POST-OP INSTRUCTIONS

Oral Health Department Simple Guidelines

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Post-Op Instructions

Post-Op Care for Your Extraction

  • Avoid disturbing the treatment area.
  • Avoid dislodging the clot with swishing or sucking through a straw.
  • Prevent toothpicks, eating utensils, or crunchy foods from making contact with the treated area.
  • Chew on the opposite side of your mouth for 24 hours.
  • Control bleeding with gauze and light pressure for 30 minutes after your procedure. Avoid removing the gauze during that time. The appearance of blood is normal for in the hours following your procedure.
  • Avoid smoking after your procedure for at least one week. The suction can dislodge the clot and you may also be susceptible to “dry socket.”.
  • Reduce your pain with over-the-counter pain relievers (Tylenol, Advil, non-aspirin pain relievers) every 4 hours or as directed until bedtime.
  • Apply an ice-bag to the facial area of your procedure in 15 minute increments for the first day following your procedure.
  • Expect numbness to last for a few hours following the procedure. Avoid chewing or biting until the anesthesia wears off.
  • Eat soft foods for the first 2 to 4 days, maintain a balanced diet, and drink plenty of water.
  • Avoid alcohol for 48 hours.
  • Avoid chewing directly on the area of your procedure.
  • Contact us if you have uncontrollable pain, excessive or severe bleeding, fever, excessive swelling, numbness that persists beyond 24 hours, or any reactions such as rash, itching, or breathing problems to medications.

Post-Op Care for Your Scaling and Root Planning Procedure

  • Avoid eating and chewing on the treated area for two hours following treatment or until your anesthesia wears off.
  • Avoid hard foods such as chips, popcorn, and seeds for several days.
  • Rinse your mouth two to three times per day with a warm salt water mix. Use one teaspoon of salt to three ounces of water.
  • Resume your home oral hygiene routine. Be gentle in the area of your treatment.
  • Avoid smoking for 24 to 48 hours after your procedure.
  • Use a non-aspirin pain reliever (Advil, Tylenol, etc.) according to your medical conditions.
  • Contact us if you have persistent discomfort or swelling following your procedure.

Post-Op Care for Your Dentures

  • Ease into your daily routines with your new dentures. Eat softer foods first and practice speaking.
  • Be patient with the adjustment period for fit and adapting to your gums.
  • Return to your dentist within a recommended period of days for an adjustment and progress observation. Inform your dentist about any soreness, loose fit, difficulty chewing or speaking.
  • Remove your dentures before bedtime.
  • Brush your dentures daily inside and out. Use a soft tooth brush or denture brush but do not use toothpaste.
  • Soak your denture occasionally in a cleansing solution.
  • Avoid dropping your dentures while cleaning. Clean them over a sink of water or a soft wash cloth.
  • Schedule annual check-ups with your dentist to check fit, make adjustments, and assure proper gum and bone tissue health.

Post-Op Care for Your Dental Crown and Bridge

  • If you required anesthesia, avoid eating until the anesthesia wears off.
  • Contact our dental office if your bite feels uneven. Schedule an adjustment to avoid unnecessary pain or discomfort.
  • Floss your permanent crown as you would your natural tooth. Use a floss threader to clean under your dental bridge.
  • Avoid eating hard food such as nuts, candies, and ice.
  • Consider the use of a night-guard if you clench or grind your teeth at night during sleep.
  • Expect some hot/cold sensitivity following your crown procedure.  You may take an over-the-counter analgesic (Tylenol, ibuprofen, Aleve, etc.) if needed.
  • If you experience any gum irritation, rinse your mouth two to three times per day with a warm salt water mix. Use one teaspoon of salt to three ounces of water.

Post-Op Care for Your Root Canal

  • Use an over-the-counter pain reliever within one hour following your procedure. This helps with any discomfort once the anesthesia begins to wear off.
  • Chew on the opposite side from the treatment area. Continue doing so until your permanent crown or filling is seated to avoid fracturing your tooth.
  • Avoid chewing gum, caramels, or other sticky candy that could dislodge your temporary crown or filling.
  • If you experience any gum irritation, rinse your mouth two to three times per day with a warm salt water mix. Use one teaspoon of salt to three ounces of water.

