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HomeHealth Care & MedicalPeriapical Periodontitis — Signs, Symptoms, Types, and Treatment

Periapical Periodontitis — Signs, Symptoms, Types, and Treatment


Did you know that over 40% of adults in the United States have some form of gum disease? Periapical periodontitis is just one of the many troubles that ail us. Of course, the obvious solution would be to improve our oral health and prevent anything from happening, but what can you do if you notice any signs of this disease?

There are numerous ways to solve the problem once you notice the first symptoms. Based on the type of condition and how serious it is, your dentist might suggest root canal treatment, fillings, or even extraction. However, there are a few things you need to know about periodontitis and what to do if you notice symptoms. 

What Does Periapical Mean?

In short, the word “periapical” refers to the root of the tooth, so a periapical condition is one that affects the root apex. In the majority of cases, the condition is actually a periapical abscess. Naturally, that is not the only problem that can target the root of the tooth. 

The most common problems are periapical abscess, apical periodontitis, periapical periodontitis, and so on. There are a lot of similarities between these conditions, but most importantly, they all require treatment. If left unattended, an abscess, for example, can lead to tooth decay and even tooth loss. 

Periapical vs. Apical Periodontitis

What is the difference between periapical and apical periodontitis? The primary difference is in where the problem occurred in the first place. Apical periodontitis is a general term, and it is used to describe the bacterial infection or inflammation in the root canal. You will notice that a lot of people use these two terms interchangeably, but the reality is that apical periodontitis is an umbrella term that covers different types of periapical conditions we mentioned earlier. However, since both terms are fairly similar, there is nothing wrong with using either of them. 

Periapical Periodontitis

In the majority of the cases, periapical periodontitis is a problem caused by a bacterial invasion, and, as we’ve said, it affects the apex of the tooth. 

The condition has a couple of steps of evolution. It is not rare for it to evolve into caries, leading to tooth decay. If you leave the tooth untreated, you can easily lose it. That is why you should address the problem as soon as you spot it. 

In some cases, it will be difficult for the patient to notice the signs of periapical periodontitis. Until the condition worsens. If you aim to spot it in the early stage, the best course of action would be to regularly visit your dentist. 

Types of Periodontitis

As we’ve previously mentioned, periodontitis can manifest in many different ways. Based on the type of condition, the dentist will suggest a way to fix the problem. Hopefully, the situation hasn’t advanced too far, and tooth extraction won’t be necessary. 

Acute Periapical Periodontitis

When the bacteria enters the tip of the tooth, the patient can develop acute periapical periodontitis. Usually, this happens after some sort of trauma, injury, or infection. As a result, the affected tooth will feel weighted, and the surrounding gums will become red and inflamed. 

If untreated, the entire area will start hurting, and the condition will worsen with time. As the periodontitis progresses, it will continue damaging the tooth until it evolves into a periapical abscess. 

Asymptomatic Periapical Periodontitis

As the name suggests, asymptomatic apical periodontitis won’t show any symptoms in its early stage. The condition will gradually worsen with time, and if left untreated, it will lead to inflammation of the tissue surrounding the tooth. 

Fortunately, your dentist will be able to spot asymptomatic periapical periodontitis in its early stages, which is one of many reasons you should have regular checkups. 

Symptomatic Periapical Periodontitis

Unlike the asymptomatic version of the disease that worsens over time, symptomatic periapical periodontitis appears suddenly. The patient will notice an acute pain in the tooth and surrounding gums, and the condition will get worse if they don’t visit the dentist immediately. 

Chronic Periapical Periodontitis

This is often the last stage of periodontitis. It is mostly non-painful, and it appears around the top of the root causing the infection. Since the condition is chronic, it means that it has been around for a long period of time. 

It is also possible for the patient to experience drainage via the gums, and it will also appear around the root. If the drainage leads to the nerve canal, it will lead to numbness. After the treatment of chronic apical periodontitis is finished, all the symptoms should disappear. 

Periapical Abscess

Periodontitis can also progress into an abscess, forming a pocket of pus near the root. Periapical abscess is the most common form of dental abscess, and there are numerous different factors that could lead to it. Mainly, broken or chipped teeth, tooth decay, and of course, periodontal disease. A similar abscess can appear if the patient underwent root canal therapy that wasn’t finished properly. 

What to Do?

The only thing you can do is schedule an endodontic treatment if you already have periodontitis. But to prevent it from developing in the first place, having regular visits to the dentist will be able to solve the issue before it progresses and causes more damage to your teeth. 

Based on the situation, your dentist might go for root canal fillings, give you antibiotics, or opt for extraction. It is always better to be safe than sorry, and just because you don’t feel anything happening with your oral health, that doesn’t mean that it is. Your dentist will be able to spot any irregularity with gums and teeth, and they will be able to start treating the condition before it worsens even further. 


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