Why would I need Endodontic Surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Dr. Pikewill recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an Apicoectomy?

The video on the right illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged/diseased tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the incision is sutured. The sutures used will dissolve. The bone naturally heals around the root over a period of months restoring full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure.

Post-operative Instructions

Initially, place an ice pack over the surgical site for half an hour. In order to minimize swelling, continue to apply ice packs every hour for 10 to 15 minutes during the first 4-6 hours. It is not unusual to have swelling and/or bruising after this treatment.

If any medication is prescribed, please take it as directed. For pain relief, it is suggested that medication is to be taken regularly for the first 48 hours. Thereafter, it is only to be taken as needed.

Sleep with your head in an elevated position for the first night (one extra pillow). Swelling may be worse the following morning; this is completely normal.

Avoid eating for the first 6-8 hours. After that, we encourage you to maintain a soft food diet for at least 2 days. It is best to avoid steaming hot or ice cold foods or liquids. Brittle items such as crackers, celery, seeds, and peanuts should be avoided as they may irritate the incision or may tear the sutures.

Do not raise your lip to look at the area. Try to avoid talking during the first few hours following surgery. Any unnecessary movement may disrupt the sutures and the healing process.

Please wait a full 24 hours after surgery before rinsing your mouth. Then rinse after breakfast and before retiring using Chlorhexidine. This process should be followed for 5 to 7 days.

Maintain your normal dental hygiene regimen of brushing and flossing in all other areas of the mouth. Please avoid the incision area.

Refrain from smoking, alcoholic beverages and strenuous activity for the first 48 hours. Reduce your smoking during the remaining healing phase as this tends to dry out the mouth and delay healing.

Should you have any questions, or experience any problems, please do not hesitate to contact our office. Please note that after hours care can be acquired by dialing our office number 519-579-8381 or 1-800-444-9174.