Apicectomy

What is it?

Teeth are held in the jaw by their roots.

At the core of each tooth is a soft mass of tissue called the dental pulp. In a healthy tooth, the pulp contains living fibers, cells, nerves and a blood supply, extending in to the roots through the root canal

Tooth decay or injury can destroy the living pulp. Dead pulp is more prone to infection, leading to an abscess and toothache.

This can usually be dealt with successfully by root canal treatment (also known as endodontics or root filling) sometimes infection can persist at the end of a tooth root, in the surrounding bone, in this case a dentist will carry out an apicectomy.

What will my dentist do?

• Give you a local anaesthetic to numb the mouth around the infected tooth, so that the procedure is painless

• Make a small cut in the gum, well away from the tooth, so that there won’t be a visible scar afterwards

• Move a small flap of gum to one side and make a small window in the bone to uncover the infected area

• Clean out the infection and cut off the tip or apex of the root

• Put a small filling at the end of the root canal to stop any more infection

• Stitch the gum back in place

You may feel some pressure and hear instruments being used, but you should not feel any pain during an apicectomy

After treatment you will need to keep the area clean

• For the first day rinse with warm salt water several times a day, especially after meals. Use half a teaspoon of salt in a glass of warm water, not hotter than is comfortable

• Brush teeth normally, but be very careful not to disturb the cut

• On the next day continue rinsing and begin to gently brush the teeth next to the cut

There may be some bruising or swelling for two or three days afterwards. There will also be some slight discomfort – an ice pack or packet of frozen peas wrapped in a towel applied to the outside of the face can help. It usually takes about a week for a apicectomy to heal

Points to remember

• An apicectomy stops pain

• An apicectomy saves a tooth that would otherwise have to be taken out