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Symptomatic apical periodontitis

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Brief description of the condition

Symptomatic apical periodontitis refers to acute inflammation of the soft tissues immediately surrounding the tip of the root of a tooth, often caused by necrosis and infection of the pulp tissue following tooth decay or trauma. 

Key signs and symptoms

  • Pain (usually localised to a single tooth); tender to pressing on the hard, and sometimes soft, tissues of the affected tooth.

Initial management

Recommend optimal analgesia (see Analgesia).

Do not prescribe antibiotics.24,25

Advise the patient to seek urgent dental care.

Subsequent care

Consider:

  • Root canal therapy or extraction depending on restorability and patient preference.26
  • Relieving occlusion on the affected tooth, if appropriate.
  • Recommending appropriate analgesia to control post-operative pain (see SDCEP Drug Prescribing for Dentistry guidance).