Apicectomy

An infection has developed at the tip of the root of one of your teeth. This leaflet outlines the treatment you now need, and answers to many of the commonly asked questions. If after reading this leaflet you have any more questions, please ask a member of staff.

What are the symptoms?

Sometimes this infection does not cause any symptoms, but 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 does the treatment involve?

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 in a procedure called an apicectomy. This involves cleaning out the infection from the bone, removing a small part of the tip of the tooth’s root, and sealing the root with a small filling.

• A small cut is made in your gum over the root of your tooth, and then 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 then sealed with a small filling and the gum is stitched back into place with dissolvable stitches. These stitches take around two weeks to disappear.

How long will the procedure take?

The whole procedure will take around 45 to 60 minutes, from start to finish.

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. It might also be necessary 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, although it may take a couple of weeks to completely disappear.

There may be swelling both inside and outside your mouth after your surgery; this is usually for the first two 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. If you find it difficult to use a toothbrush, the area can be kept 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), starting the day after surgery.

When can I continue my normal activities?

You may need a day or two off work, and you should avoid any strenuous exercise during this time.

Are there any risks or complications?

• It is unusual for the area to bleed after surgery, but 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 contact details on the discharge sheet given to you after your surgery).

• This surgery can sometimes lead to your gum feeling 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 now 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 but sometimes it is better to remove the tooth.

What if I have any questions or concerns?

If after reading this leaflet you still have questions or concerns, please speak to a member of the healthcare team responsible for your care.