Post Treatment Dental Care Guidelines

Below we have added a few guidelines for you to follow after having received dental treatment at our hospital. These guides will help you recover quickly and reduce risk of complications

1. After Tooth Extraction
2. After Oral Surgery
3. After Root Canal Treatment
4. After Scaling or Periodontal Surgery
5. Local Anesthesia
6. Oral Sedation
7. General Anesthesia/IV Sedation
8. Laser Dentistry - Periodontal Surgery
9. Flap Surgery
10. Veneers
11. Crowns
12. Dentures
13. Dental Implants or Bone Grafting Surgery

Tooth Extraction Post Op Instructions

1. Firmly bite the gauze placed over the wound for one hour (1/2 hour for a baby tooth) to help the bleeding stop. If bleeding persists, change to a new gauze and continue biting firmly for another 1/2 to one hour or until the bleeding stops.
2. Do not rinse your mouth vigorously for 24 hours after the treatment. Keep your teeth and mouth clean by brushing gently after meals, but avoid touching the wound.
3. During the first week after treatment, gently rinse your mouth with warm salt water (1/2 teaspoon of salt with 1 glass of warm water) several times a day to help heal the wound.
4. Take medications as prescribed by the dentist
   • Pain relief medication: Take 1-2 tablets only when necessary.
   • Antibiotics (prescribed in some cases): Please take the complete dosage prescribed.

(Root Canal Therapy or Retreatment)

Pre -Treatment Instructions

• Get a good night’s rest.
• Eat breakfeast and or lunch prior to your visit.
• Take your normal medications.
• If your orthopedist or cardiologist have advised taking antibiotics prior to dental treatment, please do so.
• Bring a list of your medications, including supplements, and herbal remedies.
• Bring your referral form, and dental insurance information.
• If you are a minor, have a parent and guardian remain during your visit.
• Feel free to return to work or school after your treatment.
• Avoid scheduling treatment prior to any important events.
• Please refrain from wearing perfumes and colognes.

Post-Treatment Instructions

• After your visit, avoid eating for 60 minutes. Avoid hard foods such as pretzels, peanuts, hard candy until you visit your general dentist.
• It is common for your tooth to be sensitive to touch, biting, chewing and tapping. Sensitivity usually subsides in a few days, but may continue for weeks. Avoid chewing on that side of your mouth. Improvement is gradual. If swelling and pain occur call our office immediately.
• Rinse your mouth with saline rinses 5 times daily for 3 days. (1/2 teaspoon salt with 8oz. warm water), brush carefully.
• DO NOT APPLY HOT OR COLD COMPRESSES TO THE OUTSIDE OF YOUR FACE.
• Reduce discomfort by taking 600 mg of ibuprofen OR 1000mg acetaminophen (Extra strength Paracetamol) every 6 hours for 3 days. If symptoms persist call our office.
• Take all medications prescribed by Dr. Anshu.
• Visit your dentist as soon as possible for a permanent restoration or crown. Recommendation is within 2-4 weeks.

For Surgical Procedures (such as Apicoectomy - Root Canal)

Pre & Post-Operative Surgical Instructions

• Get a good night’s rest.
• Eat a light meal prior to your surgery, and take your normal medications.
• If your orthopedist or cardiologist have advised taking antibiotics prior to dental treatment, please do so.
• After your surgery, do not pull or lift your lip in order to keep the sutures intact, mild swelling, bleeding and discoloration is normal.
• You will be given an ice pack to take home with you, place the pack on your face for 20 minutes and remove for 90 minutes. Use the ice pack throughout the day until bedtime.
• The next morning, begin saline rinses (1/2 teaspoon salt with 8oz. warm water) rinse 5 times daily for 7 days.
• Eat a soft diet, and brush your teeth while being very careful at the surgical site. Diluted mouthwash may be used on the 5th day.
• Reduce discomfort by taking 600mg of ibuprofen OR 1000mg acetaminophen (Extra strength Paracetamol) every 6 hours for 3 days.
• A post-operative appointment will be scheduled.

Oral Surgery Post Op Instructions

Follow the same procedures as for a tooth extraction, but with the following additional recommendations:

1. On the first day after the surgery, even if there is no swelling, apply a cold pack (or ice wrapped in a small towel) to the area of the face closest to the wound to help reduce swelling.
2. The swelling usually starts on the second day after the surgery and continues throughout the first week. During this time, limit strenuous exercise and water sports.
3. Maintain a soft food diet during the first week.
4. If indicated by your dentist, return to the dentist at the end of the first week for suture removal.

