Post-Op Instructions



General Guidelines for all procedures:


Avoid hard or sticky foods such as “hard tack” candies for a least 24 hours as chewing on these types of foods can loosen or damage a restoration. Never chew on ice. Carefully follow all guidelines provided by our office, and, most importantly, practice good oral hygiene. Additional instructions following various types of treatment are listed below. Please click on the below topics for detailed instructions. In the event of an emergency please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.


Following Tooth Preparation:  Sensitivity and tenderness of the tooth and surrounding gums is common for the first day or two after a tooth has been prepared for a restoration. If the tenderness or sensitivity lasts longer than this, please contact our office. If anesthesia is used, avoid chewing, biting, and eating until the numbness wears off. The final restoration may be placed the same day that the tooth is prepared or may be placed during a separate appointment.

For Temporary Restorations:  Eat softer foods, and avoid foods that are particularly crunchy, chewy, or hard. Carefully clean around the restoration, brushing and flossing daily.  Be gentle when flossing, taking extra care not to loosen the temporary restoration. Slowly pulling the floss out by one end can help avoid putting too much pressure on the temporary. If the temporary restoration becomes loose or breaks, please call us immediately.

After Final Restoration Placement:  Avoid chewing on hard, crunchy, or sticky foods for 24 hours in order to give time for the cement to fully bond. Mild sensitivity to hot or cold foods is not unusual and should dissipate after a few weeks. If sensitivity lasts more than six weeks, please let the office know.

Ongoing Care:  Proper care of your restoration includes brushing your teeth after every meal and snack, and flossing at least once a day before bedtime. Rinsing your mouth with water or mouthwash with also help to remove any additional particles that may have been missed during brushing and flossing.

Please call our office if you are in pain or have any questions regarding your treatment.

Do not eat or chew until any numbness from anesthesia has worn off. If you are supervising a child who has had treatment, make certain that they are not eating or chewing while numb. Please make sure they do not bite their lips or tongue as doing so can cause serious injury to their soft tissue. Avoid sticky, crunchy, or hard foods for 24 hours.

Sensitivity to cold and heat, as well as any soreness, should not last more than a few days. Please call our office if you experience pain or discomfort for more than a few days.

Immediate Postoperative Care

Care should be taken in the immediate postoperative period to minimize contact with the implant. Aside from normal hygiene, it is best to completely leave the implant alone for the first 2 weeks after placement. You may want to limit foods to softer items and chew in an area away from the implant during the 10 to 12 week integration stage.

Bleeding

Minimal bleeding is expected after implant surgery. Bleeding after surgery may continue for several hours. The best way to stop bleeding is to fold 2 pieces of damp gauze over the extraction site and gently bite for 30-60 minutes, making sure pressure is being applied to the extraction site. Rest quietly with your head elevated. Pink or blood-tinged saliva may be seen for 2-3 days following the surgery and does not indicate a problem. Suture material may last 2-3 days and should be left alone. You will be asked to return to the office for a 2-week follow-up appointment. Any sutures remaining at that time may be removed at the surgeon’s discretion. Do not pull or cut the sutures yourself.

Swelling

Swelling is the body’s normal reaction to the surgery and healing. The swelling will not become apparent until 24 hours after surgery and will not reach its peak for 2-3 days. After this time, the swelling should decrease but may persist for 7-10 days. Swelling may be minimized by the immediate use of ice packs. Apply the ice packs to the outside of the face 20 minutes on and 20 minutes off while awake for the first 24 hours. After 48 hours, begin use of a warm, moist compress to the cheek.

Medication/Pain

Most oral surgery is accompanied by some degree of discomfort. If you do not have an allergy to non-steroidal anti-inflammatory medications (Ibuprofen, Motrin, Advil) we recommend taking this prior to the local anesthetic wearing off. More severe pain may require a narcotic pain medication. Narcotic pain medications will make you drowsy, do not drive or operate mechanical machinery while taking the prescription. Alternate Ibuprofen (2 tablets/200 mg each) and the narcotic medication every 2 hours if needed. Once you feel like you can stop the narcotic, use Ibuprofen or Tylenol. You may also be prescribed an antibacterial mouth rinse, which should be used twice daily in the first 2 weeks following implant surgery. All medications should not exceed the recommended dosage.

*NOTE: If you are taking PLAVIX or COUMADIN, do NOT take Ibuprofen or Aspirin products.

    Diet

    After general anesthetic or IV sedation, start with liquids. While numb, patients should avoid hot liquids or foods. Patients may have applesauce, pudding or jello. Once numbness wears off, patients can progress to solid foods, chewing away from the surgical sites.

    Oral Hygiene

    The best way to prevent infection and ensure healing is to keep your mouth clean. Clean your mouth thoroughly after each meal beginning the day after surgery. Use a soft bristle toothbrush and toothpaste after meals and at bedtime. Should bleeding resume after brushing, repeat the use of gauze as described above. Do not rinse your mouth the day of surgery.

    Activity

    For the first 48 hours you should rest and relax with no physical activity. After 48 hours, you may resume activity as tolerated.

