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POST-OPERATIVE INSTRUCTIONS

POST OPERATIVE 
CARE FOLLOWING EXTRACTIONS IMPLANTS

To insure rapid healing and to avoid complications that could be both
harmful and painful to you, please follow these instructions carefully.

  • BLEEDING: You have been given a supply of gauze. To prevent unnecessary bleeding, maintain gentle pressure over the area by biting on a piece of gauze placed over the surgical site. Change the gauze in your mouth every 15-20 minutes until bleeding has significantly decreased. If more gauze is required, they are readily available in drug stores. It is not unusual to have some slight oozing for up to 24 hours following surgery especially if bone grafting was placed. Rest today and keep your head slightly elevated. Do not engage in physical activity since this promotes bleeding.
  • SWELLING: You have been given an ice pack to help prevent swelling. Your ice pack should be applied on the side of your face adjacent to surgery site. To the extent possible, apply for periods of 20 minutes on and 5 minutes off until bedtime on the day of surgery. By 48 hours, swelling should be noticeably decreased. If it is not, please call the office. In the event of facial or neck bruising, this is normal and its resolution can be expedited with frequent heat packs and gentle massage.
  • EATING: It is important to get adequate nutrition after surgery to help the healing process. You may want to start with fruit juices and then progress to a soft diet. Begin chewing foods when you are able to do so without it hurting. Where your teeth were removed, your jaw is now hollow and somewhat weaker than before. For that reason, you should not chew or tear food forcefully for 5-6 weeks. Doing so could bring about a bone fracture or implant loss (if applicable).
  • RINSING AND BRUSHINGDo not rinse for the first 24 hours, since this will contribute to clot dislodgement and dry sockets. After 24 hours, rinse with warm salt water (1/2 tsp in 8 oz of water every few hours). Other actions that can contribute to potentially painful dry sockets are using a straw and smoking. It is best to refrain from smoking for 4-5 days. Starting on the day after surgery, carefully brush in areas of the mouth not affected by the extractions.
  • MEDICATIONS: If a pain medication was prescribed to you, pick it up from the pharmacy as soon as possible and take as directed. Generally, a long-acting local anesthetic is used, which may prolong numbness and pain relief. If you were placed on an antibiotic prior to surgery, please finish all doses.
  • POST-OPERATIVE: In most cases, a suture is placed in the area. You will be appointed to return 7-10 days after your dental surgery to have the suture removed and to make certain that healing is progressing normally. If an implant was placed, we will see you back every 4-6 weeks for x-rays to monitor healing leading up to the final implant restoration.
  • UNFORSEEN COMPLICATIONS: If you suspect any problems with the normal course of healing, (severe pain, swelling, uncontrolled bleeding) do not hesitate to call immediately.

 

POST OPERATIVE INSTRUCTIONS
CARE FOLLOWING ROOT CANAL THERAPY

There are usually very few post-operative problems following root canal therapy. Endodontic treatment (root canal) is necessary when the nerve of the tooth becomes inflamed or infected. The inflammation or infection can have a variety of caused including deep decay or a crack or chip in the tooth.

  • SENSITIVITY: Root canal procedures are performed to relieve the pain of toothaches and sensitivity caused by pulp inflammation or infection.  For the first few days after treatment your tooth may feel sensitive. This is normal, especially if there was pain or an infection beforehand. Usually over the counter medications can help relieve some discomfort. Your tooth may feel slightly different from your other teeth for a few days. Some soreness is common, however if you have severe pain, swelling or pressure that lasts more than a few days, please call the office.
  • OCCLUSION: Once the root canal tooth has been treated, a temporary or permanent restoration will be bonded to the tooth. A crown is usually recommended to support the natural tooth so in the future it will not break. Due to local anesthesia to numb the area, you may not be able to tell if the bite feels normal. Wait until the anesthesia wears off and if your occlusion (bite) is not comfortable please call the office for it to be adjusted. If your bite is not correct and does not get corrected you could break the filling or tooth. It is not uncommon for the new restoration or crown to need a slight adjustment.
  • CHEWING: You have been given local anesthesia to numb the area. Please do not chew in that area until the feeling returns. When you are “numb” you cannot feel if you are biting your lip or cheek.

 

POST OPERATIVE INSTRUCTIONS
CARE FOLLOWING COMPOSITE RESTORATIONS

You have just had one or more teeth restored with a tooth colored, bonded composite. How quickly you adjust to the new restoration depends upon the size of the restoration and the proximity to the pulp (nerve). The larger the restoration, usually the longer it will take you to become accustomed to it.

