Post-Op Dental Instructions – Fort Worth, TX

 

Congratulations on completing your chosen dental procedure! Now, you’ll be able to show off a beautiful and healthy set of teeth that you can be proud of. However, whether you’ve undergone cosmetic dentistry or replaced damaged or missing teeth with restorative treatment, you’ll still need to take steps to preserve good oral health. For this reason, our team has compiled the following list of post-op dental instructions in Fort Worth to follow. The below tips will guide you on best practices, such as brushing, flossing, and your diet, to help you preserve a healthier smile in the long run.

At-Home Teeth Whitening Instructions

At Home:     

• Brush and floss teeth. Take a syringe out of the kit. Remove the cap and insert a dispensing tip by twisting it securely onto the syringe.
• Place a small drop of gel onto the front side of every compartment of the tray for the teeth undergoing treatment (only include only teeth that are visible when you smile).
• Seat the tray with the gel around your teeth.
• Wipe away any excess gel on the gums with your finger, a tissue, or a dry soft toothbrush.
• Wear the trays in your mouth for 45 min 1x per day, unless otherwise directed by our team.
• After treatment, remove the tray. Rinse the tray and your mouth with lukewarm water to avoid thermal sensitivity.
• Brush teeth. Repeat the procedure daily until all material is used.

The following are some suggestions to help maximize the results of your whitening efforts.

• During the time you are whitening, and for 48 hours after, avoid or minimize:
• Smoking
• Highly colored foods (red sauce, blueberries, etc.) and
• Dark beverages (coffee, tea, etc.) – basically anything that would stain a white shirt.
• Mild sensitivity to hot or cold liquids may occur. This usually passes within 1-2 days.  If sensitivity is severe or persists, contact our office.
• If you experience gum sensitivity do not brush the afflicted area while brushing your teeth.
• Immediate whitening results can be quite dramatic due to minor dehydration of your teeth. It is normal for the color to tone down somewhat after treatment when your teeth rehydrate to a natural white tone.
• 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 (red wine, coffee, tea, etc.)
• “Touch-up” treatments are recommended every 6-12 months to retain color.
• Existing fillings, crowns, bonding, etc. will not whiten. Therefore, these may need to be changed in order to match your new smile.
• If your family or friends notice your new smile, let them know that we can help improve their smile too!

Cleaning Dentures

• Dentures should be removed at night and placed in water while you sleep.
• Place dentures in Clorox-Calgon Solution overnight, or at least 30 minutes daily.
• After soaking, thoroughly remove all cleanser by light brushing under tap water. Lightly brush dentures with a soft toothbrush. Denture brushes with stiff, coarse bristles can cause wear to the denture materials.
• To prevent breaking dentures, brush them over a towel or over a basin half-filled with water.
• Massage gums daily with a thumb, finger, or soft toothbrush for five minutes in the morning and five minutes in the evening.

CLOROX-CALGON SOLUTION (a low-cost, effective cleanser for dentures)

Formula:

• 1 teaspoon Clorox
• 2 teaspoons Calgon
• 6 ounces water

Notes:

• Calgon is a water softener that is available at some grocery stores. Do not use Calgonite (a dishwasher detergent) or Calgon Bath Oil Beads.
• Do not use this solution on dentures that have metal components.
• Do not use this solution on dentures that have a soft lining.
• Soaking dentures in this solution for a minimum of 30 minutes is required to kill most bacteria.

Tooth-Colored Composite Fillings

Take caution not to bite or chew on your cheeks, lips, and or tongue for they may be numb for several hours following your appointment.

Tooth-colored fillings may be sensitive for up to 6 months.

 It is normal for your gums to possibly be sore and bleed for a couple of days.  To ease discomfort rinse with warm salt water. (Teaspoon salt in warm water: swish & spit)

It is normal for excess “glue” that is used to help the fillings adhere to your tooth to chip off.  This is not your filling or tooth structure.  Call the office if your bite does not feel normal once the anesthetic wears off.  We can simply adjust your bite without getting you numb again.

Please call the office if you have pain in the tooth/teeth that wakes you up at night or if your cheeks /face become swollen.

Like a new set of tires, fillings can wear and break down. Proper brushing and flossing are recommended to help you retain your fillings.  Having your teeth cleaned every six months and an exam and x-rays every year will help prolong the life of your fillings.

If discomfort continues, or progresses to severe pain, or if you have any questions, please do not hesitate to call us.