    Healing

    Bad breath is common and will disappear as healing occurs. Two to three days following surgery, white, possible hard tissue may be seen in the surgical site. The signifies normal, healing tissue. It’s not unusual to see the silver healing cap appear through gum tissue following the procedure.

    Antibiotics

    If an antibiotic is prescribed, take the tablets or liquid as directed. Take the entire prescription until gone. Antibiotics can be given to help prevent infection. Make sure to call the office if a rash or other unfavorable reaction occurs.

    Foods to Drink and Eat While Numb

    AVOID carbonated beverages and hot liquids for 48 hours

    Drink: Water, juice, ice chips, popsicles

    Eat: Applesauce, jell-o, pudding, yogurt, milkshake (NO straw)

    Add soft foods when numbness is gone

    Mashed potatoes, pasta, eggs, pancakes, creamed cereals, soups (be careful – not too hot)

    Increase diet as tolerated

    Other considerations

    We will notify you when your implant is ready for restoration; typically 10 to 12 weeks following placement.

    Dentures and partials will often need several adjustments in order to fit comfortably. To help yourself adjust to your dentures you can practice reading aloud for a little while each day. Dentures should be removed overnight or for at least 6 hours a day to give your mouth and gums time to rest. At night you should remove your dentures and clean them. They should be stored in a clean container filled with denture cleaning solution. Food particles can become trapped under dentures causing inflammation or sore spots. Lightly brush the roof of your mouth, your tongue, and your gums after removing your dentures. You may have discomfort for a few days after receiving your final dentures or partials.

    Ongoing care of your denture or partial includes brushing your teeth and the surrounding tissues after every meal and snack and flossing at least once a day before bedtime.  If you have full dentures,  brushing the dentures daily is very important. Rinsing your mouth with water or mouthwash will help to remove any additional particles that may have been missed during brushing and flossing.

    Make sure to visit our office at least once a year to have your dentures or partial adjusted and checked by the doctor. Wearing ill-fitting dentures or partials without proper care and adjustment can cause bone loss in the jaw area and oral disease. Please call our office if you are experiencing ongoing pain or discomfort or if you have any concerns regarding your denture or partial.

    Immediately following surgery, keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops. A certain amount of bleeding is to be expected following a surgical procedure. Placing the gauze pad over the area and biting firmly may control excessive bleeding. Slight bleeding, oozing, or redness in the saliva is not uncommon. Repeat as necessary within a one-hour period following surgery.

    If you have been prescribed pain medication besides aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication. Do not take more than 800mg every 4-6 hours. Medication should not be taken on an empty stomach. If you have been placed on antibiotics, take the medicine as directed. Antibiotics may be prescribed to help prevent infection.

    Swelling around the face, eyes and surgical site is not uncommon. This swelling may not appear until the day following the surgery and may become more noticeable two to three days following surgery. You can help to minimize the swelling by applying a cold compress on the face near the extraction site alternating on for 20 minutes then off for 20 minutes. After 36 hours the ice will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling.

    For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke. Avoid hot and spicy foods, carbonated and alcoholic beverages. During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies. Restrict your activities on the day of your surgery, avoid excessive work or play and resume normal activity the following day as tolerated.

    After the first day, gently rinse with a warm salt water rinse, approximately one-half teaspoon of salt in an eight ounce glass of water, three times a day.

    If any sutures were required, they will dissolve on their own in 7-10 days. It will not be necessary to return to the office for sutures to be removed. Children should be supervised after having an extraction to make sure they do not bite or their tongue or lips as it can cause serious injury to their soft tissue.

    Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns. In the event of an emergency, please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

    DO NOT Smoke or use tobacco of any kind following surgery. This WILL prolong healing.

    Medications

    • If you took a sedative prior to your appointment, DO NOT drive for the next 24 hours.
    • Antibiotic: It is important that you take this on time, and completely. (Failure to do so may result in infection.)
    • Mouth Rinse: 24 hours after surgery, gently rinse twice a day for 30 seconds. Between meals you can rinse with warm saltwater.
    • Pain Medication: Take your prescription immediately following dental surgery, then as prescribed for the first day. You may take the pain medication as needed therafter.

    Food

    • DO NOT eat anything solid or hot while you are still numb (you could bite or burn yourself).
    • DO NOT spit or suck for two days following surgery (no straws, mints, hard candies, popsicles, cigarettes).
    • Drink plenty of fluids (preferably cold drinks the day of the surgery).
    • It is recommended that you eat a soft, nutritious diet for a few days following surgery (pasta, eggs, fish, soup, yogurt, canned fruits, cottage cheese, mashed potatoes, ice cream).
    • Avoid hard, crunchy foods and foods containing small seeds (chips, apples, carrots, celery, lettuce, peanuts, popcorn, strawberries, hard meats).

    What to Expect

    Discomfort

    • Generally, patients will describe an achiness, which will decrease each day following your procedure, although this can vary from person to person. Keep up with the pain medication as needed.
    • Some patients will have a slight headache due to TMJ (jaw joint) strain.

