Post-Operative Instructions

Crown and Fixed Partial Denture Procedures (Caps and Bridges)

Following the initial appointment for a crown or bridge procedure, a provisional temporary crown or bridge is usually placed on the tooth or teeth involved.

Occasionally, a temporary crown or bridge may come off. Call us if this happens, and bring the temporary with you so we can re-cement it. It is very important for the temporary to stay in place, as it will protect your teeth from shifting or moving, which may compromise the fit of the final restoration.

To keep your temporaries in place, AVOID eating sticky foods (including gum) and hard foods. If possible, chew on the opposite side of your mouth. It is important to brush normally, but floss carefully. We recommend that you pull the floss through the side of your teeth around the temporary because pulling upward on the floss may dislodge the temporary crown or bridge. After the appointment, it is normal to experience some temperature and pressure sensitivity with a tooth that was crowned, as well as with the adjacent teeth. The sensitivity should decrease in the next few days following an appointment. If the sensitivity does not improve, or if you feel like your bite has been compromised, please contact the office to schedule an appointment to check the bite and evaluate the temporary crown or bridge.

Once the final restoration is placed, please restrict yourself to a softer diet and allow twenty-four hours before chewing on that side (if possible).

Restorative Treatments (Fillings)

You may experience some minor sensitivity following treatment. This will diminish gradually over the next few days. You should wait to eat or drink until the anesthetic completely wears off to avoid biting your cheek or tongue. In the case where an amalgam (silver) filling is placed, avoid chewing on that side and generally have a softer diet for eight hours following your appointment. Your bite should feel comfortable after the anesthetic diminishes. If sensitivity to hot, cold, or bite pressure persists longer than one week, please call our office for a follow up evaluation and/or simple adjustment. The surface texture may feel different from your other teeth, but it will smooth with use.

Follow proper oral hygiene after treatment, such as brushing, flossing, and using a mouth rinse twice daily. Proper maintenance will not only prolong the life of the restoration, it will also help to prevent dental decay in other areas.

Oral surgery (e.g. Tooth extractions)

Our goal is for your healing process after an extraction to be as comfortable as possible. The removal of teeth is a surgical procedure, and proper post-operative care is imperative. Please follow all instructions carefully to avoid any unnecessary pain and possible infection.

If you have any difficulties or concerns following your surgery, please do not hesitate to call us or return to our office for a follow-up exam.

Immediately Following Surgery

  • Keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops.
  • It is advised that you take your prescribed medication as soon as you can following your procedure. Take your medication as prescribed to avoid feeling discomfort.
  • Do not suck on a straw, spit, or smoke.
  • Restrict your activities the day of surgery, and resume normal activity when you feel comfortable.
  • Place ice packs on the side of your face where surgery was performed. Refer to the section on swelling for an explanation.
  • For mild discomfort, use Ibuprofen (Advil, Motrin). DO NOT take more than 800mg every 4-6 hours.
  • Vigorous mouth rinsing or touching the affected area following surgery should be avoided. This may initiate bleeding caused by dislodging the blood clot that has formed as part of a typical healing process. Do not rinse your mouth for the first post-operative day or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and after meals to flush out particles of food and debris that may lodge in the area.
  • Restrict your diet to liquids and soft foods which are comfortable for you to eat.

Bleeding

A certain amount of bleeding is to be expected following a surgical procedure. Slight bleeding, oozing, or redness in the saliva is not uncommon. Bleeding is best controlled by the use of pressure. Excessive bleeding may be controlled by placing a gauze pad over the affected area and biting on the pad firmly for thirty minutes. Repeat if necessary. If bleeding has not decreased in 3-4 hours, bite on a dampened tea bag placed directly over the surgical site. The tannic acid in the tea helps the blood to clot.

