Post Operative Instructions

  • After tooth extraction, it is important for a blood clot to form to stop the bleeding and begin the healing process. Although we may have placed a dissolvable material in the extraction area to assist with clotting, it is recommended that you firmly bite on the gauze pad for 30 to 45 minutes following the procedure. 

• We will also give you a package of gauze to take with you to use at home if the bleeding should continue. Should you need to use the gauze at home, remember to roll it into a ball large enough to cover the wound and moisten with water. Gently place gauze over the extraction site and hold firmly in place, by biting or with finger pressure, for about 20-30 minutes.

• After the blood clot forms, it is important not to disturb or dislodge the clot, especially for the first 24 hours. Do not smoke, suck through a straw, eat small seeds, rinse vigorously, or brush near the extraction site for one to two days.

• Reduce exercise for the first 24 hours. This will keep blood pressure lower, which will reduce bleeding from the extraction site.

• To reduce swelling, place an ice pack or zip top baggie with ice and water against the cheek adjacent to the affected area. Apply alternately, 20 minutes on then 20 minutes off, this is most effective if performed during the first 12 hours post extraction. The swelling should subside after 48-72 hours.

• In some cases, prescription pain medications may be prescribed. Please take only as directed, and do not drive or operate machinery if taking narcotic medications. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone.

• After 24 hours, you may gently rinse your mouth with salt water three times a day (one teaspoon of salt in one cup of warm water, rinse-swish-spit). Rinsing after meals will help in preventing food from accumulating in the extraction site.

• Drink lots of fluids, and eat soft food on the opposite side from the extraction site. Avoid alcoholic beverages and hot or spicy foods. You may resume normal eating as soon as you are comfortable.

• Sutures (stitches) may have been placed to help control bleeding and promote healing. These sutures :

❒will dissolve and do not need to be removed OR 

❒ will be removed at your follow-up visit. 

If the stitches come out during the first 48 hours, please call our office.

• If you have heavy uncontrolled bleeding, severe pain, continued swelling after two to three days,  or a reaction to the medications prescribed, visit your nearest emergency room to seek immediate 

care. 

Please remember that after dental work, it can take time to adjust to the feel of your new bite. When your bite is altered or the position of your teeth changed, it can take several days for your brain to recognize the new position or thickness of your teeth. This is completely normal.

Post-Procedure Tips

• If  you detect any high spots or problems with your bite, call our office so we can schedule an appointment to adjust your bite. 
• It’s normal to experience some hot and cold sensitivity following a filling procedure. Teeth require some time to heal after removal of tooth structure and may be sensitive in the meantime.
• Soreness in the gum tissue surrounding your tooth is common after certain procedures; however, symptoms usually disappear within a few days. Rinsing with warm salt water in the area can help alleviate the soreness and      promote faster healing.
• If  you were given a local anesthetic, you’ll want to refrain from drinking or eating hot liquids or foods until the numbness wears off to prevent scalding yourself. Also, avoid chewing in the area to prevent accidentally      biting your tongue or jaw.

Reasons for Discomfort

• At the site where the local anesthetic (numbing agent) was injected, you might have some bruising or swelling that will resolve in a few days—just like a bruise that occurs anywhere else on your body.
• Take an anti-inflammatory such as ibuprofen or naproxen to limit or resolve any initial discomfort. Normally, the discomfort will disappear within the      next few days or weeks. If the pain doesn’t subside or becomes severe, give us a call.
• Your jaw might be sore due to keeping your mouth open for an extended period during the procedure. If you experience temporomandibular (TMJ) soreness, avoid opening your mouth extremely wide or chewing on foods that cause discomfort until the issue resolves. An ice pack or warm compress along with an anti-inflammatory such as ibuprofen or naproxen can help.
• You may notice increased salivation. This is because your brain is responding to the new size and shape of your teeth. This should return to normal in about a week.
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Taking Care of Your Dental Work

• Daily brushing and flossing are a must. Consistent plaque removal is critical for the long-term success of your new restoration as are regular professional cleaning appointments.
• Any food that can crack, chip, or damage a natural tooth can do the same to your new filling. Do not bite into hard foods such as hard nuts, peanut brittle, ice, apples, frozen candy bars, sticky caramel, or anything else that can put undue pressure on your teeth.
• Never use your teeth as tools!  Teeth are not meant to open frozen vegetable bags, pull on strings, or hold      objects. Also, no biting on fingernails, chewing pencils, or doing anything else that could cause pressure or trauma to your teeth.
• While refraining from coffee, red wine, tea, and berries isn’t realistic for most people, these things will stain your teeth, as will tobacco. Use a straw as much as possible for liquids, and always brush, floss, and rinse your teeth with a whitening mouthwash as soon as possible      after consuming drinks and foods that stain.