Scaling or Periodontal Surgery Post Op Instructions

1. Teeth sensitivity and slight discomfort of the gums are common symptoms during the first few days after scaling. Avoid sour tasting food and extremely cold or hot food during this period.
2. Maintain a soft food diet for the first week after gum surgery. During this period, limit strenuous exercise and water sports.
3. Do not rinse your mouth vigorously after gum surgery for 24 hours. Keep your teeth and mouth clean by brushing gently after meals, but avoid touching the wound.
4. Take medications as prescribed
• Pain relief medication: Take 1-2 tablets only when necessary.
• Antibiotics (prescribed in some cases): Must take the complete dosage prescribed.
• Use special mouth-rinse as recommended by your dentist.

Local Anesthesia Post Op Instructions

Following local anesthesia, special attention is required for young children, elderly patients and medically compromised patients

1. To avoid injury to the inside of the mouth, there should be no chewing or biting of lips, cheeks or tongue while the area is still numb. The numbness will gradually wear off in 2-3 hours.
2. During the first 24 hours, chew food by using teeth on the side of the mouth that did not receive treatment.
3. If lips or tongue have been accidentally bitten, the wound may be swollen with white or yellowish plaque covering it. Do not rub or apply any medication to the wound. The wound will disappear by itself in approximately 7-10 days without scar. Pain relief medication can be taken if necessary.

Oral Sedation Post Op Instructions

Pre-operation Instructions:

1. Do not eat or drink anything (except plain water) for at least four hours prior to the appointment.
2. If you develop a fever or cold before the appointment, please contact Advanced Dental Center. If your child is the patient and he or she develops a fever or cold, contact the pediatric surgeon at the Center.
3. After taking oral sedation medication, children may appear agitated and cry before being completely sedated.

Post-operation Instructions:

1. There should be more than one adult accompanying a child home so that the non driver can care for him/her during the trip. If you are the patient, be sure you have arranged for transportation.
2. Patients are placed in a comfortable position until fully awake after an operation.
3. Upon awakening, patients may drink and eat, but only a soft food diet is recommended during the first day.
4. It is common for some patients to remain asleep almost the entire day. To prevent dehydration, the patient should be awakened within 4 hours after the treatment to be given liquid or soft food.

General Anesthesia/Intramuscular (IM) or Intravenous (IV) Sedation

Pre-operation Instructions:

1. Patients must have a complete physical examination (including lab work if indicated) within 7 days of the operation.
2. If the patient develops a cold, fever or any other reasons that would defer the appointment, please contact us immediately to consult the dentist. If it is necessary to re-schedule, our staff will notify all doctors and personnel involved.
3. For patient safety, please strictly follow these instructions:
   • If the patient is less than four years old, he/she should not eat or drink for six hours (four hours for water) prior to the appointment.
   • If the patient is more than four years old, he or she should not eat or drink for eight hours (six hours for water) prior to the appointment.

Post-operation Instructions:

1. In most cases, patients will be able to return home after becoming fully alert (usually takes approximately one hour after the procedure). There should be more than one adult accompanying the patient home so that the non-driver can care for the patient during the trip.
2. Common side effects include:
   • Nausea and Vomiting: This is common during the first 1-2 hours after the procedure. Avoid eating or drinking excessive amounts of water or food during this period.
   • Fever: A small child may develop a slight fever from dehydration. In this case, frequent consumption of liquid is recommended along with fever relief medication.
   • Sore Throat: Small sips of water are allowed after awakening. A soft food diet is recommended during the first day.
   • Discomfort and Pain: If the procedure includes oral surgery or the removal of several teeth, please follow the instructions of the oral surgeon. Take pain relief medication as necessary.
3. Keep the mouth clean by brushing with a soft toothbrush after meals.
4. Patients can go back to normal activities the day following surgery unless notified otherwise by the oral surgeon.

Laser Dentistry - Periodontal Surgery - Post Op Instructions

Vitamins, dietary supplements, or medications may be prescribed to improve your overall health. Take any prescribed medication according to directions.

Dental laser procedures result in little or no discomfort following surgery. Take prescribed pain medications according to instructions if needed.

For the first 24 hour period immediately following surgery, stay on a liquid diet only. For the following 3-7 days after surgery, a soft diet is recommended. Try to eat soft but nutritious foods such as eggs, yogurt, cottage cheese, smoothies, etc. Stay away from spicy and "chippy" foods and always maintain good fluid intake during this period.

