Post Op Instructions

 

Fillings

When an anesthetic is used, you may find that your lips, cheeks and tongue may experience numbness for several hours after your dental visit. To avoid burning or biting your tongue or lip, do not drink hot beverages or eat until the numbness has dissipated.

Experiencing sensitivity to pressure, heat and cold are normal, as is a bit of soreness where injections were given. Ibuprofen or Tylenol, one tablet every four hours for pain, will help to alleviate tenderness. If the filled tooth is not contacting your remaining teeth properly, make an appointment for an adjustment.

Once numbness wears off, you may start chewing with your filled tooth, as the filling will have completely set upon your leaving the office. When a silver filling has been used, refrain from eating for eight hours. Silver fillings take a longer period of time to set completely.

Crowns and Bridges

It usually takes two visits for crowns and bridges to be fitted and placed in the mouth. Once anesthesia has been administered, the teeth will be prepared for the restoration and an impression will be taken, which is a very important part of the procedure. To ensure that your crown/bridge fits properly, more than one impression may be needed. For protection, you will receive a temporary crown/bridge. Your temporary restoration will not be as precise in size, color or shape as the permanent one, and it can be easily removed. Care must be taken not to dislodge your temporary restoration.

You should avoid sticky foods such as chewing gum. Flossing will need to be done carefully by pulling the floss out the side rather than popping it through the contact with the adjacent tooth. With a temporary bridge, you cannot floss between the teeth. If your temporary restoration comes loose, a small amount of Fixodent, available through your local pharmacy, can be put inside the restoration. It can then be placed back in the mouth until you are able to come into the office for it to be re-cemented. Your temporary bridge should never be left off as your other teeth can shift, creating a problem with the fit of your new bridge. You would then need to purchase another bridge. If your bite feels off in any way, a simple adjustment can be made at the office.

For sore gums, rinsing with warm salt water will aid in healing. It is common to feel sensitivity to heat and cold, as your temporary bridge will not fit as accurately as your new bridge. If you feel that you are not biting correctly, an adjustment can be made to prevent the development of a sore tooth.

Take care to keep your new bridge clean with proper brushing and flossing. You will need to use special floss or other dental aids in order to clean your bridge effectively.

We will be happy to help you with any concerns or questions you may have regarding your new restoration. Your comfort is important to us.

Root Canal Treatment Los Angeles

It may take one, two or more treatments for root canal therapy to be completed, depending on how severe the infection is. To begin treatment, our dentist may isolate the tooth by applying a rubber dam in order to avoid contamination of the root canal from saliva and also to protect you from the irrigants that are needed to perform the procedure. Between appointments, you’ll be provided with a temporary crown to protect the tooth.

You will experience numbness of lips, gums and cheeks from the anesthesia that will last for several hours after each appointment. Do not chew anything while you are experiencing numbness.

If your tooth was not giving you any discomfort before treatment began, there will normally be no flare-ups between dental visits. But you may have some flare-ups if you were experiencing a bad toothache or swelling, as healing will take some time.

Between dental visits, a portion of your temporary filling may break off or wear away. You may also notice a bad taste. Call the office if the entire filling falls out or if a temporary crown comes loose.

Discomfort is normal for several days following a root canal treatment, which can be especially noticeable upon chewing. Pain medication will help, and warm salt rinses three times a day can relieve pain and swelling.

If you have received a prescription for antibiotics, you must continue to take them even if symptoms have disappeared. Sticky and hard foods should be avoided following treatment as the tooth will be fragile. You should refrain from chewing on that side until you receive your permanent crown, which will protect the tooth from breakage.

Extractions

With an extracted tooth, a blood clot needs to form in order for bleeding to stop and healing to take place. For that reason, we ask you to bite down on a gauze pad for 30-45 minutes after the procedure. It may be necessary to do this several times. If there is still bleeding, it usually helps to bite down on a moist tea bag that has been wrapped in gauze. Tea contains an ingredient that helps stop bleeding.

