When Is Endodontic Surgery Necessary?

Generally, root canal treatment is all that is needed to repair your injured tooth.  Occasionally, the root canal procedure will not be sufficient to completely eliminate the problem.  If the tooth is not healing we may suggest surgical treatment.  Endodontic surgery can be used to remove persistent infections, locate fractures or treat hidden canals that do not appear on x-rays but cause pain in the tooth.  Damaged root surfaces or the surrounding bone may also be treated with this procedure.  The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

Endodontic Surgery FAQs

Many of our patients have concerns about their endodontic surgery. Here are the answers to some of the most commonly asked questions.

You may need endodontic surgery for one of several reasons. The specific reasons you need surgery will be discussed during your assessment appointment. During this visit, you can also ask any questions about preparing for your specific type of surgery, whether you need prescriptions, and how to best recover.

The most common type of endodontic surgery is apicoectomy. This type of procedure often follows root canal therapy, after which you still have inflammation in the root end of the tooth. The endodontist cuts into the gum to reach this portion of the tooth to take out any infected or inflamed material and the tip of the tooth’s root end. They will then place filling in the area and stitch the gums closed. Over the next few weeks, the bone will naturally regrow around the operated area.

By removing the infected matter, the endodontist can stop the infection that would require you to have a tooth extraction. For a patient who needs it, an apicoectomy can save their tooth.

In most cases, antibiotics and narcotic pain relievers are not necessary. The pain that many people feel before endodontic surgery is from inflammation but not necessarily infection. If you do have signs of infection such as facial swelling or fever, talk to your endodontist about these conditions to see if you need antibiotics before surgery.

After your surgery, you should only experience minor pain that you can easily control with ibuprofen (Advil) or acetaminophen (Tylenol).

Studies have shown that taking alternating doses of acetaminophen and ibuprofen produces similar pain-relieving effects as stronger narcotics. Plus, patients don’t have the severe side effects of those prescription medications. Therefore, only in very rare instances will Dr. Ber or Dr. Gaudet need to prescribe stronger pain relievers.

You may need endodontic surgery for one of several reasons. The specific reasons you need surgery will be discussed during your assessment appointment. During this visit, you can also ask any questions about preparing for your specific type of surgery, whether you need prescriptions, and how to best recover.

The most common type of endodontic surgery is apicoectomy. This type of procedure often follows root canal therapy, after which you still have inflammation in the root end of the tooth. The endodontist cuts into the gum to reach this portion of the tooth to take out any infected or inflamed material and the tip of the tooth’s root end. They will then place filling in the area and stitch the gums closed. Over the next few weeks, the bone will naturally regrow around the operated area.

By removing the infected matter, the endodontist can stop the infection that would require you to have a tooth extraction. For a patient who needs it, an apicoectomy can save their tooth.

In most cases, antibiotics and narcotic pain relievers are not necessary. The pain that many people feel before endodontic surgery is from inflammation but not necessarily infection. If you do have signs of infection such as facial swelling or fever, talk to your endodontist about these conditions to see if you need antibiotics before surgery.

After your surgery, you should only experience minor pain that you can easily control with ibuprofen (Advil) or acetaminophen (Tylenol).

Studies have shown that taking alternating doses of acetaminophen and ibuprofen produces similar pain-relieving effects as stronger narcotics. Plus, patients don’t have the severe side effects of those prescription medications. Therefore, only in very rare instances will Dr. Ber or Dr. Gaudet need to prescribe stronger pain relievers.

Endodontic surgery is a localized procedure, and you should not feel serious pain after. Most people return to school, work, or hobbies the following day. In fact, most patients can drive themselves home from the procedure since it only uses a local anesthetic that does not impair your driving ability.

Endodontic surgery is a localized procedure, and you should not feel serious pain after. Most people return to school, work, or hobbies the following day. In fact, most patients can drive themselves home from the procedure since it only uses a local anesthetic that does not impair your driving ability.

Endodontic surgery does not cause pain during the procedure. You will have a local anesthesia that completely numbs the area the doctor operates on. The endodontist will verify that the anesthesia has taken full effect before operating.

You may feel pain once the anesthesia wears off. However, patients describe this pain as minor compared to an inflamed tooth. Over-the-counter analgesics work well to manage this discomfort.