The phone is ringing
Doctor: Yes, Dental Surgery, how can I help you?
Patient: Good morning, is it possible to schedule an appointment for today? There is no pain, however my face is swollen a bit.
Doctor: Yes, it is possible, I have an opening at 4 o’clock, so please come over.
Patient: Thank you very much. I’ll be there for sure.
A few hours later
Patient: Good afternoon, I’ve an appointment at 4 p.m.
Doctor: Hello, please come in and take a seat.
After a while
Doctor: How long has swelling been present?
Patient: Actually, it started this morning. It was painful a bit yesterday, but I did not think that something like that will happen.
Doctor: Is it hurting? (Doctor is tapping patient’s teeth)
Patient: Oh, now. Not too hard, but I feel some discomfort.
Doctor: This swelling is caused by the upper right tooth. It’s got a porcelain crown. I have to take some X-rays, so I invite you to the next office where I have an X-ray equipment.
After the X-rays
Doctor: Well, the case is clear. The tooth was treated with a root canal. The canal was a bit underfilled and there are some of inflammatory lesions at the apex of the root, but I can not do anything here. There is a very large and long inert filling cemented in your tooth, it reaches almost to the end of the canal. If I wanted to remove it, I’d have to first remove the crown. Besides the root could be broken during the removal because the walls are pretty thin, and as I mentioned, the inert filling is very long.
Patient: So what now?
Doctor: I will refer you to my colleague – a surgeon. In such cases, you can make a resection of the apex, in other words to cut off the top of the root.
Patient: Does it mean that the gum will have to be cut?
Doctor: Yes, it does. There is no other way. But actually this is the only way to save the tooth.
Patient: And when it can be done? I’m going on vacation in a month.
Doctor: I think that in a few days. My colleague has a lot of patients. For now I’ll give you an antibiotic, because there is a swelling of the face. I do not cut the abscess, because one hasn’t actually formed. Here is a phone number to my colleague. I think he will meet with you prior to the procedure to discuss all the details. And here is a prescription for an antibiotic. Please buy it right away and take 1 tablet every 12 hours. The effect will be present approximately in 2 days.
Patient: Thank you, sir.
Doctor: And if something happened, for example it started hurting or swelling increased, please do not hesitate to call me.
Patient: Ok, thank you very much and goodbye!
Doctor: Goodbye!
VOCABULARY PRACTICE
Decide if these statements are true (T) or false (F). Correct wrong information
- In most cases, infections in and around the root of the tooth are dealt with by root canal treatment. T/F
- Apicoectomy is the only option if infection in the root of the tooth has recurred. T/F
- An apicoectomy is done only after a tooth has had at least one root canal procedure. T/F
- Another term for apicoectomy is a root resection. T/F
- An apicoectomy is sometimes called endodontic microsurgery because the procedure is done on a very limited area. T/F
- Apicoectomy is done with help of local anasthesia. T/F
- To perform this procedure the gum must be cut. T/F
- After the dentist has removed the inflammed tissue around the tip of the root he may just put some stitches to close the gum and the procedure is complete. T/F
- The procedure takes at least 2 hours. T/F
- An apicoectomy is a permanent solution, and should last for the life of the tooth. T/F
Below you’’ll find pieces of follow-up advice a dentist should provide a patient with after apicoectomy procedure. Complete the sentences with words from a table
|
avoid |
apply |
disrupt |
|
stitches |
bruise |
OTC |
|
numb |
swollen |
smoking |
- ................... ice to the area where the procedure was done for 10-12 hours after the surgery.
- The area may ................. and swell.
- The area may be even more ............... after the second day after the procedure than on the first day.
- If you feel pain or discomfort, it may be controlled with any............... anti-inflammatory drugs.
- ............... brushing the area to allow for healing.
- ............... is not allowed as it inhibit healing.
- Do not lift your lip to examine the area, because this can ................ blood-clot formation and cause loosening of the sutures.
- The area of the procedure may be ............. for a few days. It does not mean that the nerve was damaged.
- Your ............ will be removed after 2 to 7 days after the procedure.
Look at the dentist’s answers. Write questions that were asked by a patient
1. Question:
..........................................................................................................................................................
Doctor’s answer: Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the gum incision heals. This is typical for any surgical procedure. But I can recommend also some painkillers which can be bought at any pharmacy or I’ll provide you with a prescription for something stronger to control the pain after the procedure.
2. Question: ..........................................................................................................................................................
Doctor’s answer: Most patients return to work or other daily activities the next day.
3. Question:
..........................................................................................................................................................
Doctor’s answer: In your case options are limited. Another root canal treatment is not an option. So, the extraction of the tooth would be the only option at this point.
Question:
..........................................................................................................................................................
Doctor’s answer: The main problem could be that the surgery may not work and the tooth may need to be extracted. Also, depending on where the tooth is located, there may be other risks associated with the procedure. If the tooth is in the back of your upper jaw, the infection can involve your sinuses. On the other hand, the roots of the back teeth in the lower jaw are close to some nerves. Surgery on one of these teeth carries a slight risk of nerve damage. However the danger is really low.
Lesson 64 - answers
