Post-Op Care

Fillings

• Numbness: Be careful not to bite your cheek, lip, or tongue while you’re numb. Wait until the numbness wears off before eating.
• Eating: You can resume normal foods as soon as the numbness is gone.
• Sensitivity: It’s normal for teeth to be sensitive to cold, hot, or pressure for a few days. These symptoms will lessen within a few days to a few weeks. As long as the sensitivity gradually improves, there is no need for concern.
• Bite: If your bite doesn’t feel quite right after the numbness wears off, please call us. A quick adjustment can prevent soreness.
• Discomfort: It is normal for your gums or injection site to feel tender after your procedure. Rinsing with warm salt water and taking an over-the-counter pain reliever such as Tylenol or ibuprofen can help decrease discomfort.
• Home Care: Although the filling has been placed, the tooth is still vulnerable to decay. It is important to resume regular brushing and flossing as well as regular dental visits. This will increase the longevity of your new restoration.

Final Crown Placement

• Final Crown:  After the crown is cemented, delay eating on that tooth for 24 hours to allow the cement to fully harden. The crown may feel tight against the adjacent teeth, but this should go away within a day or two.
• Sensitivity: It’s normal for teeth to be sensitive to cold, hot, or pressure for a few days after the final crown is placed. These symptoms will lessen within a few days to a couple of weeks. As long as the sensitivity gradually improves, there is no need for concern.
• Bite: If your bite doesn’t feel quite right after the numbness wears off, please call us. A quick adjustment can prevent soreness.
• Discomfort: Where we removed the excess cement, it is normal for your gums to feel tender. Rinsing with warm salt water and taking an over-the-counter pain reliever, such as Tylenol or ibuprofen, can help reduce discomfort.

In-Office Teeth Whitening

• Eating: Particularly for the next 48 hours, avoid foods and beverages that stain (e.g., red sauce, coffee, juice, tea, curry powder, fruits).
• Sensitivity: Mild sensitivity to hot or cold liquids may occur. This usually passes within 1–2 days. If sensitivity persists, we recommend taking over-the-counter pain medication.
• Home Care: It is important to resume regular brushing and flossing as well as regular dental visits. This will increase the longevity of your new restoration.

Long-term results vary from patient to patient. This can depend on the original shade of your teeth and include habits such as smoking or drinking colored beverages (e.g., red wine, coffee, tea).

Pediatric Dentistry

• Numbness: Be careful not to bite your cheek, lip, or tongue while you’re numb. Wait until the numbness wears off before eating.
• Eating: You can eat as soon as the numbness is gone.
• Sensitivity: It’s normal for teeth to be sensitive to cold, hot, or pressure for a few days. These symptoms will lessen within a few days to a few weeks. As long as the sensitivity gradually improves, there is no need for concern.
• Bite: If your bite doesn’t feel quite right after the numbness wears off, please call us. A quick adjustment can prevent soreness.
• Discomfort: It is normal for your gums or injection site to feel tender after your procedure. Rinsing with warm salt water and taking over-the-counter pain relievers such as Tylenol or ibuprofen can help decrease discomfort.
• Home Care: Although the treatment has been completed, the tooth is still vulnerable to decay. It is important to resume regular brushing and flossing as well as regular dental visits. This will increase the longevity of your new restoration.
• Sealants: This is a protective covering to help reduce the likelihood of a cavity in the natural grooves of the teeth. It is normal for the bite to feel off for a few hours. Avoid sticky candy or gum.

Root Canal

Avoid eating until numbness has worn off, and be careful not to bite your cheek, lips, or tongue. Once feeling returns, you may eat, but avoid chewing on the treated tooth until

• Numbness: Be careful not to bite your cheek, lip, or tongue while you’re numb. Wait until the numbness wears off before eating.
• Eating: You can eat as soon as the numbness is gone. Avoid chewing or biting on the treatment area until your permanent restoration is placed. You may experience increased sensitivity prior to the placement of the final restoration.
• Discomfort: Some discomfort is normal for 2–4 days following root canal therapy. In some cases, the tooth and surrounding tissue may be sore for a few weeks following treatment. You may choose to take ibuprofen (as long as you do not have any allergies to it) to relieve discomfort and swelling. Alternatively, you may use Tylenol. Do not exceed the guidelines printed on the label for any medication.
• Swelling: Applying a cold compress to the face near the treatment area will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin, but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on, then at least 20 minutes off, for the next 6-8 hours as needed.
• Home Care: Please keep the treated area clean by brushing and flossing as usual. Follow any other instructions provided by our office during your visit and take all medications as prescribed.

While flare-ups are not common, they occur in about 5 percent of cases and may cause significant pain. They generally only occur with teeth that are extremely irritated and/or infected or with teeth that have a history of prior treatment. These sometimes occur randomly, even in patients who have had root canals done in the past without problems. If you have a flare-up, you may experience moderate to severe pain, swelling, throbbing, or general discomfort; please contact our office right away. You may be prescribed additional medication such as antibiotics, and/or you may be asked to come to the office for further treatment.

