Recovering From Apexification: What to Expect

Apexification preserves your natural tooth when a unique problem — an opening in the tooth root — leads to a tooth infection. Though this problem most often affects children and teens, it may develop in adults.

Whether you or your child face the pain of an abscessed tooth, you need an expert endodontist like Robert Scott Nance, DDS, MS, PA, to perform apexification. Here, he explains the procedure and your recovery afterward, which is much easier than you may envision.

About apexification

After a child’s permanent tooth grows, the tip of the root, called the apex, gradually closes over the next few years as the tooth matures. Sometimes the root doesn’t close and leaves the sensitive pulp inside the root canal exposed to bacteria. A traumatic injury or inflammation can erode the root tip, causing a similar problem in people of all ages.

If the pulp inside the root becomes infected, it gets treated with a root canal. And if the root tip (apex) is open, it’s essential to close it with a procedure called apexification.

During apexification, we create a tiny opening in your tooth, use a specialized tool to remove the infected pulp, and cleanse and disinfect the canal. Then we insert medications into the canal that gradually harden and create a barrier that closes the root tip.

Recovery after apexification

Recovering after apexification is an easy process. Most people have temporary gum tenderness that lasts a few days and should improve with over-the-counter pain medications like ibuprofen (Advil®) or acetaminophen (Tylenol®).

After the tenderness goes away, you shouldn’t have any discomfort. But it’s still essential to protect the tooth until your endodontic treatment ends.

Here are four essential steps to follow after apexification:

Protect the tooth

Don’t chew on the side where your treated tooth is until we complete your treatment. The tooth remains weak and vulnerable until we permanently seal the opening, and you return to your dentist for a restoration like a crown. Limiting the pressure on the tooth protects it from damage.

Keep up with daily brushing and flossing

Removing food particles and plaque with twice daily brushing and flossing lowers the risk of getting another bacterial infection during your ongoing treatment after apexification.

Watch for signs of side effects

Side effects aren’t typical; however, they can occur. Watch for signs of infections, irritated nerves, and sinus complications.

Infections are the most frequent problem after an apexification procedure. Schedule an office visit when you notice gum redness, swelling, pain, or increased tooth pain or sensitivity.

Nerve irritation might occur if your lower tooth had apexification performed. Symptoms like tingling and numbness are usually temporary and disappear as the nerve heals, but call us if you have any concerns.

Sinus problems may occur after apexification on an upper tooth. Separated by a thin tissue, the roots of your upper teeth come close to your sinuses. Sometimes unavoidable but slight damage can occur to the tissue during apexification.

If this happens during your procedure, we tell you about it and give you self-care instructions while the area heals. Call us if sinus congestion, pressure, or pain develops after apexification.

Keep your follow-up appointments

Your treatment isn’t complete after apexification. We cover the opening with a temporary seal to ensure all the infection is gone and the root apex hardens.

You need to return for at least one follow-up appointment and possibly several, depending on the medications we use to close the root.

At each follow-up appointment, we determine if the root has closed or if we need to cleanse the canal, refresh the medication, and give the root more time to harden. We can permanently seal the opening when a solid barrier forms and the apex closes. That’s when your endodontic treatment is complete.

Do not wait to seek treatment

Tooth sensitivity may be an early sign that a pulp infection (tooth abscess) is developing; however, many people don’t realize they have a problem until the hallmark sign of infection — sudden, excruciating tooth pain — appears.

At that point, you need immediate endodontic care to ease your pain and get the treatment that heals the tooth and prevents complications. Call Robert Scott Nance, DDS, MS, PA, today to schedule an appointment in the Statesville or Hickory, North Carolina office.