When the blood has clotted, the clot should not be disturbed as it will help in the healing process. For a period of 72 hours, there should be no vigorous rinsing, sucking on straws, drinking of alcohol, smoking or brushing of the teeth next to the affected area, as these actions can dislodge the clot and interfere with healing. Vigorous exercise should also be avoided for 24 hours following the procedure, as this will raise blood pressure and may cause bleeding to start at the location of the extraction.

If the instructions mentioned above are not followed, the clot may become dislodged, resulting in throbbing, severe pain at the site of the extraction. This is due to exposure of the bone. Some pain and swelling may occur once the tooth has been extracted, which can be relieved with an ice pack or an unopened package of frozen corn or peas applied to the affected area. Pain medications will also help. The swelling will usually subside in two days.

If the pain medication does not seem to be working, call the office. Antibiotics should be taken for the appropriate period of time, even if symptoms seem to have gone away. On the day of the extraction, you should eat soft, nutritious food and drink plenty of fluids. When you feel comfortable, you will be able to go back to a normal diet.

After 24 hours have elapsed, you should return to your usual dental routine, which should include brushing at least twice a day and flossing. Not only will this keep your mouth clean and healthy, it will also help to aid in healing. In a matter of days, you should feel like yourself again and be able to return to your normal activities. Immediately call our office if you experience heavy bleeding, swelling for two to three days, severe pain or any reaction to medication.


Bone Grafting

If a graft has been done within the socket site after extraction of the tooth, the above instructions will apply, but there will also be a few additional points that need to be made.

Since the bone graft is made up of fine particles, small granules in your mouth for the first few days will not be unusual. It is perfectly normal and no cause for alarm, as granules will become dislodged from the area. There are a few things you can do, though, to minimize the amount of dislodged granules:

•    For the first three to five days, you should not rinse vigorously or spit.
•    Do not disturb the graft site by applying pressure with your tongue or finger as the material is movable while the area is healing.
•    You need to remember not to lift your lip or pull it back in order to examine the sutures, as you can damage the wound, tear the sutures and hamper the success of the bone graft. The sutures may or may not be resorbable. External silk sutures will need to be removed at the office. If a barrier has been placed for the graft, it may or may not be resorbable and may need to be removed at the office.


It is wise to allow the area to settle on the first day, giving the blood clot a chance to stabilize the graft material. There should be no rinsing of the mouth on the first day. After 24 hours have elapsed, you may then do gentle rinsing with warm salt water. Vigorous rinsing and forced spitting should be avoided.

Deep Cleaning

Sometimes a regular cleaning will not be enough, and our dentist or hygienist may need to do a deep cleaning, otherwise known as a scaling and root planing. It will take two sessions. First, one half of the mouth is cleaned, then the other half will be done during another dental visit. The teeth and gums will be anesthetized, then ultrasonic and hand instruments are used to clean the teeth. After the cleaning, hot and cold sensitivity may be experienced, the teeth may be sensitive upon chewing, and the gums may bleed somewhat and be sore.

An antibiotic, either Arestin or Perio-chip, may be placed in the pocket if it is larger than 4mm. There should be no brushing for 12 hours, and flossing should be avoided for 10 days. Foods that are sticky, hard and/or crunchy should be avoided for one week.

Upon completion of deep cleaning, it is important to maintain good oral care at home with regular brushing, flossing and the use of either a prescribed or over-the-counter mouth rinse. You may have follow-up care for a three to four month period following the deep cleaning treatment. If you do not adhere to this care, you will end up with your gum condition returning to the way that it was previously. With follow-up care on a regular basis, gums and bone will be better able to heal, thus preventing any further damage. Gum disease harms the condition of the mouth silently, so follow-up care is extremely important.

Immediate or Transitional Dentures

As soon as the teeth that are non-restorable have been removed, these dentures will be ready for placement. They control the bleeding and act as a bandage for the sockets. The dentures should be left in the mouth for the next 24 hours. Immediately following the appointment, you will need to firmly bite on a gauze pad for a period of 30-45 minutes. This may need to be done several times. Any swelling and bleeding can be controlled with the application of cold packs externally. The swelling will be contained by your immediate dentures. Antibiotics and pain medication should be taken, and the mouth should not be rinsed vigorously. Soft and cold foods may be eaten. If you notice blood on your pillow, it is no cause for panic. Just remember to rinse your mouth gently the next morning.

