Endodontic apicoectomy: is it possible for the dentist to drill all the way down and through the tip of the root to avoid slicing into an inch of gum?

No: That's not how an apicoectomy is performed.

Not really.: In order to do a good job the dentist has to see well. We do that by creating a window through the gum and the bone. It is nearly impossible to do it the way you suggest. Remember an x-ray is only two dimensional and doesn't really tell us exactly where the tip of the root is. We need to see it. Don't worry it really isn't as bad as you think it is. It would be much worse to lose the tooth.

No: In the hands of a qualified Endodontist an apicoectomies is a safe procedure with very high success rate. It's often indicated when conservative root canal treatment cannot be successfully accomplished. Drilling a big hole in tooth roots is neither safe nor conservative. Ask to see an Endodontic Specialist for highest level of care.