Sometimes, even after a root canal treatment, infection can persist near the tip of a tooth’s root. That doesn’t mean the tooth is lost — in many cases, Apical Surgery (also called an Apicoectomy) can save it.

At the Endodontic Office, we specialise in this advanced, microsurgical procedure to remove infection, preserve your natural tooth, and help you avoid an extraction.

What Is Apical Surgery?

Apical Surgery is a minor surgical procedure performed when inflammation or infection continues around the apex (tip) of a tooth’s root after a root canal. The goal of the procedure is to remove the infected tissue, trim the root tip, and seal it to prevent further issues.

It’s often recommended when:

• A tooth continues to show signs of infection after root canal treatment
• Retreatment isn’t possible due to complex root anatomy or existing restorations (like crowns or bridges)
• A cyst has formed around the root of the tooth
• Persistent pain or swelling occurs despite clean root canal fillings

Apical Surgery is a proven method to save teeth that would otherwise require extraction.

Step-by-Step: What Happens During an Apicoectomy?

1. Local Anaesthesia: The area is fully numbed to ensure a comfortable and painless experience.
2. Small Gum Incision: A small incision is made in the gum near the affected tooth to access the bone and root tip.
3. Infection Removal: The infected tissue around the root tip is carefully removed. The tip of the root is also trimmed.
4. Root-End Filling: A special filling is placed at the end of the root to seal it and prevent future reinfection.
5. Gum Closure: The gum is stitched back in place, and healing begins.

What to Expect After Surgery

Recovery from Apical Surgery is generally smooth and well-tolerated.

Common Post-Procedure Symptoms Include:

• Mild swelling or bruising
• Discomfort or tenderness at the surgical site
• Temporary numbness in the area (rare)

How Successful Is Apical Surgery?

Apical Surgery has a success rate of over 85–90%. With good oral hygiene and follow-up care, the treated tooth can remain healthy and functional for many years, often for life.

At The Endodontic Office, we use advanced magnification, microsurgical instruments, and biocompatible materials to maximise treatment success and comfort.

Is Apical Surgery Right for You?

Not every case of persistent infection requires apical surgery, but it can be the ideal option when:

• Retreatment of a root canal isn’t feasible
• The tooth has a post or crown that can’t be removed easily
• There’s a persistent cyst or infection near the root tip
• Non-surgical treatments have failed

If you’ve had a root canal and are still experiencing symptoms—or if your dentist has recommended a surgical evaluation—we’re here to help.

Post-Operative Care

Now that your procedure is complete, let’s walk you through the recovery process so you can heal quickly and avoid any hiccups along the way.

1. First Few Hours: Immediate Care

• Don’t rinse your mouth for the first hour. This allows the blood clot to stabilise and prevents it from dislodging.
• Avoid touching the surgical site. Resist the urge to disturb the surgical site with your tongue or fingers—it can introduce bacteria or delay healing.
• Minor bleeding? Bite down gently on a clean, damp gauze pad for several minutes to control it.
• Control swelling with an ice pack. Apply to your cheek in 15-minute intervals (15 minutes on, 15 minutes off) during the first 24 hours.

2. Managing Pain and Medications

• Take your prescribed painkillers as instructed to stay on top of discomfort.
• Complete your course of antibiotics if prescribed—don’t stop midway.
• Swelling may peak around day 2, then gradually reduce. Continue using a cold compress initially; then switch to warm compresses after 48 hours.

3. Oral Hygiene & Wound Care

First 3 Days:

• Avoid brushing near the surgical site.
• Use the prescribed antiseptic mouthwash twice daily for 5–7 days.
• Gently swish mouthwash or warm salt water—avoid forceful rinsing.

After 3 Days:

• Resume gentle brushing of the surrounding teeth, avoiding direct contact with the surgical area until you’re cleared by your dentist.

4. Eating & Lifestyle Tips

• Stick to soft foods such as mashed potatoes, soups, eggs, yoghurt, and smoothies.
• Avoid hot, spicy, or crunchy foods. They can irritate the surgical area.
• No smoking or alcohol. Both slow down healing and increase infection risk. Please avoid them completely.

5. Rest & Activity

• Take it easy for 48–72 hours: no strenuous exercise, bending, or lifting.
• Keep your head elevated when lying down to reduce swelling.

6. Your Follow-up Appointment

Please return to The Endodontic Office for:

• Suture removal
• Healing check-up
• Progress evaluation

Don’t skip this step—it ensures you’re healing well and gives us the chance to address anything early.

When to Call Us

Call us right away if you experience:

• Severe pain not controlled by medication
• Excessive or ongoing bleeding
• Swelling that worsens after 2–3 days
• Signs of infection: fever, pus, or foul taste

FAQs

Q: How is apical surgery different from a root canal?

A: A root canal is a non-surgical procedure that treats infection from inside the tooth. Apical surgery, on the other hand, is a minor surgical procedure used when infection remains at the tip of the root after a root canal. It allows us to remove infected tissue and seal the root from the outside.

Q: Can any tooth be treated with apical surgery?

A: Not always. The location, anatomy, and condition of the tooth are important. Your endodontist will evaluate whether apical surgery is the best choice or if another approach (like retreatment or extraction) is more appropriate.

Q: Will I need stitches?

A: Yes, we typically place a few small sutures to close the surgical site. These are either dissolvable or removed at your follow-up appointment.

Q: What should I do if pain or swelling worsens after a few days?

A: Contact our office immediately if symptoms worsen or don’t improve within a few days. Persistent pain, swelling, or fever may indicate a complication that needs prompt attention.