While endodontists are best known as specialists in root canal therapy, their expertise goes beyond that.
They focus on saving teeth by treating problems inside the tooth — and can perform a variety of endodontic surgeries to preserve your natural smile.
Apicoectomy: When a Root Canal Isn’t Enough
One of the most common surgeries an endodontist performs is an apicoectomy.
This procedure is needed when conventional root canal treatment cannot completely treat an infection or abscess.
How it works:
- The endodontist gently moves back the gum tissue near the affected tooth to access the bone underneath.
- The very tip of the tooth’s root is removed.
- Any inflamed or infected tissue is cleaned out.
- The root end is sealed to prevent further infection.
- The gum is sutured back into place.
Over the next few months, the bone naturally heals around the treated root.
When You Might Need Surgery Instead of Extraction
If your first root canal doesn’t fully resolve the problem, you may not need to have your tooth extracted.
An endodontist can often save your tooth with a surgical procedure like an apicoectomy — avoiding the need for dentures, bridges, or implants.
During your consultation, your endodontist will:
- Explain all possible treatment options
- Discuss potential risks and benefits
- Answer your questions so you can make an informed decision
Other Endodontic Surgeries
In addition to apicoectomies, endodontists can perform:
- Root division – separating a tooth into two parts
- Root repair – fixing a cracked or injured root
- Root removal – extracting only the damaged root while preserving the rest of the tooth
These procedures are designed to save as much of your natural tooth as possible.
The Bottom Line
Endodontists are highly trained specialists in saving teeth — and surgery is just one of the many tools they use.
If you’ve been told your tooth needs to be removed, consider getting a second opinion from an endodontist. The right procedure could help you keep your natural smile for years to come.