Post-Apical Surgery: When to Seek Dental Care

Apicoectomy

Hello, I previously had a gum abscess and underwent two apicoectomies at a general dental clinic (the first one was unsuccessful).
It has been about 20 days since the surgery, and I occasionally feel mild tooth pain and discomfort.
The area where the surgery was performed, which was initially quite recessed, is gradually becoming flatter (it feels soft to the touch, and I'm unsure if another abscess has formed).
I would like to ask:
1.
Is it appropriate to have a check-up now, or should I wait a month or until it becomes noticeably swollen before seeking treatment? How can I determine when I need to get checked?
2.
Are there different procedures for apicoectomy in clinics versus hospitals? Would it be better to go to a larger hospital for an examination?
3.
Can you recommend an endodontist in Taipei? Where can I find a suitable and willing dentist for treatment?
4.
How can I determine if the tooth can still be saved, or if it should be extracted?
5.
After the first surgery failed, I consulted another dentist two months later, but that dentist didn't take any X-rays and only applied medication to the abscess area, stating it was a minor issue and that I should let the original dentist handle it.
This has left me feeling uncertain about what to do.
Do dentists generally hesitate to accept patients who have had previous treatment failures? I want to seek another dentist's opinion, but I'm worried it might be a waste of time.
I have many questions and would greatly appreciate your advice.
Thank you very much.

Wu zhu, 30~39 year old female. Ask Date: 2007/04/15

Dr. Chu Boqin reply Dentistry

Hello,
1.
The second dentist may be more conservative in treatment due to concerns about potential medical disputes, so we should be understanding of that.

2.
After completing endodontic treatment, there should be no clinical symptoms.
Apicoectomy is a supplementary method that involves retrograde filling from the apex to block bacteria from re-entering the root canal.

3.
Currently, if there is weakness or mild pain in the tooth, it can be observed for another two to four weeks.

4.
Teaching hospitals can be considered for the next outpatient visit.

Thank you for your question! Best wishes!
Sincerely,
Chou Bo-Qin

Reply Date: 2007/04/15

More Info

Post-apical surgery care is crucial for ensuring the success of the procedure and the overall health of your teeth and gums. Given your situation, where you have undergone two apical surgeries due to a previous failure and are now experiencing mild discomfort and changes in your gum appearance, it is essential to approach this matter with caution and awareness.

When to Seek Dental Care
1. Persistent or Worsening Symptoms: If you are experiencing ongoing discomfort or pain that does not subside, it is advisable to seek dental care sooner rather than later. Mild pain can be a normal part of the healing process, but if it escalates or is accompanied by swelling, it may indicate an infection or other complications.

2. Changes in Gum Appearance: You mentioned that the area where the surgery was performed feels soft and has changed in appearance. If you notice any signs of a new abscess or if the area becomes increasingly swollen or painful, it is critical to consult your dentist. The presence of soft tissue or a "pocket" in the gum could signify that the healing process is not proceeding as expected.

3. Timing of the Check-Up: While it is generally recommended to wait a month after surgery for a follow-up, if you have concerns about your healing or if symptoms worsen, do not hesitate to schedule an appointment. Early intervention can prevent further complications.

Differences Between Dental Clinics and Hospitals
- Facility Capabilities: Dental clinics and hospitals may offer different levels of care. Hospitals typically have more resources and specialists available, which can be beneficial for complex cases. If you feel that your situation requires more comprehensive evaluation or treatment, visiting a hospital with a dental department may be advantageous.

- Specialist Availability: In larger hospitals, you may find specialists who can provide a second opinion or more advanced treatment options. If you are unsure about your current dentist's approach, seeking a consultation at a hospital can provide you with additional insights.

Finding a Suitable Dentist
- Referrals and Reviews: To find a qualified dentist in Taipei, consider asking for referrals from friends or family. Online reviews and dental association directories can also help you identify reputable practitioners.

- Consultation: When seeking a new dentist, consider scheduling a consultation to discuss your case. This allows you to gauge their approach and comfort level with your specific situation, especially since you have a history of treatment failures.

Determining the Fate of Your Tooth
- Signs of Tooth Viability: To assess whether your tooth can be saved, your dentist will likely perform diagnostic tests, including X-rays, to evaluate the condition of the tooth and surrounding structures. Signs that a tooth may not be salvageable include persistent pain, mobility, or significant bone loss.

- Treatment Options: If your tooth is deemed non-viable, extraction may be necessary. However, if there is still hope for recovery, your dentist may recommend further treatment options, such as additional root canal therapy or other interventions.

Conclusion
In summary, it is essential to listen to your body and seek dental care if you have concerns about your healing process following apical surgery. Early intervention can prevent complications and improve outcomes. Additionally, exploring different dental care options, including hospitals and specialists, can provide you with the best chance for successful treatment. Remember, your oral health is paramount, and finding a dentist who understands your unique situation is crucial for your peace of mind and recovery.

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