How to Know If You Need a Root Canal or Endodontic Surgery

If you’re dealing with persistent tooth pain, swelling, or sensitivity, your dentist may mention terms like root canal or endodontic surgery. While these procedures might sound intimidating, they’re actually designed to relieve pain, save your natural tooth, and protect your long-term oral health.

So how do you know which treatment you need — or if you need one at all? Let’s break it down.

Signs You Might Need a Root Canal

A root canal is a common procedure used to treat infected or inflamed pulp — the soft tissue inside your tooth. Left untreated, the infection can spread, causing severe pain and even tooth loss. Here are the most common signs that a root canal may be necessary:

• Persistent tooth pain that doesn’t go away, especially when chewing or applying pressure.
  
• Lingering sensitivity to hot or cold temperatures.
  
• Swollen or tender gums around a specific tooth.
  
• Tooth discoloration, especially a darkened or gray tooth.
  
• A small pimple or bump on the gums near the painful tooth (a sign of abscess).
  

If you’re experiencing any of these symptoms, it’s time to see your dentist as soon as possible.

When a Root Canal Isn’t Enough

In most cases, a root canal successfully removes the infection and saves the tooth. But sometimes, additional treatment is required — especially if:

• You’ve already had a root canal, and the symptoms return.
  
• The infection is located in a complex or curved root that’s difficult to clean completely.
  
• A fracture or hidden canal was missed during the first procedure.
  
• An infection persists at the tip of the root (apex) after treatment.
  

That’s when endodontic surgery may be recommended.

What Is Endodontic Surgery (Apicoectomy)?

Endodontic surgery, most commonly an apicoectomy, is a minor surgical procedure used to treat infections that don’t heal with a standard root canal.

Here’s how it works:

• A small incision is made in the gum to access the root of the tooth.
  
• The infected tissue and root tip are removed.
  
• The root is sealed, and the area is stitched to promote healing.
  

This procedure is often performed by an endodontist — a dental specialist in saving natural teeth through root canal-related treatments. It’s typically quick, minimally invasive, and highly successful.

How Your Dentist Determines Which Treatment You Need

Your dentist or endodontist will perform a thorough evaluation to determine the best course of action. This may include:

• Digital X-rays to assess the tooth’s roots and surrounding bone.
  
• 3D imaging (CBCT) to detect tiny fractures or hidden canals.
  
• Clinical testing, such as tapping on the tooth or testing for temperature sensitivity.
  

If the infection is accessible and straightforward, a root canal is often enough. For more complex cases or if a root canal has failed, endodontic surgery may be the next step.

When to See an Endodontist

You may be referred to an endodontist if:

• You’ve already had a root canal on the tooth in question.
  
• You have ongoing pain despite previous treatment.
  
• Your dentist detects issues at the root tip or inside complex canal structures.
  
• You want a second opinion before considering extraction.
  

At Cedar Walk Family and Cosmetic Dentistry, our team includes skilled professionals trained to handle complex cases with care and precision.

Our Approach to Root Canal and Endodontic Surgery in Charlotte

We understand that dental pain can be stressful — and so can the idea of treatment. That’s why we use advanced imaging, gentle techniques, and sedation options to ensure you’re comfortable every step of the way.

Our priority is preserving your natural tooth whenever possible and giving you long-term relief from pain and infection.

Schedule Your Consultation Today

Tooth pain is never something you should ignore. If you’re wondering whether you need a root canal or a more advanced procedure, our team at Cedar Walk is here to help.

Call us or book your consultation online to get the answers and relief you need.