All dentists receive endodontic treatment training in dental school. However, because endodontic surgery can be more difficult than nonsurgical treatment, many dentists refer patients needing endodontic surgery to those more specialized. Endodontists are dentists with at least two years of advanced education and training in root based techniques and procedures. In addition to treating routine cases, they are experts in performing complicated procedures including surgery. Endodontists often treat difficult cases – such as teeth with complex root structure or small, narrow canals. This special training and experience can be very valuable when surgery is necessary. Surgery may be used in the diagnosis of issues. If you have persistent symptoms but no problems appear on the x-ray, your tooth may have a small fracture or canal that could not be detected during non-surgical treatment. In that case, surgery allows your endodontist to examine the root of your tooth, find the problem, and provide a solution. A tooth that has undergone a root canal can last the rest of your life and never need further treatment. In some cases, a tooth may not heal. The tooth can become painful or diseased months or years after what seemed a successful treatment. If this is true in your case, surgery may help save your tooth.