What Happens When A Root Canal Procedure Isn't Enough?

Typically, if you have a tooth infection, your general dentist sends you to the endodontist for a root canal procedure. However, there are some cases when a root canal procedure alone can't save the tooth. If this is the case, your endodontist may need to perform a surgical treatment called an apicoectomy. Check out these important facts about this surgical procedure.

It Stops Persistent Infections  

Hopefully, after your root canal treatment, the tooth remains free of infection. Unfortunately, some infections are persistent. The root canal treatment may not be enough to completely remove the infection, or the infection may continue to return months or even years later. In these cases, the endodontist may suggest apicoectomy to save the tooth. Your endodontist may also suggest an apicoectomy if you have persistent symptoms, but your X-rays show no problems. In this instance, the endodontist uses the surgery for diagnostics. In other cases, you may require this procedure if the root surface or surrounding bone are damaged.

It's Usually the Last Resort

Just because you had one failed root canal procedure, it doesn't mean your dentist will immediately recommend surgery. Tooth roots are tiny and easy to miss, so some infection may have been missed during the first procedure. Typically, your endodontist will perform a second root canal procedure before suggesting surgery. However, there are cases where a second root canal procedure may not be possible, such as the tooth has a crown, which could get damaged during treatment. In this instance, the endodontist may forgo the second root canal procedure in favor of surgery

The Procedure Removes All Infected Tissue

To access the tooth root, the endodontist makes an incision in the gum near the root and retracts it to expose the bone. While the area is exposed, the endodontist removes any infected tissue, which may include some of the jawbone around the tooth. In some cases, the endodontist may use a bone graft to help the jaw recover properly. Once the tissue is removed, the gum is repositioned and stitched into place. Endodontic surgery is about 85 percent effective.

There Isn't Much Pain Involved

The actual procedure should be pain-free, because the endodontist uses a local anesthetic. If you do experience pain, simply request more anesthetic. During recovery, however, it is common to experience some swelling and discomfort, especially near the incision. The pain is usually mild and can be controlled with over-the-counter pain medications, such as ibuprofen. While it may take months for the tissue to completely heal, most patients can return to their daily activities the day after the procedure.

There Is Typically Only One Alternative

If you don't like the idea of endodontic surgery, there is an alternative: tooth extraction. While this may seem like a cheaper and easier option, think again. After the tooth is extracted, you'll want to replace it with an implant, bridge or partial denture to restore chewing function and prevent your remaining teeth from shifting. Having the tooth extracted and then replaced, however, increases the total cost and number of procedures. Plus, a dental implant can be just as invasive as endodontic surgery, and a dental bridge permanently affects your surrounding teeth. So unless you're happy with the struggles of a partial denture, it's actually more cost and time effective to just bite the bullet and agree to the surgery. Extraction is also the only alternative if your endodontic surgery fails.

Root canal treatment doesn't always work, but instead of having your tooth pulled, consider an apicoectomy. This surgical procedure is highly effective and can save your tooth. Stop suffering with the pain of infection. If you think you have a persistent infection or symptoms, contact your dentist today to ask about endodontic surgery or go to websites for additional information.