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When You Might Need an Apicoectomy

Most people have heard of the dreaded root canal and hope they never need one. But, they do help people keep their natural teeth longer, which is better for long-term oral health. Sometimes, a root canal doesn’t solve the problem, though. When this happens, a minor surgical procedure called an apicoectomy may be needed.

The endodontists at Endodontic Consultants of San Antonio are experts in preserving and protecting natural teeth. Here’s what they want you to know about apicoectomies.

What is an apicoectomy?

An apicoectomy is surgical removal of the tip (apex) of a tooth’s root. It’s a minor surgery done in our office under local anesthesia. This means you’re awake for the procedure and can drive yourself home afterward.

It also means you shouldn’t feel any pain while one of our specialists completes the apex removal. An apicoectomy is also called a surgical root canal or root-end resection.

Why would I need one?

An apicoectomy is needed when a standard root canal doesn’t solve the issue. If you had a root canal but still have pain and swelling, you may need an apicoectomy.

A tooth can become infected or painful months to years after a standard root canal. In this situation, a surgical root canal may be needed to get rid of the infection while keeping your tooth and crown intact.

How to prepare

We may prescribe anti-microbial mouthwash and antibiotics to treat the infection and medication to reduce inflammation, and we may also suggest over-the-counter pain relievers. Once the infection is under control, it’s safe to perform the apicoectomy.

What to expect

As with a standard root canal, we numb the area to be treated so you won’t feel any pain. We cut through the gum and bone and access the tooth’s root. We remove the infection and the tip of the root, and then we clean and seal the area.

We finish up with a few stitches that either dissolve on their own or that we remove at a later date. The entire procedure takes 30-90 minutes depending on which tooth we’re working on. 

Does it hurt?

We use local anesthesia during the procedure so you shouldn’t feel any pain. You may feel some pain as the anesthesia wears off, but this is normal. Use over-the-counter pain relievers and let us know if the pain becomes unbearable. 

Believe it or not, some patients say getting an apicoectomy isn’t as bad as getting a root canal.

Is there a long recovery? 

You should take it easy the first day, but you should be able to resume your normal activities the following day. You may have some slight bruising or swelling in the treatment area for a few days. Follow our home care instructions to recover faster. You’ll feel better in no time!


At Endodontic Consultants of San Antonio, Dr. Rick Davis and Dr. Rick Schwartz do everything they can to save your natural teeth for years to come. Sometimes, a situation is so severe that not even an apicoectomy can help. In these cases, the tooth needs to be removed.

To find out whether a root canal or apicoectomy can save your tooth, call our San Antonio, Texas, office at 210-497-6699 or use our online booking tool to schedule an appointment today.

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