Pain and Inflammation After Periapical Surgery

In this procedure the canals of the roots are cleaned out and any infected tissue is taken out. However if for any reason, a conventional root canal treatment fails to completely eliminate the infection and re-treating the area has no effect then you may require a apicectomy. If the area is left untreated then bone loss in the area can continue and the patient will experience a significant amount of discomfort and pain. In most cases another root canal treatment will be tried before moving on to an apicectomy but if the infection continues this could indicate the problem may be nearer the tip of the root.

The Procedure

Before undergoing your apicectomy, it’s usual to have a meeting with your surgeon to discuss your dental history, the treatment and the procedure. You’ll also need to have x-rays of the tooth and surrounding bone taken before undergoing surgery. Immediately before surgery you’ll be given some medications which will help control the inflammation, antibiotics and an antimicrobial mouth wash. During the procedure your dentist will first administer a local anaesthetic to numb the area. Then a cut will be made in your gum which will allow it to be separated from the bone making access to it easier. Following this your dentist uses a drill to make a tiny hole in the bone which covers the root of the tooth. In this area any infected tissue is cleaned away using ultrasonic equipment under a microscope before the last section of the tip of the root is eventually removed. After removal your dentist will seal up the hole with a bio compatible material and use stitches to close the gum. The entire procedure takes around an hour but this can vary depending on the complexity of the structure of the root and the tooth’s location.

Aftercare

Immediately following surgery it’s usual to feel some discomfort and your dentist will most likely prescribe some painkillers to help ease any pain. It’s also usual to be prescribed antibiotics to promote healing and guard against infection. It’s important to keep the treated area as clean as possible in the weeks following surgery, particularly after eating. Around a month after surgery any residual pain in the gums should completely subside and the healing process should be complete.

The Risks

Despite the vast majority of apicectomy procedures being performed safely, as with any surgical procedure there are certain risks involved. If you’ve had previous apicectomies on the tooth then the chances of success are low and whilst complications with local anaesthetic are rare, they do occur. Bleeding in the treated area can occur after surgery but this can usually be stopped by putting pressure on the area. Some patients also experience numbness in their gums but in most cases this disappears after a couple of months.