Swelling

The amount of swelling that is normally expected after an extraction depends on the type of surgery. Swelling around the mouth, cheek, eyes, and side of the face is not uncommon. The swelling sometimes may not appear immediately, and it may occur up to 2-3 days post-surgery. You can help to minimize swelling by applying ice packs to the affected area. For the first 3 hours, apply the ice packs directly to the area, alternating on for 20 minutes then off for 20 minutes. Applying ice after 24 hours has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. If the swelling is significant, you may use a moist heat compress to help suppress it.

Pain

Post-operative pain will be the most severe the first day after surgery. It is beneficial to take your pain medication before your numbness wears off. For moderate pain, 600mg of Ibuprofen (Motrin or Advil) may be taken every 4-6 hours. For severe pain, take the prescribed medication that was provided. DO NOT take this pain medication on an empty stomach as nausea may result. The prescribed medicine may make you drowsy. DO NOT drive an automobile or operate machinery, and AVOID alcoholic beverages. Pain or discomfort following surgery should subside more and more each day. If pain persists, it may require attention, and you should contact our office.

Antibiotics

If you have been placed on antibiotics, take the medicine as directed. Antibiotics may be prescribed to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. PLEASE NOTE: If you are currently taking birth control pills, they may be inactivated by the antibiotic.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, DO NOT take anything by mouth for at least an hour, including the prescribed medication. You should then sip on water, tea, or juice. Sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medication.

Sutures

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.

Activity

Over-exertion may start or intensify your pain. AVOID excessive work or play. It is not necessary to stay indoors following uncomplicated surgery. However, rest and minimal activity will help to minimize pain, swelling, and bleeding. Normal activity may be resumed the following day as tolerated.

Cleaning

Do not rinse or spit vigorously for the first 24 hours following surgery. You can brush your teeth the night of the surgery, but rinse gently. The day after surgery, you should begin rinsing four times a day and after eating. Do this gently as to not dislodge the blood clot. To rinse, mix a teaspoon of salt and a cup of warm water. DO NOT use a non-prescription rinse for 24 hours after surgery. Clean the rest of your mouth as usual.

Diet

It is advisable to eat only soft, non-spicy food for the first few days following surgery. AVOID hot food or liquid that could agitate the already inflamed area. AVOID foods that are very small as they may become lodged in the area.

Special Considerations

Trismus (stiffness) in the face muscles may cause difficulty in opening your mouth for a period of days. Moist heat compresses can minimize this condition. You may experience aching from other teeth. This discomfort is caused by referred pain and is a temporary condition. It is not unusual to develop bruising in the area of the extraction. There may be a slight elevation in temperature for 24-48 hours. If the fever persists, please contact our office.

Dry Socket

A “dry socket” is the loss of the blood clot in the socket. This condition delays healing at the extraction site and presents symptoms such as pain in the ear, chin, adjacent teeth, and jaw. The discomfort usually begins about the third or fourth day after the surgery and can last for many days. The cause of a dry socket is unknown, but it can be attributed to the difficulty of the surgery, increased age, medications (such as birth control pills), and smoking. Treatment is for the symptoms only.

Root canal Therapy

When Root Canal Therapy is performed on a tooth, the nerve, blood, and nutrient supply to the tooth, as well as some hard tissue, are removed. This may causes the tooth to become more prone to fracture. If a crown (cap) is needed to prevent the tooth from breaking it will be advised at the time of the procedure. In the meantime, AVOID nuts and hard, crunchy food that could break the remaining tooth structure.

While you are still anesthetized, AVOID eating and drinking in the area, as you may bite your lip or tongue.

You may experience some discomfort on the tooth that has been treated. This may last between 3-7 days. Some swelling in the affected area is unlikely but possible.

Please continue any medication that was prescribed, unless otherwise instructed by the doctor.

In some cases a temporary filling will be used to seal the access in the tooth. This temporary material may chip or wear away. It is only a problem if it becomes uncomfortable for you. If this happens, we can adjust the temporary filling for you to make you more comfortable. In such cases, be sure to schedule your next appointment for the final restoration. Remember, if you have any questions or concerns regarding your treatment, please do not hesitate to contact our office.

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