Anyone had an apicoectomy (tooth root tip removal) ?

[witchycatsmother]

Well, I've been to the dentist today and am now feeling sick at the apparent possibility I may have to have an apicoectomy .... where gum is sliced, peeled back, and very tip of tooth root (where infection may or may not be sitting in my case) surgically removed.

I have a front tooth with a longstanding filling which was previously root treated, which has been niggling over the last few weeks. Dentist says Xray shows there might be the start of an abcess in my gum, and looks like the very tip of the root wasn't filled and there might be some infection there (if I've understood correctly).

Has said to monitor situation ... i.e. come back if pain increases and/or if gum swells at all, so he can take another Xray and refer if necessary.

Apart from the fact I am terrified of all things dentist - and even more so now having googled what it entails, I am also petrified about the cost. Dentist has said I'd need to be referred to a dental hospital and probably "need" to go private as "NHS isn't much good for things like this". Again, googling shows that this seems to be normal practice as it's a specialist procedure with specialist micro tools etc., and I'm assuming that the option to have it on the NHS is severely constrained by lack of facilities and waiting times.

I am absolutely sick at the thought of what this might cost. The alternative is extraction and either a denture (!!!) or an implant ... the 2nd option obviously being hugely expensive too. Dentist did say that if situation doesn't alter the niggles could be due to sensitivity so am hoping that nothing gets worse, but if I do need further treatment would be very grateful for others' experiences of this operation, and how much it cost private. Am thinking that if it gets to the stage where I'm referred, could potentially have to live in serious pain for as long it'd take me to wait to be seen on the NHS, and if an abcess does develop you can't just leave it anyway can you as wouldn't it spread ? That'd mean having to go private one way or another wouldn't it ?

Any advice / experiences very gratefully received !

[DooinMeCleanin]

Yes I have had that. T'is fine, honestly. You don't feel anything other than the usual tugging.

And the pain is nowhere as bad afterwards as you would imagine. I hardly felt much pain, tbh. I felt bruised and sore, but it wasn't pain as such iyswim?

And if your infected root is a painful as mine was it's a walk in the park compared to that. I'd have removed my own tooth with a pair of pliars if I could reached it properly (it was a back tooth)

[TattyCatty]

I had this done to one of my top canines almost 4 years ago, but was lucky enough to be able to have it done under General Anaesthetic as I am not particularly brave when it comes to all things dental (despite years of orthodontic work as a teenager). I could have had it done in my surgery with sedation, but would have had to pay for the actual procedure - thankfully I managed to get it covered by my private medical insurance in the end. I was on a waiting list to have it done in an NHS hospital under GA, but seemed to fall off the list after around 3 years as they stopped writing to me with updates.

The actual problem with my tooth that triggered the infection (root canal treatment not filled deep enough) happened around 16 years before I finally had my operation. I got infections in the gum every few years, but they were easily treated with antibiotics, so you might not end up with an abcess as quickly as you imagine. I'd push for a referral as soon as you can, and start asking on what local guidelines are around the use of sedation / GAs for the procedure, so that you know what your options are.

[witchycatsmother]

Thanks all .... so far fingers crossed the pain has been more a niggle than out and out excrutiating. Have had to take pain killers a few times but it seems to come and go.

Unfortunately, no private health insurance so will have to be NHS or private paid for. Does anyone have any idea what I might be looking at ?

[TattyCatty]

From memory, it was around £200 for the sedation and around £150 for the actual treatment. If I had had it without the sedation, I think it was nearer £100 for the whole treatment. I was told that I couldn't mix and match private sedation with NHS treatments, so had to pay privately for both elements, despite the fact that I would have had it done on my NHS dentist's premises.

[MillyMollyMardy]

It's the type of procedure that can be done in any maxillofacial/oral surgery department under the NHS.However you might prefer to have it done by an endodontist privately as they would use a microscope and have specialist filling materials. OP the guidelines are normally that if there is a possibility of the original root canal treatment being redone this should be done first as this has a higher chance of success. This usually has to be done privately as there is very little specialist root canal work done on the NHS (too darn expensive to comission).

[sdowner]

I had this done yesterday................go for a general! (NHS) had mine under local and nearly killed the nurse and surgeon! total of 9 injections and i still felt every dig and poke! Giving birth was far less painfull and this has instilled a fear of returning to the dentist, I was usually looking forward to dentist for clean polish!
Today i have very swollen top lips, and 2 black eyes a mouth full of bruises and stitches.
No hot food or drinks and no alcohol for 24hrs, and a weeks worth of antibiotics and painkillers.
I wouldnt wish this procedure on my worse enemy.

[Grumpystiltskin]

I'm a dentist and I would only have this done by an endodontist, not a specialist oral surgeon. Talented as they are, their success rates do not compare to the endodontists. I have never come across one of these who works on the NHS, even in hospital. OP, don't be put off by anyone else's stories, each case is individual and because someone else had a hard time doesn't mean that you will.