What Is Apical Surgery?
When decay causes severe damage to a tooth, the first line of defense is usually a root canal. This is typically an effective solution because it involves removal of the damaged portions, including the pulp and nerve.
Some infections can be external to the tooth and may best be treated with a different approach than traditional root canal treatment; root canals can sometimes fail, or may not be an option at all. In those cases, an apicoectomy, or apical microsurgery, may be a viable solution. Here’s what you should know about this dental procedure.
What Is an Apicoectomy?
Much like a root canal, apical surgery involves the removal of the infected areas from within and around the root end. Your endodontist will typically only recommend this procedure if you had a root canal and it has a persistent infection, abscess, or cyst.
While surgery may not be your preference, it may be the best chance you have at salvaging your tooth. Otherwise, your endodontist may recommend extracting the tooth as an alternative. While it’s an option, it does involve more extensive work beyond just removing the affected tooth.
Once that tooth is extracted, your provider will replace it with either a bridge, implant, or partial denture. These devices fill the gap, both aesthetically and functionally, making it easier for you to chew and protecting neighboring teeth from moving.
Since this kind of work typically involves performing surgery even on those healthy neighboring teeth, it makes sense to consider endodontic surgery instead. When performed by an experienced professional, you can have confidence that your natural tooth may be restored.
How Can You Tell if a Root Canal is Reinfected?
Root canal reinfection isn’t always obvious. Symptoms may not emerge right away, but eventually, you might experience some of the following issues that require follow up and re-evaluation with your endodontist’s office.
- Increased sensitivity, especially when biting and chewing
- Pressure sensation in the affected tooth
- Pain in the affected tooth
- Tender gum tissues surrounding the treated tooth
- Swelling in the neck, face, or mouth
- Pus or drainage in the vicinity of the tooth
When Should You Be Concerned?
It’s natural to feel some pain after a root canal, especially as the numbing medication wears off. You can usually manage that with over-the-counter medication as advised by your provider. However, if your pain persists or becomes worse, or if it affects your ability to go about your everyday routine, it might be a sign of potential root canal failure.
Your endodontist will typically take an X-ray of the area to determine the efficacy of the root canal. They’ll assess the condition of the pulp, the ligament, and the surrounding bone. If it’s still inflamed or if signs of infection are present, then they may advise apical surgery to treat it.
What Happens During Apical Surgery?
Your endodontist will begin by numbing the area surrounding the treatment site. You shouldn’t feel any pain, but may experience mild pressure throughout the procedure. Plus, you can communicate with your endodontist if necessary.
The procedure itself involves creating a microscopic opening in the gum surrounding the affected area. From here, your endodontist can then reach and remove the infected apex and any inflamed tissue. They’ll then clean this area thoroughly before placing a filling there to create a seal. A final X-ray may be taken to confirm that the procedure was performed successfully. As a final step, they’ll stitch the gums closed to promote healing.
What Can You Expect After Apical Surgery?
As with any dental procedure, you might have some mild discomfort due to swelling after apical surgery. However, the American Association of Endodontists (AAE) reports that post-surgical pain is usually minor at best. You should be able to resume normal activities within a day.
It’s important to take the right precautionary measures after apical surgery. Your endodontist will advise you to avoid eating anything that is crunchy, hard, or sticky, all of which could disturb the surgical site and potentially harm the stitches.
Taking consistent over-the-counter painkillers is usually effective for managing any discomfort you have and reducing inflammation. You may also be prescribed antibiotics to prevent infection. Finally, be sure to attend follow-up appointments with your endodontist as required to ensure that the surgical site is healing properly.
Apical Surgery at Forest Lake Endodontics
If you fear your root canal has failed or you’re experiencing pain or discomfort, let the team at Forest Lake Endodontics help. We’re committed to providing you with a comfortable experience from start to finish. Find out more about our apical surgery services and learn how we can salvage your tooth, or give us a call at 651-464-9888 to schedule an appointment today.