Scaling and Root Planing

• Numbness: Be careful not to bite your cheek, lip, or tongue while you’re numb. Wait until the numbness wears off before eating.
• Eating: You can resume eating normally as soon as the numbness is gone.
• Soreness: It’s normal to feel some soreness in your gums following scaling and root planing. You may also notice mild tenderness at the injection site. Rinsing with warm salt water (1/2 teaspoon salt and 8 ounces of warm water) and taking an over-the-counter pain reliever such as Tylenol or ibuprofen can help decrease discomfort.
• Mobility: It’s normal for some teeth to feel loose after scaling and root planning, especially if a large amount of calculus was removed. That calculus often acts like a splint, so when it’s removed, teeth may feel mobile at first, but as your gums heal and inflammation decreases, your teeth may feel more stable again.
• Bleeding: You may see some bleeding over the next few days after brushing, but your gums will start to improve after today’s procedure. You will also notice a decrease in your bleeding as your gums heal.
• Sensitivity: After the cleaning, you may notice more of the root surfaces. Sensitivity to cold and heat may also increase, but it is typically mild and temporary. Products like Sensodyne could help reduce symptoms.
• Smoking: To help your gums heal properly, it’s best to avoid smoking. Smoking can hinder healing and is one of the strongest risk factors for gum disease.
• Home Care: Although you may be tempted to brush gently for the next few days, it is important to resume regular brushing and flossing over treated areas. This will decrease the bacterial load and improve healing. Follow-up appointments are important in preventing further progression of the gum disease.

Surgery

Avoid these 4 S’s:

• No sucking through a straw
• No spitting
  
• No swishing vigorously
• No smoking

Bleeding: Slight bleeding after surgery is not unusual. Your saliva may be tinged with blood for up to 24 hours. A gauze pack will be placed over the site after surgery. Gauze should be left in place over the surgery site for 60 minutes, maintaining firm biting pressure—replace as needed (Moisten a clean gauze and place directly over the surgery site. Apply moderate biting pressure. Repeat if necessary). Do not forcefully spit or irritate the surgery site. This may cause further bleeding.

Pain: It is not uncommon to have discomfort and pain for the first few days after surgery. Alternate between Tylenol (500 mg) and ibuprofen (600 mg) every 3–4 hours. Do not exceed the daily guidelines printed on the label for any medication. Take pain medications as needed. The first day, it is recommended to take medication even with minimal pain, as it is easier to prevent pain than decrease it. Pain medications are most effective when taken before local anesthesia diminishes and normal sensation returns. Do not take pain pills on an empty stomach.

Swelling: After extractions, swelling around the mouth, cheeks, eyes, and side of the face is very common. This is the body’s normal reaction to surgery and eventual repair. Swelling usually will not become apparent until the day following surgery and will not reach its maximum until 2–3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Apply an ice pack to the outside of your face over the surgery site for 20 minutes on, 20 minutes off for the first 24 hours. After 24 hours, moist heat can be applied to the area, as ice will increase swelling. Sleeping with your head elevated above the level of the heart for the first two post-operative nights tends to lessen swelling.

Bruising:  Bruising is also very common after surgery. Bruising may be present over the surgery site and in the lower chin area. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2–3 days post-operatively and last up to 14 days. Moist heat applied to the area may speed up the removal of the discoloration.

Diet: Drink lots of clear liquids and eat soft, nutritious foods. Do not drink through a straw for at least 72 hours. If you had surgery on only one side of your mouth, favor the other side while chewing for the first few days. Start by eating soft, non-chewy foods like applesauce, yogurt, pudding, protein shakes (no straws), or ice cream. Then, gradually move on to soft foods such as scrambled eggs, mac and cheese, cottage cheese, cooked potatoes, or tuna. For the first week, avoid opening your mouth wide or biting into foods aggressively.

Numbness: Be cautious until the anesthesia wears off, as you have no feeling in the surrounding area, and you may unknowingly injure yourself. After surgery, you will have prolonged numbness in the surgical area. Care should be exercised in eating or drinking any hot fluids, as you may cause injuries to the soft tissues. Ideally, eat and drink on the opposite side until the numbness subsides. If numbness persists after 24 hours, please contact our office.

Oral Hygiene: Hygiene should not be neglected, as an accumulation of food and debris may promote inflammation and/or infection. You may rinse and brush your teeth starting the day after extractions. Irrigate the sockets if you have food caught in them (we will give you a plastic irrigation syringe).

Activity: Limit strenuous activity for the first 2–3 days. This will reduce bleeding and minimize swelling. Strenuous work or exercise may promote bleeding and increase swelling, which may be damaging to the surgery site and delay healing.

