What’s the problem? Infection at the tip of the root or roots of a tooth, spreading into the surrounding bone that supports the tooth. Usually there is discomfort, episodes of swelling, gumboils or bad taste, but occasionally people are unaware of the problem
Why do I need treatment? If you don’t receive treatment, the infection will spread and could develop into an abscess or cyst, or damage bone and the tooth may become loose. The infection cannot be cured with antibiotics, but they may be used to give temporary relief of symptoms.
What is the treatment? A small surgical procedure called an apicectomy which is used to cure an infection at the tip of the root or roots of a tooth. An apicectomy may be used when it has proved impossible for your dentist to cure the infection by removing the dead nerve and placing a root filling.
What happens during the apicectomy? An apicectomy is usually carried out under local anaesthetic (injection into the gum). A small cut is made in the gum, which is then lifted off the bone. A drill is then used to gain access through the bone to the root tip. The infection is cleaned out and part of the root tip removed. A small filling is placed in the end of the root. The gum is put back in place with the aid of dissolvable stitches.
What can I expect to feel after the operation? A few hours after surgery, the local anaesthetic will wear off and there may be some discomfort. It varies from patient to patient and is usually managed with normal painkillers. Antibiotics may also be prescribed. Some swelling at the operation site and sometimes overlying skin is normal, peaking in the period 24 to 48 hours after the operation, but usually subsides over the next few days.
What can I do to aid recovery? It is important to keep the site of surgery as clean as possible. Brush the area gently with a toothbrush softened in hot water and use a hot salty mouthwash (a teaspoon of salt in a beaker of warm water), two to three times a day, beginning the day after surgery for 1 week.
What problems should I look out for? Prolonged bleeding is rare. If it occurs, applying pressure with a cotton handkerchief or swab for at least 15 minutes usually stops it. Some tooth roots lie very close to important nerves. If these are damaged, it may cause numbness of the lower lip and chin on one side. Your dentist will discuss this with you if he or she thinks there is a risk of this. Occasionally the gum will shrink back slightly following surgery, which may expose the margin of a crown if one is present. Finally, occasionally the operation is unsuccessful in removing the infection.
Download this page as a fact-sheet for printing – Apicectomy Fact Sheet (pdf file)
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