Post Treatment Instructions

Temporary Crowns or Bridges

You have just received a temporary crown. This temporary crown is meant only to serve your needs while a permanent crown is being made for you.

Color: The color of the plastic temporary crown does not resemble the final (permanent) crown in any way.

Shape and Size: Temporary crowns are custom-made for each patient but they will not be like the final crown, which indeed is being made especially for you.

Here are some other things you need to know about your temporary crown:

Your gums and teeth may be very tender after tooth crown preparations. Mix one teaspoon salt in an 8 ounce glass of warm water and swish. Do this 2 to 3 times a day. You can expect your tooth to be sensitive to temperature change for awhile.

When brushing, use a soft bristled brush. Gently massage gums and teeth as instructed in hygiene.

Avoid sticky foods (gum, taffy, caramels, etc.) chewing ice, nuts and hard candy.

Floss your temporary crowns gently. Just clean and pull floss out to the side, so crown will not “pop off”.

If the nerves of your teeth were unhealthy before treatment, they may become symptomatic at this time. If the tooth does not settle down after the initial tenderness, please contact us.

Temporary crowns are not strong. They may occasionally break or come of. If this should happen to you, please contact our office immediately, bring your crown with you and we will replace it. Should you be unable to contact us, simply go to a pharmacy and get some Fixodent or a commercial product especially made to reseat your temporary crown. Replace the temporary crown on your tooth using the Fixodent to hold it in place until you can contact us.

What To Do After Dental Surgery

Here are some tips on helping you recover from dental surgery:

Get your prescriptions filled and take as instructed. Each one is very important. Be sure to take at least 1 pain pill before numbness wears off. Take 2 grams of Vitamin C each day until fully healed.

Bleeding — some bleeding is to be expected. Oozing of blood will be greatly exaggerated when it dissolves in saliva. If you do not have a dressing on, then take gauze and press firmly for 30 minutes. That pressure will help form a clot.

If you have a dressing on, do not disturb it for 2 days. If it works off after that, do not be concerned. It helps soothe, protect and position your gums during the first couple of days.

Apply ice to your face near the surgical area. A bag of crushed ice in a towel will do. Apply 15 minutes on, then 15 minutes off, for the first 24 hours.

Do not smoke, drink alcohol, or carbonated beverages for at least 24 hours.

Tomorrow morning, rinse your mouth gently with warm salt water. Repeat every 3 or 4 hours, especially after meals, using 1/4 teaspoon of salt to a glass of warm water. Continue until healing is complete.

Food — for the first couple of days chew soft food until it is comfortable to chew your normal diet.

Cleaning — as soon as you are allowed to clean the surgical area, clean gently at first, then as vigorously as you can tolerate as it heals. The purpose of surgery was to make it easier for you to maintain your own health so the earlier the better.

We must see you several times after surgery and follow up until you heal. It is very important that we follow the healing process and direct your home care. We both went to a lot of trouble to get to this point and your cooperation and effort will determine our success.

General Post-operative Instructions for Oral Surgery

Medications

Patients taking medications to relieve pain or other drugs that may impair reflexes should not operate machinery, cars, et., while taking these drugs. Antibiotics should be taken as directed until this prescription runs out. Antibiotics may impair the efficiency of oral contraceptives for the duration of the present cycle.

Extractions and Impactions

1. Bleeding

A certain amount of bleeding is expected and the saliva may be tinged for 24 to 48 hours. Firm gauze should be maintained on the extraction sockets for three hours after the extraction. If bleeding is persistent, it should be controlled by placing a piece of sterile gauze or a moist tea bag over the wound and biting on it for 1 hour. Repeat if necessary. Do not rinse your mouth. It is important that the gauze be placed directly over the site where the tooth was removed and not over the adjacent teeth. The gauze must be bulky enough to prevent the upper and lower teeth from meeting when biting firmly.

If bleeding persists after proceeding as above, examine the surgical site for an extruded clot. This is a mass of dark colored rubbery material which projects from the surgical site and may extend along adjacent teeth. If this is present, remove all of it by wiping the area with a piece of dry gauze. Then rinse the mouth vigorously with warm water to remove any further remnants of extruded clot. Proceed again as in part 1.a.

2. Pain

This can be controlled by taking 2 Iburprofen or Tylenol capsules every 3-4 hours if necessary. You have been given a prescription for relief of pain. Use this prescription as directed. The pain medication should be taken with some food. Avoid alcoholic beverages.