Carefully avoid chewing food in the areas of the mouth where the laser has been used. One of the most important results of laser surgery is the healing that occurs following the initial procedure. It is extremely important not to dislodge the tiny clots (scabs) that form in the gums. Do not apply excessive tongue or cheek pressure to the surgerized area.

Daily Care:

Brush the teeth by placing the bristles of the brush on the gums below the tooth and carefully rolling the bristles toward the tooth surface. Do not stick the bristles into the gums. 
Brush the chewing surfaces of the teeth. 
Try to keep your mouth as clean as possible in order to help the healing process. Brush and follow other home care instructions in all areas of the mouth except for the surgerized area.

Do not be alarmed with any color changes or appearance of tissues following laser therapy. Tissues can be gray, yellow, red, purple, "stringy" and reflect normal response to laser treatment.

Reduce activity for several hours following surgery.

It is OK to spit, rinse, and wash your mouth today. Rinse as directed with Peridex morning and night. It is OK to gently rinse with warm salt water every three (3) hours.

Do not eat spicy or very hot (temperature) foods.

Do not be alarmed if one of the following occurs: light bleeding or swelling, some soreness, tenderness or tooth sensitivity and a medicinal taste from the Peridex.

If your doctor determines you need it, a surgical pack will be placed on the area to prevent food, trauma, and/or smoke from irritating the tissues. If a piece of the pack falls out, or the entire pack loosens, do not be alarmed.

Swelling may possibly occur. To keep this at a minimum, gently place an ice pack outside the face for 20 minutes each hour until you retire for sleep at night. Do not continue using the ice pack beyond the day of the surgery.

Some oozing of blood may occur and will appear to be greatly exaggerated when it dissolves in saliva. If excessive bleeding occurs, call the office.

Please call the clinic if any of the following occurs:

• Prolonged or severe pain
• Prolonged or excessive bleeding
• Considerably elevated or persistent temperature

Do not be alarmed that beginning with just 2 weeks after surgery and extending for as long as 1 year or more, the teeth may become sore, tender, or sensitive as the bones and ligaments around the teeth regenerate and become more firm. This is a sign of healing, but also may indicate that presence of a bite imbalance which will need to be adjusted.

Flap Surgery Post Op Instructions

ACTIVITY: Following your procedure, we suggest you consider relaxing or at least limiting your activity as much as possible for the remainder of the day. Avoid strenuous activity and aerobic exercise for the next 3 days.

DISCOMFORT: Some discomfort may be present when the anesthesia wears off. You have been given a prescription for moderate discomfort. Please take this as directed for 1-2 days. This drug will greatly decrease the possibility of post-surgical swelling and pain and has been shown to accelerate healing. After the first few days, 2 Tylenol, or 2 Advil taken every 4-6 hours as needed, should keep you comfortable. Should intense discomfort occur at any time after the surgery, please contact the office.

INFECTION: If you have been given an antibiotic please continue taking it as directed until all of the tablets have been taken. If you notice that after a few days, pain or swelling are increasing, or that you are experiencing an elevated temperature, please call the doctor.

SWELLING: It is normal for some swelling to occur after surgery, particularly in the lower jaw. To minimize swelling after surgery, apply an ice bag wrapped in a light towel or handkerchief to the outside of your face over the operated area. This should be left on your face for about 10 minutes, then removed for 20 minutes, or alternated from side-to-side, between operated areas, for 12-24 hours after surgery. The use of both ice and the analgesic as described above will reduce the amount and duration of facial swelling. Please do not be concerned if mild to moderate swelling continues to increase for up to 4 days following your procedure.

BLEEDING: It is common to have slight bleeding for a few hours following surgery. Try to avoid repeatedly spitting or rinsing during the first 24 hours after surgery as this will encourage bleeding. If bleeding persists, rinse your mouth or remove blood by wiping with a clean tissue to identify the location of the bleeding site, and then apply a tea bag to the area with firm but gentle continuous pressure for 15-20 minutes. Let yourself rest for 15 minutes then repeat the application of the tea bag for a second time if you still have slight bleeding. If excessive bleeding continues, please call our office. Remember, most of the blood you may see in your mouth is actually a little bit of blood mixed with a lot of saliva - blood is a very strong “dye” and a little bit of blood will color your saliva dramatically.

