Apical periodontitis is an inflammatory condition in which inflammation around the apex of tooth root occurs due to bacterial invasion of tooth pulp. It occurs as a result of ignored dental caries, improper dental care, infection in the tooth following a trauma, and due to a pre-existing medical condition that lowers immunity.
Apical periodontitis is fairly common. The treatment protocol varies from patient to patient. Sandalwood Smiles, the best dental care provider in Brampton, sums up the available treatment options for apical periodontitis and how to go about them.

Differential diagnosis is very important to rule out the cause of dental pain and swelling. A patient usually presents with pain in the oro-facial region which originates due to a pulpal or peri-radicular lesion.

It’s important that your dentist records medical and dental history of patients. After taking history of patient, a dentist conducts clinical examination in which patient is examined intra-orally and extra-orally. After checking for pyrexia and noting down patient’s blood pressure, he/she proceeds to conduct the diagnostic tests. There are various differential diagnostic tests that should be applied in this case. Starting with palpation, the diagnostic tests include

  • Mobility test,
  • Percussion,
  • Periodontal examination,
  • Pulp sensitivity tests,
  • Occlusal analysis,
  • Testing for possible cracked teeth,
  • Trans-illumination,
  • Selective local anesthesia,
  • Radiography,
  • Color matching,
  • Sinus tract exploration.

More than one radiograph from different angles might be required to get a proper hold of the root cause, at times supplemented with bite-wing and occlusal plane radiographs.

Planning the Treatment Strategy
Once the cause of periodontitis is apparent, treatment protocol is planned and executed. Certain factors indicate towards the need of a root canal treatment, such as


  • If the tooth pulp is necrotic/non-vital or irreversibly damaged
  • Prior to carrying out orthodontic correction of misaligned teeth in the light of a doubtful pulp health


For teeth that have been damaged beyond repair with insufficient periodontal support, teeth having poor prognosis, and if the patients exhibit poor oral conditions, root canal treatment is no good here. Surgical endodontics is the way out in conditions where a previous root canal treatment has failed or is not expected to yield results.

The treatment protocol differs completely in case of traumatic injuries of tooth. In this case, treatment strategy is planned according to extent of damage and focus is on prevention of infection rather than curing an already existing infection.

Tooth extraction is the last resort in case the root canal treatment and surgical endodontic treatments fail.

Precautions and Prevention
Certain precautions are laid out post treatment for patients to follow. Regular follow up at the clinic is necessary.

Even though certain conditions are unavoidable, we can keep apical periodontitis at bay by following proper dental care regime and getting the teeth examined once a year. It’s not good to ignore dental caries and mild tooth ache. In case of trauma, seek medical help immediately and consult your dentist ASAP to prevent building up of infection. In any case, Sandalwood Smiles is here to provide you with the best dental care there is.

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