Post-Op Care for Your Filling

  • Expect some hot/cold sensitivity following your procedure.  You may take an over-the-counter analgesic (Tylenol, ibuprofen, Aleve, etc.) if needed.
  • If an amalgam filling was done, chew on the opposite side from the treatment area for 48 hours.  There are no special precautions needed for composite fillings.
  • If you experience any gum irritation, rinse your mouth two to three times per day with a warm salt water mix. Use one teaspoon of salt to three ounces of water.

Post-Op Care for Your Dental Cleaning

  • The most commonly experienced reaction is gum sensitivity. This may last a couple of days following your appointment. To reduce sensitivity, rinse with a warm salt water solution (½ tsp Salt in ½ cup of very warm water). Repeat rinsing several times a day. Ibuprofen every 4 to 6 hrs may be used as well.
  • Brushing and flossing may be uncomfortable for the first few days, but don’t stop brushing and flossing. Gentle home cleaning of your teeth and gums is the best treatment you can give your mouth at this time. Bleeding and soreness will gradually diminish over time.
  • Flossing is recommended at night after all meals and before brushing. “C” shape method is best- pulling the floss to the side of the tooth and sliding it up and down a few times before moving on to the next.
  • Brush at a 45 degree angle towards the gum line with little to no pressure morning and night for 2 minutes each time, brushing the top of the tongue or using a tongue scraper is also important to remove excess bacteria and “white film.”
  • Mouth rinse is beneficial for keeping bacteria at a minimum. I recommend using an alcohol free mouth rinse and one that contains fluoride.

Post-Op Care for Your Fluoride Varnish

  • Do not brush or floss for at least 4 hours.
  • Avoid products containing alcohol (i.e beverages, oral rinses, etc.) during the treatment period 4 hrs.
  • You will be able to feel the varnish on your teeth. At the completion of the treatment period you may brush and floss to remove any remaining varnish.

Post-Op Care for Your Dental Sealant

  • Eat soft food for the remainder of the day. Avoid foods such as popcorn, hard candy, ice, etc. Resume a normal diet the following day.
  • Resume normal brushing and oral hygiene today.
  • Your child may mention that the bite feels different. This is normal and will subside over the next few days as the excess material wears off, leaving only what is needed in the deepest grooves.
  • Please inform our office if the sealant is lost.

Post-op Instructions after Oral Surgery

DO NOT DISTURB THE AREA:  It is important to allow your body to form a clot and start the natural healing process. For the next 2-3 days, avoid swishing, sucking through a straw, and smoking as it can dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils).  Chew on the opposite side for 24 hours.

BLEEDING:  When you leave the office, you will be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 20 minutes. Don’t change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 20 minutes you may remove it. You may bite on gauze or a tea bag for another 30 minutes if you feel it is still bleeding.  Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

SMOKING:  Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful Dry Socket.

PAIN:  Some discomfort is normal after surgery. To minimize pain, take two Tylenol, Nuprin, Advil, or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

NAUSEA:  This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING:   Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, and then remove for 15 minutes. Continue this for the first day.

NUMBNESS:  The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area.  If numbness persists after the first postoperative day, please let us know.  On the rare occasions when this does occur, it is usually temporary in nature. 

BRUSHING:  Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.

RINSING:  Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 8 ounces warm water). Avoid commercial mouthrinses.

DIET:  Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

ACTIVITY:   After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

ANTIBIOTICS:  If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS:  If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

DISCOLORATION:  In some cases, discoloration of the skin follows swelling.  The development of black, blue, or yellow discoloration is due to a small amount of bleeding in the tissues just beneath the skin.  This is a normal post-operative occurrence, and it may not be noticed until 2-3 days post-operatively.  Moist heat applied to the area may speed up the removal of the discoloration.

INFECTION:  Infection is uncommon in routine tooth removal surgery, but on some occasions may still occur.  It is usually characterized by swelling that increases rather than decreases after the first several days.  If swelling is noted to increase after the first several days, contact the office.

OTHER COMPLICATIONS:

Slight elevation of temperature immediately following surgery is not uncommon.  If the temperature persists, or becomes higher than 101.5 degrees, notify the office.  Tylenol or ibuprofen should be taken to reduce the fever. 

