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Retrograde root canal treatment – Woodridge, Downers Grove, IL

What Is Apicoectomy?

Your teeth are held in place by roots that extend into your jawbone. Front teeth usually have one root. Other teeth, such as your premolars and molars, have two or more roots. The tip of each root is called the apex. Nerves and blood vessels enter the tooth through the apex, travel through a canal inside the root, and into the pulp chamber, which is inside the crown (the part of the tooth visible in the mouth).

An apicoectomy may be needed when an infection develops or persists after root canal treatment,or retreatment. During root canal treatment, the canals are cleaned, and inflamed or infected tissue is removed. Root canals are very complex, with many small branches off the main canal. Sometimes, even after root canal treatment, infected debris can remain in these branches and possibly prevent healing or cause re-infection later. In an apicoectomy, the root tip, or apex, is removed along with the infected tissue. A filling is then placed to seal the end of the root.

An apicoectomy is sometimes called endodontic microsurgery because the procedure is done under an operating microscope.

What It’s Used For

If a root canal becomes infected again after a root canal has been done, it’s often because of a problem near the apex of the root. Your dentist can do an apicoectomy to fix the problem so the tooth doesn’t need to be extracted. An apicoectomy is done only after a tooth has had at least one root canal procedure.

In many cases, a second root canal treatment is considered before an apicoectomy. With advances in technology, dentists often can detect additional canals that were not adequately treated and can clear up the infection by doing a second root canal procedure, thus avoiding the need for an apicoectomy.

An apicoectomy is not the same as a root resection. In a root resection, an entire root is removed, rather than just the tip.

Preparation

Before the procedure, you will have a consultation with your dentist. Your general dentist can do the apicoectomy, but, with the advances in endodontic microsurgery, it is best to be referred to an endodontist.

Your dentist may take X-rays and you may be given an antimicrobial mouth rinse, anti-inflammatory medication and/or antibiotics before the surgery.

If you have high blood pressure or know that you have problems with the epinephrine in local anesthetics, let your dentist know at the consultation. The local anesthetic used for an apicoectomy has about twice as much epinephrine (similar to adrenaline) as the anesthetics used when you get a filling. The extra epinephrine constricts your blood vessels to reduce bleeding near the surgical site so the endodontist can see the root. You may feel your heart rate speed up after you receive the local anesthetic, but this will subside after a few minutes.

How It’s Done

The endodontist will cut and lift the gum away from the tooth so the root is easily accessible. The infected tissue will be removed along with the last few millimeters of the root tip. He or she will use a dye that highlights cracks and fractures in the tooth. If the tooth is cracked or fractured, it may have to be extracted, and the apicoectomy will not continue.

To complete the apicoectomy, 3 to 4 millimeters of the tooth’s canal are cleaned and sealed. The cleaning usually is done under a microscope using ultrasonic instruments. Use of a surgical microscope increases the chances for success because the light and magnification allow the endodontist to see the area better. Your endodontist then will take an X-ray of the area before suturing the tissue back in place.

Most apicoectomies take between 30 to 90 minutes, depending on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest.

Follow-Up

You will receive instructions from your endodontist about which medications to take and what you can eat or drink. You should ice the area for 10 to 12 hours after the surgery, and rest during that time.

The area may bruise and swell. It may be more swollen the second day after the procedure than the first day. Any pain usually can be controlled with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofem (Advil, Motrin and others) or prescription medication.

To allow for healing, you should avoid brushing the area, rinsing vigorously, smoking or eating crunchy or hard foods. Do not lift your lip to examine the area, because this can disrupt blood-clot formation and loosen the sutures.

You may have some numbness in the area for days or weeks from the trauma of the surgery. This does not mean that nerves have been damaged. Tell your dentist about any numbness you experience.

Your stitches will be removed 2 to 7 days after the procedure, and all soreness and swelling are usually gone by 14 days after the procedure.

Even though an apicoectomy is considered surgery, many people say that recovering from an apicoectomy is easier than recovering from the original root-canal treatment.

Risks

The endodontist will review the risks of the procedure at the consultation appointment. The main risk is that the surgery may not work and the tooth may need to be extracted.

Depending on where the tooth is located, there may be other risks. If the tooth is in the back of your upper jaw, the infection can involve your sinuses, and your dentist may suggest antibiotics and decongestants. The roots of the back teeth in the lower jaw are close to some major nerves, so surgery on one of these teeth carries a slight risk of nerve damage. However, your endodontist will use your X-rays to see how close the roots are to the nerves, and the chances of anything happening are extremely small.

An apicoectomy is usually a permanent solution, and should last for the life of the tooth.

When To Call a Professional

If you’re having any pain or swelling from a tooth that has had root-canal treatment, contact your dentist, who will take X-rays and do an exam. If your dentist feels you need an apicoectomy, you will need to set up an appointment for a consultation.

Call Alivio Dental to schedule an appointment today! Proudly serving patients from Downers Grove, IL, Lisle, IL, Darien, IL, Lombard, IL, Clarendon Hills, IL, Bollingbrook, IL, Woodridge, IL, Westmont, IL, La Grange, IL and Wheaton, IL communities now.

Credits: Aetna Inc.

Woodridge dentist bad breath

If you’re serious about learning what’s causing your bad breath, consider scheduling an appointment with your dental professional. Given your full medical and dental history along with an oral examination, your dentist should be able to identify the culprit. The causes of bad breath are numerous and include certain foods, alcohol or cigarettes, poor oral hygiene, periodontal disease, diabetes, dry mouth, sinus or throat infections, lung infections or abscesses, kidney/liver failure, gastrointestinal issues and severe dieting.

Treatment of Bad Breath

It is important to conduct thorough oral hygiene at home twice daily utilizing tooth brushing with a fluoride antibacterial toothpaste and flossing to remove food debris and plaque on teeth, bridgework and implants, and brushing the tongue to remove odor-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased bleeding of the gum tissue over a two week period of time as well as reduced bad breath¹. Another clinical study conducted by the University of Buffalo dental researchers confirmed that brushing twice a day with an antibacterial toothpaste and using a tooth brush with a tongue cleaner can eliminate bad breath².

Tongue Cleaning is the Key to Fresher, Cleaner Breath

Cleaning your tongue is very important. You can purchase a Colgate 360 toothbrush with the tongue cleaner on the back of the toothbrush for cleaning both your teeth and tongue. After tooth brushing your upper and lower teeth with an antibacterial toothpaste, flip the toothbrush over to the tongue cleaner and place the tongue cleaner in the posterior region of the tongue and move it forward to the anterior section of the tongue. After you have scraped that portion of the tongue, rinse the tongue brush off with warm water to remove any odor causing bacteria. Then replace the tongue brush in the next posterior section again and repeat as described above again.

Consult your dentist or dental hygienist when choosing oral hygiene aids to help you eliminate plaque and odor causing bacteria and review the techniques that should be utilized at home. Also, ask your dental professional what oral hygiene care products they would consider you use to help eliminate bad breath (antibacterial toothpaste, antiseptic mouth rinse, tongue brushes or scrapers and interproximal cleaning devices). The key to a clean, fresh mouth is optimal oral hygiene conducted at home on a regular basis and professional recommendations discussed with you by your dental professional.

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Retrograde root canal treatment (Apicoectomy)