Post Operative Instructions and Specialist Information

Root Canal Therapy - Endodontic Treatment

Surgical Procedure:

This procedure will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. Our Manus dentist will be available for consultation at all times should a problem arise after your treatment.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.

Please eat a full breakfast or lunch as applicable.

If you have been advised by your physician or dentist to use antibiotic premedication because of Mitral Valve Prolapse (MVP), heart murmur, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment.

If you can take ibuprofen (Advil) or naproxen sodium (Aleve), it does help reduce inflammation when taken preoperatively. We recommend 2 tablets of either medication 2-4 hours before endodontic therapy.

General Instructions:

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and previous condition of your tooth. This tenderness is normal and is no cause for alarm.

Do not chew food on the affected side until your endodontic therapy is completed and your tooth is covered with a protective restoration provided by your restorative dentist.

You may continue your regular dental hygiene regimen. Discomfort may be alleviated by taking ibuprofen (Advil), aspirin, or acetaminophen (Tylenol) as directed. NOTE: Alcohol intake is not advised while taking any of these medications.

Should you experience discomfort that cannot be controlled with the above listed medications, or should swelling develop, please contact our office immediately. Our Dr. can be paged 24 hours a day.

After Completion of Endodontic Treatment:

Following your endodontic treatment the root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. Placing this permanent restoration is one of procedures we specialize in at Manus. In most cases your endodontic treatment will be performed by a Manus dentist and therefore a follow up appointment for this permanent restoration will be made at the time of your root canal. If an outside referring dentist was needed we will coordinate all x-rays and appointment arrangements to make this process as pain-free as possible.

Cosmetic Procedures

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. 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 3-4 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. You may notice increased salivation. This is because your brain is responding to the new size and shape of your teeth. This should subside to normal in about a week.

Daily brushing and flossing are 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 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 provided 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 fillings (white fillings)

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.

Ibuprofen (Motrin), Tylenol or aspirin (one tablet every 3-4 hours as needed for pain) work well to alleviate the tenderness.

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.

Surgical Procedures

Preoperative Instructions

You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.

The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.

Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery.

The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

• The surgical area will swell.
• Swelling peaks on the 2nd or 3rd post-operative day
• Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a few days.
• You may have a slight earache.
• A sore throat may develop.
• Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
• If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
• There will be a space where the tooth was removed. After 24 hours this area should be rinsed following meals with warm salt water until it is healed. This cavity will gradually fill in with new tissue.
• There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
• It is not unusual to develop bruising in the area of an extraction.

Please take all prescriptions as directed.

Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

Post Operative Instructions

• Do not rinse or spit for 24 hours after surgery.
• Keep fingers and tongue away from socket or surgical area.
• Use ice packs on surgical area (side of face) for first 48 hours, apply ice 20 minutes on — 10 minutes off. Bags of frozen peas work well.
• For mild discomfort take Tylenol or Ibuprofen every three to four hours.
• For severe pain use the medication prescribed y applying pressure to the surgical area using small rolled gauze for 90 minutes.
• After that time remove the gauze and then you may eat or drink.
• If bleeding persists, a moist teabag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists call our office.
• We suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a "dry-socket".

To Relieve Pain

Immediately following the procedure... begin taking medication as directed by your doctor to minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an ice bag can also help relieve discomfort.

After 24 hours, continue to take your medication if pain persists, and use an ice bag if needed.

To Minimize Swelling

Immediately following procedure apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 24 hours to help prevent excessive swelling and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice. Tie end securely and cover with a soft cloth to avoid skin irritation.

After 24 hours. . . it should not be necessary to continue with cold applications. You may expect swelling for 10 days to two weeks and a fever of 99 to 100 degrees Fahrenheit.

Feel free to contact us if any doubt arises as to your progress and recovery.

Removal of Impacted Teeth:

• Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications.
• Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.
• Healing of the surgical site is variable.
• Swelling can be expected. Be certain to apply ice bags as directed above.
• Difficulty in opening your mouth widely and discomfort upon swallowing should Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.

Oral hygiene is important

Twenty-four hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing.

Brush tongue with a dry toothbrush to keep bacteria growth down, but be careful not to touch the extraction site.

Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot.

Maintain a proper diet

Eat soft, nutritious foods and drink plenty of liquids — with meals and in between.
Have what you wish, but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.

In case of problems

You should experience no trouble if you follow the instructions and suggestions as outlined. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment.

Remember your follow-up visit

Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.