Post-Op Instructions

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.

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.

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.

Scaling and root planing therapy includes the removal of tartar and bacterial plaque from the root surfaces below the gum line. This procedure helps reduce inflammation, infection and the depth of periodontal pockets, allowing more effective flossing and brushing.

For the first 24 hours you may experience some cold and heat sensitivity. Do not consume hot foods or beverages until the anesthesia and numbness have worn off. Avoid vigorous physical exercise as well as extremely hot or spicy foods for the first 24 hours. Do not consume alcoholic beverages or smoke for at least 48 hours following treatment. Some bleeding following a deep cleaning is normal, but if you experience excessive bleeding, please call our office.

You can take ibuprofen or acetaminophen as needed according to the instructions on the label or those provided by your doctor. A warm salt water rinse, approximately one teaspoon in an eight ounce glass of water, three times a day can be helpful. Brush and floss gently following a deep cleaning, resuming normal brushing and flossing when the soreness is gone.

Follow any other instructions provided by our office during your visit. Please take all medications as prescribed.

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.

• The initial healing period takes one to two weeks, and you’ll likely experience some swelling for the first 48 hours.
• Bite lightly on gauze for 1 hour, then discard.
• Before the procedure began, you were given an anesthetic to ensure your comfort. This anesthetic typically leaves your lips, teeth and tongue feeling numb after the appointment. For this reason, you should avoid chewing for 2 hours following surgery, or until the numbness has completely worn off.
• Some discomfort after the extraction is normal. An over-the-counter pain reliever, such as ibuprofen, or acetaminophen, is usually sufficient. We can also give you a prescription for a stronger pain reliever if needed.
• To avoid nausea; do not take pain medication on an empty stomach.
• You can also decrease pain and swelling by applying an ice pack-20 minutes on, 20 minutes off-for the first 6 hours following the extraction.
• A blood clot will form on the extraction site, and this clot is vital to the healing process. To keep the clot intact, avoid touching the extraction site with your tongue or fingers, do not drink liquids through a straw, and do not spit.
• Blowing your nose or sneezing violently can dislodge the blood clot and impair healing, so if you have an upper respiratory infection or suffer from allergies, be sure to have the appropriate sinus medication on hand.
• Do not rinse your mouth the day of the surgery.
• Smoking and allowing food particles to pack into the tooth’s socket should be avoided, as both will significantly affect the healing process.
• Twenty-four hours following the procedure, you can rinse gently with mouthwash or a warm salt water solution (dissolve one teaspoon of salt with one cup of warm water); gently swish the solution around the affected area, and spit carefully. You should do this 2-3 times each day for a week following the extraction.
• If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
• Relax as much as possible and avoid all strenuous activities for the first 24 hours following surgery.
• Once the numbness has worn off, you should eat, as nourishment is important to the healing process. Do not have anything hot to eat or drink within the first 24 hours; room temperature or cold only. Limit your diet to soft foods like yogurt, soft soups, ice cream, or soft-cooked eggs for the first 48 hours.
• Keep your head elevated with pillows to control bleeding. If bleeding persists, you can also bite gently but firmly on a moist tea bag for 20 minutes. Call our office if bleeding continues or increases.
• Be sure to brush and floss the other areas of your mouth as you would normally.
• The space left by the tooth will feel a bit strange at first. Eventually, new bone and gum tissue will grow into the gap left by the extraction

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FAQ’s

1. How long does a ridge preservation procedure take? The extraction of the tooth and the placement of the graft materials takes approximately 60 minutes. Naturally, the exact length of time will vary from case to case. The stitches are removed 7- 10 days later in a 10 minute visit. One or two ten minute check-up visits may be scheduled to ensure the area has healed correctly and an x-ray will be taken a few months later to evaluate the amount of new bone growth.
2. Will the ridge preservation procedure hurt? Only local anesthetic is necessary to perform an extraction and ridge preservation procedure. During the visit you feel nothing since the area is numb. When the local anesthetic wears off there will be some mild discomfort. Medication will be prescribed to control any discomfort you might experience. This procedure will not cause you to miss work, etc.
3. Does the barrier which will be placed to accomplish the ridge preservation remain in my mouth? If a dissolving type of membrane is utilized, it will be gone around 4-6 weeks after the procedure. If a non-dissolving membrane is used it will be removed at the time of implant placement or earlier in a 15 minute procedure.
4. What is the cost of the procedure? The cost of the ridge preservation procedure will vary with the situation. However, the Doctor will ensure that this matter is discussed with you thoroughly before proceeding with any treatment.
5. How well does a ridge preservation procedure work? The ridge preservation procedure is very predictable. The procedure rebuilds damaged bone, resulting in improved aesthetics, continued health of the adjacent teeth, and the establishment of adequate bone for implant placement, if necessary.

