Root end surgery is recommended when a root canal — or multiple root canals — are unsuccessful at clearing infection and relieving pain and discomfort. While dentists are usually able to treat inflammation and infection near the affected tooth’s root, sometimes an oral surgeon’s expertise is required to carry out root end surgery, also called an apicoectomy.
With root end surgery, the surgeon removes the tip of the tooth’s root along with any additional inflamed tissues, and they also may place a filling where the root end used to be in order to seal the end of the root canal.
Why it’s Done
A root canal isn’t always a straightforward procedure. It can be difficult to unearth all bacteria in every canal within the affected tooth. While it is possible to do a second root canal if symptoms persist after treatment, it is not always possible if the tooth has a crown or is part of a bridge.
Preparing for Treatment
Oral surgeons are usually called upon to handle the procedure, given the complexity, and they will help you prepare by prescribing mouthwash or antibiotics to reduce the risk of infection. They will take a number of X-ray images to confirm the diagnosis and recommended treatment. They will also review your medical history to get the full picture of all your medications, vitamins and supplements that could affect their work.
Root end surgery begins with a small incision in the gums in front of the affected tooth. Your surgeon might need to use a dental drill to reach the root. After removing all infected tissue, they shave the end of the root tip away and clean and seal the root.
The procedure is usually done under a microscope, given the detailed view necessary. Before they stitch and close the exposed bone, they will usually take one final X-ray to ensure the treatment was effective. The entire surgery usually takes about 90 minutes for one tooth.
The Healing Process
You will have swelling and discomfort immediately following the procedure, so you must ice the area and take the antibiotics your surgeon prescribes. You will usually be able to control pain with an over-the-counter drug, but if not, your surgeon may be able to prescribe you a stronger option.
If your stitches aren’t dissolvable, you will need to get them removed a few days after surgery.
While you’ll see initial bruising, all soreness should be gone about two weeks after the procedure, and you should be back to normal. If numbness or pain persists, talk to your oral surgeon.
You may notice a pimple develop near the tooth, called a fistula. This usually indicates an underlying infection, but your body is working to remove bacteria by draining it this way. It should eventually go away, but discuss it with your medical team if you are concerned or notice any other signs of infection.
Like any oral procedure, the prospect of root end surgery might leave you with many questions. At Northeast Oral & Maxillofacial Surgery, we have answers. You’re in good hands with our informative, helpful team guiding you to good oral health.