Your dentures may loosen as your sockets begin to heal, requiring several adjustments. It will take some patience as well as practice to adjust to your new dentures, especially when they are full dentures. Do not become discouraged. If you wear your dentures on a regular basis, our dentist will be able to make the proper adjustments to relieve any sore spots.

You may notice that you salivate more with your new dentures. This is a normal process and will usually stop within a few minutes to a few days. You should also practice talking by reading aloud, singing or talking to yourself. Shortly, you will sound normal.

Eating will also require some practice. You will not want your first meal with your new dentures to be in public. You will have an easier time if you cut your food into small pieces, chew slowly and choose easy to chew foods. You may find that wearing adhesives, especially with full dentures, will help you to feel more comfortable. Over-the-counter adhesives may work for you. Remember to remove the adhesive every time you clean your dentures.

Our dentist will reline your new dentures after a three-month period. It usually takes a year for bone to heal completely. When a year has transpired, your dentures will be sent to the lab to be relined. You will need to take a day off, as that is how long the process will take.

Transitional dentures will be used during the period of time that it takes for gums and bone to heal. Then our dentist may recommend permanent dentures for you.

If you have a removable partial or full denture, it needs to be removed for eight hours each day, usually at bedtime. If you wear your denture 24 hours a day, you will be allowing sores and fungus to develop. You will also need to clean your denture after meals. At bedtime removal, your denture should be cleaned with a brush and soaked in water, denture cleaner or mouthwash. Should your denture dry out, it will warp. If you are rinsing and brushing your denture over the sink, be certain to line the sink with a wash cloth and water to prevent breakage if you drop your denture.

You should always see our dentist on a routine basis, regardless of the type of dentures you have. Your dentures need to be checked regularly to ensure that the fit and bite are accurate. Dentures that fit improperly can cause damage to underlying tissue and also cause bone loss. Oral cancer screenings can be performed, as well as checking for other diseases that show up within the mouth.

Veneers

When veneers are placed on the teeth, a small amount of tooth structure will be removed. Since veneers are custom-made, an impression will be taken and sent to the dental lab. While your veneers are being fabricated, our dentist may apply temporary veneers, made of either acrylic or composite material, on your teeth. Care should be taken with them, as they will be fragile and will be placed with temporary cement, allowing them to become easily dislodged.

We will immediately replace any veneer that comes off. If you cannot get into the office right away, you may use Fixodent to place the veneer back onto your tooth until you can get into the office. Your temporary veneer will not be the shape, color or size of your permanent one.

It is not unusual for temporary veneers to leak food or saliva onto the tooth, and sensitivity to sweets, hot, cold and pressure also occurs. They may stain easily. While wearing temporary veneers, avoid vigorous brushing and do not floss between them.

Permanent veneers will be very close to natural tooth color. You may even be sent for custom shading to match your natural color as closely as possible.

We use the finest materials to bond your permanent porcelain veneers to your teeth. You should not chew excessively hard food with your veneered teeth, as they can break if extreme force is used.

To maintain your veneers, regular brushing, flossing and six-month cleanings are important. Otherwise, receding gums will reveal your original discolored tooth, and your veneers will need replacement.

Tooth Whitening

Following tooth whitening, you may experience some pain and sensitivity to cold air and fluids. This will pass within 24-36 hours.

The first day, do not smoke or consume anything that would discolor your teeth, such as red wine, colas or coffee and tea.

An instant lightening will be seen, but rebound is common. You may notice a loss of one shade unit during the first month with the loss of another shade unit during the following six months and another shade unit in the subsequent six months. Everyone is different, and you may notice more or less of an effect than what has been stated. With rebound, you may find that after two years, your teeth will look as they did originally.

Rebound can be managed through any of the following:

•    Avoiding colorants.
•    Using whitening toothpaste.
•    Meticulous oral hygiene.
•    Using at-home bleaching trays.
•    Repeating in-house bleaching annually.

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