Sometimes endodontic treatment alone cannot save your tooth, and your dentist or endodontist may recommend endodontic surgery. Endodontic surgery includes any surgical procedures used to remove infection from your root canals and surrounding areas. Surgery can also be used in diagnosing problems that do not appear on your x-ray, such as root fractures, or in treating problems in the surrounding bone.

Who performs endodontic surgery?
All dentists are trained in endodontic treatment. Because endodontic surgery can often be more challenging than routine treatment, many dentists refer patients needing surgery to endodontists.

Endodontists are dental specialists who diagnose and treat oral pain. They specialize in endodontic (root canal) treatment, including any treatment for the inner tissues of the tooth. In addition to dental school, endodontists receive two or more years of advanced education. They study root canal techniques and procedures in greater depth, including the area of endodontic surgery.

What is an apicoectomy?
An apicoectomy is the most common endodontic surgical procedure. This procedure is used to remove infection or inflammation from the bony area around the end of your tooth. The endodontist starts by opening the gum tissue near the tooth. This allows him or her to see the underlying bone.

Next, your endodontist will remove any inflamed or infected tissue. The very end of the root is also removed.

After the inflamed or infected tissue is removed, a small filling may be placed in the root-end to seal the root canal. A few stitches are placed in the gum to help the tissue heal properly. Within a few months, the bone heals around the end of the root.

Are there other types of endodontic surgery?
There are several other types of surgery that are performed, depending upon the situation. Your endodontist will be happy to discuss the specific type of surgery that you might need.

Will endodontic surgery hurt?
Your endodontist will provide you with local anesthetics that will make the procedure comfortable. You may feel some discomfort or experience slight swelling after the procedure, but this is normal for any surgical procedure. If necessary, your endodontist will recommend appropriate pain medication to alleviate your discomfort.

What do I do after the surgery?
Your endodontist will give you specific postoperative instructions to follow. If you have questions or if you have pain that does not respond to medication, call your endodontist.

Can I drive myself home?
Patients who have had endodontic surgery are usually able to drive themselves home. But it is a good idea to talk to your endodontist about this prior to your appointment to decide if other transportation arrangements will be necessary.

When can I return to my normal activities?
Most patients return to their normal daily activities one or two days after their surgery. Your endodontist will discuss your expected recovery time with you.

Does insurance cover endodontic surgery?
Many insurance plans do cover endodontic surgery. Each insurance plan is different, however. You should consult with your employer or insurance company prior to treatment.

What are the chances that the surgery will be successful?
Your dentist and endodontist have suggested endodontic surgery because they believe it is the best option for you. Your endodontist will discuss your chances for a successful surgery so you can make an informed decision. Keep in mind that there are no guarantees with any surgical procedure.