Endodontic Surgery (Apicoectomy)

Endodontic surgery involves an attempt to retain a tooth which may otherwise require extraction. Although the procedure has a high degree of success, it cannot be guaranteed. Occasionally a tooth which has had root canal therapy, including surgery, may need to be extracted.

Endodontic surgery involves cleaning out the ends of the roots and sealing them in order to help the adjacent tissue heal properly. The procedure is done using a local anesthetic and is entirely comfortable. A small incision is made along the gum line to gain access to the root tips. If a cyst or abscess or other diseased tissue is present it is removed and a biopsy may be done. A few sutures are placed after the procedure which will be removed about one week later.

General Information

Discomfort following dental surgery is normal. Following the recommended use of analgesic (pain-relieving) medications should control and minimize your discomfort. You may expect some swelling after dental surgery. Swelling is a part of the natural healing process and may last several weeks. This is dependent on the nature and the extent of your surgery. Individuals with fair skin or who bruise easily may anticipate some discoloration (bruising) of the skin in the area surrounding the surgical procedure. Any bruising typically resolves within a few weeks.

Post-Operative Instructions

1. Apply ice/cold packs for 15 minutes once or twice per hour throughout the first day to minimize swelling and discomfort. When not using the ice/cold pack, pressure can be maintained by your finger, hand, or fist by pressing on the outer cheek as demonstrated to you in our office.

2. DO NOT lift your lips to "look" at the surgery area. It is possible to tear the sutures or open the incision and delay healing. Sutures may begin to unravel and come out before your follow-up appointment. If this occurs within the first 3 days please call our office as additional sutures may need to be placed. If this occurs after the third day and the gum tissue remains in place then you may trim the hanging or loose sutures.

3. Minimize chewing on the treated side. DO NOT try to eat solid foods until the local anesthetic wears off. You will have no feeling in the surrounding area, possibly including your tongue, and may unknowingly bite yourself. Please avoid shredded meats and acidic foods for 7-10 days after surgery as they may cause discomfort. Consider a nutritious diet with soft foods.

4. Avoid brushing the teeth in the surgical area for the first day only. Very gentle brushing of the teeth in the surgical area is recommended starting the day after surgery to help remove plaque and food debris. Our staff will review the proper technique with you. Flossing in the surgical area may typically be resumed 7-10 days following the surgery.

5. An antibacterial mouthwash will be given to you. Starting the day after surgery gently soak the tissue twice daily (after breakfast and before bed) for 7-14 days. DO NOT RINSE AGGRESSIVELY.

6. If an antibiotic or pain medication is prescribed, please take the medication exactly as directed on the prescription to completion.

7. Resting for the remainder of the day is recommended. The following day you may perform most non-strenuous activities. Avoid vigorous exercises for the first 72 hours as these may result in bleeding or discomfort at the surgical site and delay in the natural healing process.

8. DO NOT SMOKE OR USE ORAL TOBACCO FOR 72 HOURS.

9. If you have ANY concerns or questions please call our office during regular business hours at (503) 231-0882 or (541) 716-5072. Usually, a simple explanation can resolve the situation and free you of worry.