Filling vs Root Canal: What’s the Difference Between These Procedures?

    filling vs root canal
    940 627 Golsen Family Dentistry

    Ever met one of those people that’s never dealt with a cavity in their life? They seem so proud of themselves and their upbringing or technique. Truth is, they’ve dodged a very common occurrence.

    Surveys indicate that 92% of adults deal with dental caries (the technical term for cavity).

    Dental caries may impact nearly everyone, but they don’t do so in the same way each time. Depending on the severity of the decay, dentists weigh the need for a filling vs root canal to see if either procedure is necessary.

    To you, tooth pain is just tooth pain. It may pinch, radiate, pulsate, or sting, but all you care about is that it goes away. Tooth problems are one of those things the average person can’t readily self-diagnose.

    Read on to learn more about the exquisite anatomy of the tooth and its treatments.

    Filling vs Root Canal

    Both procedures relieve pain in the mouth and prevent further damage. Dentists perform both procedures hundreds of times a week without complications. There are some distinct differences in the approaches that you should know.

    Key among the differences are the degrees and areas of damage to a tooth. From there, the procedures further differentiate in the complexity of the work needed to treat.

    The biggest difference between a cavity that needs a filling or a root canal is how much tooth is still salvageable after the decay.

    Tooth Fillings

    Fillings rank among the oldest treatments of teeth. Even primitive humans understood that a hole in a tooth was an issue and that filling it with something made it better.

    We’ve come a long way since pine resin was used for this purpose, but even today’s best techniques aren’t eternal. Filling materials today come from composite resins, silver, gold, or sometimes metal amalgams.

    The amalgams are mostly phased out and you may recognize them as the black or silver color fillings.

    Fillings last a number of years, but they need to be replaced a max of three to five years as they whittle down. Once a hole forms in the filling, bacteria can get up into the tooth and your mouth’s natural defenses can’t defend as they should.

    Damaged Areas

    The tooth has several layers with different names and purposes. The outer most layer is called the enamel. This hard layer protects the softer and more vital parts of the tooth from damage.

    Cavities (or dental caries) form when the enamel wears down or gets broken. From there, bacteria infiltrate and start to dissolve the dentin layer. This forms holes that grow faster than the body can repair them.

    While teeth don’t regenerate, they do repair themselves to some degree using cells from the inner pulp component. The pulp makes odontoblasts which attach to the dentin and reinforce it.

    If the damage is in the dentin, but hasn’t grown into the pulp, a filling can be used. A filling replaces the lost tooth material, providing both a structure for chewing and keeping bacteria out.


    The common drill and fill take care of most cavities. For damage along the side of a tooth, parallel to the pulp, you may even get a deep cavity filling.

    Bacteria in a tooth don’t come out easily. The abrasion of a toothbrush and toothpaste work great on enamel, which isn’t porous. Inside the dentin, scraping out the bacteria doesn’t go so well.

    To get the bacteria out, a dentist drills a tooth before filling it. This larger space makes it easier to get a better bond with the filling material, it also ensures bacteria won’t be hiding inside, defeating the purpose of the whole endeavor.

    A Tooth Root Canal

    Frequent visits to a dentist and following proper oral health guidelines will make fillings the most common procedure you face.

    Keeping to a dedicated health regiment isn’t something most of us are good at. As decay increases, a root canal becomes necessary to protect the mouth from damage that spreads to the pulp of a tooth.

    Not all root canals come from decay or over-time wear. Trauma from trips, car accidents, and other blows to the mouth count for a portion of the 15.1 million root canals performed each year.

    Crowns, applied at the end of a root canal, can come in various materials. Crowns protect the tooth below and give a better surface for biting.

    Damaged Areas

    Damage to the pulp warrants a root canal. Most of the time the damage comes from extensive decay through the layers of the tooth. However, in some cases, the damage comes from a crack to the tooth.

    Damage to a tooth also can come from below. When gums recede from periodontal disease or gingivitis, the bacteria can get into the root and do damage to the pulp while the outer layers of the tooth remain intact.

    A dentist uses an X-ray or other imaging to determine the extent of damage when recommending a root canal.


    The procedure for a root canal starts similar to a filling. You receive a stronger anesthetic for a root canal, as the repair goes deeper into the tooth and even the jaw.

    Drilling begins to remove the infected area. Once the drilling’s complete, the dentist installs a temporary dam around the tooth to keep out particles and saliva.

    The final stage sees the dentist clean out the canals of the tooth, removing the pulp and sterilizing the area. This part uses specialized tools to remove the tissues completely. Any remaining pulp connected to the nerve will cause pain and allow the infection to spread.

    With everything cleaned out, the dentist fills in the large cavity. After a short recovery time, a dentist affixes a crown to the top.

    A tooth that undergoes a root canal needs the extra protection that comes from the crown because the pulp is gone and the tooth is effectively dead. The material of the dentin and enamel that remains protect the mouth and work as before.

    Open Wide for Better Teeth

    You perceive pain differently than anyone else, so it’s hard to use that as a gauge when dealing with tooth issues.

    Seeing a dentist is the best way to find out if a filling vs root canal is better for your teeth or even necessary.

    Contact us for further information and to set an appointment. We share your concern for a pain-free and healthy mouth.