Following Conscious Sedation

• Patients must be accompanied by a responsible adult. Patients may sleep, but must be watched for at least 6 hours after treatment to ensure that they are able to breathe well.
• Escort the patient from the vehicle to the house by supporting them under the arm. Do not leave the sedated patient alone in the car unassisted.
• The patient must be conscious and alert before any additional pain medication can be given. Wait at least 4-6 hours or as directed by Dr. Presley.
• Do not give food until the patient is fully awake and can speak and breathe well. The patient should be alert enough to respond to questions or ask questions.  It is very common for patients to have partial or little memory of occurrences or events that occurred during the sedation and for the first several hours after treatment.

FOR THE FOLLOWING 24 HOURS the patient is NOT to drive or perform any activities with legal implications or requiring dexterity or alert decision-making. This includes:

• Do not drive a motor vehicle
• Do not work with power tools or machinery
• Do not go to your place of employment
• Do not ingest alcohol for 24 hours after your procedure
• Only walk up and down stairs with assistance

If the patient experiences any complications call our office as soon as possible. If it is after regular office hours you may call our office through our automated answering service.

Conscious Sedation

• IF SEDATING: NO SOLIDS for 6 hours prior to surgery.
• NOT SEDATING: Eat a light meal 2 hours prior to surgery.
• NO LIQUIDS for 2 hours prior to surgery. No diuretic “water pill” day of surgery.
• NO CAFFEINE day of surgery.
• If you are an insulin-dependent diabetic, check with your physician for special insulin dosing instructions on the morning of your surgery.
• If you were prescribed a pre-med for your surgery, be sure to take the medication as directed by Dr. Oliver or Dr. Presley with a small amount of water (clear liquid only).
• Take all other medications as directed.
• Please confirm all prescriptions with your pharmacist.
• Wear loose, comfortable clothing with short sleeves to your surgery.
• Make sure fingernails are not painted and acrylic nails are removed.
• Wear flat shoes, no flip-flops or heels to your surgery.
• Remove contact lenses.
• Please turn off your cell phone before entering the operatory room.
• NO ALCOHOL within 24 hours before and after surgery.
• NO SMOKING with implant surgery 10 days prior to and 10 days after surgery.
• Following your surgery, you will be given further instructions by Dr. Presley, and post-op instructions will be reviewed with your caretaker.
• If you have any questions, please call our office.

Triazolam (Halcion®)

If prescribed, take the Triazolam (Halcion®) pill just before bed the night before your dental surgery for a better night’s sleep. If you take other sleeping medications, take those instead of Triazolam (Halcion®). Do not mix the two.

If you have a morning appointment, you should fast from solid foods after midnight. If you have an afternoon appointment, have a light breakfast.  Unless you have a medical reason to eat (diabetic, etc.), do not eat anything for 6 hours before your appointment time. Water, apple juice, and black decaffeinated coffee/tea are OK for 3 hours before your appointment. Triazolam (Halcion®) is absorbed better on an empty stomach. Do not take caffeine or sugar) for 3 hours before your appointment, as all are stimulants that decrease the effectiveness of triazolam (Halcion®). No tobacco use for 8 hours before, as it is a stimulant.

Take the triazolam (Halcion®) or diazepam (Valium®) pill(s) with a glass of water. Sparkling water makes them absorb better.

Alcohol---do not drink within 24 hours before to 24 hours after taking triazolam (Halcion®) or diazepam (Valium®).

Recreational/illegal drugs---Do not use for 7 days before your dental surgery and until 7 days after (never if you are taking narcotic pain medication). For example—using cocaine and then having local anesthetics (novocaine) can cause cardiac arrest and death.

Do not take triazolam (Halcion®) or diazepam (Valium®) if you are allergic to triazolam (Halcion®), alprazolam (Xanax®), chlordiazepoxide (Librium®, Librax®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), estazolam (ProSom®), flurazepam (Dalmane®), lorazepam (Ativan®), oxazepam (Serax®), prazepam (Centrax®), temazepam (Restoril®).

Do not take triazolam (Halcion®) or diazepam (Valium®) or use nitrous oxide (laughing gas) if you are, or think you might be, pregnant.

If you are a nursing mother, discard your milk for 1 day after taking triazolam (Halcion®) and 1 week for diazepam (Valium®). Nitrous oxide (laughing gas) alone should not affect breast milk).

Do not take triazolam (Halcion®) or diazepam (Valium®) if you have acute narrow-angle glaucoma.

Triazolam  (Halcion®) can dry your eyes out. Don’t wear contact lenses to your appointment.

Antacids (such as Maalox®, Mylanta®, and Tums®), reduce the absorption and effectiveness of triazolam (Halcion®) or diazepam (Valium®) if taken within 3 hours of taking triazolam (Halcion®) or diazepam (Valium®).