Occasionally, patients may feel hard projections in the mouth with their tongue.  They are not roots, but are the bony walls that support the tooth.  These projections usually smooth out spontaneously.  They will sometimes become exposed over time and can feel sharp to the tongue.  If these sharp areas persist, contact the office, as they can sometimes be removed. 

If the corners of your mouth are stretched, they may dry out and crack.  Keep moist with an ointment such as Vaseline. 

Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery.  This is a normal post-operative event that will resolve in time.

FOLLOW-UP APPOINTMENTS:  You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.

Please call your dentist if you have:

  • uncontrollable pain
  • excessive or severe bleeding
  • marked fever
  • excessive warm swelling occurring a few days after the procedure
  • numbness that persists beyond 24 hours
  • reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.

Dentures – Home Care Instructions

The care and cleaning of dentures are important to the health of the oral tissues and the lifespan of the dental prosthetics.

Dentures MUST be left out at night; if not, underlying tissues become more prone to yeast infections, and shrinkage of the ridges may occur more rapidly, causing the dentures to need refitting or remaking more often.

Cleaning

  • A soft nylon brush, made for natural teeth, should be used to brush the tissues under the dentures and all other oral tissues daily. Holding the bristles under running hot tap water will soften them and make them more comfortable, no paste is needed. Besides brushing your ridges and roof of your mouth, it is also good to brush the top of your tongue and the inside of your cheeks.
  • A stiff denture brush and a toothpaste made for dentures should be used for brushing the dentures a minimum of two times per day – never miss at bedtime and after all meals is ideal.
  • If tartar (calculus) builds up on the denture, it can be removed by soaking the denture overnight in pure WHITE vinegar. Brush the denture again in the morning and rinse thoroughly before reinserting. It may take more than one night of soaking to remove all the calculus.
  • Stains from tea or coffee (or smoking!!) or certain foods or iron pills can be very hard to remove and often are not removed by regular brushing. Stains can be removed by occasionally soaking the denture in a 5-/50 mix of bleach of water – for just enough time to bleach out the stain. Check it every 15 minutes until the stain is gone, then rinse the denture well and throw away the solution.
  • During sleep, dentures must be left out, brushed and rinsed, stored in a denture bath of water and a squirt or two of liquid soap solution (use hand soap or dish soap). Rinse well in the morning before reinserting.

Eating

  • Stay with soft foods that are high in nutritive value until all sores are relieved and healed (1-3 weeks).
  • Consider taking a daily multiple vitamin.
  • Do NOT try difficult foods like apples or steak during the break-in period. Even after the break-in period, these difficult foods should be cut into small pieces before chewing. Let your fork and knife do much of the chewing for you.
  • Individuals with dentures are more prone to choking than those with natural teeth, so be careful. Do not speak and eat at the same time.
  • Chew your food well before attempting to swallow. Remember, it is perfectly normal for you not to be able to eat as well with your new dentures as you had been before, because it takes a lot of adapting for your tongue to get used to the new dentures and for your tongue and lips and cheeks to learn to balance the dentures in place.

Speech

Speaking with the new dentures may be more difficult for up to a few weeks, until your tongue adjusts to the new contour of your palate and lower jaw. It is common to whistle slightly on some sounds, especially “S” sounds; and also common to slur some words during this break-in period. Be patient and the adjustments will become automatic. If speech problems persist, many patients find it helpful to read out loud in front of a mirror, and to consciously try to adjust the sounds that do not sound normal to them. By practicing, the correction will be automatic.

Realistic Expectations

Complete dentures can only generate 20% masticatory forces (biting forces) at best; so it will take you about 5 chewing strokes to chew as well as one stroke when you had your own natural teeth.

