Endodontic Surgery

Extraction/Endodontic Surgery/Apicoectomy

Before Treatment:

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician.  If there is a question, please call our office prior to your appointment.

Please eat a full breakfast or lunch as applicable, unless otherwise instructed by the doctor.  If oral conscious sedation has been arranged then it will be required that you fast for six hours prior to your treatment, these instructions will be given to you by the doctor and staff.

If you have been advised by your physician or dentist to use antibiotic pre-medication because of an existing medical condition (artificial joints, heart condition, etc) please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment.

After Treatment:

On the day of surgery, take it easy for the rest of the day.  Avoid any heavy lifting, exercise, or strenuous activity that might increase your heart rate and circulation, rest as much as possible.  Smoking and alcohol consumption delay wound healing and should be avoided for several days after surgery.  Eat only soft foods; nothing difficult to chew, hot, or spicy.  Continue to keep activity to a minimum and maintain a soft diet for the first five days.

Apply cold pressure, alternating, ON for 20 minutes and OFF for 20 minutes, for the rest of the day.  Use of the ice pack after the first twenty-four hours can delay healing.

Starting the day of surgery, you should begin rinsing twice a day for 30 seconds with the prescribed PERIDEX (chlorhexidine) mouth rinse.  Continue to rinse twice a day for 5 days after completion of your surgery.

Post-surgical pain will be at its peak when the anesthetic wears off.  Prescribed medications are to be obtained and taken immediately.  If antibiotics are prescribed, they are to be taken until gone.  Prescription medications for pain are recommended for the day of surgery and to be used only as needed on the days following the surgery.  Ibuprofen, which can be purchased over the counter is very effective.  For patients who can take Ibuprofen, we recommend taking 800mg every 8 hours for the first 48 hours following surgery.  Ibuprofen may be continued as needed after that.

Some swelling and facial skin discoloration (bruising) may appear following surgery and will gradually disappear in a few days.  The swelling will be greatest on the second and third days after surgery.  Some oozing of blood from the surgical site is normal during the day and evening following the surgery.  If severe bleeding occurs, please call our office.

DO NOT suck through a straw, rinse your mouth, or brush your teeth for the remainder of the day following surgery.  If you were informed that bone graft material was placed as part of your procedure, do not use a straw for a full week following surgery to prevent the graft from being disrupted.

Avoid manipulation of your facial tissues as much as possible.  DO NOT raise your lip or retract your cheeks to look at the surgical site.  It is possible to tear loose the stitches accidentally, which will open the incision, cause significant pain and substantially delay the healing process.  Try to sleep on your back, or away from the side on which your surgery was performed.

The sutures (stitches) will dissolve on their own.  We will see you for a one week post-operative appointment to check healing in the surgical area.

If any unusual symptoms develop, or questions arise, please contact our office at (417) 782-3636.

Are There Any Potential Problems After Treatment?

• Lower teeth and nerve injury. There is a slight possibility that nerve injury can occur during root canal surgery to the lower posterior teeth. Your endodontist is trained to assess this possibility prior to treatment and will advise you accordingly. For lower posterior teeth, the root tips may be near a nerve that supplies feeling to the lip, chin and gums. Your endodontist is trained to design your surgery to minimize the chances of damaging this nerve. Rarely, this nerve can become irritated during the process of surgery. In these cases, when the local anesthesia wears off, you may experience tingling, altered sensation or, in rare cases a complete lack of feeling in the affected tissues. Should this occur, it is usually temporary and will resolve over a period of days, weeks or months. In rare cases, these changes can be permanent and/or painful.
• Upper teeth and sinus communication. The upper teeth are situated near your sinuses, and root canal surgery can result in a communication between your mouth and the adjacent sinus. Should this complication occur, it will usually heal spontaneously. We will give you special instructions if this is apparent at the time of surgery. We prefer that you don’t blow your nose for two to three days after surgery. If you have to sneeze, you should sneeze with an open mouth into a tissue. You should not create any pressure in the sinus area. If you sense a complication after surgery, please contact us.
• Post-operative infections. Post-operative infections occasionally occur. This usually requires just an office visit and examination. Many times placing you on an antibiotic for one week will take care of the infection Occasionally, other follow-up procedures will be needed.