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  • Post-apicectomy Reviews

    A post-apicectomy review is a meeting with your surgeon to determine whether healing is satisfactory, and if stitches need to be removed. Usually, an x-ray will also be taken.

    This appointment is usually 7-10 days after your operation, and it is important that you attend this appointment.

    The surgeon will usually wish to see you again 4-6 months later for a further x-ray to check that the bone has healed satisfactorily.

  • What are the complications involved in this procedure?

    This is usually a very safe procedure, which is carried out by specially trained staff who are very experienced.

    Complications with this type of surgery are, fortunately, rare and may not apply to you, but it is important that you are aware of them.

    Bleeding

    Although there may be a little bleeding at the time if extraction, this usually stops very quickly and is unlikely to be a problem if the wound is stitched. Should the area bleed again when you get home this 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 us for further help and advice, or if out of hours then call 111.

    Gum recession

    The gum around the crown of your tooth can recede following your surgery.

    Infection

    It is important to keep your mouth clean and to reduce or cut down your smoking following the removal of your wisdom teeth to prevent infection.

    Antibiotics are not routinely prescribed after surgery, but your surgeon may prescribe antibiotics for particular cases.

    Failure of the operation

    An apicectomy is not always successful but is often the last attempt to save your tooth. Your surgeon will explain your individual chance of success.

  • Do I need to take any time off work?

    Usually it will be necessary to take a few days off work and avoid strenuous exercise for this time. Depending on the type of anaesthetic used, you may well be able not to drive (24 hours after intravenous sedation or after a general anaesthetic).

    Immediately following a general anaesthetic, you may feel tired dizzy or weak. You must have somebody to collect you and stay with you for the first 24 hours.

    During the first 24 hours you must not drive or operate any motorised vehicles or electrical equipment, sign any legal documents, make any important decisions, or drink any alcohol.

  • Is there anything else I need to do after the apicectomy?

    It is important to keep the surgical site as clean as possible for the first few weeks after surgery.

    It may be difficult to clean your teeth around sites of the extraction because it is sore. If this is the case is it best to keep the area free from debris by gentle rinsing with a mouthwash or warm salt water (dissolve a flat teaspoon of kitchen salt in a cup of warm water), starting on the day after surgery.

  • Is there much pain or swelling after an apicectomy?

    It is likely that there will be some discomfort and swelling both on the inside and outside of your mouth after surgery. This is usually worse for the first 3 days, but it may take up to 2 weeks before all the soreness goes.

    You may also find that your jaw is stiff and you may need to eat a soft diet for a week or so. It is likely to be sore after your surgery and your surgeon will advise you about pain relief medication.

    It may also be necessary for you to have a course of antibiotics after the apicectomy. There may be some bruising of the skin on your face which can take up to a fortnight to fade away.

  • Will the apicectomy make the tooth loose?

    Teeth often feel slightly loose for 3-4 weeks after an apicectomy until new bone grows around the tooth root.

    Then they usually become firm and more comfortable than before the operation, because the infection has been removed.

  • What type of anaesthetic is used?

    A number of options are available and depend on how difficult the wisdom tooth is to remove.

    Local anaesthetic

    this is an injection into the gums surrounding the wisdom tooth, rather similar to that you may have had at your dentist for a filling. The injection takes a couple of minutes to numb the area and means that you feel no pain while the wisdom tooth is removed. This is the best option for wisdom teeth that are simple to remove.

    Local anaesthetic and intravenous sedation

    In addition to a local anaesthetic injection you can be given an injection in your arm. This makes you feel relaxed and less aware of the procedure.

    General anaesthetic

    It is usually possible to remove wisdom teeth under a โ€˜day caseโ€™ general anaesthetic, i.e. although you are put to sleep completely, you will be able to go home on the same day as surgery.

    If you are having day surgery with sedation or under a general anaesthetic, you need to ensure that a responsible adult is with you for the first 24 hours after surgery and that they can escort you home as well. You will need to make our own transport arrangements for your discharge unless arranged by the hospital in advance. If arrangements are not in place your surgery will be cancelled.

  • What does the treatment involve?

    A cut is made in the gum above the tooth, followed by removal of bone to find the root tip.

    The tip of the root is then removed, and a seal is put into place.

    Once the apicectomy has been completed, the gum is put back into place with stitches.

    In the majority of cases these stiches are dissolvable and take around two weeks to disappear.

  • Why do I need treatment?

    When a tooth is badly decayed, has a large filling, or receives a blow in an accident, the soft tissues within it (the pulp) may die. The dead tissue must be removed to prevent infection and this is usually undertaken by your dentist by a procedure called root canal treatment.

    Sometimes this root canal treatment is unsuccessful, and infection persists at the tip of the root. This may sometimes cause pain, but more often the infection will spread and cause a small spot or gumboil nest to the tooth.

    An apicectomy is an operation designed to remove this infected part of the root tip.

    Usually a small filling is also placed in the end of the root to seal it.

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    Nicholas Lee: Oral & Maxillofacial Surgeon, Sheffield UK