Endodontic Surgery in Houston, TX

Root canal therapy is a routine way to save a badly infected or decayed tooth, and it works for the vast majority of patients. But sometimes bacteria linger or find a way back into the root system, leading to a persistent or new infection. When that infection camps out at the very tip of the root—an area that instruments inserted through the tooth can’t fully reach or clean—endodontic surgery becomes the next logical step.

This surgical approach allows us to directly access the root tip, clean out the infection, and seal the canal from the outside. The most well-known type of endodontic surgery is the apicoectomy, or root-end resection. Dr. Casandra Barnes at Care Dental has extensive experience helping Houston-area patients hang onto their natural teeth with this precise procedure.

Conventional root canals work from the inside out: we enter the tooth through the chewing surface and treat the canals from top to bottom. Endodontic surgery flips that paradigm. Instead, we make a small incision in the gum near the problem tooth to create a window to the root tip and surrounding bone. This lets us remove inflamed or infected tissue, trim the tip of the root, and place a tiny filling to block future bacteria from re-entering.

Because the procedure is performed under magnification, we can spot tiny fractures or extra canals that may have been missed previously. Not every case is suited for surgery, which is why we take a careful look at your X-rays and 3D imaging when appropriate. We’ll explain whether an apicoectomy or another form of endodontic microsurgery is right for you.

When you come in for an apicoectomy at Care Dental, your comfort is our first priority. We’ll use a local anesthetic to thoroughly numb the treatment area. Once you can’t feel a thing, we’ll gently reflect the gum tissue and create a tiny access point through the bone to reach the root tip.

Next, we remove any infected material and trim roughly two to three millimeters off the end of the root. The remaining root canal is cleaned and sealed with a biocompatible filling, effectively shutting the door on bacteria. We then close the gum with small sutures, and your body begins the natural healing process. The length of the appointment varies depending on which tooth is involved and the complexity of the infection. Throughout the visit, we’ll keep you informed so there are no surprises.

After the anesthetic wears off, it’s common to have some mild discomfort, swelling, or even a little bruising near the surgical site. Over-the-counter anti-inflammatory medication or the pain relievers we recommend usually manage this well. For the first 24 hours, applying an ice pack to your cheek helps hold swelling down.

We advise sticking to soft, lukewarm foods for a few days and avoiding hard brushing or flossing around the area. The sutures will either dissolve on their own or we’ll remove them at a brief follow-up visit. Most people feel ready to return to work or normal activities within one to two days. The gum usually knits together in a week or two, while the deeper bone continues to remodel over the next several months. We’ll schedule a postoperative check to monitor your progress.

The top reason to choose endodontic surgery is simply to save your natural tooth. When you extract a tooth and replace it with a bridge, implant, or partial denture, the process is often longer, more costly, and never quite the same as a healthy, natural tooth. Surgery can eliminate the pain and swelling that brought you in, stop the infection from damaging more bone, and give that tooth many more years of function.

We want you to have realistic expectations: no dental procedure comes with an absolute guarantee. Success depends on factors like the size of the infection, the condition of the tooth and its existing restoration, and your body’s healing response. During your consultation, Dr. Barnes will discuss what you can reasonably anticipate and explain alternative treatments—such as extraction and tooth replacement—so you can make a confident, informed decision.

No two endodontic surgery cases are exactly alike, so the cost varies based on the tooth’s location and the difficulty of the procedure. Before we move forward, we always prepare a detailed, written treatment plan that outlines all expected fees.

We work with a wide range of dental insurance plans and will verify your benefits for you. Because coverage levels differ dramatically from plan to plan, we encourage you to contact our office to discuss your specific policy. We can help you understand your out-of-pocket responsibility and go over flexible payment options if needed. Our goal is to eliminate financial surprises so you can focus on your treatment.

If a previously treated tooth is still giving you trouble—whether it’s a dull ache, sharp pain when chewing, swelling, or a recurring pimple on the gum—come see us for an evaluation. At your consultation, Dr. Barnes will examine the area, take any necessary images, and walk you through her findings clearly. She may recommend endodontic surgery or, if appropriate, another approach that better fits your situation.

We welcome every question and want you to feel fully comfortable with the path forward. To schedule your appointment, call Care Dental at (832) 564-1800. We are conveniently located at 3301 Tidwell Rd Suite D, Houston, TX 77093, proudly serving patients from Houston, Aldine, Humble, Spring, North Houston, and Greenspoint.