How to Prepare for an Apicoectomy

What is an apicoectomy? Well an apicoectomy is a dental procedure that is performed to remove infected pulp, following root canal therapy. It is also performed when an infection, deep decay, and/or gum or tooth trauma develops. In these situations, you may be required to have a second root canal to make sure the infection and/or decay is properly extracted. In most cases, an endodontist (dental specialist) performs the apicoectomy; however an oral and maxillofacial surgeon is also highly capable of performing this dental procedure.

Your endodontist or oral surgeon may recommend an apicoectomy, if a second root canal cannot be performed. He or she may also recommend this procedure, if the second root canal was unsuccessful or ineffective. This dental procedure consists of removing both the tip of your tooth’s root, and any infected gum tissue. An apicoectomy is also known as endodontic microsurgery because tiny microscopes are used during the procedure. If you are wondering how to adequately prepare for an apicoectomy, you have come to the right place. This article will help you prepare for your dental procedure.

Steps to prepare for an apicoectomy include:

Preparation

Consultation: Before scheduling your procedure, you will first want to have a consultation with a dentist. In some cases, a dentist with advanced training in performing apicoectomies may perform the oral surgery in-office; however, most dentists refer these patients to an endodontist or oral and maxillofacial surgeon. Endodontists must have 2 or more years of additional root canal therapy training (i.e. diagnosis and treatment), while oral and maxillofacial surgeons must have between 4 and 6 years of training in oral surgeries like apicoectomies.

X-Rays: During your consultation, your endodontist or oral surgeon may take additional X-rays of the affected tooth and any nearby bone and tissue. Following the X-rays, your dental provider may give you an anti-bacterial mouthwash (a medicated rinse used to reduce inflammation and infections), and/or an oral antibiotic. He or she will then review your medical and dental history with you.

It is important that you reveal all of the prescription medications, vitamins, over-the-counter drugs, and supplements that you are taking to your dental provider. If you being treated for a medical condition, your dental provider may consult with your physician before scheduling your apicoectomy. Prior to the procedure, you will be given a local anesthesia like laughing gas. Following the procedure, you should be able to return to work and/or driving immediately.

Limited Foods and Liquids: It is imperative that you eat a light meal (i.e. soup, hot oatmeal, cold cereal, salad, etc.), and reduce your fluid intake the night before your apicoectomy. If you have decided to have nitrous oxide (laughing gas) or IV sedation during the procedure, you will need to stop all foods and drinks at least 6 hours in advance. In addition, it is important that you brush and floss your teeth after eating your last meal, and before your procedure the next day

Medication Maintenance: It is also important that you continue all of your blood pressure, thyroid, diabetes, and other medical condition medications before and after your apicoectomy. If you have diabetes, ask your physician and dental provider for ways to manage your condition prior to and following the procedure (i.e. diet, insulin, and hyperglycemic medication administrations). You will more than likely be instructed to temporarily stop your blood thinners (Coumadin) (i.e. 3 or more days before your dental procedure). If you have any questions and/or concerns, contact your dental provider prior to your appointment.

References:

American Association of Endodontists. (2014). Endodontic surgery explained. Retrieved from https://www.aae.org/patients/treatments-and-procedures/endodontic-surgery-explained.aspx

Colgate. (2014). Apicoectomy. Retrieved from http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Gum-Disease/article/Apicoectomy.cvsp