Fever: After surgery, it is normal for the body temperature to be slightly elevated for 24 hours. Please remember to drink sufficient amounts of clear liquids to keep your body hydrated. Please contact the office if there is a high temperature or if a low-grade temperature persists after the first 24 hours.

Smoking/Alcohol: Smoking and alcohol use will delay healing and predispose you to infection, which can result in the failure of the implant or bone graft. This will result in possible surgical intervention, delay in treatment, and possible loss of the implant/bone graft. Do not smoke or use alcohol until the incision line is completely healed (~2 weeks).

Sutures: Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help with healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be dissolvable and should disappear on their own in approximately 7–14 days. If they are still present, our office will remove them at your post-op appointment.

Medications: It is very important that you take all your prescribed medications from your physician as prescribed. DO NOT DISCONTINUE ANY MEDICATIONS (especially blood thinners) UNLESS INSTRUCTED TO BY YOUR PHYSICIAN. Additionally, take all medications that our office prescribes for you. Each medication has a specific role in the post-operative period of your surgery, which will decrease the possibility of infection, swelling, and pain. Discontinue the antibiotic medication if a rash develops or if an upset stomach persists. Report this immediately to our office. Women, please note: If you are currently taking birth control pills, be aware that taking antibiotics will decrease the effectiveness of the Birth Control Pills and alternative methods should be utilized.

Wearing your prosthesis: Partial dentures, flippers, or full dentures should not be used immediately after surgery, unless specifically instructed otherwise. If you have a temporary “flipper” to wear for esthetics, do not insert it until the numbness in the area is gone. When it is inserted, it should not touch the gums in the area of the surgery. If it does, this may cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the implant or bone graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until our office can see you.

Temporary Crown Placement

Numbness: Be careful not to bite your cheek, lip, or tongue while you’re numb. Wait until the numbness wears off before eating.

Eating: You can eat as soon as the numbness is gone. Avoid chewing gum or sticky foods as they can dislocate the temporary crown. Eat on the opposite side if possible.

Temporary Crowns: Temporary crowns are meant to be easily removed later when we cement your final restoration. If the temporary crown is dislodged, don’t panic. Although it’s not as urgent as losing a final crown, you may contact our office for the next steps. You may also place temporary cement (purchased from any drug store) and place the temporary crown back over the tooth. You could also use Vaseline.

Sensitivity: It’s normal for teeth to be sensitive to cold, hot, or pressure for a few days after a temporary crown is placed. These symptoms will lessen within a few days to a few weeks. As long as the sensitivity gradually improves, there is no need for concern.

Bite: If your bite doesn’t feel quite right after the numbness wears off, please call us. A quick adjustment can prevent soreness.

Discomfort: It is normal for your gums or injection site to feel tender after your procedure. Rinsing with warm salt water and taking an over-the-counter pain reliever such as Tylenol or ibuprofen can help decrease discomfort.

Home Care: It is important to resume brushing and flossing. For the temporary crown only, pull the floss out from the side rather than popping it upwards. The upward motion may dislodge the temporary crown.

Tooth Extractions

Avoid these 4 S’s:

• No sucking through a straw
• No spitting
  
• No swishing vigorously
• No smoking

Bleeding: Slight bleeding after surgery is not unusual. Your saliva may be tinged with blood for up to 24 hours. A gauze pack will be placed over the site after surgery. Gauze should be left in place over the surgery site for 60 minutes, maintaining firm biting pressure—replace as needed (Moisten a clean gauze and place directly over the surgery site. Apply moderate biting pressure. Repeat if necessary). Do not forcefully spit or rinse the surgery site. This may cause further bleeding. If excess active bleeding occurs after 2 hours, please call our office.

Pain: It is not uncommon to have discomfort and pain for the first few days after surgery. Alternate between Tylenol (500 mg) and ibuprofen (600 mg) every 3–4 hours. Do not exceed the daily guidelines printed on the label for any medication. Take pain medications as needed. The first day, it is recommended to take medication even with minimal pain, as it is easier to prevent pain than decrease it. Pain medications are most effective when taken before local anesthesia diminishes and normal sensation returns. Do not take pain pills on an empty stomach.

Swelling: After extractions, swelling around the mouth, cheeks, eyes, and side of the face is very common. This is the body’s normal reaction to surgery and eventual repair. Swelling usually will not become apparent until the day following surgery and will not reach its maximum until 2–3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Apply an ice pack to the outside of your face over the surgery site for 20 minutes on, 20 minutes off for the first 24 hours. After 24 hours, moist heat can be applied to the area, as ice will increase swelling. Sleeping with your head elevated above the level of the heart for the first two post-operative nights tends to lessen swelling.

