What a root canal costs in Ontario, and what changes the figure

If you have been told you need a root canal, the cost is probably one of the first things on your mind. It is a fair thing to want a straight answer to, and most of what you find online gives you a national average or a range so wide it does not help.

These are our actual fees. For root canals, cores and examinations we charge the fees in the Ontario Dental Association's suggested fee guide for general practitioners. Every fee here is the same for every patient, whether or not you have insurance.

The short answer

The main thing that sets the fee is how many canals the tooth has. Front teeth usually have one. Premolars, just behind the canines, have one or two. Molars at the back have three or four.

• Front tooth, one canal: $757
• Premolar, one or two canals: $757 to $938
• Molar, three or four canals: $1,251 to $1,461

Those figures are for a canal that is straightforward to treat. The sections below cover what raises them, what is included, and what usually comes afterwards, which is often the bigger part of the total.

Why the number of canals matters

Each canal is a narrow channel running down through the root. In a root canal, every one of them is cleaned out, shaped and sealed. More canals means more work, and the canals in molars are often smaller, more curved and harder to reach, right at the back of the mouth.

When a canal is harder to treat

Some canals take considerably longer than others, and the fee guide recognizes that. There are three common reasons:

• Calcified canals. Over the years, or after an old injury, a canal can narrow until the finest instrument will not pass through it and it barely shows on an X-ray.
• Difficult access. A limited jaw opening, a tilted tooth, or an existing post or build-up in the way.
• Unusual anatomy. Roots that curve sharply, branch, or are shaped in ways that make the canal harder to follow.

Any of these puts the fee at $846 for a front tooth, up to $975 for a premolar, and $1,438 to $1,635 for a molar. Some of these show on the X-rays before we start and are reflected in your written, itemised estimate. Occasionally one only becomes clear once treatment is under way.

Redoing an old root canal

Sometimes a tooth that had a root canal years ago becomes infected again. Treating it a second time means removing the old filling material from the canals first, so it costs more: $901 for a front tooth, $901 to $1,085 for a premolar, and $1,447 to $1,629 for a molar.

Occasionally a tooth is complex enough that we refer you to an endodontist, a dentist registered as a specialist in root canal treatment. Specialists set their own fees, and we will tell you if that applies before anything is booked.

What the fee includes, and what it does not

The root canal fee covers planning the treatment, the treatment itself, the X-rays taken during it, and any temporary filling placed between visits.

It does not cover the examination and diagnostic X-rays beforehand, or the permanent restoration afterwards. At our practice an emergency examination is $56 to $162, depending on what it involves, and a single X-ray is $43.

What usually comes next: a core and a crown

In most cases, a root-treated tooth needs a core and a crown to finish it. The core is a filling that rebuilds the inside of the tooth. The crown is a cap that covers and protects what is left.

The reason is strength. A tooth that has had a root canal is more brittle than a living tooth, and it has usually lost a fair amount of its structure to decay or an old filling. A 2002 study by Aquilino and Caplan in the Journal of Prosthetic Dentistry found that root-treated teeth without a crown were lost at six times the rate of teeth that were crowned. We explain more on our root canal therapy page.

• Core: $395 to $507, depending on the material and whether the tooth needs a post to hold it.
• Crown: $1,500 to $2,000, including the laboratory fee.

A front tooth with plenty of healthy structure left can sometimes be finished with a filling instead. We will tell you which applies to your tooth. You can read about the options on our dental crowns and same-day crown pages.

Putting it together

For a molar with three straightforward canals, the root canal, core and crown together come to $3,146 to $3,758, plus the examination and X-rays that come first. For a front tooth that needs the same three steps, it is $2,652 to $3,264.

Those totals are why the crown matters so much when you are planning. It is often the larger cost, and it is usually covered at a different level by insurance.

Insurance and the Canadian Dental Care Plan

Most private dental plans treat a root canal as basic care and typically pay about 80% of it, and treat a crown as major care, typically paid at about 50%. Most plans also have an annual maximum, usually between $1,000 and $2,000, and a root canal with a crown can use much of it. Before major treatment, we can send your insurer a predetermination so they confirm in writing what they will pay. More on our insurance page.

The Canadian Dental Care Plan covers both root canals and crowns. What you pay yourself depends on your adjusted family net income: nothing under $70,000, 40% between $70,000 and $79,999, and 60% between $80,000 and $89,999. We accept the plan; see our CDCP page. For the rest, we also offer financing.

What a root canal cannot do

It is worth knowing the limits before you decide:

• It will not make the tooth as strong as it was. That is what the crown is for.
• It cannot save every tooth. A crack that runs down into the root, or a tooth with too little structure left to hold a crown, may not be worth treating.
• It does not work every time. A 2010 review by Ng, Mann and Gulabivala in the International Endodontic Journal found that 86% to 93% of root-treated teeth were still in place two to ten years later. Teeth that had a crown afterwards did better. When one fails, the options are a second root canal or removing the tooth.

The alternative: removing the tooth

Taking the tooth out costs less on the day, but it leaves a gap. At our practice a single dental implant is $3,500 to $6,000, all-inclusive, which is about what it costs to save a molar, or more. A conventional bridge is $1,500 to $3,000; it costs less, but it means crowning the healthy teeth on either side of the gap to hold it. Leaving the gap is also an option, and we can talk through what that means for the teeth around it.

You can read more on our single-tooth implants, dental bridges and extractions pages. If you are weighing the two, the examination is the place to start, because whether a tooth can be saved decides most of the rest.

Common questions

How much does a root canal on a molar cost in Ontario?

At our practice, a molar root canal is $1,251 to $1,461 when the canals are straightforward, and up to $1,635 when they are calcified or hard to reach. Most molars also need a core ($395 to $507) and a crown ($1,500 to $2,000, including the lab fee) afterwards.

Does insurance cover a root canal?

Most private plans cover a root canal as basic care, typically at about 80%, up to the plan's annual maximum. The Canadian Dental Care Plan also covers root canals. We can check your coverage before treatment.

Do I need a crown after a root canal?

In most cases, yes, especially on a back tooth. Root-treated teeth are more brittle, and a 2002 study found teeth without a crown were lost at six times the rate of crowned teeth. Some front teeth can be finished with a filling instead.

Is it cheaper to have the tooth pulled?

On the day, yes. Replacing it later with an implant ($3,500 to $6,000) costs about as much as saving the tooth, or more. A bridge ($1,500 to $3,000) costs less but means crowning the teeth on either side, so it is worth comparing the full picture.