Most of the time, a root canal saves a tooth for good — a tooth that's had one can often last the rest of your life without needing anything else. But in a small number of cases, a second procedure is needed to fully resolve the problem. That's what endodontic surgery is.
The quick refresher on root canals
To understand endodontic surgery, it helps to understand the non-surgical version first. A root canal is needed when the soft tissue inside a tooth — the pulp — becomes inflamed or infected. Treatment removes the damaged pulp, and then the tooth's canals are cleaned and filled to preserve the tooth.
Usually that's the end of it. Usually.
Why surgery is sometimes needed
Surgery can also be used for diagnosis. If you've had persistent symptoms after a root canal but nothing shows up on an X-ray, your tooth may have a tiny fracture or an extra canal that couldn't be detected the first time around. Surgery lets us see what's going on and fix it.
The most common procedure: an apicoectomy
In this procedure, we open the gum tissue near the tooth to see the underlying bone, and we remove any inflamed or infected tissue. The very end of the root is also removed. A small filling is placed to seal the end of the root canal, and a few stitches are placed in the gum to help the tissue heal properly.
Other types of endodontic surgery
Depending on what's needed, we might divide a tooth in half, repair an injured root, or in some cases remove one or more roots while keeping the rest of the tooth intact. We'll talk through the specific type of surgery your tooth needs and why, so you're never in the dark about what's happening.
Who performs it
All dentists receive training in endodontic treatment — Dr. Carroll included. For surgical cases, we may refer to an endodontist, who has completed at least two additional years of advanced education and training focused specifically on root canal techniques and procedures. Either way, you're in experienced hands.
Will it hurt?
Local anesthetic keeps the procedure itself comfortable. Afterward, you may feel some discomfort or slight swelling while the incision heals — that's normal for any surgical procedure. We'll recommend appropriate pain medication to keep you comfortable while you heal.
What the alternative looks like
Most of the time, the alternative to endodontic surgery is extracting the tooth. That sounds simpler, but extraction typically requires additional surgery or dental work on the teeth next to the gap — a bridge, an implant, or a partial denture, any of which takes more time and more cost. For that reason, endodontic surgery is usually the most cost-effective way to keep your mouth healthy and whole.
A tooth that's had a successful root canal — with or without surgery — can last the rest of your life. Saving your own tooth is almost always worth it, and we'll help you understand the trade-offs before anything gets scheduled.