Diet: Drink lots of clear liquids and eat soft, nutritious foods. Do not drink through a straw for at least 72 hours. If you had surgery on only one side of your mouth, favor the other side while chewing for the first few days. Start by eating soft, non-chewy foods like applesauce, yogurt, pudding, protein shakes (no straws), or ice cream. Then, gradually move on to soft foods such as scrambled eggs, mac and cheese, cottage cheese, cooked potatoes, or tuna. For the first week, avoid opening your mouth wide or biting into foods aggressively.

Numbness: Be cautious until the anesthesia wears off, as you have no feeling in the surrounding area, and you may unknowingly injure yourself. After surgery, you will have prolonged numbness in the surgical area. Care should be exercised in eating or drinking any hot fluids, as you may cause injuries to the soft tissues. Ideally, eat and drink on the opposite side until the numbness subsides. If numbness persists after 24 hours, please contact our office.

Oral Hygiene: Hygiene should not be neglected, as an accumulation of food and debris may promote inflammation and/or infection. You may brush your teeth and gently rinse starting the day after extractions. Irrigate the sockets gently if you have food caught in them starting the third day (if we didn’t do a bone graft, we will give you a plastic irrigation syringe).

Activity: Limit strenuous activity for the first 2-3 days. This will reduce bleeding and minimize swelling. Strenuous work or exercise may promote bleeding and increase swelling, which may be damaging to the surgery site and delay healing. Lie down with your head slightly elevated. Slowly return to light activity around 3 days post-surgery.

Infection: After surgery, it is normal for the body temperature to be slightly elevated for 24 hours. Drink sufficient amounts of clear liquids to keep your body hydrated. Please contact the office if there is a high temperature or if a low-grade temperature persists after the first 24 hours. Infection may show up 2 weeks post-surgery. Watch for heat, swelling, pus, or bad taste.

Smoking/Alcohol: Smoking and alcohol use will delay healing and predispose you to infection. This will result in possible surgical intervention, delay in treatment, and possible loss of bone graft (if any has been placed). Do not smoke or use alcohol until the incision line is completely healed (~2 weeks).

Sutures: Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help with healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be dissolvable and should disappear on their own in approximately 7–14 days. If they are still present, our office will remove them at your post-op appointment.

Medications: It is very important that you take all your prescribed medications from your physician as prescribed. DO NOT DISCONTINUE ANY MEDICATIONS (especially blood thinners) UNLESS INSTRUCTED TO BY YOUR PHYSICIAN.  Additionally, take all medications that our office prescribes for you. Each medication has a specific role in the post-operative period of your surgery, which will decrease the possibility of infection, swelling, and pain. Discontinue antibiotic medications if a rash develops or if an upset stomach persists. Report this immediately to our office. Women, please note: If you are currently taking birth control pills, be aware that taking antibiotics will decrease the effectiveness of the Birth Control Pills and alternative methods should be utilized.

Invisalign

Please follow the guidelines below and contact us with any questions:

• Most people experience some mild soreness for a day or two after starting each new stage. This is normal. It is a sign that the aligners are working and moving your teeth to their final destination.
• On some occasions, aligners may temporarily affect your speech slightly. As your tongue gets used to having the aligners in the mouth, disturbance in normal speech will usually disappear within 48 hours (depending on how much you speak).
• During the first few days, higher salivation is normal. This should return to normal after the first few days of wearing your trays.
• Aligners should be worn as close to 24 hours as possible. They should only be removed for eating and brushing. After eating, we recommend that you brush, floss, and insert your aligners as soon as possible.
• When brushing your teeth, brush off your aligners as well. Never place them in boiling water or soak them in mouthwash or denture cleaner.
• When inserting aligners use your fingers to press them into place followed by biting on your chewie. Patients who use the chewie regularly have the best results. During treatment, your bite will not be aligned. It is possible at the end of treatment you may need a bite adjustment.
• When removing aligners begin with your back teeth. Unseat your aligners with your fingernail at the back, then gently wiggle your way forward.
• When not wearing your aligners, always store them in the Invisalign storage case. NEVER WRAP YOUR ALIGNERS IN A NAPKIN, they will get thrown away.
• Keep your aligners away from pets. Dogs and cats love to chew on used aligners.
• When one week is up and you are ready to change trays, it is best to do so in the evening so you can sleep through any minor aches or pains.
• Never discard your aligners. When finished with a set, clean them and place them back in their original pouch. These can be used as backups in case an aligner is lost or broken.
• If several of the bonded attachments fall off your tooth during treatment, please notify the office to have it replaced.
• You may drink clear fluids while wearing your aligners. Please keep in mind that beverages high in sugar and/or acid will damage your teeth if held against your teeth by the aligner for an extended period of time. Avoid very hot drinks as they could warp or distort your aligner. After drinking, we recommend that you rinse off your aligners and rinse your teeth. Always use the munchie provided for 60 seconds every time you seat your aligners and for 20 minutes