PRE-SURGICAL RECOMMENDATIONS AND INFORMATION

Please read the following carefully prior to your surgical appointment:

1. Have a quiet, restful evening before your surgical appointment.
2. Unless instructed otherwise, have a good meal prior to your appointment.
3. Wear a blouse or shirt with short sleeves, or with sleeves which can be rolled up to accommodate a blood pressure cuff.
4. If pre-medication has been prescribed to make you feel more relaxed during the surgical appointment (e.g., Ativan), you must have someone bring you to your appointment and accompany you home. You cannot drive a motor vehicle for the rest of the day.
5. If pre-surgical antibiotics (e.g., Penicillin or equivalent) have been prescribed for you due to medical reasons, please be sure to take them as directed.
6. Ideally, you should return home immediately following the surgical appointment, take any prescribed analgesic and/or antibiotics, and use an ice pack as directed in the post operative instructions. Physical activity and talking should be kept to a minimum for the rest of the day.
7. You may return to work the day following surgery. However, if your work involves physical labor, it is suggested that you try to work at a somewhat slower pace.
8. It is suggested that you do no physical exercise during the first post-operative week to avoid any possible complications.
9. It is preferable that you do not fly in a commercial airplane during the first 4 to 5 days after the surgery.
10. If possible, do not have the surgical treatment less than 1 to 2 weeks prior to an important business or social event.
11. Flying is restricted to 3 weeks after a sinus procedure.

Please do not hesitate to ask any questions regarding the above. Click here to download and print these instructions.

We are committed to providing the same quality of care following procedures that began during your initial
visit. To that end, please refer to some general postoperative guidelines below, and by all means, CALL at any hour of any day to report a continuing problem of lingering concern.

• Do not disturb the area of surgery. The first stages of healing are aided by placing tissues at rest. Avoid vigorous chewing on hard or chewy items.
• A small “healing cap” can be seen flush against your gum tissue. Keep the area clean by gently brushing with a soft bristled toothbrush and rinsing with warm water. Do not use electronic toothbrushes. The rinsing can be done frequently, 2-4 times per day.
• If the “healing cap” loosens or comes off, please call the office within a 48-hour period of time.
• If some degree of discomfort arises, take one or two Advil, Tylenol, or Aspirin and repeat as necessary, or take the pain medication prescribed according to the instructions on the container.
• If there is any discomfort, you can apply ice to the outside of your face with a 20 minute ON/OFF cycle; this will relieve discomfort as well as prevent any swelling.
• Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule unless advised to do so otherwise.
• Do not drive an automobile for 24 hours following surgery if you have had intravenous sedation or if you are taking prescription pain medication.
• Do not use a straw.
• Please do not smoke for at least five days after surgery.
• Oral hygiene is important. Twenty-four hours after surgery, rinse mouth gently with a solution of one half
  teaspoonful of salt dissolved in a large glass of warm water (tea temperature). Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris and thus helps promote healing. Brush tongue with a dry toothbrush to keep bacteria growth down, but be careful not to touch the surgical site. Resume your regular tooth brushing, but avoid disturbing the surgical site.
• If a sinus floor augmentation (lift) was performed in conjunction with upper implants:
  • Do not blow your nose.
  • Do not cover your mouth when you sneeze or hold back.
  • Do not smoke or use a straw.
  • Avoid swimming and strenuous exercise for at least one week.
  • It is not uncommon to have a slight amount of bleeding from the nose for several days.
• Please remember that occasionally a second procedure may be required if there is persistent
  communication.
• If tense facial muscles occur or black and blue marks appear on the skin during the first few days, apply
  warm moist heat to the area.
• You will be seen in one week for a brief follow-up visit to evaluation how you are healing.

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Faithful compliance with these instructions will add to your comfort and hasten your recovery.

Be sure to follow these instructions carefully. Only in this way will you avoid complications, which may lead to unnecessary discomfort and delayed recovery. Should any undue reaction or complications arise, notify the office immediately.

If you need to contact us after hours please call the office at 603-332-7300 and follow the emergency instructions to page the doctor.

We make every attempt to answer our emergency pages as promptly as possible. Occasionally, your messages do not reach us. If you do not hear back from us within one-half hour, please call back. Do this until the doctor has answered your call.

Click here to download and print these instructions.