Heartburn/ulcer medications: Tagamet® (cimetidine), Pepcid® (famotidine),  Zantac® (ranitidine), Prilosec® (omeprazole and Nexium® (esomeprazole) should not be taken within 24 hours before to 24 hours after taking triazolam (Halcion®) or diazepam (Valium®). They increase the potency of both taking triazolam (Halcion®) and diazepam (Valium®).

Narcotic pain medications (such as codeine, Vicodin®, Percodan®, Demerol®, and others) should not be taken within 12 hours before to 8 hours after taking triazolam (Halcion®) or diazepam (Valium®).  Post-operatively, do not take any narcotic pain medication until 8 hours after you take the triazolam (Halcion®). 1000mg Tylenol® (acetaminophen) and 600 mg ibuprofen taken together (maximum of once every 6 hours) is an excellent replacement/substitute for a narcotic. If you can’t take ibuprofen, let us know so we can get you another medication you can take that triazolam (Halcion®) will not interfere with.

Do not eat grapefruit or drink grapefruit juice while taking triazolam (Halcion®) or diazepam (Valium®). With either drug, grapefruit increases the amount of the drug absorbed and the amount of time it stays in the body, thus having the potential to way over sedate you.  Therefore, people taking triazolam (Halcion®) or diazepam (Valium®) should totally avoid grapefruit and grapefruit juice starting 3 days before taking these medications and wait until the day after your appointment to consume them again. Even one small glass or a half grapefruit will have this effect and take 3 days to clear your body.

The following drugs have the same effect as grapefruit. They increase the potency and duration of triazolam (Halcion®) or diazepam (Valium®). Let us know if you are taking these, as we may reduce the amount of triazolam (Halcion®) or diazepam (Valium®):

Antidepressants, such as but not limited to Sertraline (Zoloft®), Paroxetine (Paxil®),   Amitriptyline (Elavil®), Clomipramine (Anafranil®), Isocarboxazid (Marplan),  Phenelzine (Nardil®), Tranylcypromine (Parnate®), Fluoxetine (Prozac®), Bupropion (Wellbutrin®)  Ergotamine (Cafergot®) used migraines  Fluvoxamine (Luvox®)  used for obsessive-compulsive disorder  Alprazolam (Xanax®)  or BuSpar  used for anxiety

Nutritional supplements: St. John’s Wort, Kava Kava, Gotu Kola, and Valerian may greatly decrease the longevity of the sedation effects of triazolam (Halcion®) and diazepam (Valium®), while potentially greatly increasing the profoundness of the sedation. Do not take these herbs for 10 days before taking triazolam (Halcion®) or diazepam (Valium®). You can resume taking them the next day.

Do not take triazolam (Halcion®) if you are taking the following medications:

Diltiazem (Cardizem®, Dilacor®, Tiazac®, Tiamate®, Cartia®, and others) used for high blood pressure and angina Verapamil (Calan®, Verelan®, Covera®, Isoptin®, Tarka®) used for high blood pressure.

Do not take triazolam (Halcion®) or diazepam (Valium®) if you are taking the following medications: Ketoconazole (Nizoral®)  used for yeast/fungal infections Itraconazole  (Sporanox®)  used for yeast/fungal infections Nefazodone (Serzone®) used as an anti-depressant Ritonavir (Norvir®)  used for HIV/AIDS Atazanavir (Reyataz®)  used for HIV/AIDS Cyclosporin, (Sandimmune®, Neoral®) used for organ transplant rejection  Diltiazem (Cardizem®, Dilacor®, Tiazac®, and others) used for high blood pressure  and angina  Imatinib (Glivec®)  used to treat leukemia  Izoniazid (Nydrazid®) used to treat TB  Nicardipine (Cardene ®)  used to treat high blood pressure  Quinidine (Quinora®, Quinidex®, Cardioquin®) used to treat abnormal heart rhythms  Clozapine (Clozaril®, FazaClo®)  used to treat schizophrenia, Erythromycin (many brands including E-mycin®), EES®, PCE®) used as an antibiotic Clarithromycin (Biaxin®) used as an antibiotic  Telithromycin (Ketek®) used as an antibiotic  Diclofenac (Voltaren®), used as prescription eye drops or pills for arthritis or cramps.

