Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Teeth Whitening - Brighter, whiter...
The subconscious impact of a white smile is radiant health, happiness, warmth and invitation. This phenomenon has been reinforced with the spread of American culture worldwide, where an especially white smile has even been coined a "Hollywood smile". Today brighter, lighter, whiter teeth have become a norm. Tooth whitening by bleaching is a successful, conservative, relatively inexpensive and safe alternative... Read Article
Smile Design with Porcelain Veneers
In part two of the series on Smile Design, Dear Doctor takes an in-depth look at Porcelain Veneers, a superior yet minimally invasive technique for smile enhancement. We'll explain not only when they're appropriate, but also when they're not... Read Article
Porcelain Veneers – Without A Drill
No drilling — reality or ridiculous? A no-drill technique requires a second look, as new materials and concepts have created new esthetic possibilities. Reactions and opinions among dentists have ranged from absolute disbelief to moderate acceptance. This article gives hope and reasons for patients to get excited about this conservative drill-free cosmetic technique... Read Article
Cosmetic Dentistry - A Time For Change
Join us as we review the myriad of possibilities available to you for cosmetic dental change. But the biggest part is not just how your smile looks, it's how you feel when you show it... Read Article
Dental Implants - Your Third Set of Teeth
A discovery fifty years ago paved the way for one of dentistry's most exciting, natural looking and successful tooth replacement systems. Learn how dental implants might just possibly change your life... Read Article
What is Tooth Decay?
Tooth Decay is an infection, and many people don't realize that it is preventable. This article is the first in a series about tooth decay, perhaps the number one reason children and adults lose teeth during their lifetime. Explore the causes of tooth decay, its prevention and the relationship to bacteria, sugars and acids... Read Article
Don't wait for cavities to occur and then have them fixed — stop them before they start. Modern dentistry is moving towards an approach to managing tooth decay that is evidence-based — on years of accumulated, systematic, and valid scientific research. This article discusses what you need to know to assess your risk and change the conditions that lead to decay... Read Article
The Beauty of Tooth Colored Fillings
The public's demand for aesthetic tooth colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible, has led to the development of special "adhesive" tooth colored restorations... Read Article
Wisdom Teeth – To Be Or Not To Be
Facts you need to know about these curiously named teeth. They are so-called because a moderate amount of wisdom is supposedly achieved at about the same time these teeth typically make their appearance. This article will review the problems associated with wisdom teeth and whether or not they should be removed... Read Article
Oral Hygiene - Dental Health for Life
The best tools for maintaining your oral health and minimizing dental problems are a quality toothbrush, toothpaste, a roll of dental floss, approved mouthwash and good diet. This article cuts through the confusion with a winning game plan for oral health... Read Article
Understanding Gum Disease
Have your gums ever bled when you brushed or flossed? This most commonly overlooked simple sign may be the start of silent (periodontal) disease leading to tooth loss. Learn what you can do to prevent this problem and keep your teeth for life... Read Article
The Impact of a Smile Makeover
Americans are catching on to the emotional and social importance of a healthy, beautiful smile, and they're seeking out ways to improve their smiles. Learn why and what a change could mean for you...Read Article
The orthodontic treatment using clear aligners consists of a series of aligners that you change about every two weeks over a course of treatment lasting six to eighteen months depending on how much movement is needed... Read Article
This article may just save your life. Learn how to notice any unusual lesions (sores or ulcers) anywhere in your mouth that do not heal within two-three weeks. Early detection is key... Read Article
Implant overdentures represent a major change for the dental profession and the public. The lower jaw two-implant overdenture may be considered a more appropriate starting point over regular dentures... Read Article
TMD – The Great Impostor
This “chameleon” of dental disorders manifests in a variety of ways, including joint pain, sinusitus, ear pain, tooth and headaches. The causes of TMD, its signs and symptoms and what can be done to treat this common disorder... Read Article
Lasers Shine a Light on Dentistry
Lasers have revolutionized medicine and now they're beginning to blaze a new trail in dentistry. Today, at the dawn of the 21st century there are a variety of dental uses for lasers, from diagnosing cavities and the removal of gum and tooth structure to the treatment of disease... Read Article
Oral Sedation Dentistry
Step out from under the shadow of fear and into the calm of sedation dentistry. There are safe and time-tested options available to ensure that you have a positive and painless dental experience. Your apprehension and hypersensitivity to pain melt away, yet you remain awake and in control... Read Article
Sleep Disorders and Dentistry
If my partner snores loudly, should I be concerned and what can be done to alleviate the problem? Why does my sleeping partner have lapses in breathing while sleeping and is it dangerous? Why do I wake up exhausted even though I get up to 10 hours sleep at night? The answers to these and more questions and how dentistry can help all revealed within... Read Article
About Dear Doctor Dentistry Magazine
Dear Doctor - Dentistry & Oral Health is a dental magazine written for the education of the general public. Dear Doctor provides information that is accurate, authoritative, and trustworthy on all aspects of dentistry and oral health including teeth whitening, porcelain veneers, dental implants, cosmetic dentistry, smile makeovers and more.
Copyright © 2012 Dear Doctor, Inc. All rights reserved. Copying or reproducing any text or graphics is strictly prohibited.
Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth's roots. That's when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it's considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth's root, along with any surrounding hard or soft tissue that may be infected.
What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth's roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.
Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.
The Apicoectomy Procedure
Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won't feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth's roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.
Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth's root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you'll go home. Most apicoectomies take about 30 to 90 minutes to complete.
Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that's needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren't self-dissolving, you will be asked to return in about a week to have them removed.
The Goal: Saving Your Tooth
Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That's why apicoectomies are not recommended unless further root canal treatment won't be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.
While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.
Root Canal Retreatment As occasionally happens with any dental or medical procedure, a tooth may not heal as anticipated after a root canal treatment. In these cases, it's often possible to save the tooth with a second root canal procedure... Read Article
Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article