    Bleeding

    • Typical bleeding lasts 4-6 hours.
    • Is it NOT uncommon to experience oozing for up to 24 hours following surgery.
    • Remember, a small amount of saliva mixed with blood may lead you to believe that your bleeding is worse than it actually is.
    • Use the gauze pads as needed, generally changing it whenever it is too moist, until bleeding stops.
    • If there is uncontrollable bleeding that is not slowing, apply a cold, moist tea bag wrapped in gauze to the affected area. This applies only to extraction sites. (There is tannic acid in tea which may help stop or slow bleeding.)
    • DO NOT LEAVE GAUZE IN THE MOUTH WHILE EATING OR SLEEPING
    • Slight to moderate swelling is expected.
    • Typically the worse swelling occurs on the third day, and then will gradually decrease.
    • To help control the swelling, use a cold pack for 15 minutes intervals (15 minutes on and 15 minutes off) until swelling has peaked.
    • If you are still experiencing swelling on the fourth day, you can use warm, moist compresses on the outside of your face.
    • Possible bruising is also expected, and may appear anywhere from the third to fifth day.

    Care of the Mouth

    • DO NOT brush or floss around the surgery site until after suture removal.
    • Do brush and floss normally in other areas of your mouth and use the prescribed rinse as instructed.

    Rest

    • DO NOT vigorously exercise or exert yourself for 48 hours.
    • Do try to keep your head elevated while resting or sleeping for the first two days.

    You should consult our office if you have:

    • Uncontrollable bleeding after the above measures have been taken.
    • Severe, uncontrollable pain.
    • Profuse swelling after three days that has only gotten worse or is not decreasing in size.

    If you have any questions or concerns, please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

    Please follow the guidelines below and contact us with any questions.

    1. No eating or drinking for the first 30 minutes following your treatment. Also avoid feeling around your tooth with your tongue. This is to allow the temporary filling sufficient time to harden.
    2. If you were given any prescriptions, please have them filled promptly and take as directed. If no prescriptions were given, you may choose to take ibuprofen medications such as Motrin or Advil (as long as you do not have any allergies to these medications) for alleviation of discomfort and swelling.  Alternatively, you may use Tylenol.  Do not exceed the guidelines printed on the label for any medication.  If you are unable to achieve adequate pain control, please call our office.
    3. Applying a cold compress to the face near the treatment area will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off for the next 6-8 hours as needed.
    4. Once you resume eating and drinking, avoid chewing or biting on the treatment area until your permanent restoration is placed. The temporary filling or crown placed immediately following root canal treatment is usually a soft composite that is vulnerable to fracturing (cracking).  For this reason, it is important to avoid chewing on hard substances such as peanuts, pretzels, hard candy, ice cubes, etc.. You may experience increased sensitivity prior to the placement of the final restoration.  You will need to see a restorative dentist within a month to have a permanent crown or filling placed.  Please contact your restorative dentist to make an appointment at your earliest convenience.  Waiting longer than a month increases the chances that the temporary will fracture or that decay will develop in the affected area.
    5. Please keep the treated area clean by gently brushing and flossing regularly.
    6. It is rare for a temporary filling to fall out although it may divot while in use.  If the temporary falls out, please contact your general dentist as soon as possible.  If your temporary falls out after office hours, you may purchase some temporary filling material from a pharmacy and follow the included instructions to cover the area until you can be seen in our office.
    7. Some discomfort is normal for 2 to 4 days following root canal therapy.  In some cases the tooth and surrounding tissue may be sore for a few weeks following treatment.
    8. Please brush and floss as usual unless otherwise instructed by our office. Follow any other instructions provided by our office during your visit. Please take all medications as prescribed.

    THIS SECTION IS VERY IMPORTANT, PLEASE READ CAREFULLY

    While flare-ups are rare, they occur in about 5% of cases and may cause significant pain.  They generally only occur with teeth that are extremely irritated and/or infected or with teeth that have a history of prior treatment.  These sometimes occur randomly, even on patients that have had root canals done in the past without problems.  If you have a flare-up, you may experience moderate to severe pain, swelling, throbbing, or general discomfort; please contact our office right away.  You may be prescribed additional medication such as antibiotics, and/or you may be asked to come to the office for further treatment.

    For the First 48 Hours Following Bleaching:
    Teeth are more susceptible to staining for the first 48 hours following bleaching treatments. For the first 48 hours after whitening, it is best to avoid dark-colored foods or beverages that can stain your teeth. Any item that can stain your clothes can also stain your teeth.

    Avoid: Berries, cola or other dark sodas, red wine, coffee and tea, tobacco, and ketchup, soy or other dark sauces.

    Using Your Custom Trays:
    Follow the instructions given by our office, placing the bleaching gel in the center of each tooth position on the tray so that the gel will rest against the anterior surface of the teeth once it is placed in your mouth. Wear trays for the recommended time. Rinse the mouth, and gently remove any gel remaining on your teeth with a soft bristle toothbrush. Clean the trays.