The following medications can decrease the effects of sedation from triazolam (Halcion®) or diazepam (Valium®). That does not mean discontinue these medications, just be aware that the sedation may not be profound.  Aminoglutethimide (Cytadren®) is used to treat Cushing’s syndrome.  Carbamazepine (Carbatrol®, Tegretol®) used to treat seizures, bipolar,  trigemina neuralgia.  Nafcillin  (Unipen®) is a specific antibiotic.  Nevirapine  (Viramune®) is used to treat HIV/AIDS.  Phenobarbital is used to control epileptic seizures. Phenytoin (Dilantin®) is used to control epileptic seizures.  Rifamycins are a class of antibiotics used to treat TB.  Theophylline  (TheoDur®, Theolair®, and others) used to treat asthma, emphysema, or chronic bronchitis

Arrange for a ride to and from your dental appointment. Your ride does not need to stay the entire appointment. They can come back at a certain time, and leave a telephone number in case we finish early or run late.  We will ask your driver to sign that we are releasing you into their care and they will drive, not you.

Do not drive a motor vehicle after taking triazolam (Halcion®) or diazepam (Valium®). Do not drive for the rest of the day after taking the triazolam (Halcion®) or diazepam (Valium®) pill(s). It is illegal to drive a motor vehicle under the influence of any mind-altering substance, including legal medications. That also includes narcotics, such as codeine, Vicodin® (hydrocodone), Demerol® (meperidine), and Percodan®/Percocet®/Roxicet® (oxycodone). Ibuprofen, Tylenol®, and antibiotics are not mind-altering.

Go to the restroom as soon as you get here. It saves interrupting your surgery for a “groggy” trip to the restroom.

After you get home from your oral surgery, rest and drink plenty of water, at least 6 glasses the rest of the day. If you get up in the middle of the night, have another glass of water. Water consumption eliminates a “Halcion hangover” the next day. If you take plenty of water after you get home, you will not experience a hangover and you will feel fine the next day.

Arrange for someone to stay with you the rest of the day after you get home. You may feel fine, but triazolam (Halcion®) can be amnesic for some people for up to 8 hours later. That means you may do stuff you don’t remember. That’s not safe if you are alone, or if you try to drive a car, cut the grass, etc.

Do not plan on signing any legal papers for 24 hours after you take triazolam (Halcion®) or diazepam (Valium®), or for as long as you are taking narcotic pain medications.

Do not go up and downstairs for the rest of the surgery day without an adult helping you and they are one step below you, It is best to avoid stairs for the day.

Follow your post-op instructions for rest in a recliner chair, ice the surgical area and have something of nutritious value, like Ensure, Carnation Instant Breakfast, Boost, Glucerna for diabetics, etc. as soon as you arrive home.

***We will discuss your procedure and follow-up instructions and care with your driver, escort/companion, spouse, or caregiver because you may not remember what we told you.

Dental Crown Delivery

• Please avoid chewing or biting directly on the treated tooth.
• Always brush and floss around the tooth. When flossing, pull the floss through instead of upward or downward.
• Try to stay away from sticky foods such as gum, caramel, and taffy.

You may experience some temperature sensitivity with the crown; this is not unusual and should be short-term.  The bite on the new crown should feel normal; if the bite feels “off,” please contact the office for a simple bite adjustment.

You may have some tenderness in the gums around the teeth we worked on for a day or so.  It is helpful to swish with warm salt water to reduce inflammation and redness.

Over-the-counter analgesics usually alleviate the discomfort.  We usually recommend 600 mg Ibuprofen every 6 hours as needed for pain.

If discomfort continues or progresses to severe pain, or if you have any questions, please do not hesitate to call us.

Dental Crown Preparation

Your tooth has just been prepared for a crown, and a temporary crown has been placed.

It is very important that your temporary crown stays on!  The temporary crown protects your tooth and helps it maintain its position.  If it comes off, your tooth may shift, and the permanent crown may not fit.  Please contact the office to have it re-cemented as soon as possible.

• Please avoid chewing or biting directly on the treated tooth. The temporary crown is plastic and could break.
• Always brush and floss around the tooth. When flossing, pull the floss through instead of upward or downward.
• Try to stay away from sticky foods such as gum, caramel, and taffy.

You may experience some temperature sensitivity with the temporary crown; this is not unusual and should be short-term.  The bite on a temporary should feel normal; if the bite feels “off,” please contact the office for a simple bite adjustment.

You may have some tenderness in the gums around the teeth we worked on for a day or so.  It is helpful to swish with warm salt water to reduce inflammation and redness.

Over-the-counter analgesics usually alleviate the discomfort.  We usually recommend 600 mg Ibuprofen every 6 hours as needed for pain.

