Abstract Background Decision-making is a process that the dentist does every day, and which is based on experience and the patients status. Many factors influence the decision of the therapy regarding extraction or endodontic treatment such as stress, economy, lack of time, acutepain and tooth status. This means that the choice of treatment does not become obvious when choosing between these two therapies. Aim The purpose of the study is to investigate whether the dentists perform adequate treatments regarding extraction versus endodontics, based on the data provided to the participants. Methods Nine different cases are sent to nine different clinics in Västerbotten with access to patient information. Patient material in the form of X-rays is deidentified. Each patient case was assigned a code. Information letters, the questionnaire and the cases were sent digitally via e-mail. Result 20 dentists answered the survey out of 98 dentists who were included in the study. One of the questionnaires was excluded due to incomplete answers which resulted in a total of 19 complete responses. 35% of the answers chose extraction treatment, 33% endodontic treatment and 32% of the answers could not suggest a treatment. Conclusion In consultation with an endodontic specialist, one third of the dentists in Västerbotten do not make adequate therapy decisions. However, it is not possible to draw any general conclusions due to the large dropout.