Apicectomy

The Problem

An infection has occurred at the tip of the root or roots of a tooth, spreading into the surrounding bone that supports the tooth. Occasionally people may be unaware of the problem but usually there is discomfort, episodes of swelling, gumboils or bad taste.

Why do I need Treatment?

If left untreated the infection will spread possibly developing into an abscess or cyst, or damaging bone around nearby teeth. The tooth may become loose. The infection cannot be cured with antibiotics, but they are often used to give temporary relief of symptoms.

What is the Treatment?

An apicectomy is a small surgical procedure designed to cure an infection at the tip of the root or roots of a tooth. It is indicated when, for a variety of reasons, it has proved impossible for your dentist to cure the infection by removing the dead nerve and placing a root filling.

It is carried out under local anaesthetic (injection into the gum).

What can I expect after the operation?

As the local anaesthetic wears off a few hours after surgery there may be some discomfort but this is quite variable. This is usually managed with a single dose of an analgesic such as Ibuprofen. Antibiotics may also be prescribed. Analgesics are seldom required after the first day. Some swelling at the operation site and sometimes overlying skin is normal. This is worse 24-48 Hours after the operation and resolves over the next few days. It is important to keep the site of surgery as clean as possible. The area can be brushed gently with a toothbrush softened in hot water, together with hot salty mouthwash (teaspoon of salt in a beaker of warm water), 2-3 times a day, beginning the day after surgery and continuing for 1 week. 

What are the possible problems?

Prolonged bleeding is rare but if it occurs pressure with a cotton handkerchief or swab for at least 10 minutes usually stops it. The operation is occasionally unsuccessful at removing the infection. If unsuccessful after 2 attempts the tooth is probably better removed.