Patient Education

• The initial healing period usually takes one to two weeks, and you’ll likely experience some swelling for the first 24 hours.

• Before the procedure began, you were given an anesthetic to ensure your comfort. This anesthetic typically leaves your lips, teeth and tongue feeling numb after the appointment. For this reason, you should avoid chewing for two hours following surgery, or until the numbness has completely worn off.
• Some discomfort after the extraction is normal. An over-the-counter pain reliever, such as ibuprofen or acetaminophen, is usually sufficient. We can also give you a prescription for a stronger pain reliever, if needed.
• To avoid nausea, do not take pain medication on an empty stomach.
• You can also decrease pain and swelling by applying an ice pack – 20 minutes on, 20 minutes off – for the first six hours following the extraction.
• A blood clot will form on the extraction site, and this clot is vital to the healing process. To keep the clot intact, avoid touching the extraction site with your tongue or fingers, do not drink liquids through a straw, and do not spit vigorously.
• Blowing your nose or sneezing violently can also dislodge the blood clot and impair healing, so if you have an upper respiratory infection or suffer from allergies, be sure to have the appropriate sinus medication on hand.
• Do not rinse your mouth the day of the surgery.
• Smoking, or allowing food particles to pack into the tooth’s socket, should be avoided, as both will significantly affect the healing process.
• 24 hours following the procedure, you can rinse gently with mouthwash or a warm salt-water solution (dissolve one teaspoon of salt with one cup of warm water); gently swish the solution around the affected area, and spit carefully. You should do this 2-3 times each day for the week following the extraction.
• If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
• Relax as much as possible and avoid all strenuous activities for the first 24 hours following surgery.
• Once the numbness has worn off, you should eat, as nourishment is important to the healing process. Limit your diet to soft foods like yogurt, soft soups, ice cream, or soft-cooked eggs for the first 48 hours.
• Drink at least eight large glasses of water or fruit juice each day.
• Keep your head elevated with pillows to control bleeding. We will give you a supply of gauze sponges to place over the bleeding area. Change the pad as necessary, and use them until the bleeding stops completely. You can also bite gently but firmly on a moist tea bag for 20 minutes. Be sure to call our office if bleeding persists or increases.
• Be sure to brush and floss the other areas of your mouth as you would normally.
• The space left by the tooth will feel a bit strange to you at first. Eventually, new bone and gum tissue will grow into the gap left by the extraction.

During your appointment today, one or more of your teeth was prepared for a crown or bridge. A temporary crown was fabricated for each prepared tooth. Temporary crowns are cemented with a temporary dental cement to allow for easy removal at your next appointment. Temporary crowns are of universal size and shade. Your final restoration will be shaped and shaded to match your other teeth in both color and function. Until your next appointment:

• Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.
• You may experience sensitivity to temperature and pressure, gum soreness and slight discomfort on the tooth / teeth; it should subside after the placement of permanent crown.

• Avoid hard or sticky foods that may dislodge temporary crowns, such as:
• Hard chewy breads such as bagels or French bread.
• Chewy candies such as taffy, caramels or gum.
• Hard crunchy foods such as corn nuts or popcorn kernels.
• Do not bite into foods such as corn on the cob or apples.
• If a temporary crown becomes loose or comes off, try to place it back onto the tooth and call the office at your convenience to get the crown re-cemented. Temporary cement is also available at most drug/grocery stores.
• Rinse your mouth with Listerine™ mouthwash or warm salt water to minimize inflammation of the gum tissue.
• Acrylic temporaries attract more bacterial plaque than natural teeth; therefore it is important to brush normally, at least three times a day. Floss at least once a day, but floss carefully and don’t pull up on the floss which may dislodge the temporary. Pull the floss out from the side of the temporary crown.
• You may experience sensitivity to hot or cold foods or beverages after treatment.
• Mild to moderate discomfort after dental work is common. An over the counter pain reliever/anti-inflammatory is recommended for patients who are able to tolerate them. (Tylenol™, Advil™, Aleve™, etc.) If discomfort increases, please call the office.

If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call your doctor.

Composite or white fillings and silver(amalgam) fillings you have just had a new filling. This is what you may feel:

• Hot Sensitivity that may last a few days

• Cold sensitivity that may last up to 8 weeks, but gradually decreasing in pain during that time period.
• Sensitivity to chewing that may last up to 8 weeks, but gradually decreasing in pain during that time period.
• After the numbing wears off, you may feel you are not biting correctly. Please call so your bite can be adjusted. You may not feel this for some time if the bite is only slightly high. Remember, when you are numb it is hard for you to judge if you are biting your teeth together correctly.
• White fillings are hard right away so you can chew on them immediately, but they may be sensitive.