If you have any questions or concerns following your filling procedure, please let us know!

Endodontic treatment (root canal) is now complete.

The canals inside the roots have been cleaned, irrigated, medicated and sealed.

The opening in the tooth through which root canal treatment was done has been sealed with a temporary filling.

**Delay in obtaining final restoration (crown) may result in fracture and/or possible loss of the tooth**

WHAT TO EXPECT:

· 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 a few days (or even weeks). This occurs because of conditions, which existed before treatment was started. Experience shows that if there was pain prior to treatment there may be a degree of pain that will continue for a few days after the procedure. Remember that pain radiates. You may feel sensations of discomfort that are not related to the treated area during the healing process. This can be created by inflammation in this area and/or due to increase in blood volume that naturally occurs in the healing process.

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

· Discomfort in this area for a few days to a couple of weeks is common. Warm saltwater rinses for the next two days will help, and avoid chewing on this side until all tenderness is gone.

· 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.

**A CROWN or FINAL RESTORATION IS NOW NEEDED TO PROTECT THE TOOTH***

WHAT TO DO AT HOME:

· Please do not chew or attempt to eat on the side of your mouth that has been worked on while this area is still numb.

· Eat a soft diet for at least two days and remember not to chew on the treated side.

· Avoid very hot or cold foods during the healing process.

· Please avoid crunchy or hard foods which could cause the tooth without a crown to fracture.

· Whenever possible, try to chew on the opposite side from the tooth we have just treated, until you have a crown placed.

· You may want to put an ice pack over the area where the procedure was done for 1/2 hour when you first get home to minimize swelling. Apply the ice pack (or use frozen vegetables like peas) every hour for 10-15 minutes during the first 4-6 hours.

· Sleep with your head in an elevated position for the first few nights if you do not have any physical limitations.

· We recommend you take something for pain-relief/sensitivity within one hour of leaving our office, to get the medication into your blood system before the anesthesia we administered begins to subside. Generally, only one dose is needed. We recommend

ibuprofen (Advil, Motrin) 600 mg (three tablets). Two to three tables may be taken four times a day for the next 3-4 days to help control the sensitivity in this area. If you have a medical condition or gastrointestinal disorder which precludes ibuprofen,

acetaminophen (Tylenol, Excedrin) is a substitute, although it does not contain anti-inflammatory properties. Aspirin and aspirin-containing products are NOT advisable, as they tend to increase bleeding from the area that was treated.

· Please take prescribed medication (antibiotics and /or pain medication) as directed.

Please take the full course of antibiotic medication. If you were given a prescription for pain, it is meant to help you with more serious discomfort and only for a couple of days.

Delay in obtaining final restoration (crown) may result in fracture and/or possible loss of the tooth.

WHAT TO DO FOR NON-HEALING AFTER ENDODONTIC TREATMENT:

Fortunately for everyone, most root canals heal with about a 95% success rate. When they don't heal, we would prefer to call this "non-healing". Be aware that this is not mere carpentry --

it is a medical procedure and all medical procedures do not heal 100% of the time, including root canals.

Generally speaking, the non-healing takes one of two avenues:

1. Pain (mild too severe) with or without swelling, or

2. No symptoms at all, but rather, changes on the x-ray suggestive of non-healing (i.e.: bone dissolving around the root tips).

Typically, the non-healing is caused by one of two things:

1. Inflammation-The inflammation may be from the tooth being inflamed prior to treatment, or the treatment itself may elicit more inflammation. Usually time and medication like Advil, or

steroids can resolve this.

2. Infection can be from three main causes:

a. The original infection persists

b. There is a crack in the tooth,

c. There is leakage through the top of the tooth (i.e.: the filling) that re-infected the root canal filling.

If the non-healing is due to infection, usually time and antibiotics will resolve this. If signs or symptoms persist, there are three options:

1. Retreat the root canal

2. Surgically clean the bone that surrounds the root tip and seal the tip of the root (Apicoectomy) 

3. Extract the tooth.