Apical Surgery

Sometimes, a procedure called apical surgery is needed to remove an infection from the tip of the
root of a tooth. Root canal surgery is usually needed if there has been an infection in the tooth’s pulp, or it’s been damaged in some way.

The vast majority of root canal complications these days are treated non-surgically, but in some cases conventional root canal treatment doesn’t get rid of the infection or damaged root tip. Left untreated, the infection could turn into a painful abscess, and even get into the jaw bone. Other possible treatments for an infection are antibiotics and removal of the tooth, but most dentists will advise you that carrying on with antibiotics that haven’t been effective can simply cause the infection to get worse, so they usually advise either apical surgery or removal of the tooth completely.

What happens in apical surgery?

Apical surgery usually involves removing the tip of the root of one or more teeth, along with any infected tissue around it. It’s a way of trying to save your tooth if root canal work hasn’t worked, or isn’t possible.

Some dentists offer conscious sedation for the procedure, which is carried out under a local anaesthetic like a filling or extraction. In some complicated cases, you can opt to have the procedure in hospital under a general anaesthetic. Once you have been anaesthetised, your dentist will start by making a small cut into the gum area, over the root of your tooth, and then lift your gum away from your jaw bone. The dentist then takes away a small piece of bone using a drill, so that they can get to the infected area.

Once they’ve got to the affected area, the dentist will clean away any infected tissue from the tip of the root and then remove 2-3mm of the root tip itself. The root is then sealed with a small filling and your gum is stitched back into position with dissolvable stitches.

After the surgery, you might feel some discomfort for a few days, but it should be less painful than the infection, and will allow you to keep the tooth. If you’ve had conscious sedation, you’ll be advised to take the day off work and take it easy for 24 hours, but you should be able to return to normal the following day.