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A guide to Apicoectomy

Sometimes, dental procedures can sound a lot more confusing and terrifying than they really are, simply because the medical names can sound mystifying to most of us. So if your dentist says you need an ‘apicoectomy’, what does that actually mean? What does the treatment actually involve? And more to the point, is it going to hurt?

An apicoectomy is a surgical procedure for people who have an infection in the root of their tooth. Normally, infections in and around the root of the tooth are dealt with by root canal treatment. This basically means that your dentist cleans around the root of your tooth, ensuring that any plaque, decay and infection are removed so that the tooth and gum can become healthy once again.

In some cases, however, root canal treatment is not sufficient to stave off infection, which can return. Therefore, your dentist has a choice. To once again attempt root canal treatment and clean away the infection, even though this has failed already. Or, an alternative procedure can be attempted, which may hopefully yield more lasting results.

Often, if the returning infection is spotted early, your dentist will choose attempt a second root canal treatment and this may clear up the infection once and for all. If the infection is more deep-seated, then your dentist may recommend an apicoectomy.

Think of it this way. You’ve got an infection around the root of your tooth. If you let it continue, then the tooth will decay, starting causing you pain and eventually fall out. From your dentist’s perspective, the aim of the game is to stop you losing that tooth. The first plan of attack, therefore, is the root canal treatment, a.k.a ‘let’s clean it up and see how it looks’. But we’ve tried that and the infection has returned. So what next?

Well, your dentist can either admit defeat, concede that the tooth cannot be saved and perform an extraction. But as we mentioned above, this should be a last resort – the more of your natural teeth you can keep, the better. So your dentist does not admit defeat just yet. Instead, he or she explores the possibility of an apicoectomy.

The first step is to cut into the gum so that you dentist can take a closer look at the infected root. At this point, the right solution is still to be decided. If the tooth root is badly cracked, then it may still be susceptible to infection in the future – so the only option may be to perform an extraction.

However, if the tooth root is still strong, then your dentist will clean away the infection around the root as during root canal treatment. However, to stop the root becoming infected further in the future, the dentist will perform an extra surgical step, known as an apicoectomy. This involves slicing away the tip of the root. This means that the entire infection has been removed and the end of the tooth root can be cleaned and sealed, thus better protecting it in the future.

Therefore, if your dentist is considering performing an apicoectomy, you should not be fearful. You should in fact be glad that there is still an opportunity to save your tooth. However, apicoectomy is not successful in 100% of cases. It is possible for infection to return, in which case an extraction may still be required in the future.

We hope that’s answered the majority of your questions regarding an apicoectomy. Of course, there was one more – will it hurt? You’ll be under anaesthetic for the surgery, but you may have some bruising for a couple of weeks after the procedure, and there could be some swelling and tenderness around your jaw. In all honesty, it’s nothing that an over-the-counter painkiller shouldn’t ease. Most patients have their stitches removed within this time as well, so hopefully you’ll feel as good as new – if not better – in no time at all.

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