Healthy teeth aren’t damaged, decayed or infected. To keep your teeth healthy means practicing good daily oral hygiene habits and seeing your dentist twice a year for cleanings and exams. But what if a tooth is infected? In most cases, it is best to save a tooth rather than replace it. Your tooth is worth saving unless the decay has advanced too far. Our endodontist can perform a nonsurgical treatment called a root canal to help save a problem tooth. But occasionally, a root canal by itself may not get rid of the infection to save the damaged tooth.
Treating tooth infection with an apicoectomy
When a tooth was severely infected in the past, it was often pulled and then replaced with an artificial tooth. But, with modern technology and precision surgery, today we can provide additional treatment to save your tooth if a root canal was unsuccessful the first time, or after a root canal retreatment. With retreatment, the problem will be addressed, the canal(s) cleaned and the restoration rebuilt. Called an apicoectomy, or root-end resection, it involves treating the damaged pulp in the affected tooth by removing and sealing the tip (or apex) of the tooth’s root anchored in the jawbone with a dental filling.
Normally, with a root canal, the infected tooth is cleaned and the infection removed. A root canal can often last for the rest of your life. But sometimes the tooth might not heal properly or may become infected months (or years) after an initially successful root canal treatment. If there is any infection left behind, the tooth will still be sensitive, and the infection can spread into the soft tissues around it. Once the tip of the tooth is removed, as well as the infected areas, a sealant can be placed at the root tip so that infection can’t come back. This allows us to save the tooth instead of having to extract it.
Why do root canals sometimes fail?
– If the affected tooth has atypical root formation
– If there are additional root canal channels that can’t be cleaned out with a root canal
– If there are cysts surrounding the damaged tooth
– If the tooth has suffered a break or crack that extends into a tooth’s root
Signs that indicate a root canal treatment has failed include severe pain that won’t go away after your root canal if it starts hurting after it felt better for a while, or experiencing new swelling around the tooth that was treated. Another red flag is finding blood or pus-filled discharge around the tooth and gums that were treated. This is true even if the discharge isn’t accompanied by pain.
Having an apicoectomy
You will be made comfortable for your surgery with the help of a local anesthetic so that our endodontist can open the gum tissue next to the tooth to see the underlying bone material. Next, we will take out the inflamed or infected tissue, including removing the tip of the affected root. To seal the end of the root canal, a small filling will be placed in the root and closed with stitches in your gums to allow the tissue to heal. Within a few months, the bone will heal around the end of the tooth root.
While more than 90% of root canals are successful, an apicoectomy can still save a damaged tooth for those that were not. If you are experiencing pain or swelling around a tooth that has had a root canal done previously, or if you have concerns about a painful tooth, please call our office to be seen. We look forward to helping you keep your teeth for a lifetime of healthy smiles!
