At Eastern Idaho Endodontics, our #1 goal is to save your natural teeth. Most of the time, a root canal does the trick. But what happens when a root canal doesn’t fully resolve the issue—or the infection comes back? That’s where a special procedure called an apicoectomy may come in.

Don’t worry if you’ve never heard of it before—we’re here to walk you through exactly what it is, why it’s done, and what you can expect if it’s recommended for you.

So, What Is an Apicoectomy?

An apicoectomy (pronounced ay-puh-co-EK-tuh-mee) is a minor surgical procedure that involves removing the tip of a tooth’s root—called the apex—along with any infected tissue around it. It’s sometimes referred to as root-end surgery.

Why remove just the tip? Because sometimes, even after a root canal, bacteria can hang out at the end of the root where traditional tools can’t reach. An apicoectomy allows us to clean and seal the area directly, stopping the infection and saving the tooth.

When Is an Apicoectomy Needed?

Good question! Most root canals are successful and last for many years. But occasionally, a tooth doesn’t heal properly or becomes reinfected later. If a second root canal (called retreatment) has already been done—or isn’t likely to fix the problem—an apicoectomy may be the next best step.

Here are a few reasons we might recommend it:

  • Persistent or recurring infection near the root tip

  • A blocked or curved canal that can’t be cleaned with traditional root canal tools

  • A small fracture or hidden canal that wasn’t visible during the original treatment

  • A cyst or lesion at the root tip

In short, if retreatment isn’t an option—or hasn’t worked—an apicoectomy might be the most effective way to save your tooth.

What Happens During the Procedure?

It might sound intense, but an apicoectomy is a routine, in-office procedure—and we make it as comfortable as possible.

Here’s a quick breakdown:

  1. Local anesthesia is used to numb the area.

  2. A small incision is made in your gum near the affected tooth.

  3. We remove the root tip and any surrounding infected tissue.

  4. The root end is cleaned and sealed with a filling material.

  5. The gum is stitched back in place to begin healing.

The whole process usually takes less than an hour, and you’ll be on your way home the same day.

What About Recovery?

Good news—recovery from an apicoectomy is usually quick and manageable. You might experience mild swelling or soreness for a few days, but most patients return to normal activities the next day.

We’ll give you specific aftercare instructions, like:

  • Avoiding chewing on the treated side for a few days

  • Using ice packs to reduce swelling

  • Taking over-the-counter or prescribed pain relievers if needed

  • Returning for a quick follow-up, if necessary

Will It Work?

Apicoectomies have a high success rate, especially when done by skilled endodontists (like us!). With proper care, the treated tooth can last many years—if not a lifetime. And the best part? You get to keep your natural tooth.

Bottom Line: It’s All About Tooth Preservation

We get it—no one loves hearing they need a procedure. But an apicoectomy is often the final step in stopping a stubborn infection while avoiding tooth extraction. If you’ve already had a root canal and are still experiencing symptoms, this might be the solution that saves your smile.

At Eastern Idaho Endodontics, we’re here to explain everything clearly, answer your questions, and help you feel confident about your care. If you think you might need an apicoectomy—or if you’re dealing with recurring tooth pain—don’t wait. Let’s take a look and find the right path forward together.