If discomfort continues or progresses to severe pain, or if you have any questions, please do not hesitate to call us.

Denture Maintenance

Removable partial or full dentures require proper care to keep them clean, free from stains, and looking their best. For good denture care:

• Remove and rinse dentures after eating. Run water over your dentures to remove food debris and other loose particles. You may want to place a towel on the counter or in the sink or put some water in the sink so the dentures won't break if you drop them.
• Handle your dentures carefully. Be sure you don't bend or damage the plastic or the clasps when cleaning.
• Clean your mouth after removing your dentures. Use a soft-bristled toothbrush on natural teeth and gauze or a soft toothbrush to clean the tongue, cheeks, and roof of your mouth (palate).
• Brush your dentures at least daily. Gently clean your dentures daily by soaking and brushing with a nonabrasive denture cleanser to remove food, plaque, and other deposits. If you use denture adhesive, clean the grooves that fit against your gums to remove any remaining adhesive. Do not use denture cleansers inside your mouth.
• Soak dentures overnight. Most types of dentures need to remain moist to keep their shape. Place the dentures in water or a mild denture-soaking solution overnight. Check with your dentist about properly storing your dentures overnight. Follow the manufacturer's instructions on cleaning and soaking solutions.
• Rinse dentures before putting them back in your mouth, especially if using a denture-soaking solution. These solutions can contain harmful chemicals that cause vomiting, pain, or burns if swallowed.
• Schedule regular dental checkups. Your dentist will advise you about how often to visit to have your dentures examined and professionally cleaned. Your dentist can help ensure a proper fit to prevent slippage and discomfort. Your dentist can also check the inside of your mouth to make sure it's healthy.
• See your dentist if you have a loose fit. See your dentist promptly if your dentures become loose. Loose dentures can cause irritation, sores, and infection.

Here are a few things you typically should avoid:

• Abrasive cleaning materials. Avoid stiff-bristled brushes, strong cleansers, and harsh toothpaste, as these are too abrasive and can damage your dentures.
• Whitening toothpaste. Toothpaste advertised as whitening pastes is especially abrasive and generally should be avoided on dentures.
• Bleach-containing products. Do not use any bleaching products because these can weaken dentures and change their color. Don't soak dentures with metal attachments in solutions that contain chlorine because it can tarnish and corrode the metal.
• Hot water. Avoid hot or boiling water that could warp your dentures.

Please do not hesitate to call our office with any additional questions or concerns.

Instructions for Dental Infections

An infection (abscess) of a tooth or the gums can start out small, but can quickly become quite severe, even requiring hospitalization, if not attended to properly.

Be sure to follow these instructions faithfully. The success of fighting the infection is dependent largely on how closely you follow them. If you have any questions or problems, contact us, please.

• If antibiotics are prescribed, start taking them immediately. Take them exactly as it says on the label. Finish all the pills even if you feel better before they are gone.
• If pain medication is prescribed, take it as you need it. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions.
• Avoid pain medications with aspirin. Nuprin or Advil are good alternatives.
• Use warm saltwater "holds". Mix 1 teaspoon salt in a glass of warm water. Take a mouthful and pouch it in your cheek over the infection area until the water cools; repeat until the water is gone. Doing this every hour helps pull the infection toward the surface of the gums so it can drain. Doing this at the same time as using the cold packs outside of the mouth enhances the effect.
• Use cold packs on the face over the infected area. Place on face for 15-20 minutes, then leave off for 15-20 minutes. DO NOT use heating pads on the outside of the face. This can cause the infection to worsen and spread further.
• Maintain a good, balanced diet, and get plenty of rest. Your body needs extra energy when fighting infections. You may need to eat softer foods.
• Avoid smoking until the infection has subsided. If you must smoke, keep it to an absolute minimum.

Even when following these instructions, it may take at least 24 hours for the infection and discomfort to stop increasing. If you don't get significant improvement within 48 hours, or if it continues to get worse after 24 hours, call our office.

Night Guard / Occlusal Guards

Getting Used to the Occlusal Guard: If you are concerned about getting used to your occlusal guard, especially if this is your first appliance, then consider the first week as an adjustment period.

At first, you may salivate more than normal. If you are having a hard time getting used to your appliance, after dinner each night, wear the night guard for several hours. Once you find you no longer notice it, you will be able to wear it comfortably while you sleep.

Our Concerns:

• If it binds on a tooth (teeth), we should adjust it.
• If, after wearing for the entire night, when removed it feels like your teeth have shifted or you experience jaw pain, please call our office as soon as possible.
• If you attempt to wear it after it has been “out” for a period of time, you may find that it no longer fits. Your teeth have shifted. We need to adjust the appliance.

