Endodontic Surgery

Endodontists do more than root canal treatments. Our doctors at Southern Endodontic Specialists also perform surgery when a patient needs it to save a tooth. Through the use of high-tech tools and our endodontists’ expertise in treating problems with the internal structures of the tooth, our patients get quality, professional care.

About Endodontic Surgery

Endodontic surgery deals with treating the interior portions of the tooth. While root canal therapy is a non-surgical treatment that some patients can have to remove infection or inflammation from inside the tooth, it may not be the best option for all patients. The various forms of endodontic surgery allow the doctor to treat teeth in multiple ways.

There are several types of endodontic surgery. The most common is an apicoectomy, in which an endodontist treats the tooth interior through the root tip. Other forms of surgery include removing a tooth to treat it outside the mouth, dividing a cracked tooth, removing tooth roots, or repairing injured roots. In rare instances, an endodontist may perform surgery for diagnostic purposes. Though with modern imaging techniques such as cone beam CT scans and digital radiography, this reason for surgery is not as common.

Endodontic Surgery FAQs

Many of our patients have concerns about their endodontic surgery. Here are the answers to some of the most commonly asked questions.

You may need endodontic surgery for one of several reasons. The specific reasons you need surgery will be discussed during your assessment appointment. During this visit, you can also ask any questions about preparing for your specific type of surgery, whether you need prescriptions, and how to best recover.

The most common type of endodontic surgery is apicoectomy. This type of procedure often follows root canal therapy, after which you still have inflammation in the root end of the tooth. The endodontist cuts into the gum to reach this portion of the tooth to take out any infected or inflamed material and the tip of the tooth’s root end. They will then place filling in the area and stitch the gums closed. Over the next few weeks, the bone will naturally regrow around the operated area.

By removing the infected matter, the endodontist can stop the infection that would require you to have a tooth extraction. For a patient who needs it, an apicoectomy can save their tooth.

In most cases, antibiotics and narcotic pain relievers are not necessary. The pain that many people feel before endodontic surgery is from inflammation but not necessarily infection. If you do have signs of infection such as facial swelling or fever, talk to your endodontist about these conditions to see if you need antibiotics before surgery.

After your surgery, you should only experience minor pain that you can easily control with ibuprofen (Advil) or acetaminophen (Tylenol).

Studies have shown that taking alternating doses of acetaminophen and ibuprofen produces similar pain-relieving effects as stronger narcotics. Plus, patients don’t have the severe side effects of those prescription medications. Therefore, only in very rare instances will Dr. Ber or Dr. Gaudet need to prescribe stronger pain relievers.

Endodontic surgery is a localized procedure, and you should not feel serious pain after. Most people return to school, work, or hobbies the following day. In fact, most patients can drive themselves home from the procedure since it only uses a local anesthetic that does not impair your driving ability.

Endodontic surgery does not cause pain during the procedure. You will have a local anesthesia that completely numbs the area the doctor operates on. The endodontist will verify that the anesthesia has taken full effect before operating.

You may feel pain once the anesthesia wears off. However, patients describe this pain as minor compared to an inflamed tooth. Over-the-counter analgesics work well to manage this discomfort.

Reasons You May Need Endodontic Surgery

There are several types of endodontic surgery, each with specific reasons why you may need it. Some of the most common reasons for an endodontist to operate on a tooth are the following:

Calcium Deposits in the Tooth to Make Root Canal Treatment Impossible

If you have root canals that are too narrow or blocked by calcium deposits, an endodontist might not be able to successfully perform root canal therapy on you in a nonsurgical format. In this situation, you may need surgery after root canal treatment for the doctor to remove the infected pulp from the root end of the tooth.


Occasionally, patients will experience pain in a tooth and have a problem too small to appear on traditional X-rays. In these rare instances, an endodontist may need to examine the root of the tooth directly and remove the infection or inflammation causing the pain.

Inflammation in the Root End of a Tooth After Root Canal Therapy

Occasionally, the bony area at the root end of a tooth will still have inflammation in it. An apicoectomy is a surgery an endodontist performs to remove inflammation by cutting into the root end of the tooth.

Treat Damaged Tooth Roots

Sometimes the tooth roots sustain damage that requires surgery to repair or remove the roots.

Save Part of a Cracked or Split Tooth

If you have a cracked or split tooth, the endodontist may choose to save a portion of it by dividing the tooth through surgery.

About Us at Southern Endodontic Specialists

Our endodontists Drs. Benjamin Ber and Steven Gaudet at Southern Endodontic Specialists use the latest surgical technology to provide quality patient care. Our doctors have the best views inside your teeth by using cone-beam CT scans and surgical microscopes, allowing optimal approaches during surgery. Contact us at Southern Endodontic Specialists to treat serious conditions that require endodontic treatments, such as surgery or root canals. We have two locations in the Tri-Parish Area for your convenience, Houma, and Thibodeaux. Call the location nearest you to schedule your appointment.