  • CHEWING: If you have been given a local anesthetic, please do not chew in that area until full feeling returns. When you are “numb” you cannot feel if you are biting your cheek or lip.
  • OCCLUSION:The “bite” of the new restoration has already been adjusted. If you have been anesthetized you may not be able to note if the bite feels normal. Wait until the anesthesia wears off and then if the occlusion is not comfortable, call the office to have it adjusted. If you have had multiple restorations placed, please give yourself time to become adjusted to them before you call the office. This may take one or two days. If the bite is off and it is not corrected you could break the filling or the underlying tooth structure. As you might imagine, when the time comes for us to check your bite, your tooth has been anesthetized, you can’t feel the bite well and it is often difficult for you to make your teeth meet as they usually meet. It is not uncommon for the new restoration to need a slight adjustment.
  • SENSITIVITY: Any time a tooth is prepared (drilled) for a filling, tooth structure is removed very quickly. The natural wear process that occurs in everyone’s teeth proceeds much more slowly. The response of a vital, healthy nerve to this wear is to recede and deposit insulation later between the nerve and the surface of the tooth. Normally, the wear of the tooth proceeds at more or less the same pace as the nerve recedes and deposits insulation. When a tooth is drilled, tooth structure is removed much more quickly than the nerve can “defend” itself. One response of the nerve is to become sensitive to temperature changes. This will persist until the recession and insulation process can catch up to the rapid removal of the tooth structure caused by the drill. This sensitivity can last from several days to several months. Usually, the more drilling, the more and longer the sensitivity you will experience.
  • HOME CARE AND RECALLS: you may (and please do!) brush and floss your teeth after the local anesthetic has worn off. There is no need to refrain from your normal, daily oral hygiene routine. Continue with your oral hygiene maintenance appointments at the interval we have previously recommended. Problems that might develop around the restorations can be found at an early stage and are easily repaired. If you wait too long, the entire restoration may have to be redone.

 

POST OPERATIVE INSTRUCTIONS
CARE FOLLOWING PERMANENT CEMENTATION OF

CROWNS/BRIDGES/ONLAYS/INLAYS

There are usually very few post-operative cementation problems.

  • SENSITIVITY: Occasionally there may be some passing sensitivity after the cementation process that could last from several days to several months. This is not unusual and may relate in part of the cementation procedure or the amount of tooth that was removed during the preparation for the restoration. It may also be related to the occlusion (bite). If you were anesthetized for the procedure, then it is possible that you were not sufficiently aware of the proper position of your anesthetized jaw when it was in contact with the opposing tooth (which is not uncommon). When this happens it becomes very difficult and maybe impossible to adjust the restoration into its proper position at that time.  When the anesthesia wears off, you might then notice that the bite does not feel correct –it is “high” or contacts the opposing teeth too soon. This may cause the nerve in the tooth to become irritated and sensitive to hot or cold simulation. Adjusting the “bite” will usually help this problem. Sometimes the sensitivity does not go away and may in fact get worse. This is not usually related to the procedure but it is a result of the extensive amount of original tooth destruction from decay. Although the tooth may appear to be fine while the temporary restoration is in place, the nerve may in reality be slowly dying. In this situation the restored tooth may experience nerve death and the tooth would need endodontic (root canal) treatment. The need for this may show up days or years after the crown is cemented.
  • SHORT TERM AFTER CARE: After the cementation, it is advised to wait at least 1 hour to use the tooth to chew food, or after the anesthesia wears off in the area, whichever comes first. The cement sets partially while you are in the office, but requires at least 24 hours to achieve better physical properties. (No gum chewing, no taffy, do not bite on nuts or bagels for 24 hours.) It is ok to brush and floss teeth normally after cementation of the permanent restoration. It is very important to continue your oral health habits, and to return for your normal preventative maintenance appointments with the hygienist and recall exams with the dentist in intervals of normally 6 months. You may also rinse daily with mouth rinse containing fluoride. Follow the instructions on the label. Regular use of topical fluoride has been shown to reduce the incidence of some dental problems.
  • LONG TERM AFTERCARE: You should receive several years of service from these restorations. We have used the best information, procedures and materials available in their fabrication. It is possible that they may require replacement if they fracture due to extreme force or trauma (the same is to be expected with natural teeth). The gums may also recede from the margins of the restoration, exposing metal or original tooth structure. This usually takes years and is a result of the normal aging process. In this office, we guarantee your new work for 5 years from the delivery date, against recurrent decay, chipping or fractures of the porcelain. This will be honored as long as a patient does not miss any re-care visits.

 

POST OPERATIVE INSTRUCTIONS
CARE FOLLOWING SCALING/ROOT PLANING

Proper homecare is of utmost importance to improve your periodontal condition.

  • Warm salt water rinsing as often as feel needed to aide in healing. (1 Cup water : 1/2 tsp salt)
  • Gentle brushing for the first 24 hours with a soft toothbrush.
  • You may take ibuprofen or acetaminophen if needed. If the discomfort is not alleviated with OTC pain relievers, please call the office.
  • Start with a soft diet, being careful to not eat or drink anything hot right after your treatment; due to the anesthesia you may be unable to sense temperature extremes. In addition, be careful to not chew your lips, cheeks, and tongue while anesthetized. 
  • There may be some slight bleeding the first day. This will subside with the salt water rinsing, and proper homecare. 
  • Follow the homecare and recall instructions set up for you with brushing and flossing as discussed with your hygienist.
 


POST OPERATIVE INSTRUCTIONS
CARE FOLLOWING ZOOM IN OFFICE WHITENING
 

  • For 2 hours following appointment, do not consume coffee, tea, red wine, red sauce or tobacco.
  • SENSITIVITY: Tooth sensitivity is normal and temporary. OTC pain reliever may be taken after appointment as directed in addition to use of the ACP sensitivity relief gel. If sensitivity after whitening occurs, dispense relief gel into white trays and wear for 10-30 minutes. If trays are not available, brush product on teeth and leave on for 3 minutes. For best results, do not eat or drink for 30 minutes after relief gel application.
  • MAINTENENCE: All tooth whitening requires maintenance. Use day white or nite white take home refills for 1-3 nights every 4-6 months, depending on habits.

For whiter results following in office whitening, use day white or nite white as instructed, 24 hours after in office procedure is completed.

 

If you have any questions about your treatment, please feel free to contact the office for assistance.