Our goal is to help you keep your teeth for a lifetime of good health. Wearing this appliance helps decrease pressure on your teeth, joints, and bone.

Rationale: While the appliance does protect your teeth from grinding and clenching, it is actually meant to remind you to keep your teeth apart. If it gets so comfortable that you find yourself grinding into it, please tell us and we will adjust it.

Cleaning: Occlusal guards will discolor over time. This is not a problem. Rinse thoroughly after every use with lukewarm water (hot water will cause distortion). Brush with a toothbrush and dial soap to help prevent tartar buildup. Soak in denture cleaner 1x/week.

Please bring your occlusal guard with you for all dental appointments.

We will examine and clean it for you.

Warning: Dogs love to chew night guards!

It’s an expensive snack!

Recommendations for Moderate to Severe Pain Following Dental Surgery

Recent studies on pain control are indicating that taking a non-steroidal anti-inflammatory drug such as ibuprofen (Advil®, Motrin®) together with acetaminophen (Tylenol®) has more significant post-operative pain relief than taking either drug alone.  Also, the ibuprofen and acetaminophen combination has significantly more pain relief than narcotic medications such as codeine, hydrocodone (Vicodin®, Norco®, Lortab®), and oxycodone (Percocet®, Percodan®).

For mild discomfort following endodontic treatment, 400-600mg of ibuprofen (2 or 3 Advil®, Motrin®) is usually adequate (or if you are unable to take ibuprofen, 500-1000mg of acetaminophen (1 or 2 Extra Strength Tylenol®).

If you are experiencing moderate to severe pain, we suggested you take 600mg of ibuprofen and 1000mg of acetaminophen at the same time.  If this does not give you adequate pain relief, please contact us for advice.

Maximum daily doses for these over-the-counter medications (OTC):

Drug Generic Name	Max Daily Dose	Brand Name
Ibuprofen	3200mg	Motrin®, Advil®, Nuprin®
Acetaminophen	3000mg	Tylenol®, Excedrin®
Naproxen Sodium	1250mg	Aleve®, Anaprox®, Pamprin®, Midol® extended relief
Aspirin (Acetylsalicylic Acid)	4000mg	Bayer®, Bufferin®, Ecotrin®, Anacin®

Please DO NOT take over the recommended maximum daily dosage of either medication.

Maximum Dose per day: Ibuprofen (Advil or Motrin) 3200 mg, Acetaminophen (Extra strength Tylenol) 3000 mg

It is important to note that many over-the-counter cold relief medications contain some of the above medications and will impact your daily maximum dose.  Also note consumption of alcohol with acetaminophen (Tylenol, Excedrin) can be harmful due to the effect on the liver. Many prescription medications can also be impacted by these over-the-counter medications and you should consult with your pharmacist or physician for advice prior to taking any medications

Immediate Denture

• For the first 24 hours, your immediate denture is not to be removed from your mouth. If the denture is removed, swelling may occur that will make it difficult or impossible to replace the denture. Oozing of blood around the denture is normal and is no cause for concern.
• Your immediate denture not only replaces your missing teeth, but is acting to protect the surgical site, control swelling, and control bleeding. The denture needs to be in place to be effective.
• Do not rinse your mouth with anything for 24 hours; however, continue to brush your remaining teeth carefully. After 24 hours, we will see you for a follow-up. After your follow-up, in addition to your routine brushing, gently rinse your mouth with a lukewarm salt-water solution (made by dissolving 1/2 teaspoon of table salt in an 8 oz. glass of warm water.) Rinse 3 to 4 times a day for four or five days. Take care not to strain or empty your mouth with undue force.
• After extractions do not spit, smoke, or suck on a straw. Do not rinse your mouth vigorously. Do not drink any hot beverages or carbonated beverages. All of these things can dislodge blood clots that are necessary for healing.
• Take all medications as prescribed. If a prescription for pain is written, you should not operate a motor vehicle while taking this medication. Some discomfort may be expected following oral surgery procedures.
• Provided you are not allergic to aspirin or aspirin-related medication, one or two aspirin or Ibuprofen every 4-6 hours will usually relieve discomfort. You can take up to 800 mg of Ibuprofen every 6 hours (do not exceed 3200mg in a 24-hour period)
• If you cannot take aspirin or aspirin-related medication then one or two Tylenol tablets every three to four hours will usually relieve the discomfort.
• Swelling is common after oral surgery for up to one week with the maximum amount of swelling usually present on the second day after surgery. The swelling will slowly resolve over 4-7 days. Apply an ice bag to the outside of the face for 20 minutes, and then leave off for 20 minutes. Repeat this procedure for 24 hours, and then discontinue using the ice. This will reduce discomfort, bleeding, and swelling.
• You may eat and drink. Soft foods are advisable for at least 24 hours. Avoid hard or crunchy foods. Drink as much liquid as possible, but do not go on a liquid diet. Do not consume liquids through a straw. You may resume normal physical activity as tolerated 2-3 days after your surgery.

