Am I a Candidate for an Apicoectomy?

Root canals are an excellent option to preserve a tooth with internal damage, decay, or infection. But when a root canal can’t save your tooth, you have other options to consider before extraction, including an apicoectomy. Apicoectomies are endodontic surgical procedures to treat or remove damaged or infected tissue from your tooth.

Our expert dentist, Robert Scott Nance, DDS, MS, PA, performs apicoectomies to restore your tooth and prevent tooth loss or extraction. Apicoectomies aren’t as common as root canals, so you might have a few questions about what they are and who might need one. 

About apicoectomies

Unlike a root canal, when Dr. Nance accesses the inside of your tooth through the crown, during an apicoectomy he opens your gum to reach the root of your tooth. 

This approach allows him to remove or treat infected tissue in your gums and jaw, as well as the inside of your tooth. 

Dr. Nance also removes the tip of your tooth root and seals your tooth with the same materials used during a root canal. 

Apicoectomy candidates

You must meet specific criteria to be eligible for an apicoectomy. Dr. Nance considers each case individually, but in general the following conditions need to be met.

Former root canal patients

An apicoectomy isn’t a first-line approach to internal tooth decay. Root canals are usually sufficient to treat teeth with any dental decay or infection that affects the pulp of your tooth. 

A root canal removes the decay and protects your tooth with a protective crown. The crown also restores your smile and prevents pain or sensitivity.

However, if your root canal fails, your dental pulp may become infected again. While you could have a second root canal, it would involve removing the crown, which could potentially damage your gumline and the root of your affected tooth.

If Dr. Nance doesn’t think a second root canal would help, he recommends an apicoectomy as the best treatment to stop the infection and restore the health of your tooth. 

Your tooth must be salvageable

In some cases, even the most advanced endodontic treatment won’t save your tooth. Dr. Nance provides thorough exams and X-rays to evaluate your tooth and determine if it can be saved and the correct treatment to do so. 

If Dr. Nance can’t protect your tooth with an apicoectomy, he can extract the tooth and talk to you about your prosthetic options. 

What to expect during and after an apicoectomy

Dr. Nance reviews personalized preparation instructions during your consultation. You should ask a friend or family member to drive you to and from your appointment. Depending on the state of your tooth, Dr. Nance might prescribe antimicrobial mouthwash, antibiotics, and medication to reduce inflammation in the affected tooth.

Dr. Nance offers local anesthetics and a sedative to help you stay comfortable during your surgery. Then, he makes a tiny incision in your gum to expose the root of the infected tooth.

Once he exposes the tip of the root, Dr. Nance removes any infection and decay, as well as the end of the root. He then seals the root of your tooth with a filling and closes the incision with stitches.

You should be able to return to your normal activities the day after your apicoectomy. You might need to take antibiotics or anti-inflammatories to prevent infection or swelling. 

Contact us to make an appointment if you have persistent tooth pain after a root canal and want to see if an apicoectomy is right for you.