3. Swelling

Apply ice to face in the area of the surgery for a period of 20 minutes on and 20 minutes off, for the first 3 hours after the surgery, while awake. Swelling is not uncommon after surgery. It is usually moderate within 48 hours and may last several days thereafter. Discoloration of the skin of the face and neck may occur within 10 days following surgery and should be no cause for alarm.

4. Mouth Rinse

Do not rinse the mouth within 24 hours after surgery. After this time use one half teaspoon of salt plus two tablespoons hydrogen peroxide in a glass of warm water and rinse gently after each meal. Patients who have had impacted teeth removed, should rinse after eating for approximately six weeks.

5. Diet

Cold, soft and bland foods are advisable for the first 24 hours. Good nutrition post-surgery is essential. Do not use a straw for drinking. Smoking can delay healing. Avoid peanuts and other hard foods for 4 weeks.

6. Hygiene

Continued proper oral hygiene is imperative. Normal care should be maintained, but the surgical area should be excluded from care involved when brushing, flossing, dental irrigation appliances, etc. until advised.

7. Exercise

It will be beneficial to exercise your jaw by chewing sugarless gum starting 24 hours after the extraction and lasting for approximately one week.

8. Fever

A low grade fever may occur following surgery for 2 or 3 days and should be no cause for alarm.

Incision and Drainage

Rinse mouth 3 or 4 times per day with one half teaspoon of table salt and 2 tablespoons of hydrogen peroxide in a glass of warm water and start rinsing immediately after surgery.

Do not apply ice to face.

If the drain inserted falls out or extrudes, do not become alarmed. This is normal.

You may be aware of drainage from the incision for a few days after surgery.

Pain, diet, hygiene, fever, unusual disturbance — see instructions for impactions and extractions.

Apiccoectomy, Root Resection and Soft Tissue Surgery

Bleeding

A certain amount of bleeding is expected, and the saliva may be blood tinged for up to 48 hours. If bleeding persists it can be controlled by placing a piece of gauze on the surgical site and press-on for about 15 minutes. Repeat if necessary.

Pain and Swelling

See instructions for impactions and extractions.

Mouth Rinse, Hygiene, Pain, Diet, Fever, Unusual Disturbance

See instructions for impactions and extractions.

Aftercare Following Root Canal

What To Expect

Antibiotics and other medications – These should be taken as prescribed and completed. This will aid in reducing the chance of swelling and reinfection.

It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root-canal therapy. This should subside within one week.

Your tooth will be sensitive to biting pressure and may even appear to feel loose. This feeling is result of the sensitivity of nerve-endings in the tissue just outside the end of the root, where we cleaned, irrigated, and placed filler and sealer material. This feeling will be short-lived.

Whenever possible, try to chew on the opposite side from the tooth we have just treated, until you have a crown or onlay placed. Until that time, your tooth still is weakened and could fracture.

Avoid chewing gum, caramels, or other sticky, soft candy, which could dislodge the temporary material or fracture your tooth.

You may feel a depression or rough area (on the top of a back tooth or the back of a front tooth) where our access was made. There is a soft, temporary material in that area, which may wear away to some degree before your next visit.

Occasionally, a small “bubble” or “pimple” will appear on the gum tissue within a few days after completion of a root canal. This represents the release of pressure and bacteria which no longer can be sustained around the tooth. This should disappear within a few days.

Second Appointment – It sometimes takes two or more appointments to start and finish a root canal. Failure to have a root canal finished will result in the loss of your tooth.

Restoration – After a root canal is finished, you usually need to have a core and a crown placed on the tooth. A core builds and restores the strength to the inside of the tooth. Under certain circumstances a filling can be placed. There is a separate fee for a core, a crown, or a permanent filling.

Your New Complete Dentures

We have done our best to provide you with well fitted, functional, and esthetic dentures. We feel confident that after a few weeks of becoming adjusted to the new dentures, you will have years of satisfaction and use from them.

The following information will be helpful to you at this time:

1. YOUR FIRST FEW WEEKS: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.

2. SORE SPOTS: Usually, your mouth will have a few “sore spots” after wearing the dentures for 24 hours. Don’t worry about these areas. They can be relieved with very little effort on your next appointment. Another appointment will usually eliminate any other sore areas.