If you have any questions or concerns please call our office at your soonest convenience.

Dental Bone Graft

What to expect following surgery:

• Bleeding: Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
• Pain: Moderate discomfort may be noticed when the anesthetic first wears off and may continue for several days.
• Swelling: Some swelling and discoloration of the lip and/or cheek may occur and may last for a few days.
• Sensation: There may be a temporary loss of feeling in the gums in the operated area. The teeth may also feel loose for a time. The teeth may be sensitive to hot and cold temperatures.

What to do following the surgery:

• After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.
• Take two Tylenol, Nuprin, Advil, or similar non-aspirin pain relievers every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off.
• If pain medication is prescribed, take it as you need it. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.
• Nausea is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.
• Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.
• Eat soft foods for the first 2 - 4 days. Maintain a good, balanced diet. Drink plenty of water. Do not drink through a straw. Avoid alcohol for 48 hours.
• Avoid chewing directly over the operated area until the sutures are removed.
• Brush all of your teeth after each meal. Avoid the operated area for the first day. Take care to avoid pulling the sutures.
• Do not rinse vigorously; do not use a Waterpik®.
• A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water) held in your mouth for 2 to 3 minutes every hour may make your mouth more comfortable.
• If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.
• Avoid lifting the lip with your fingers to look at the area. It is possible to accidentally tear the sutures, open the incision, and delay healing.
• Smoking should be stopped following surgery. The healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body.
• If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.
• You may be instructed to use a prescription antimicrobial mouth rinse.
• Return to your dentist's office for removal of the sutures or follow-up checks as directed.

Please call your dentist if you have:

• uncontrollable pain
• excessive or severe bleeding
• marked fever
• excessive warm swelling occurring a few days after the procedure
• reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.

Dental Implant Placement

BLEEDING:  Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

SMOKING:  Smoking should be stopped following surgery. The healing and success of the implant will be substantially reduced by the cigarette smoke chemicals in your body.

PAIN:  Some discomfort is normal after surgery. To minimize pain, Take two Tylenol, Nuprin, Advil, or a similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

NAUSEA:  This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING:   Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

NUMBNESS:  The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the implant procedure causes residual numbness or tingling for six weeks or longer.

BRUSHING:  Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.

RINSING:  Avoid all rinsing or swishing for 24 hours after your procedure. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water). Avoid commercial mouth rinses. You may be instructed to use a prescription antimicrobial mouth rinse.

DIET:  Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

ACTIVITY:   After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid heit aling.

ANTIBIOTICS:  If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS:  If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

REMOVABLE APPLIANCES, DENTURES:  Your dentist will give you specific instructions about your prosthesis. To avoid putting any pressure on the new implants before they have healed, your denture might be adjusted or significantly modified. In certain cases, you will need to go without your dentures for a period (days or weeks) after the implants are placed. Sometimes a temporary removable appliance is made for cosmetic purposes until a new non-removable one can be made.

FOLLOW-UP APPOINTMENTS:  You may need to return to the office within the first 14 days to have sutures removed, or just for a brief follow-up healing check. You may need to return after the implant has been integrated for a small second procedure to expose it in preparation for the final restoration.

Please call your dentist if you have:

• uncontrollable pain
• excessive or severe bleeding
• marked fever
• excessive warm swelling occurring a few days after the procedure
• reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.

Root Canal

Root canal treatment often takes two or more appointments to complete.  After each appointment when an anesthetic has been used, your lips, teeth, and tongue may be numb for several hours.  Avoid any chewing on the side of the treated tooth until the numbness has completely worn off.

A temporary filling or crown is placed by your dentist to protect the tooth between appointments.

Between appointments, it's common (and not a problem) for a small portion of your temporary filling or crown to wear away or break off. If the entire filling falls out, or if a temporary crown comes off, please call our office so it can be replaced.

To protect the tooth and help keep your temporary in place:

• Avoid chewing sticky foods (especially gum), and hard foods, such as ice.
• If possible, chew only on the opposite side of your mouth.
• It's important to continue to brush and floss normally.