On the other hand silver fillings are soft for the first 24 hours

• So please chew on the other side of the mouth .Chewing to soon on the tooth causes small fractures that will effect the longevity of the restoration. In some cases the filling may even come out. If silver filling were placed on both sides of the mouth please eat soft foods only.

• Since children do not usually follow the 24 hour rule for silver fillings it is more likely that their fillings come out. Children usually cannot tell if they are missing a filling (;therefore check for a few weeks to a few months in their mouths to check to be sure if it is in tact. If a filling is left out till the next cleaning it will have decay and need to be refilled. It will be larger and deeper than before.

Possible need for root canal treatment;

Any filling no matter what the size or depth may result in the need of a root canal. The symptoms you look for include:

• Hot sensitivity that lasts longer than a few weeks.

• Hot sensitivity that begins after the tooth has been asymptomatic or problem free for a period of time.
• Spontaneous pain that occurs anytime during the day or night.
• Swelling, either in the mouth or on the face.
• Cold sensitivity that lingers on for many minutes. Sharp instantaneous reaction to cold is probably not a root canal symptom.

DO NOT eat or drink anything for the next half hour. DO NOT try to feel around your tooth with your tongue. You have a temporary filling in the tooth and it takes about half an hour to harden.

• You need to have a permanent filling or a crown placed on your tooth within 1 MONTH of the root canal being completed. It is essential for you to follow up with your general dentist on this. If this is not done, the tooth is very likely to fracture or to develop new decay underneath the temporary filling which may cause your root canal to fail.
• DO NOT use the tooth to bite down on anything hard (peanuts, pretzels, ice, etc.) until the permanent filling/crown has been placed on the tooth. Again, the tooth is prone to fracture and if you bite down on anything too hard or crunchy you may crack the tooth.
• It is normal for the temporary filling to “divot” in with use. It is very rare for it to fall out entirely. If the temporary falls out you should contact us, as soon as possible.
• Some minor discomfort in the area is normal following the root canal. It is normal for the tooth to be uncomfortable for 2-3 days Sometimes, depending on the circumstances, the tooth and surrounding tissues may remain sore for a few weeks post treatment. The three most common reasons for pain are:
  • Sore jaw joint from having your mouth open for a prolonged time.
  • Sore muscle from the injection
  • You may floss and brush your tooth as normal, unless told otherwise by the doctor

Everyone’s teeth have a protective layer called the acquired pellicle. This layer contains the surface dental stains and is removed during a regular dental cleaning or the whitening process. It takes twelve to twenty-four hours for the barrier to fully develop again. To maximize the whitening, we ask that you

• Do not consume dark liquids or foods (i.e. coffee, tea, dark soft drinks, or red wine).

• Please also refrain from wearing coloured lipsticks in order to minimize shade relapse.
• In addition, we recommend that you avoid any “yellow” foods such as white wines and potato chips.
• Smoking is not permitted for the first 48 hours. The teeth will darken if the patient smokes within the first 48 hrs.
• If post-operative sensitivity occurs (usually for the first 48 hours), please use Advil or Tylenol, or what you would normally use for a headache. Sensitivity may occur following any dental treatment.
• Remember that you must not use any coloured toothpastes or gels for the first 48 hours. 7)In addition, do not use any colored mouthwash or home fluoride treatments. If your daily homecare involves the use of Perio-Rx or any Chlorahexidine, please wait 48 hours before continuing the usage of this product.

Every consideration must be given to keep the surgical site clean and free of food particles.

Instructions for mouth care and other helpful information:

• NO SMOKING! Smoking is to be avoided for the time specified by the doctor. Smoking increases the heat in the surgical site and significantly lowers the body’s ability to heal the site.

• AVOID these after surgery: alcohol with post operative medications, commercial mouth rinses and very hot fluids.

Gentle rinsing of the mouth should be started the day after surgery.

Frequent gentle rinsing with lukewarm salt water will aid the healing process. (add one half teaspoon of salt to a 6oz glass of water).

Avoid the use of a water-pik tooth brush.

Pain: A certain amount of pain must be expected with all types of surgery. An appropriate pain medication has been prescribed for you. Please take it according to the directions. It is advised that you do not drive while taking the pain prescription. However, if only Ibuprofen or Tylenol is needed, most people are able to drive without a problem.