3. CHEWING: The new “bite” or occlusion will not feel comfortable for a period of days. We will adjust the contacting surfaces of your teeth after 24 hours and again in about one week after the dentures have “settled” into place.

4. UPPER VS LOWER DENTURES: Your upper denture will rest comfortably in place with moderate to strong “suction”. Although your lower denture will have good stability, it is infrequent that “suction” can be expected on a lower denture.

5. CLEANING THE DENTURES AND YOUR MOUTH: Your dentures can be cleaned easily by using a denture brush and a mild toothpaste. Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush daily to toughen and clean them. You may leave the dentures in or out of your mouth at night depending on your preference. They are best left out. If they are out of your mouth leave them soaking in water or a cleaning solution.

6. THE FUTURE: Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This is one of the main disadvantages of dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated once per year by us. We will inform you when relining or rebasing the dentures is necessary. Wearing ill fitting dentures for too long without refitting can cause sever bone loss and very serious oral diseases.

We look forward to helping you adjust to and enjoy your new dentures.

Self Care for TMD Patients

(TMJ AND MYO-FACIAL PAIN)

TMD (temporomandibular disorder) problems can be more successfully treated with your help and cooperation. Following these tips will help to alleviate most symptoms.

1. REST THE MUSCLES AND JOINTS:
This will allow healing. Rest includes:
a. EATING SOFT FOODS: Avoid crunchy and chewy foods like hard nuts, chips, carrots, and hard breads.
b. NO CHEWING GUM
c. AVOIDING CLENCHING OR TENSING: Learn to say “teeth apart and jaw relaxed.”

2. AVOID OPENING TOO WIDE:
This protects the joints, preventing them from locking open and includes:
a. CONTROLLING YAWNS: Limit how far your mouth opens during a yawn, so that you are forced to yawn against pressure.
b. AVOIDING GENERAL ANESTHESIA: When possible as there is a tendency to put pressure on the jaw joint.
c. EATING IN SMALL BITES.

3. APPLY COLD:
For sever pain, new injuries (less than 72 hours) and reinjured areas, apply cold for 5-10 minutes. Off and on for an hours. Twice a day.

4. APPLY MOIST HEAT:
To promote healing, apply moist heat for 10 minutes for mild to moderate pain to increase circulation and muscle relaxation 72 hours after the injury. You can heat a moist towel in the microwave for the source of moist heat.

5. MASSAGE THE JAW AND TEMPLE MUSCLES:
This action stimulates circulation, relaxes muscles and decreases soreness. You can release the tension in the muscles using some simple exercises. One good one is to place your elbow on a table and put your fist under your chin. Force the jaw open against this constant pressure. This action forces the muscles of closure to relax. If you are having trouble opening, try to gently increase the amount of opening several times a day to stretch the muscles.

6. MAINTAIN GOOD POSTURE:
Avoid a forward head posture which may increase jaw and neck muscle activity and soreness.

7 HOLD THE PHONE:
Do not cradle the phone. Cradling irritates the jaw and neck muscles.

8. SLEEP ON YOUR SIDE:
Lie on your side with a pillow between your neck and shoulders and a soft support along the face and jaw.

9. EXERCISE REGULARLY:
Exercise 3-4 times a week for 20-30 minutes. Choose low impact type exercise to minimize pressure on the joints.

10. PRACTICE STRESS REDUCTION:
Strive to reduce the stress on your life. Stress may cause an increase in clenching and grinding.

11. EAT WELL:
Good nutrition promotes joint and muscle healing. Certain foods, such as those containing sugar and caffeine, may increase muscle tension and increase the clenching and grinding habits. These foods are worse if consumed later in the day.

12. WEAR YOUR NIGHT GUARD/BITE APPLIANCE AS INSTRUCTED:
You may be able to function well with only nightly use. If symptoms are more severe, you may at first need to wear the bite appliance around the clock until your symptoms subside.

13. TAKE MEDICATIONS AS PRESCRIBED:
Initially, we may give you a prescription for a muscle relaxant to temporarily decrease muscle tension and break the pain cycle. Take the medication only as prescribed. An anti-inflammatory drug such as ADVIL might be recommended to help with the pain and decrease the inflammation. Do not take this medication if you have any aspirin allergies or stomach problems.

PLEASE NOTE:
If your symptoms worsen instead of getting better, please inform us immediately.