Apicectomy

An infection has developed at the tip of the root of one of your teeth. This leaflet explains the following.

• What the symptoms are.

• Why you need treatment and what happens if you choose not to.

• What happens during the operation.

• How to look after your mouth following surgery.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What are the symptoms?

Sometimes this infection does not cause any symptoms. However, most people are aware of discomfort and occasional swelling, gum boils, or a bad taste in their mouth.

Why do I need treatment?

If left untreated, the infection is likely to develop into an abscess or cyst. As well as causing pain, this can lead to the loss of bone surrounding the root. As a result your tooth will become loose.

What happens during an apicectomy?

Your dentist will have already tried to get rid of the infection by removing the tooth’s nerve and placing a root filling. The infection now needs to be removed surgically, using a procedure called an apicectomy.

• A small cut is made in your gum over the root of your tooth. The gum is lifted off the bone. The area of infection is uncovered by removing a small amount of bone with a drill.

• Any infected tissue is cleaned away from the tip of the root, before 2 to 3mm of the root tip is removed.

• The root is sealed with a small filling. The gum is stitched back into place with dissolvable stitches. These stitches take around 2 weeks to disappear.

How long will the procedure take?

The whole procedure will take around 45 to 60 minutes.

What type of anaesthetic will be used?

Usually an apicectomy is carried out under a local anaesthetic (an injection into your gum, which will numb the area). This will prevent you feeling any pain during the procedure.

How will I feel after my operation?

• The local anaesthetic will wear off a few hours after your surgery. When this happens you will feel some discomfort. If it is likely to be very sore, your surgeon will give you some painkillers.

• You may also need to take a course of antibiotics, but this will be discussed with you after your procedure.

• The discomfort is usually worse for the first few days. It may take a couple of weeks to completely disappear.

• You may have swelling both inside and outside your mouth after your surgery; this is usually for the first 2 days.

How do I care for my wound?

It is important to keep your wound site as clean as possible for the first few weeks after surgery.

You may find it difficult to use a toothbrush. If so, starting the day after surgery, you need to keep the area free of food debris by gently rinsing with:

• a mouthwash, or

• warm salt water (dissolve a teaspoon of kitchen salt in a cup of warm water).

When can I continue my normal activities?

You may need a day or two off work. Avoid any strenuous exercise during this time.

Are there any risks or complications?

• It is unusual for the area to bleed after surgery. If this happens, it can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled-up handkerchief or swab. If the bleeding does not stop, please contact the Unit. See the contact details on the discharge sheet given to you after your surgery.

• After surgery your gum may feel numb. If this happens it usually disappears after a few months.

• Your gum can sometimes shrink back a few months after surgery, as scar tissue forms. This is not normally a problem, but if your tooth has been crowned you may be able to see the edge of the crown.

• Even if all of the infection is removed, it can sometimes return months or even years later. If this happens, we may need to repeat the operation. Sometimes it is better to remove the tooth.

What if I have any questions or concerns?

If you have questions or concerns, please speak to a member of your healthcare team.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

If you would like to give us feedback about this leaflet, please fill in our short online survey. Either scan the QR code below, or use the web link. We do not record your personal information, unless you provide contact details and would like to talk to us some more.

If you would rather talk to someone instead of filling in a survey, please call the Patient Voice Team.

• Patient Voice Team
  Telephone: 01227 868605
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