- After Cosmetic Reconstruction
- After Crown or Bridge Visit
- After Root Canal Treatment
- After Teeth Extractions
- After Implant Surgery
- After Socket Bone Grafting
- Self Care Instructions for TMD
AFTER COSMETIC RECONSTRUCTION
Remember that it will take time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed it takes several days for the brain to recognize the new position of your teeth or their thickness as normal. If you continue to detect any high spots or problems with your bite, call our office so we can schedule an adjustment appointment. It is normal to experience some hot and cold sensitivity.
Care and Healing
The teeth require some time to heal after removal of tooth structure and will be sensitive in the interim. Your gums may also be sore for a few days. Warm salt water rinses (a teaspoon of salt in a cup of warm water) three times a day will reduce pain and swelling. A mild pain medication (one tablet of Tylenol or Ibuprofen [Motrin] every three to four hours) should ease any residual discomfort. Don't be concerned if your speech is affected for the first few days. You'll quickly adapt and be speaking normally. Your brain may respond to the new size and shape of your teeth by increasing saliva flow, but this should subside to normal within a week or so.
Daily brushing and flossing is a must for your new dental work. Daily plaque removal is critical for the long-term success of your new teeth, as are regular cleaning appointments.
Any food that can crack, chip or damage a natural tooth can do the same to your new teeth. Avoid hard foods and substances (such as beer nuts, peanut brittle, ice, fingernails, or pencils) and sticky candies. Smoking will stain your new teeth. Minimize or avoid your use of foods that stain such as coffee, red wine, tea, and berries.
If you engage in sports let us know so we can make a custom mouthguard. If you grind your teeth at night, wear the night guard we have custom fit for you. Adjusting to the look and feel of your new smile will take time. If you have any problems or concerns, please let us know. We always welcome your questions.
After composite filings (tooth colored restorations)
When an anesthetic has been used, your lips and tongue may be numb for several hours after the appointment. Avoid any chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue or lip while you are numb.
It is normal to experience some hot, cold & pressure sensitivity after your appointment. Injection sites may also be sore. If pressure sensitivity persists beyond a few days or if the sensitivity to hot or cold increases, contact our office.
You may chew with your composite fillings as soon as the anesthetic completely wears off, since they are fully set when you leave 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.
AFTER CROWN OR BRIDGE VISIT
Crowns and bridges usually take two or three appointments to complete. In the first visit the teeth are prepared and molds of the mouth are taken. Temporary crowns or bridges are placed to protect the teeth while the custom restoration is being made. Since the teeth will be anesthetized, the tongue, lips and roof of the mouth may be numb. Please refrain from eating and drinking hot beverages until the numbness is completely worn off.
Occasionally a temporary crown may come off. Call us if this happens and bring the temporary crown with you so we can re-cement it. It is very important for the temporary to stay in place, as it will prevent other teeth from moving and compromising the fit of your final restoration.
To keep your temporaries in place, avoid eating sticky foods (gum), hard foods, and if possible, chew on the opposite side of your mouth. It is important to brush normally, but floss carefully and don’t pull up on the floss which may dislodge the temporary but pull the floss out from the side of the temporary crown.
It is normal to experience some temperature and pressure sensitivity after each appointment. The sensitivity should subside a few weeks after the placement of the final restoration. Mild pain medications may also be used as directed by our office.
If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office.
AFTER ROOT CANAL TREATMENT
The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone.
It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time.
These symptoms are temporary and usually respond very well to over-the-counter pain medications.
If needed please take: Ibuprofen (Advil or Motrin) 200mg tablets
3 tablets (600mg total) 3-4 times a day (Breakfast, Lunch, Dinner and if necessary at Bedtime)
If you are allergic, have medical conditions or are taking prescribed medicine that prevents you from taking Ibuprofen (Advil or Motrin) then please take:
Tylenol Extra-Strength (Aspirin Free) 500mg tablets
2 tablets (1000mg total) 3 times a day (Breakfast, Lunch, Dinner).
Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, please contact our office.
Contact our office immediately if you develop any of the following:
- a visible swelling inside or outside of your mouth;
- an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction);
- a return of the original symptoms; or
- your bite feels uneven.
