Fixing a decaying tooth can cost anywhere from $50 for a small filling to $5,000 or more if the tooth needs to be extracted and replaced with an implant. The total depends on how far the decay has progressed, what type of restoration you need, and whether you have dental insurance. Here’s what to expect at each stage.
The Initial Exam and X-Rays
Before any work begins, you’ll need a dental exam and x-rays to determine how deep the decay goes. Without insurance, a dental exam typically runs $50 to $200, and x-rays add another $25 to $300 depending on how many images are needed. With insurance, your out-of-pocket cost for both often drops to $0 to $150 total, since most plans cover preventive visits at 100%.
This visit is where the real cost picture comes into focus. A dentist can tell you whether you’re looking at a simple filling, a crown, a root canal, or something more involved. If you have multiple decaying teeth, expect the dentist to prioritize them by severity and lay out a phased treatment plan.
Fillings for Early to Moderate Decay
If the decay hasn’t reached the inner nerve of the tooth, a filling is usually all you need. This is the least expensive fix and the most common one.
Silver amalgam fillings cost $50 to $200 for one or two teeth, or $150 to $400 when three or more teeth need work. They’re durable and have been used for decades, but they’re silver-colored and visible when you open your mouth. Tooth-colored composite fillings blend in with your natural teeth but cost more: $150 to $300 for one or two teeth, or $200 to $550 for three or more. Most dentists now default to composite for visible teeth and may offer either option for molars.
The price also depends on how many surfaces of the tooth are affected. A small cavity on one surface of a molar is cheaper to fill than a larger cavity that wraps around two or three sides of the tooth. Your dentist will describe the filling as “one-surface,” “two-surface,” or “three-surface,” and each additional surface adds to the cost.
Crowns for Heavily Damaged Teeth
When decay has destroyed too much of the tooth structure for a filling to hold, you’ll need a crown. A crown is essentially a custom cap that fits over what remains of the tooth, restoring its shape and strength. This is common when a large chunk of the tooth has broken down or when a tooth has been weakened by repeated fillings over the years.
Crown prices vary by material. Porcelain-fused-to-metal crowns are the most affordable option, followed by all-ceramic crowns (which look the most natural), with gold crowns at the top of the price range. Expect to pay roughly $800 to $1,500 per crown without insurance, though prices in major metro areas can run higher. Most dental insurance plans cover crowns at 50% after your deductible, which can bring your share down to $400 to $750.
Getting a crown usually takes two appointments. At the first, the dentist shapes the remaining tooth and takes impressions. You’ll wear a temporary crown for a couple of weeks until the permanent one is ready.
Root Canals for Deep Decay
Once decay reaches the pulp (the soft tissue inside the tooth containing nerves and blood vessels), you’ll likely experience significant pain, sensitivity to hot and cold, or swelling. At this stage, a root canal is typically needed to save the tooth.
A root canal on a front tooth costs approximately $620 to $1,100. Molars are more expensive because they have multiple root canals that each need to be cleaned and sealed, pushing the price to $890 to $1,500. These figures are for out-of-network treatment; in-network pricing with insurance is usually lower.
Keep in mind that a root canal almost always requires a crown afterward, since the treated tooth becomes more brittle without its living pulp. So the realistic total cost for saving a badly decayed molar is the root canal ($890 to $1,500) plus a crown ($800 to $1,500), putting you in the range of $1,700 to $3,000 before insurance.
Extractions When a Tooth Can’t Be Saved
Sometimes the decay is so extensive that saving the tooth isn’t practical or cost-effective. In that case, extraction is the next step. A simple extraction, where the tooth is visible above the gumline and can be pulled in one piece, costs $100 to $400 per tooth. A surgical extraction, needed when the tooth has broken off at the gumline or the roots are curved, runs $132 to $700 per tooth.
Extraction is the cheapest option upfront, but it creates a gap that can cause neighboring teeth to shift over time. Most dentists will recommend replacing the tooth, which adds significant cost (see below).
Replacing an Extracted Tooth
If you choose to replace a tooth after extraction, the three main options are dental implants, bridges, and partial dentures, each at a different price point.
A single dental implant is the most durable and natural-feeling replacement. The total cost, including the titanium post, the connector piece (abutment), and the final crown, typically falls between $3,000 and $5,000 per tooth. If you’ve lost bone in the area due to infection or long-term decay, a bone graft may be needed first, which adds to the total. The process takes several months from start to finish because the implant post needs time to fuse with your jawbone before the crown can be placed.
A dental bridge, which anchors an artificial tooth to the teeth on either side of the gap, generally costs $1,500 to $3,500. A removable partial denture is the most affordable replacement option, often running $500 to $1,500, though it requires daily removal and cleaning.
How Insurance Changes the Math
Most dental insurance plans follow a tiered coverage structure. Preventive care (exams, cleanings, x-rays) is covered at 80% to 100%. Basic procedures like fillings are typically covered at 70% to 80%. Major procedures like crowns, root canals, and implants are covered at 50%, if they’re covered at all. Many plans cap annual benefits at $1,000 to $2,000, which means a single crown and root canal can eat through your entire yearly allowance.
Implants are a notable gap in many plans. Some insurers classify them as cosmetic or simply exclude them. Check your specific plan before assuming coverage.
Ways to Lower Your Costs
Dental school clinics are one of the most significant money-saving options available. Dental students perform the work under close faculty supervision, and the quality of care is high. The University of Colorado’s dental school, for example, offers discounts of up to 55% off standard fees depending on the clinic. Most major universities with dental programs run similar patient clinics. The trade-off is longer appointment times, since students work more slowly and each step is checked by an instructor.
Community health centers that receive federal funding offer dental services on a sliding fee scale based on income. Dental discount plans, which aren’t insurance but membership programs that negotiate reduced rates with participating dentists, typically cost $80 to $200 per year and provide 10% to 60% off listed prices.
Why Waiting Costs More
Dental decay doesn’t stabilize on its own. A cavity that could be fixed today with a $150 filling will eventually need a $1,000 crown or a $2,000 root canal if left untreated. The progression from “small cavity” to “tooth that needs extraction and an implant” can mean the difference between a $200 fix and a $5,000 one.
The financial consequences extend beyond the dentist’s office, too. Dental-related emergency room visits in the United States totaled more than $2 billion nationally in 2017, according to data from the Agency for Healthcare Research and Quality. ERs can manage pain and prescribe antibiotics, but they can’t perform fillings or root canals, so patients end up paying for an ER visit and still need to see a dentist afterward. Addressing decay early is consistently the least expensive path, even when it doesn’t feel urgent.