Q How do I know if I really need a root canal, extraction, or implant?
Typically, root canals are necessary when the doctor finds an infection has reached the inside of the tooth and that it cannot be resolved in any other way. Symptoms often include sensitivity to touch and variations in temperature. Your dentist should also be taking an x-ray to confirm that an infection is present.
The decision to do a root canal and restoration (typically a crown), as opposed to an extraction, implant and crown is a medical one that is determined by many factors. Successful root canal therapy requires enough tooth structure to support the restoration. Without enough tooth structure, the more likely choice would be extraction and an implant..
This is a medical judgment best left to professionals, but if you have any doubt about whether a course of treatment is necessary, you should feel free to seek a second opinion.