When tooth pain strikes, most people think of a root canal as the solution—but it’s not the only option. In some cases, an apicoectomy may be the right procedure to save your natural tooth. At Eastern Idaho Endodontics, we often hear patients ask, “What’s the difference between a root canal and an apicoectomy?” Let’s clear that up so you feel confident in your treatment choices.

What Is a Root Canal?

A root canal is one of the most common endodontic procedures. It’s performed when the pulp—the soft tissue inside your tooth—becomes infected or inflamed. During the treatment:

  • The endodontist carefully removes the infected pulp.

  • The inside of the tooth is cleaned, shaped, and disinfected.

  • The space is filled and sealed to prevent further infection.

The goal? To relieve pain, eliminate infection, and preserve your natural tooth structure.

What Is an Apicoectomy?

An apicoectomy—sometimes called endodontic microsurgery—is a surgical procedure performed when a root canal alone isn’t enough to resolve the issue. Instead of treating the tooth from the inside, an apicoectomy focuses on the tip of the root (apex).

Here’s how it works:

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

  • The infected tissue at the root tip is removed.

  • The end of the root canal is sealed to prevent reinfection.

This procedure is often recommended when:

  • Infection persists after a root canal.

  • The root structure is unusually complex.

  • A retreatment hasn’t fully solved the problem.

Key Differences Between the Two

Let’s compare them side by side:

Root Canal Apicoectomy
Treats the inside of the tooth (pulp). Treats the root tip and surrounding tissue.
Non-surgical procedure. Surgical procedure.
First line of treatment for infection. Used when a root canal or retreatment hasn’t worked.
Often completed in one appointment. May require more healing time.
Focuses on cleaning and sealing canals. Focuses on removing infection around the root tip.

How Do You Know Which One You Need?

That’s where a specialist comes in. At Eastern Idaho Endodontics, we use advanced imaging and diagnostic tools to determine whether your tooth needs a root canal, a retreatment, or an apicoectomy.

  • If it’s your first time addressing an infected tooth, a root canal is usually the right choice.

  • If you’ve already had a root canal and the tooth is still causing pain or showing infection, an apicoectomy may be recommended.

Why Patients Trust Eastern Idaho Endodontics

Our team specializes in saving teeth—whether that means performing a root canal, retreatment, or advanced microsurgery like an apicoectomy. Patients love that we:

  • Offer state-of-the-art technology for precision and comfort.

  • Take the time to explain every option clearly.

  • Focus on long-term solutions that preserve natural teeth.

Final Thoughts

Both root canals and apicoectomies have the same goal: saving your natural tooth and keeping your smile healthy. The difference lies in how the infection is treated—inside the tooth versus at the root tip. At Eastern Idaho Endodontics, we’ll guide you toward the treatment that gives you the best chance of lasting relief.

FAQs About Apicoectomy vs Root Canal

1. Does an apicoectomy hurt more than a root canal?
Both procedures are performed with anesthesia, so you’ll be comfortable. Recovery from an apicoectomy may involve more post-op tenderness since it’s surgical.

2. Can a root canal fail?
Yes, sometimes infection returns. That’s when retreatment or an apicoectomy may be recommended.

3. How long does recovery take?
Root canals usually have minimal downtime. An apicoectomy can require a few days of healing for the gum tissue.

4. Is an apicoectomy common?
Not as common as root canals, but it’s an important option when standard treatment isn’t enough.

5. Which is better, a root canal or apicoectomy?
Neither is “better”—it depends on your tooth’s condition. Both are designed to preserve your natural tooth.