Apicoectomy Recovery
A second chance to save a tooth that's already had a root canal. Here's what the healing looks like.
The Full Guide
Sometimes an infection persists at the very tip of a tooth's root even after a root canal. An apicoectomy. Also called root-end surgery or endodontic microsurgery. Is minor surgery to access that root tip from outside, through the gum, remove the infected tissue and a small portion of the root end, and seal it from that direction, like patching a leak from the outside when you can't fix it from inside the pipe anymore. It's one of the most reliable ways to treat a persistent root canal infection without losing the tooth.
When a root canal infection lingers at the root tip, an apicoectomy gives that same natural tooth a second chance rather than jumping straight to extraction, especially valuable when the tooth already has a crown or is anchoring a bridge, since retreating the root canal from the top would mean cutting back through that restoration entirely.
It's a targeted, minimally invasive way to clear out a stubborn root-tip infection while keeping everything else about the tooth intact. Studies show roughly 83% of apicoectomies have a favorable outcome at three or more years out, making it one of the most predictable options for saving a tooth after a failed root canal.
Noticing lingering discomfort near a previously treated tooth and haven't had it evaluated yet? Book a consultation and we'll help you figure out if an apicoectomy is the right next step.
Eat a normal meal beforehand, since you'll be numb for a few hours afterward.
Local anesthetic numbs the area before we begin. For upper teeth, numbness is usually limited to the cheek, lip, and gum near the tooth. Lower back teeth typically require a "block" injection, which numbs an entire side of the lower jaw, including the lip, chin, and often the tongue, not just the tooth being worked on.
A small incision is made in the gum near the tooth's root tip. The infected tissue and the last few millimeters of the root tip are removed, the end of the root is sealed, and the gum is closed with a few small sutures.
The whole visit typically runs 30–90 minutes, depending on which tooth is involved.
You'll be numb for a few hours, and it's normal to feel some pressure or mild soreness as the anesthetic wears off. Most people are comfortable heading straight home once the visit is done.
Swelling typically begins and peaks. Ice the area in 20-minute on/off intervals for the first 24 hours.
Swelling and bruising, sometimes visible on the skin, are common and expected. Switch from ice to warm compresses if swelling lingers past day 1.
Swelling and soreness steadily improve. Sutures, if placed, are typically removed around one week.
The gum tissue finishes closing while the bone around the root tip keeps quietly healing underneath. Mild tenderness when chewing can still be normal during this stretch, and we'll often schedule a follow-up visit in this window.
Take all prescribed antibiotics and pain medication exactly as directed, even if you're feeling fine. Most people are back to normal activity within a day or two, though complete bone healing at the root tip continues quietly for 3–6 months. A follow-up X-ray down the line may be used to confirm it healed properly.
Stick to a soft food diet for several days while the surgical site settles.
Swelling increases after day 3 instead of improving, fever develops, bleeding doesn't slow with gentle gauze pressure, pain feels intense rather than mild, or you have a reaction to your medication.
A note on this guide: this is general guidance. Your treating doctor's specific instructions for your individual case always take priority over anything written here. If something feels off or you're unsure, call us. Don't wait it out.
Root canal & extraction care
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