AFTER TEETH EXTRACTIONS
Normal oozing may occur for up to 24 hours or more following surgery and is controlled by firm biting pressure on several gauze pads placed over the tooth socket
Swelling and sometimes bruising are common after surgery. The maximum swelling, pain and jaw stiffness normally occurs 2 or 3 days after surgery. Apply ice packs for 15 minutes on then 15 off until bedtime on the day of the surgery. This will keep swelling to a minimum. Also keep your head elevated until bedtime. The greatest amount of discomfort is in the first 6 to 8 hours after surgery. Never take pain medication on an empty stomach. Take pain medicine only as directed. If itching or a rash develops, stop taking all medications and contact our office immediately.
Difficulty in opening the jaws is common after third molar (wisdom) extractions. Chewing gum at intervals will help with muscle soreness along with moist heat after 36 hours.
No rinsing or smoking for 24 hours following surgery. The day after surgery, rinse with a cup of warm water mixed with one teaspoon of salt five times a day for at least one week. Brush and floss as usual but avoid the surgical sites. The corners of your mouth may dry and crack so keep them moist with Vaseline.
It is important to maintain a good nutrition following surgery. Eat a lukewarm soft diet the day of surgery. Eat whatever you can the day after surgery but stay away from hard chewy foods and sharp foods (such as chips). Drink plenty of fluids.
Infection following surgery is rare but if swelling and discomfort worsens after the 4th day following surgery along with a foul taste, fever and difficulty swallowing, contact the office immediately.
Tea bags are useful to control bleeding at home. If bleeding seems to be excessive at home on the first night, wet a tea bag with warm water and place it over the bleeding area, bite down firmly for one to two hours and bleeding should stop.
AFTER IMPLANT SURGERY
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Sometimes there will be a metal healing abutment protruding through the gingival (gum) tissue.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. Sometimes placing a moist tea bag on the surgical site for 30 minutes will also stop the oozing of blood. If bleeding continues please call for further instructions.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice pack or a small bag of frozen peas on the cheek in the area of surgery. Apply the ice continuously (15 minutes on and 15 minutes off), as much as possible, for the first 36 hours.
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed. Make sure you chew on the opposite side of your surgical site.
You should begin taking pain medication before you feel the local anesthetic wearing off. For moderate pain, Ibuprofen (Advil or Motrin) may be taken. Ibuprofen, bought over the counter comes in 200 mg tablets: 3 tablets may be taken every 4–6 hours as needed for pain. If you are unable to take a NSAID (Ibuprofen, Motrin or Advil) please take 2 tablets of extra strength Tylenol three times a day. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.
Good oral hygiene is essential to good healing. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 3-4 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise
AFTER SOCKET BONE GRAFTING
The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant replacement of the extracted tooth.
Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by this. It’s normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:
- Do not disturb or touch the wound.
- Avoid rinsing or spitting for 2 days to allow blood clot and graft material stabilization.
- Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
- Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
- Do not smoke.
Following the second day, gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules. If a partial denture or a flipper was placed in your mouth, you may have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.
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.
SELF CARE INSTRUCTIONS FOR TMD
- Rest the jaw muscles and joints.
- Soft food diet: Limit crunch and chewy foods such as nuts, carrots, hard breads and gum.
- Chew food more slowly.
- Cut foods into bite size pieces for easier chewing.
- For specific jaw joint instability, chew on the unaffected side. Chewing on the unaffected side provides more joint protection and stability.
- Limit using your front teeth to bite into foods as this compresses your jaw joint.
- Check for clenching, tensing, and tongue bracing habits. The rest position of the jaw is with the teeth apart and the tongue relaxed. The only time the teeth should touch is briefly during swallowing and randomly during chewing. Ideally, the teeth should be together as little as 4-8 minutes in a 24-hour day.
- Limit prolonged or extreme opening.
- Control your jaw with your hand during yawning.
- Check with your dentist before proceeding with other dental procedures, as dental appointments may be contraindicated until your jaw condition is managed.
- New injuries or re-injuries apply cold to the painful area for 15-20 minutes for severe pain. Also, drink cold or icy drinks to chill the inside of the jaw.
- Apply moist heat for old injuries or chronic discomfort for 15-20 minutes for mild to moderate pain to increase circulation, relax muscles and promote healing.
- Massage the jaw and temple muscles.
- Avoid prolonged head positions where your head is forward, off to the side, or backward, such as looking up at someone.
- Avoid supporting your head by placing your chin in your hand.
- Sleep in a side-lying position with enough pillow support to maintain a level head and neck position. Hug a pillow for better upper body alignment. Place a pillow between your knees for better lower body balance and support.
- Participate in a relaxing activity each day.