longer than the initial treatment. Success rates for retreatment are lower than first-time treatment.
- Apical surgery (endodontic surgery): A specialist oral surgeon makes a small cut in the gum above the root tip, removes the infected root tip and surrounding tissue, and seals the end of the root. This costs $1,500–$3,500 SGD and is usually recommended if retreatment has failed or isn't possible. It requires referral to a specialist.
- Extraction: If retreatment or surgery isn't viable, the tooth is extracted and replaced with an implant, bridge, or denture.
Persistent discomfort or slight sensitivity after root canal treatment is common for 1–4 weeks. True failure (infection visible on X-ray, swelling, or persistent pain beyond 6–8 weeks) is less common but does happen. If you're concerned about your treatment outcome, ask your dentist for a follow-up X-ray 6 months after treatment.
The pulp chamber is the hollow space inside your tooth that contains nerves and blood vessels. When bacteria reach it through a deep cavity or crack, it causes severe pain — and that's when a root canal is needed.
An endodontist is a dentist who specialises in root canal treatments and saving teeth. Complex or re-treatment cases are often referred to one — though many general dentists in Singapore perform routine root canals.
During a root canal, your dentist places a thin rubber sheet around the tooth to keep it dry and clean — it also stops any liquid from going down your throat.
An apex locator is an electronic device that tells your dentist exactly where the root canal ends — so they clean all the way to the tip without going too far.
After cleaning and shaping, the root canal is filled with gutta-percha and a sealer to prevent bacteria from re-entering. This is the final step before a crown is placed.
During a root canal, your dentist places a thin rubber sheet around the tooth to keep it dry and clean — it also stops any liquid from going down your throat.
After cleaning and shaping, the root canal is filled with gutta-percha and a sealer to prevent bacteria from re-entering. This is the final step before a crown is placed.
During a root canal, your dentist places a thin rubber sheet around the tooth to keep it dry and clean — it also stops any liquid from going down your throat.
After cleaning and shaping, the root canal is filled with gutta-percha and a sealer to prevent bacteria from re-entering. This is the final step before a crown is placed.
Cost in Singapore
$800–$2,000 SGD (root canal); $300–$2,500 SGD (extraction)
Root canal treatment can be claimed via Medisave if your dentist documents that the tooth cannot be saved by other means. CHAS card holders pay $400–$600 SGD at participating clinics (reduced from private rates). Extraction is usually not covered by Medisave but is heavily subsidised under CHAS ($50–$150 SGD). Check your CPF Dental Care balance on cpf.gov.sg or call 1800-227-7227 to confirm eligibility.
Key takeaways
- Root canal treatment preserves your tooth by removing infected nerve tissue — it doesn't extract all roots.
- If your dentist recommends removing all roots, they're talking about extraction, which is usually $300–$600 SGD for a simple case or $1,200–$2,500 SGD for a surgical extraction.
- Multi-root teeth (usually molars) cost more for root canal treatment ($1,200–$2,000 SGD) than single-root teeth ($800–$1,200 SGD) because each root canal must be carefully cleaned and sealed.
- Medisave can be used for root canal treatment if your dentist documents that the tooth cannot be saved any other way — check your CPF Dental Care balance first.
- If root canal treatment fails, you can pursue retreatment ($1,200–$2,500 SGD), endodontic surgery ($1,500–$3,500 SGD), or extraction with replacement — ask your dentist which option is realistic for your tooth.
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Need to find a dentist for root canal treatment or extraction?
Understanding your options — root canal vs extraction, private vs subsidised — is the first step. The next is booking a consultation with a dentist who can assess your tooth and explain which treatment is realistic for you. Use the SGDentistry clinic finder to locate dentists near you who handle root canal treatment and extractions, with pricing and subsidy eligibility information.