Swelling: Some swelling and minimal bruising is possible and is to be expected. IT IS NOT UNUSUAL. In most cases, swelling can be prevented/controlled. Apply the ice pack that has been given to you for a period of 20 minutes on and 20 minutes off during the day for the next two days. The application of ice to the outside of the face over the surgical area will minimize swelling. If after five days you still have unusual swelling or pain, please call the office.

Bleeding: A small amount of bleeding following surgery should not alarm you. If the bleeding is excessive or continuous, please call us at once. Vigorous rinsing of the mouth prolongs bleeding by removing the clotting blood, so when rinsing your mouth, do it gently. NO drinking through straws. The use of a straw creates negative pressure in your mouth and will tend to loosen the sutures.

Diet: Following surgery it is best to restrict your diet to fluids and soft foods for the first day. Normal diet may then be resumed the following day, but you will want to avoid chewing on the implant site until the tissue is completely healed. Soft foods such as pudding, mashed potatoes, scrambled eggs and soups are suggested. If you have difficulty chewing, try slenderized foods.

Implant Follow-Up: We will see you for the periodic check-ups until the implant has healed. This is usually for a period of one to four months, depending on your implant surgery.

• Avoid eating and drinking for an hour.
• Avoid brushing or flossing for at least 4-6 hours.
• If possible wait until tomorrow morning to resume normal oral hygiene. Any residual fluoride varnish will be removed with thorough brushing and flossing the following day.
• If you must eat, then eat a soft food diet for the next 4-6 hours.
• Avoid hot drinks and products containing alcohol (beverages, oral rinses) for at least 4-6 hours.

The purpose of the nightguard that has been constructed for your use is to relieve musculature discomfort. It has been designed to allow a balance with the skeletal and muscular structures independent of the teeth. This reduces the parafunctions of clenching and bruxing which in turn reduces the muscular discomfort of myofascial pain.

Things to remember when wearing the appliance:

• The appliance is only a reminder of where to close your jaw. It was not intended to have you constantly bite the appliance.
• The appliance is to make you feel better, not worse than when we began treatment. If the appliance makes you feel uncomfortable, then discontinue wearing the appliance and call the office for a re-evaluation.
• The appliance is not to make your teeth sore at all. If this occurs please call the office for an adjustment.
• The appliance will, initially, make you salivate quiet a bit. Your body initially interprets the appliance as a piece of food and will recognize within a day or two that the appliance is not a piece of food. The increase in salivation will then diminish.
• When the appliance is removed after night time wear, the jaw musculature will take some time to “re-acquire” your “normal” functional bite. The purpose of the appliance is to balance the anatomic structures which are seldom aligned with our functional bite. This readjustment can take a few minutes to several hours and varies from patient to patient.

Things to remember when caring for your appliance:

• When the appliance is not in your mouth, remember to place it in the case provided for you. It is very easy to lose the appliance (ie) wrapping it in a napkin at a restaurant. Animals like to chew on appliances, also.

• If you are careless and lose the appliance especially when it has been helping significantly, then the above instructions will have more meaning.
• Soap and water will clean the appliance, however over a long period of time the appliance can stain due to the porosity of the appliance. Denture cleansers are very good also. (Over the counter products are very satisfactory for this purpose.)

• New dentures always require a period of adjustment. First-time denture patients may require several weeks to get used to their new appliance. Speech may be altered, and may require adaptation of the tongue and lips.

• For the first few days, you should wear your dentures for as long as possible, and chew soft food in small bites. Remember, dentures do not have the same chewing efficiency as natural teeth and may affect your taste of food. If your bite feels uneven after several days, we can adjust the way your teeth contact at follow-up visits.
• It is not unusual for sore spots to develop in isolated areas of the mouth. These areas can be relieved easily at follow-up appointments. If a severe sore spot develops which prevents wearing the denture and an appointment is made for adjustment, please wear the denture for 24 hours prior to the appointment. This will greatly aid in locating the exact location of the area, and make adjustments significantly easier and more predictable.
• Proper cleaning of your denture is important to prevent stains and bacteria from accumulating on your appliance. Since cleaning procedures differ for various types of appliances, please follow the directions given to you at your insertion appointment.
• Do not wear your complete or partial dentures to bed. It is important to allow your gum tissues and jaw bones to rest in order to prevent further tissue irritation, infection, and future bone shrinkage.
• Over time, or with weight loss or gain, the supporting gum tissues and bone may change shape and size. Periodic relines of your dentures may be necessary to ensure a retentive fit. Denture teeth may wear or chip over time. For this reason, an annual check of your tissues and dentures is recommended