Apicectomy. Information for patients. Ambulatory Care & Local Networks

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1 Ambulatory Care & Local Networks Apicectomy Information for patients This leaflet answers some of the questions you may have about having an apicectomy. It explains the risks and the benefits and what to expect when you have the procedure. If you have any questions or concerns, please do not hesitate to speak to one of the doctors or dental nurses caring for you. 1

2 What is an apicectomy? It involves removing the tip of the root of one of your teeth and the infected tissue around it. We usually do this as a last resort to try to save your tooth after root canal treatment has failed or if root canal treatment is very difficult to do. Why do I need this surgery? You have an infection at the tip of the root of one of your teeth. You may not have any symptoms, but most people have discomfort, some swelling, gum boils or a bad taste in their mouth. You may have already taken a course of antibiotics to try to treat the infection but you still have discomfort. If we do not treat the infection, it is likely to become an abscess. This is painful and can also cause loss of bone surrounding the root. As a result, your tooth may become loose and we may have to take it out. What happens before the surgery? Your doctor or dentist will explain more about what happens during the operation and the likely result. We will give you an anaesthetic so you will not feel any pain. You have a number of choices: 1. Local anaesthetic this involves having an injection into the gum surrounding the infected area. This takes a few minutes to numb your gum and means you will feel no pain during the procedure. 2. Local anaesthetic and intravenous sedation as well a local anaesthetic, you can have a sedative injection in your arm. This makes you feel relaxed, sleepy and less aware of the procedure. 2

3 3. General anaesthetic this involves being put to sleep completely. We usually offer this only to patients who are having extremely difficult surgery. You will be able to go home on the same day, after your surgery. We will discuss these options with you at the consultation appointment before your treatment is scheduled. Treatment will usually be carried out at a later date. What are the benefits of the surgery? The area should heal within one or two weeks. It will stop the pain caused by the infection. It will save your tooth which we would otherwise have to take out. Where will I have the surgery? You will be treated in one of the clinics in the Oral Surgery Department at King s College Hospital Dental Institute. Do I need to prepare for the surgery? Your doctor/dentist will discuss with you how to get ready for your operation at your assessment appointment. It is important to discuss your operation with them so you know what to expect. What happens during the surgery? Your dental surgeon will make a small cut into your gum over the root of your tooth and then lift your gum off your jaw bone. They will then remove a small amount of bone with a drill so they can uncover the infected area. They will thoroughly clean any infected tissue away from the tip of the root before they remove 2mm-3mm of the tip. 3

4 Your dental surgeon will seal the root with a small filling and then stitch your gum back into place with dissolvable stitches that take around two weeks to disappear. How long will the surgery take? It takes minutes. Consent We must by law obtain your consent for treatment. Your written consent is required for treatment under intravenous sedation. Staff will explain all the risks, benefits and alternatives before they ask you to give consent. If you are unsure about any aspect of the treatment proposed, please do not hesitate to speak with a senior member of staff again. You must confirm your consent for the procedure before treatment starts. What happens after the surgery? You are likely to feel some discomfort when the anaesthetic wears off a few hours after surgery. Your surgeon will prescribe you painkillers to relieve this. The discomfort is usually worse for the first few days, although it may take a couple of weeks to go away totally. You may have some swelling both inside and outside your mouth for the first two days. It is important that you keep the surgery area as clean as possible for the first few weeks after your treatment. If you find it difficult to use a toothbrush, you can keep the area free of bits of food by gently rinsing with a mouthwash after each meal. Or you can rinse 4

5 your mouth with a solution of warm salt water. Simply dissolve a teaspoon of table salt in a cup of warm water and start using this the day after your surgery. Do I need to take any time off work? We usually advise you to stay off work and avoid strenuous exercise for a day or two. Depending on the type of anaesthetic you had, you should not drive: until the next day after intravenous sedation for 48 hours after a general anaesthetic Will I need any more appointments? You are likely to have a check-up one or two weeks after your apicectomy. You will then have more appointments at three months and then one year to make sure all is well and you are healing normally. Your doctor/dentist will let you know if you need any other check-ups. What are the risks of this surgery? The risks are small. There may be particular risks depending on the position of your infected tooth. Your surgeon will explain these risks to you. It is unusual for the area to bleed after surgery. If it does you can usually stop it by pressing on the area using a clean rolled-up handkerchief or a swab of cotton wool. Keep pressing for at least 20 minutes. If the bleeding does not stop, please contact us. The infection around the tooth might come back. If this happens, your surgeon will discuss with you what to do next. Because the operation involves lifting your gum to uncover the root of your tooth, your gum might shrink back a few months after surgery as scar tissue forms. This is not normally a problem. 5

6 6 But if your tooth has been crowned, the edge of the crown may become exposed or your tooth might appear longer. Are there any alternative treatments? You can have your tooth taken out. You can take antibiotics to lessen the infection for a short time. But the infection and bone loss will get worse and might harm your other teeth, so we recommend you have an apicectomy or your tooth taken out. Your doctor/dentist will discuss with you whether either of these alternatives is suitable for you. Who can I contact with queries and concerns? If you have any questions or problems, please contact us at: Department of Oral Surgery, King s College Hospital Dental Institute, King s College Hospital, Bessemer Road, London SE5 9RS Tel , 9am 5pm, Monday to Friday Sharing your information We have teamed up with Guy s and St Thomas Hospitals in a partnership known as King s Health Partners Academic Health Sciences Centre. We are working together to give our patients the best possible care, so you might find we invite you for appointments at Guy s or St Thomas. To make sure everyone you meet always has the most up-to-date information about your health, we may share information about you between the hospitals. Care provided by students We provide clinical training where our students get practical experience by treating patients. Please tell your doctor or nurse if you do not want students to be involved in your care. Your treatment will not be affected by your decision.

7 PALS The Patient Advice and Liaison Service (PALS) is a service that offers support, information and assistance to patients, relatives and visitors. They can also provide help and advice if you have a concern or complaint that staff have not been able to resolve for you. The PALS office is located on the ground floor of the Hambleden Wing, near the main entrance on Bessemer Road - staff will be happy to direct you. Tel: Fax: kch-tr.pals@nhs.net You can also contact us by using our online form at If you would like the information in this leaflet in a different language or format, please contact PALS on

8 Corporate Comms: 0286 PL112.3 April 2014 Review date April 2017