Endodontic Surgery in Kitsilano
When a Root Canal Alone Can't Resolve the Infection
Most infected teeth are saved with a standard root canal. But when infection or inflammation persists at the root tip after treatment, endodontic surgery, most often an apicoectomy, can save the tooth without removing it.
Quick answer: Endodontic surgery treats persistent infection at the tip of a tooth's root, usually after a root canal hasn't fully resolved the problem. The most common procedure, an apicoectomy, removes the infected root tip and surrounding tissue through a small incision in the gum, sealing the root to stop reinfection. It's typically a last step to save a tooth before considering extraction.
Signs You May Need Endodontic Surgery
Persistent Pain After a Root Canal
Ongoing tenderness or dull pain in a tooth that already had a root canal can signal that infection remains at the root tip.
A Recurring Abscess
A bump or swelling near the gumline that keeps coming back, even after a root canal, often points to infection that non-surgical retreatment hasn't fully cleared.
Complex Root Canal Anatomy
Some teeth have curved, narrow, or calcified canals that are difficult to fully clean from inside the tooth, leaving surgery as the most direct path to the infected area.
A Fractured Root Tip
In some cases a small fracture or crack at the very tip of the root is only accessible surgically.
What Happens During an Apicoectomy
- Local anesthesia. The area around the tooth is fully numbed before any incision is made.
- A small incision in the gum. Your dentist accesses the bone covering the root tip through a small opening in the gum tissue.
- Removal of the infected tissue. The infected root tip, along with any surrounding inflamed tissue, is carefully removed.
- Sealing the root end. A small filling is placed at the newly cut root tip to seal it and prevent bacteria from re-entering.
- Closing the incision. The gum tissue is repositioned and closed with a few small sutures, which are typically removed within a week.
The entire procedure usually takes between 30 and 90 minutes, depending on the tooth and its location, and is performed under local anesthesia in a single visit.
| Option | What it preserves | Typical recovery |
|---|
| Endodontic surgery (apicoectomy) | Your natural tooth and root structure | A few days of mild swelling and tenderness |
| Extraction + dental implant | Replaces the tooth entirely with an artificial root and crown | Several months, including healing time before the implant crown is placed |
| Extraction + fixed bridge | Replaces the missing tooth using neighbouring teeth as anchors | A few weeks for the surrounding gum tissue to settle |
Whenever a natural tooth can be reasonably saved, most dentists will recommend doing so, since no replacement fully matches the function and feel of your own tooth. Endodontic surgery is usually considered before more invasive options like extraction.
Recovery Timeline
Most patients return to normal activities the next day, with some mild swelling or bruising around the treated area for a few days. Over-the-counter pain relief is usually sufficient for any discomfort. Sutures are typically removed about a week after surgery, and the surgical site continues healing internally over the following months, though you won't notice this day to day.
Avoid chewing directly on the treated side for the first few days, and stick to soft foods while the gum tissue initially heals.
Insurance and CDCP Coverage
Endodontic surgery is often partially covered under major dental plans and may be eligible under the Canadian Dental Care Plan (CDCP) depending on your coverage tier. See our insurance and financing page for how we verify coverage and set up direct billing before your procedure.
Is Endodontic Surgery Right for You?
Your dentist will typically take new imaging, sometimes including a CBCT scan, to get a precise 3D view of the root tip and surrounding bone before recommending surgery. This helps confirm exactly where the infection is and whether surgery, non-surgical retreatment, or extraction is the most appropriate path forward.
Good candidates for endodontic surgery generally have a tooth with enough healthy structure remaining, adequate bone support, and a localized infection at the root tip rather than a fracture running down the length of the root. If the tooth is too compromised to save, your dentist will discuss replacement options like a dental implant instead.
Caring for Your Tooth After Surgery
Once your endodontic surgery has healed, the treated tooth generally behaves just like any other restored tooth. It's still important to keep up with regular checkups so your dentist can monitor the area on X-rays over time and confirm the infection hasn't returned. Good oral hygiene, including gentle brushing around the surgical site in the first week, helps the gum tissue heal cleanly.
More Frequently Asked Questions
Is endodontic surgery painful?
The procedure itself is performed under local anesthesia, so you shouldn't feel pain during surgery. Mild soreness for a few days afterward is normal and usually manageable with over-the-counter pain relief.
How successful is an apicoectomy?
Apicoectomies have a high success rate when performed on a tooth with adequate remaining structure and a localized infection, often allowing patients to keep their natural tooth long-term.
Can the same tooth need endodontic surgery more than once?
It's uncommon, but if infection returns despite surgery, your dentist will reassess whether further treatment or extraction and replacement is the better long-term option.
How long until I can eat normally after surgery?
Most patients return to a normal diet within a few days, though it's best to avoid chewing directly on the treated side and stick to softer foods until any swelling subsides.
Will I need time off work or school?
Most people return to normal activities, including work or school, the next day. Strenuous exercise is usually best avoided for a few days.
Still Dealing With Pain After a Root Canal?
Book a consultation at our Kitsilano clinic so we can evaluate whether endodontic surgery can save your tooth.
Related services: Endodontics / Root Canals · Oral Surgery · Dental Implants · Emergency Dental Care · Insurance & Financing
