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Root Canal vs. Apicoectomy

Root canals versus apicoectomies: when is each procedure recommended? In today's post, our Toronto dentists explain the differences between a root canal and apicoectomy, when you might need them and what kind of professional you will see for each.

Once your tooth becomes damaged due to decay or accidental fracture it will then be possible for bacteria to potentially enter the tooth and the inner pulp chamber. If this happens it can then result in severe tooth pain. Believe it or not, one of the most common ways to save a damaged tooth from extraction is by undergoing a root canal procedure. But there is another procedure we will also consider called an apicoectomy, which is another treatment option.

Root Canals

If you undergo a root canal procedure, this will involve the removal of the pulp, which is located in the centre of the tooth. The pulp is composed of living tissue, cells, blood vessels, and nerves, and it can be extremely painful if it becomes infected with bacteria. The steps that your dentist will follow while performing a root canal are:

  • your dentist drills an access hole into your tooth
  • the infected pulp is removed with a special dental tool
  • the inside of the tooth is cleaned and disinfected and, in place of the pulp, a rubber-like material called gutta percha is placed
  • your dentist will fill the hole in much the same way as a dental filling
  • a crown can be added to your tooth in order to provide strength and protection


An apicoectomy is a type of surgery that is performed on the root of the tooth rather than the crown of the tooth in order to cure an infection. Using the root tip, also known as the apex, it is possible to reach the infected tissue, and a filling is then used to close the root's end. This can be a good treatment option for those who suffer from tooth sensitivities.

It may be the right treatment of choice for someone:

  • who has already had a root canal procedure performed, but was unsuccessful
  • if a root canal procedure is unable to be completed
  • if the tooth in question already has a crown or is part of a bridge and where a root canal would mean cutting through the crown or bridge or both (in most circumstances, this is not a viable option)

What kind of dentist performs root canals and apicoectomies?

While a dentist can perform a root canal, they will most likely refer you to an endodontist if you need an apicoectomy. If your dentist doesn't perform root canals, they may also refer you to an endodontist for that procedure too.

Endodontists are specialized dentists who manage the treatment of tooth pain, disease, and infection. They have received training that enables them to identify and treat tooth pain, as well as perform root canal procedures, apicoectomies, and various other procedures, normally to help relieve mild to severe tooth pain.

What happens in more severe cases

In cases where a root canal is insufficient, an apicoectomy is a routine procedure that is usually recommended. Apicoectomies may also be recommended if a root canal procedure has failed and an infection has developed around the tip of the tooth's root canal system.

If you are experiencing an infection this can spread and infect other areas and potentially cause various other health concerns. As a result, if you suspect that something is wrong with your oral health, it is critical that you consult with your dentist as soon as possible.

Do you still have any questions about root canals and apicoectomies? Contact our Toronto dentists to schedule a visit today.

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