After Endodontic Surgery

You have just had an apicoectomy, a surgical procedure which is done in an attempt to seal off the root from its surrounding bone.

IT IS ESSENTIAL THAT YOU

  1. Maintain continuous pressure on gauze pad placed directly over surgical site for 30 minutes.
  2. Rest at home today and keep talking to a minimum.
  3. Wear your cold pack for the rest of today even if you have no/minimal swelling.
  4. Do not spit, suck on straws or brush teeth today.
  5. Do not smoke or vape today.
  6. Take medication for discomfort before freezing wears totally off.

Freezing

Your surgeon frequently uses a long lasting local anaesthetic which means you may be numb (especially lower lip and chin) for up to 12 hours. Do not wait for the freezing to leave before you start drinking liquids.

Bleeding

Most of your bleeding will have subsided by the time you leave our office. Continued oozing for 24 hours after surgery is quite normal. Once home, if still bleeding, change the gauze pack for a fresh one, relax, elevate your head and bite for 3o minutes. Typically 1-2 changes is all that is required if bleeding is only minimal/slight.

Mouth Rinses

Beginning tomorrow, rinse mouth every 4-6 hours with warm, slightly salty water (1/2 teaspoon in a tall glass of water) for the following week. Begin brushing your teeth the day after surgery, avoiding any areas with stitches. You may lubricate your lips with Chapstick, Vitamin E ointment or Vaseline if desired. Continue rinsing with Oro-X twice a day until the bottle is empty, if given.

Swelling and Bruising

Swelling and bruising often occurs after surgery and are completely normal. Swelling typically increases for the first 3-4 days, then gradually subsides over the following 3-7 days. Applying cold/ice packs the entire day of your surgery is very helpful to minimize the amount of swelling you will experience. Wear them even if you feel there is little initial swelling. Keep the cold packs against your cheeks for 30 minutes, and then chill in freezer for 30 minutes, then re-apply, etc.

Discomfort

Following oral surgery you can expect some degree of discomfort. This typically lasts 2-6 days and is much like a “crampy tenderness”. The degree varies, depending upon the difficulty or extent of surgery. In general, the younger the patient, the less discomfort and shorter the healing period. Teeth close to the tooth operated on may be sensitive for a month or two. Using toothpaste for sensitive teeth may help.

Jaw Stiffness

This is normal protective mechanism caused by an accumulation of fluid in the jaw muscles to aid healing. It will usually subside in 7-10 days.

Medications

Take the medications as directed on the bottle. The medication prescribed should keep you relatively comfortable and is best taken with fluid or food in your stomach. For mild discomfort Tylenol or Advil (ibuprofen) may be used. Some pain medications can cause dizziness; do not drive. If antibiotics are prescribed they should be taken until the full prescription is used. Women need to be aware that certain antibiotics can decrease the effectiveness of oral contraceptive medications.

Sutures

Your sutures are the “dissolving” type and will fall out in 3-10 days on their own.

Diet

Most people can begin drinking fluids once home. Do not wait for the freezing to be gone. Start with clear fluids initially and progress to soup (such as chicken or beef broth), fruit or vegetable juice. The evening of surgery is fine to start milk products such as milkshakes, yogurt, and pudding. Drink as much as you are able. Small amounts should be taken frequently. A vitamin supplement is a good idea.

Advance your diet over the next few days to include softer items such as pasta, scrambled eggs, well cooked vegetables, fish, etc. Avoid straws for the first few days as the suction can cause bleeding. Avoid chewing on this tooth as it may be loose for a while. You can also break the tooth if it is not capped. Teeth that have had root canals done on them become brittle and easily broken if not protected by a cap. Uncapped root canal treatment teeth should be capped after a couple of months to protect them from loss secondary to breakage. A soft diet is recommended for approximately one week.

Smoking and Alcohol

Smoking and alcohol both delay healing and may lead to complications. Do not smoke or drink alcohol for at least 48 hours following surgery.

Follow-up Appointment

Your recovery will be followed up by either a phone call from one of our nurses or you will be scheduled an appointment to come back to see your surgeon. Your nurse will inform you before you leave the office.

If you have any questions or concerns please feel free to call our office at Coquitlam Office Phone Number 604-941-2312. After office hours our answering service will reach the doctor on call.