Post-Op Instructions

General Post-Op Instructions

***PLEASE READ ALL OF THESE INSTRUCTIONS CAREFULLY***

If this is a medical emergency CALL 911.

Sometimes the after-effects of dental procedures are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, if you have a question, follow these guidelines or call our office for clarification. Our number is: 757-464-6228.

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.

OOZING: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.

SWELLING: Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen vegetables (such as peas) wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, it will reduce the chance that nausea will occur. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.

DIET: Eat any nourishing food that can be eaten with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use ¼ teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office where you had surgery. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: telephone calls for narcotic (pain killer) prescription renewal are ONLY accepted during office hours.

Root Canal Post-Op Instructions

The purpose of the root canal treatment is to remove diseased tissue from inside of the root and seal the root end. Depending on each case, endodontic treatment may be completed in one, two or three appointments. Once started, it is important to complete the root canal therapy.

Your endodontic, or root canal, therapy will usually maintain your tooth and relieve the pain you may have been experiencing. Please avoid biting on the tooth for the next few days. It is not unusual for the tooth to be tender after a root canal, and healing occurs more quickly if you do not chew on it immediately. Also, avoid biting your lip, cheek, and tongue while anesthetized (numb) since this may cause damage to them.

If your tooth was in pain prior to starting the treatment, it will take up to a week or more for the tooth to return to normal. Give the therapy a chance to work. Even if your tooth was not in pain prior to treatment, it may be quite sore for a few days after the appointment. This will be alleviated with time; it may take as much as a week or more. Should you have pain that you cannot tolerate, abnormal swelling, fever, or significant pain, please call our office.* We will suggest medication or other steps to make you more comfortable. This procedure requires your mouth to be open for a long period of time which may cause muscle spasms. Heating with a warm compress and stretching your jaw is recommended.

Over the counter analgesics such as aspirin, Acetaminophen (Tylenol™), Ibuprofen (Advil™, Motrin™), Naproxen sodium (Aleve™) products usually alleviate the discomfort. Take pain relievers before the anesthetic wears off and continue taking for two or three days as directed. Following this recommendation may substantially decrease your after treatment discomfort. We recommend taking an anti-inflammatory such as Ibuprofen. 

In most cases, antibiotics are not required after endodontic therapy. You will be given a prescription for antibiotics if we feel it will be necessary. Some medical conditions require a special antibiotic prophylaxis regimen taken prior to the appointment to help prevent damage to certain structures.

You may continue regular dental hygiene regimen. Avoid biting or chewing on the tooth during the first few days. Avoid sticky foods like caramel, jellybeans, or gum since they may loosen or remove the temporary filling, which was placed. If the temporary filling feels loose or completely falls out, please call our office. It may need to be replaced.

A permanent restoration is necessary after having a root canal and may require additional appointments. We usually place a temporary filling in the tooth, so it is important that you schedule promptly for a permanent restoration because the temporary filling will eventually allow bacteria to leak in and contaminate the tooth. Failure to complete the final restoration in a timely manner may result in the need for re-treatment of the root canal(s) in your tooth at an additional cost or possibly severe pain and infection or loss of the tooth due to fracture of the tooth and/or recontamination from leakage.

Once endodontic therapy is completed your tooth may require periodic examination, usually 6-12 months. This allows us to make sure the tooth is healing properly. Please call our office if your tooth feels unusual or discomfort persists after completion. Fortunately, most root canals heal with about a 90-95% success rate. Sometimes despite our best efforts, a small percentage of patients may need to have the root canal(s) retreated or will need root-end surgery (surgically clean the bone that surrounds the root tip and seal the tip of the root) to achieve adequate healing.

Crown Post-Op Instructions

Today a tooth was prepared for a crown. The tooth was lightly sanded down, a digital scan of the prepared tooth was taken and sent to a laboratory where a new, custom tooth will be made. A temporary crown, made from acrylic was placed on the prepared tooth to protect it while the real crown is being made.

The tooth may be sensitive. The gum will be tender and sore and can take time to heal properly. Cold sensitivity is okay as long as it goes away quickly.

Please call for an appointment if:

  1. If you cannot bite or chew on the tooth either while the temporary crown or the real crown is in place, the crown may need to be adjusted.
  2. There is any swelling of the gum and / or your face.
  3. The temporary crown comes off. In the meantime, you can place petroleum jelly inside the temporary and place it back on the tooth.

DO'S:

  • Use a warm saltwater rinse (1/4 tablespoon salt; 8 ounces water). This solution can make the tooth and gum area feel better after treatment.
  • Jaw muscles may become stiff. Heating with a warm compress and stretching of the mouth (slow opening and closing) is advised.

DON’T'S:

  • Do not eat anything sticky or anything hard on the temporary. Use good judgement here.