Fit

Usually the complete upper denture will stay in by itself due to “suction” (border seal). Usually the lower will not stay in with suction because the center part is missing to create space for the tongue. If we cut the center part, the palate, out of the upper, it also would have no suction. Another thing that causes the lower to feel loose is the fact that the lower jaw is the one that moves during speech and eating, the upper is stationary. Also, the tongue is moving on the inside of the lower denture, constantly having a lifting effect. The solution to the lifting problem: If you ever wore an old pair of slippers, you know that you learned to keep them on by learning certain position of your toes that somehow gripped the slippers and kept them from falling off. In the same way, you must learn certain tongue positions that keep the lower denture from lifting. It is the tongue that keeps the denture in place. Denture adhesive should not be relied on to held the denture down, unless it is absolutely necessary. If you feel you must use it, use it sparingly, and any brand will do. Try a different one each time you buy some, and you will develop your own favorite brand.

Soreness

Movement of lower denture will cause soreness; it may take several adjustments. Please do NOT adjust these dentures yourself, as they may be damaged beyond what can be corrected. If you adjust your own denture, you will disqualify yourself from further professional adjustments in this clinic. We cannot replace dentures when the damage is caused by self-administered adjustments.

Cheek Biting

Cheek biting is very common in the first few weeks of wearing dentures. The dentist can adjust some of this problem, however, most of the time; the problem will correct itself as the muscles of your cheek become naturally tighter from wearing the dentures. Nature is not kind, however, and as we get older, more fatty tissue deposits inside our cheeks. Gravity pulls them down and they naturally get in the way of the teeth during chewing. To a large degree, there is nothing that can be practically done for this problem. Plastic surgery to remove some of this excess tissue can be considered. This problem occurs with natural teeth, as well as dentures.

Adjustments

You will be given adjustment appointments until no soreness is present; this may take one or several appointments. Adjustments are normal and it does not mean anything is wrong with your mouth or the dentures. Everyone’s mouth is different, and each denture is different, even on the same person. In between appointments, especially between the insertion and your first adjustment appointment, if you have significant soreness, you can purchase a tube of Benzodent at the pharmacy or grocery store. Squeeze some of the product from the tube onto the inside of the denture in the area where it hurts. Please do not use a substitute, like Oragel, because some patients experience a burning reaction from it.

After completion of all adjustments, you will be placed on a 6-month or yearly recall if possible, depending on your case. If you cannot be placed on a recall here, you should have your mouth and denture checked at least every year by a private dentist, to be sure all oral tissues remain healthy.

Old Dentures

Most old dentures should be kept as spares. When you get home, brush them as well as possible, and store them in a jar which has an airtight seal. Any small jar, like a peanut butter jar, with a wide opening, will do fine. Place the denture in the jar filled with water and dish soap – any brand will do – just put in several squirts. Seal the jar and keep in the event you need a spare, due to having your new ones repaired or relined.

Post-Op Care For Your Temporary Crown Or Bridge

Temporary crowns are cemented with a temporary dental cement to allow for easy removal at your next appointment. Temporary crowns are of universal size and shade. Your final restoration will be shaped and shaded to match your other teeth in both color and function.

  • If anesthesia was used, avoid chewing on the affected side until the numbness has worn off.
  • The gum tissue around the prepared tooth/teeth may be sore for several days. Rinse your mouth with warm salt water (1/2 teaspoon salt per 8 oz. water, rinse and spit) to facilitate healing.
  • Avoid hard or sticky foods that may dislodge temporary crowns, such as:

       ** Hard chewy breads (bagels, French bread)
       ** Hard foods (corn on the cob, apples)
       ** Chewy candies (taffy, caramels or gum)
       ** Hard crunchy foods (corn nuts or ice)

  • If a temporary crown becomes loose or comes off, try to place it back onto the tooth and call our office ASAP to have the crown re-cemented. In the meantime, use temporary cement (can be purchased at any drugstore) or denture adhesive to place the temporary back in place.
  • Acrylic temporaries attract more bacterial plaque than natural teeth; therefore it is important to brush normally, at least three times a day. Carefully floss at least once a day, pulling the floss out from the side of the temporary crown.
  • You may experience sensitivity to hot or cold foods or beverages after treatment. Use a desensitizing toothpaste if teeth are sensitive to heat or cold, but contact our office if sensitivity increases or persists beyond a few days.
  • Mild to moderate discomfort after dental work is common. An over the counter pain reliever/anti-inflammatory is recommended for patients who are able to tolerate them. (Tylenol™, Advil™, Aleve™, etc.) If discomfort increases, please call the office.

If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office.

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