It's normal to experience some discomfort for several days after a root canal therapy appointment, especially when chewing. 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). Even if you were not experiencing any discomfort prior to treatment, it is normal for you to experience some degree of discomfort for a few days after. The tenderness is normal and is no cause for alarm.

To control discomfort, take pain medication as recommended by your dentist. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

If you were not prescribed pain medication by us but are experiencing pain after your appointment, we recommend taking over-the-counter pain medication. We recommend ibuprofen (Motrin, Advil, Nuprin) or naproxen (Aleve, Anaprox).

Should you experience discomfort that cannot be controlled with pain medications or should swelling develop, please call our office.

To further reduce pain and swelling, rinse three times a day with warm salt water; dissolve a teaspoon of salt in a cup of warm water, then rinse, swish, and spit.

Usually, the last step after root canal treatment is the placement of a crown on the tooth. A crown covers and protects the tooth from breaking in the future. Unless otherwise noted by the dentist, it is critical to have a crown placed on your root canal therapy-treated tooth as soon as possible.

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

If your bite feels uneven, you have persistent pain, or you have any other questions or concerns, please call our dental office.

Deep Scale Patients Instructions

To minimize the discomfort and aid proper healing following your deep cleaning, we suggest the following:

• After the procedure, take Tylenol (acetaminophen), or Advil (ibuprofen) before the anesthetic wears off. Continue to take one tablet every four hours for the next two days as needed.
• Rinse with a warm salt-water solution (mix ½ teaspoon salt in 8 oz. warm water) two or three times an hour for the next day or two.
• Use a soft toothbrush at least two times a day. Be gentle and clean thoroughly. Slight bleeding may occur while brushing as the tissues begin to heal.
• Avoid strong spicy seasonings, and hard chips for the next few days.
• As the tissues heal, some sensitivity to cold may occur. Use a desensitizing toothpaste (such as Sensodyne or Denquil), or fluoride gel (such as Prevident or Gel-Kam) frequently (at least 4 times/day) for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.
• Faithfully use any other oral hygiene aids that have been recommended (floss, Perio-Aid, rubber tip, Sonicare, Proxabrush, Gel-Kam fluoride, Peridex mouth rinse, etc).
• Refrain from smoking for 24 hours or longer. Tobacco interferes with healing.
• If you have any questions or concerns, please call our office.

Space Maintainer Delivery

Your child has just had a space maintainer placed to prevent the teeth from crowding and allows adequate space to be held for his/her permanent teeth that have not erupted into the mouth yet.

Appliance care at home will increase the longevity of the appliance and ensure that fewer dental urgencies occur.  The appliance will be evaluated at recall appointments and cleanings regularly.

Please remember to:

• Avoid chewy, sticky, crunchy foods. Chewy food can dislodge appliances, and crunchy food can get underneath and cause irritation to the gums.
• Don’t let children play with the appliance with their hands or tongues. If the appliance gets bent or damaged, it may need to be replaced.
• If the appliance is loose and can be removed from the mouth, remove it. If the appliance cannot be removed (if attached to another tooth) push the appliance back on the tooth and do not let the child bite on it, which could cause damage. In both situations, call our office as soon as possible
• Children may experience discomfort for a day or two after an appliance is placed. Over-the-counter analgesics such as acetaminophen or ibuprofen can be beneficial during this period.
• Keep the child’s appliance clean by continuing normal oral hygiene practices. If the child is experiencing significant discomfort in the area of the appliance, contact our office.
• Continue making regular dental visits so the appliance can be verified for fit, and removed at the proper time.

If discomfort continues or progresses to severe pain, or if you have any questions, please do not hesitate to call us.

Tooth Extraction

DO NOT DISTURB THE AREA: For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process. Swishing, sucking through a straw, and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side for 24 hours.

BLEEDING: When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 minutes. Don't change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on another gauze or a tea bag for another 30 minutes if you feel it is still bleeding. Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

SMOKING: Smoking should be stopped following surgery. The healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also, the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful Dry Socket.

PAIN: Some discomfort is normal after surgery. To minimize pain, Take two Tylenol, Nuprin, Advil, or a similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer.

BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.

RINSING: Avoid all rinsing or swishing for 24 hours after the extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and the risk of a dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water). Avoid commercial mouth rinses.

DIET: Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

ACTIVITY: After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

FOLLOW-UP APPOINTMENTS: You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.

Please call your dentist if you have:

• uncontrollable pain
• excessive or severe bleeding
• marked fever
• excessive warm swelling occurring a few days after the procedure
• reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success