Apicoectomy Cost and Procedure Guide

Most people have heard of the dental procedure known as a root canal — seeing as more than 15 million of these procedures are performed every year.¹ However, there's a related, but slightly more invasive procedure you've probably only heard of if you need it. This is an apicoectomy, sometimes referred to as a “reverse root canal."

Apicoectomies are typically a "procedure of last resort" when other dental procedures — such as one or more root canals, or a dental bridge — fail to keep dental tissue healthy. An apicoectomy removes the tissue at the very tip of your root to allow the tissue to heal fully and the tooth to stay intact.²

What Is an Apicoectomy?

An apicoectomy is a procedure designed to save a tooth when a traditional root canal cannot do so. It may also be referred to as a "reverse root canal."

Apicoectomies are performed by a specialized dentist known as an endodontist.³ During the procedure, a person's gum tissue is surgically opened around a tooth to access its supporting base. The endodontist then cuts away the tip of the root and any inflamed or infected tissue surrounding it.² In some cases, the endodontist may place a small filling there to seal the tip of the root canal and most likely will place sutures in the gingiva for proper tissue healing.

Root canal vs. apicoectomy

A root canal and an apicoectomy are similar in that both procedures often involve removing infected tissue in the root canals. However, while a root canal tends to focus on removing infected pulp, an apicoectomy involves removing part of the root, and typically requires a strong local anesthesia, though it is still an outpatient procedure, like a root canal.³

How Much Does an Apicoectomy Cost?

Without dental insurance, the national average cost* of an apicoectomy is $1,119, but the costs ranges between $862 to $1,962, depending upon the extent of the infection and complexity of the case.⁴

Average cost of an apicoectomy by state

Below is a breakdown of the average cost* of an apicoectomy across all 50 states and the District of Columbia.⁴ Prices do not include potential insurance coverage.

Does Insurance Cover Apicoectomy?

While you should always check with your insurance provider, most insurers likely cover part or all of an apicoectomy.⁵

Who Needs an Apicoectomy?

For some people, persistent inflammation, infection or crowding at the root's very base will require an apicoectomy. If your dentist recommends you need an apicoectomy, it's probably because a root canal failed, you've got an abscess or infction in the root tip, or you have narrow or curved root canals, making traditional root canal ineffective.⁵

Additionally if your infected tooth is too close to another sensitive facial structure such as another nerve or sinus, apicoectomy may be a safer treatment.⁵

How An Apicoectomy Procedure Works

Preparation

Before the endodontist does anything surgical, you should expect the following:⁶

• You'll have a consultation with your endodontist about your medical history, medications, current condition and what to expect of the procedure.
• Dental X-rays will be made of the tooth in question and surrounding tissue and bone.
• You'll receive pre-procedure medication recommendations, which may include an antimicrobial mouth rinse, medications such as ibuprofen to reduce inflammation, and/or antibiotics.

Procedure

Before the procedure begins, you will be given a local anesthetic to numb the area. Once the area is numb, the endodontist will make a small incision in your gum near the root tip of your tooth. Typically, only a few millimeters of the root, including the root tip, will be taken out, as well as infected tissue around the root. They'll then likely seal your root tip with a material that should prevent infection, much like a regular tooth filling before suturing it back up.⁵

Recovery

An apicoectomy is slightly more invasive than a regular root canal, due to the need to cut into the gum tissue, so you will likely have some pain and discomfort afterward. However, you might also feel better, given that the source of much pain — the infection — has now been addressed.⁶

You're likely to experience some pain or discomfort following an apicoectomy, as you will have infected tissue removed and will have been injected with anesthetics, but it should resolve within a few days.⁶

After apicoectomy surgery, some best practices can help in the healing process, including:⁷

• Stay away from smoking, eating crunchy foods or doing anything that could damage stitches.
• Brush and floss gently.
• Take your medications as prescribed.
• If recommended by your dentist, take over-the-counter pain relievers or anti-inflammatories for pain or swelling.
• Use a cold compress or ice pack on the swollen areas (from the outside only).
• Eat only soft foods that are cool and easy to chew, such as yogurt, shakes, soft pasta, mashed potatoes and scrambled eggs. Do not sip through a straw.
• Rinse your mouth with warm salt water after every meal (don't spit, just let the liquid fall out of your mouth into the sink).
• Schedule and show up to all follow-up appointments.

Potential Side Effects

Even though this procedure is fairly common, no dental procedure is without potential side effects. The following are some possible complications from apicoectomy surgery:⁸

• Infection: Although most apicoectomies are done to treat an infection, it’s also possible, though low risk, that you could also get another infection or the same infection could worsen. Be sure to follow your endodontist’s instructions to avoid this outcome.
• Nerve damage: The procedure does confer a small risk of nerve damage, which could leave you with numbness or tingling in parts of the face and mouth. Most of the time this resolves on its own.
• Tooth damage: There is a small possibility of tooth damage during the procedure.
• Sinus problems: It’s possible but rare for an apicoectomy to cause sinus problems if the affected tooth is too close to a sinus.

If you experience any new, unusual, or severe pain, numbness or fever after your apicoectomy, be sure to call your endontist.⁹

Financing an Apicoectomy Surgery With the CareCredit Credit Card

Whether you're getting an apicoectomy or you simply need a dental exam, the CareCredit credit card can help you pay for costs not covered by insurance.^** Use our Acceptance Locator to find a dentist or oral surgeon near you that accepts CareCredit. Use the CareCredit credit card, again and again, to pay for your health and wellness needs and download the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U hub for more great articles, podcasts and videos.

In addition to dental care, you can also use your CareCredit credit card for pet care, cosmetic, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more. Her work has appeared in The Atlantic, The Billfold, Good Magazine, GoBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, Paypal, The Washington Post and more.