We normally hear periapical periodontitis in dental consultations as one of the common infections that you can get when you have damaged teeth and gums. It is somewhat synonymous with apical periodontitis in that they both affect the tissue around (periapical) or at the tip (apical) of the tooth roots. We visit Lotus Smiles Dental today in Sunbury, VIC to discover what this dental condition is, its types, and what treatment and prevention can we do to combat it.
Apical Periodontitis: A Brief Background
As mentioned earlier, periapical periodontitis and apical periodontitis are used interchangeably most of the time because they affect the same tissue layer of the tooth root. Their only difference is the exact location where the infection localizes; periapical means around the tip of the root, and apical is located exactly at the tip.
What can cause Periodontitis?
The main culprit of this inflammation is somewhat a no-brainer because most dental diseases and infections come from it as well. The answer? Untreated cavities. Once your tooth gets damaged and attacked by cavity-causing bacteria, it can reach the tooth root and infect it, causing pain, inflammation, and even cell death.
Another notable cause of apical or periapical periodontitis is when a person experienced a traumatic accident that affected his mouth. If the tooth gets injured, it can cause problems with the pulp, the internal part of the tooth that houses the nerves and blood vessels. The pulp can either die or add complications to the injury, causing inflammation of the tooth root tissues.
Types of Apical Periodontitis
There are two main types of periodontitis – the symptomatic or the asymptomatic. As the names imply, asymptomatic does not cause any discomfort to the patient, but that doesn’t mean that it is not serious. In fact, it is gradually and silently destroying your tooth root and the neighboring gum tissue without you knowing it.
Symptomatic periapical or apical periodontitis, on the other hand, causes pain and sensitivity especially when the patient bites down or introduces pressure to the tooth. Some conditions because worse in a short amount of time (acute), while others develop in a gradual manner but last a long time (chronic). If we are to compare which one of the two types is worse, we might say the asymptomatic one because at least with symptomatic, you can treat it as soon as the symptoms show up.
Is Root Canal The Solution For Periodontitis?
Before we divulge information about root canal treatment and its connection to this dental condition, we might need to discuss how one can detect apical or periapical periodontitis. Because, let’s be honest, even if it is symptomatic or asymptomatic, apical periodontitis is not something that you can easily detect single-handedly. It is usually a condition that an endodontist can assess, diagnose, and effectively treat. If you think you have the symptomatic type, it is indeed a wise decision to see your dentist at once if you observe any discomfort or sensitivity when biting down food. Likewise, visiting your dentist regularly can make it possible for your dental partner to detect asymptomatic apical periodontitis, especially if you have a history of cavities, tooth decay, or recent trauma to the mouth.
Treatment for Apical Periodontitis
Now that you know the importance of seeing your dentist or dental specialist regularly, it may be time for us to discuss how you can expect them to treat your condition considering that you indeed have periodontitis. Periapical periodontitis treatment essentially relies in part on what dental procedure or treatment has already been performed. It is also dictated by the extent of the infection or inflammation.
Root Canal Treatment
When it comes to endodontic treatments, getting a root canal is probably one of the most common approaches. Root canal treatment aims to salvage the intact structure of the tooth from decay and further damage by removing the infected internal parts of the tooth. In the case of apical periodontitis, root canal treatment is beneficial since the tissue around the tooth roots can be easily removed so that the infection is contained and further destruction of the tooth is prevented. The treatment starts by removing the contents of the pulp which is typically the nerves and the blood vessels. A root canal can also clean the surrounding tissue of the tooth root to make sure that the infected or decayed parts of the roots are removed. A sealant is then injected to the space in the pulp to prevent bacteria to seep through it and continue spreading the infection. If the root canal treatment is successful, the inflammation is corrected while the crown remains intact.
There are cases when a root canal treatment may be all that is required to lessen the inflammation. However, if the patient experiencing periodontitis already has had a root canal treatment on the affected tooth but the persistent infection still recurred or a new infection affected that same tooth root, an apicoectomy might be necessary. During an apicoectomy, removal of the tip of the tooth root where the infection is will be surgically removed. This ensures that the infection will be contained since the target of the inflammation is already detached from the tooth.
All dentists aim to preserve and save their patient’s teeth. No matter how complicated a procedure may be, the primary objective of every dentist and their dental technique is to salvage the integrity of the crown. However, it is also understandable that when all else fails in any dental condition or problem, tooth extraction is considered the last resort. As with periapical or apical periodontitis, there possibly could be some situations when the best treatment option is to just extract the tooth to prevent further complications and stop the spread of the infection.