ORAL HYGIENE: Brushing and oral hygiene procedures should be done as usual in all untreated areas. In areas covered by periodontal dressing, brush only the chewing surfaces of teeth. Avoid dental flossing in operated areas during the first week following surgery. Also avoid the use of water irrigation devices such as Water-piks or electric toothbrushes in the operated areas until instructed to resume. The exposed operated areas should be gently swabbed with a Q-tip (cotton tipped applicator) saturated with the prescribed mouthrinse (Chlorhexidine) as a last oral hygiene procedure at bedtime and again in the morning, after eating and drinking. If a chlorhexidine mouthrinse has been prescribed, use it according to the directions on the bottle starting the day after surgery. Avoid eating, drinking, and brushing for 1 hour beforehand and 1 hour afterwards.

EATING AND DRINKING: Do not try to eat until all anesthesia (numbness) has worn off. High protein foods and liquids are desirable for 3-5 days following surgery. Semi-solid foods may be eaten as long as this may be done comfortably. Eggs, custard, yogurt, pasta, steamed vegetables, casseroles, cooked cereals are some things that you might consider eating during the first few days following your surgery. Avoid spicy, salty, acidic, very hot or very cold foods or liquids. Also, avoid hard foods: toast crust, nuts, chips or other crunchy or fibrous foods such as raw carrots that may become caught between your teeth or traumatize exposed operated tissues. Please refrain from drinking alcoholic beverages on the day of surgery.

USE OF REMOVALBLE DENTAL APPLIANCES: If you normally wear a removable appliance your doctor will instruct you in its use.

CARE OF THE DRESSING: If a surgical dressing has been placed and small pieces of the dressing break off, do not be concerned. If large portions of the dressing are displaced or lost, and discomfort is experienced, please contact our office. If the dressing should fall off after 4 days, and you are comfortable, replacement of the dressing is unnecessary.

VENEERS Post Op Instructions

Plastic temporary restorations will serve you for a short period of time while your permanent veneer is being made. They are attached only slightly to the underlying tooth so they can be removed easily. 
If a veneer comes off, call us and we will replace it immediately. If you are in a situation that will not allow you to come in, place the temporary back in place with some Fixodent™ (denture adhesive). You must still see us as soon as possible. 
The size, shape, and color of the temporary does not resemble the final veneer. 
Temporary veneers may leak saliva or food onto the tooth.

Sensitivity to hot, cold, pressure, or sweets is not uncommon. You may also see stains under the temporaries. These will be removed prior to final cementation. 

Avoid heavy brushing of the temporaries and do not floss between them because you may pull them off. 

Your final porcelain veneers will be as close to the natural beauty and function of teeth as possible. They look and feel normal in every way.

Permanent Veneers We place our veneers with the finest materials and techniques available today. However, you should be aware of the following information about your restorations:

As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, raw carrots, etc.) because the porcelain material can break under extreme forces. 

Proper brushing, flossing, and regular 6-month (minimal) cleanings are essential to the long-term stability and appearance of your veneers. Often, problems that may develop with the veneers can be found at an early stage and repaired easily, while waiting for a longer time may require redoing entire restorations. 

The gums may recede from the veneers, displaying discolored tooth structure underneath. This situation usually takes place after many years and may require veneer replacement. 

Crowns Post Op Instructions

Temporaries are not strong. They may break or come off occasionally. If so, slip it back on the tooth with some Fixodent™ (Denture Adhesive) and call us for an appointment. Please do not leave the temporary out of your mouth because the teeth will move and the final restoration will not fit. Please do not floss around your temporary crown. 
The size, shape, and color of the temporary does not resemble the final restoration.
Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment. 

Permanent Crowns

Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment. 

After the final cementation of your restoration, it may take a few days to get used to the new crown or bridge. Hot and cold sensitivity is possible for a few weeks and occasionally lasts for several months. As with the temporary, if the bite doesn’t feel balanced please call us. 

Do not chew hard or sticky foods on the restoration for 24 hours from the time they were cemented. The cement must set up during this time to have optimum strength. 

Proper brushing, flossing, and regular 6-month (minimal) cleanings are required to help you retain your final restoration.

The only area that a crowned tooth can decay is at the edge of the crown at the gum line. Often, small problems that develop around the restorations can be found at an early stage and corrected easily, but waiting for a longer time may require redoing the entire restoration. 

Dentures / Partials Post Op Instructions

Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the denture/partial for 24 hours. These areas can be relieved with very little effort during your next appointment.

Chewing: The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surfaces of your teeth after the dentures/partials have settled into place. 

Cleaning the Dentures/Partials and your Mouth: Your denture/partials can be cleaned easily by using a denture brush and a mild toothpaste. Periodic denture soaks are also very useful (ex: Polident). We recommend leaving your partials out of your mouth at night and soaking in water. 

