Date issued: March 2019
For review: March 2021
Ref: A-272/JB/Maxillofacial/Having an apicectomy v3
The purpose of this leaflet is to explain the procedure and answer some commonly asked questions. If you have any further questions, please contact the oral and maxillofacial department using contact information provided at the end of this leaflet
An infection has occurred at the tip of the root of your teeth. Sometimes this does not cause any symptoms but usually people are aware of discomfort and occasionally episodes of swelling, gum boils and bad taste. You may well already have been given a course of antibiotics in an attempt to treat the infection.
Why do I need treatment?
Your dentist will have already tried to get rid of the infection by removing the nerve of the tooth 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 portion of the tip of the root of the tooth and then sealing the root with a small filling..
It is necessary to make a small cut in the gum over the root of the tooth and then lift the gum off the bone. The area of infection is uncovered by removing a small amount of bone with a drill. Any infected tissue is thoroughly cleaned away from the tip of the root before 2-3mm of the root tip is removed. The root is then sealed with a small filling. The gum is then stitched back into place with dissolvable
Stiches that take around two weeks to disappear. The whole procedure will take around 30 minutes from start to finish.
What type of anaesthetic is used?
Usually an apicectomy is carried out under a local anaesthetic, ie an injection into the gum that numbs the area. This anaesthetic will prevent you from feeling any pain during the procedure.
What can I expect after the operation?
When the local anaesthetic wears off a few hours after the surgery, there will be some discomfort. If it is likely to be very sore your surgeon will arrange pain killers for you. It may also be necessary to take a course of antibiotics. The discomfort is usually worse for the first few days although it may take a couple of weeks for it to completely disappear. You may require a day or two of work during which time you should avoid strenuous exercise.
Some swelling can occur both inside and outside of the mouth after surgery. This is usually most noticeable for about two days. It is important to keep the site of the surgery as clean as possible for the first free weeks after surgery. If it is difficult to use a toothbrush, the area can be kept free of debris by gently rinsing with a mouthwash or warm salt water ( dissolve a teaspoon of kitchen salt in a cup of warm water) commencing the day after surgery.
What are the possible problems?
It is unusual for the area to bleed after surgery but should this happen 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 department.
Lifting the gum to uncover the root of the tooth can occasionally lead to a numb feeling in the gum. This usually disappears after a few months. Because the gum is cut it can occasionally shrink back a few months after the surgery as scar tissue forms. This is not normally a problem but if the tooth has been crowned, the edge of the crown may become exposed.
Even if all the infection is successfully removed, it can sometimes return months or even years later. If this happen the operation may need to be repeated but sometime the tooth is better removed
If you have any questions or concerns please contact the Hospital switchboard on
Tel: 01752 202082
And ask to be put through to the Oral and Maxillofacial Department.
Maxillofacial Department is open Mon-Fri 9:00 to 5:00