Dentures only: Brush your gums with a regular toothbrush once per day to toughen and clean them.

Partials only: Use special care to clean parts of the partial that contact any natural teeth.

Both the partial and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting.

We have done our best to provide you with well-fitted, functional, and esthetic dentures/partials. We feel confident that after a few weeks of becoming adjusted to the new dentures/partials, you will have years of satisfaction from them. Over time, your jawbone and gums shrink when there are teeth missing. When this occurs, your dentures/partials will feel loose and may require relining.

Wearing ill-fitting dentures/partials for too long without refitting can cause severe bone loss and very serious oral disease. Please call our office if these symptoms occur. 

Dental Implants or Bone Graft Surgery Post Op Instructions

General Instructions

• On the day of surgery, do not rinse, spit or drink through a straw.
• Do not disturb the surgery site or over-exert yourself. It may cause bleeding, irritation or infection. 
  The day after surgery, continue normal brushing and use a warm saltwater rinse (1/4-teaspoon salt in a glass of warm water) every 2-3 hours for 3 days. 
  
• Pain may last for 10-14 days following surgery. Usually the third day is the most uncomfortable. If your over-the-counter pain medicine does not control the discomfort, you may use the pain medication prescribed by your doctor. 
  
• If you were sedated, do not drive for 24 hours following surgery. 
  Narcotic analgesics tend to cause constipation. Keep bowel movements normal by using a mild laxative if necessary. 
  
• Following surgery, you should eat a soft diet for 24-48 hours. Avoid chewing over surgical sites until instructed otherwise by your doctor. You should supplement your diet with plenty of fluids and gradually return to your normal diet as tolerated. Avoid spicy foods and drinks for 2 weeks. 
  
• Avoid alcohol or smoking during the first week following surgery. 
  
• Ice packs may be used for the first 24 hours after surgery to reduce swelling. Rotate ice pack on and off or side to side every 30 minutes for 24 hours. Swelling is usually greater 2 days after surgery and may last about a week. If you continue to have swelling on the 4th or 5th days, or if the swelling goes down and then begins to swell again, you should call our office. 
  
• You may have sutures placed in your mouth to control bleeding and hasten healing. They will dissolve on their own over 1 to 2 weeks. Occasionally non-resorbable sutures are placed and will need to be removed in 1-2 weeks. 
  
  Bleeding

If you were given gauze, change it as directed every 30 minutes until active bleeding has subsided (usually 2-3 hours). Some bleeding may last for 24 hours. If there is excessive bleeding, follow these instructions:

• Rinse mouth with cool water and gently wipe away blood clots with a clean piece of gauze or a tissue.
• Take a large amount of gauze, a piece of sanitary napkin or 2 tea bags moistened with water and place over bleeding area and close mouth, applying constant pressure. 
  

• Remain quiet and in a sitting position for 20-30 minutes. 
  

• Repeat steps 1 and 3 until bleeding is controlled. 
  After these instructions have been followed in detail and excessive bleeding persists, you should call our office.

Specific Instructions

• Apply ice to jaw for the first 24 hours. 
  
• Leave immediate denture, partial or flipper in mouth for 24 hours, then remove it and begin salt-water rinses (¼ teaspoon salt in glass of warm water). Rinse every 2-3 hours for 3 days. Wear denture or partial as much as possible to reduce swelling from the surgical site. If you do not have a denture or partial, begin salt-water rinses 24 hours after surgery. 
  
• Use heat on swollen areas as directed. 
  
• If you had a sinus lift, do not blow your nose for 2 weeks. Take a decongestant such as Dimetapp or Tavist D for 2 weeks after surgery to decrease sinus congestion.

You may be given any of the following prescriptions:

• Pain medicine: should be taken as needed. You may take ibuprofen (400-600mg every 6 hours) in addition to or instead of your prescription pain medication. While taking prescription pain medication, do not drive or operate heavy machinery. Be sure to eat something prior to taking pain medicine to reduce nausea. 
  
• Antibiotic: should be taken as directed until gone. Be aware that some antibiotics can reduce the contraceptive effect of birth control pills. Please contact your gynecologist or pharmacist if you have concerns. 
  
• Nausea medicine: should be taken as needed. While taking this medication, do not drive or operate heavy machinery. 
  
• Mouth rinse: use as directed on the bottle. Avoid full-strength mouthwashes for 2 weeks.