Patient Info

Home Instructions

After Cosmetic Reconstruction | After Crown and Bridge Appointments | Post Operative Instructions for Tooth Extraction | After Composite Fillings | Instructions for Home care Following the Placement of Dental Implants | Cheat Sheet for Your Driver

After Cosmetic Reconstruction (Printable version)

Remember that it will take time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed it takes several days for the brain to recognize the new position of your teeth or their thickness as normal. If you continue to detect any high spots or problems with your bite, call our office so we can schedule an adjustment appointment.

It is normal to experience some hot and cold sensitivity. The teeth require some time to heal after removal of tooth structure and will be sensitive in the interim. Your gums may also be sore for a few days. Warm salt water rinses (a teaspoon of salt in a cup of warm water) three times a day will reduce pain and swelling. A mild pain medication (one tablet of Tylenol or Ibuprofen (Motrin) every 3-4 hours) should ease any residual discomfort.

Don’t be concerned if your speech is affected for the first few days. You’ll quickly adapt and be speaking normally. You may notice increased salivation. This is because your brain is responding to the new size and shape of your teeth. This should subside to normal in about a week.

Daily brushing and flossing are a must for your new dental work. Daily plaque removal is critical for the long-term success of your new teeth, as are regular cleaning appointments.

Any food that can crack, chip or damage a natural tooth can do the same to your new teeth. Avoid hard foods and substances (such as beer nuts, peanut brittle, ice, fingernails, or pencils) and sticky candies. Smoking will stain your new teeth. Minimize or avoid foods that stain such as coffee, red wine, tea and berries.

If you engage in sports let us know so we can make a custom mouthguard. If you grind your teeth at night, wear the night guard we have provided for you. Adjusting to the look and feel of your new smile will take time. If you have any problems or concerns, please let us know. We always welcome your questions.

After sealants and fillings, it is normal for extra pieces of material to come off as the restoration settles around the biting surface of your tooth. It is possible if you grind your teeth at night or through the stress of the day that the filling or sealant will fall out, but losing a sealant or filling quickly after having it placed is not usual. If you think more than excess resin material has come off of your tooth, call our office and come in for a free follow up visit.

After Crown and Bridge Appointments (Printable version)

With our advanced Cerec technology in many instances with a single visit we are able to deliver your crown with no temporaries that fall off or bad tasting impressions, and we make it convenient eliminating multiple appointments to get your crown. With a Cerec crown, the most commonly seen symptoms for patients, albeit rare, is sensitivity to hot and cold and biting pressure. This occurs when the tooth is becoming adjusted to the restoration that is being bonded to it. The bonding process creates microstrains on the tooth that can irritate the nerve creating these symptoms. With advancements in bonding we have significantly decreased this but if symptoms occur they can last for up to 6-8 weeks. It is extremely rare that symptoms persist longer than that. If they do, please follow up with our office as this is not normal.

Unfortunately Cerec technology has not advanced to the point where we can fabricate bridges. Therefore bridges are still made in the traditional sense of taking impressions, making temporaries and having multiple appointments.

So, the potential for a temporary bridge to fall off is there and if this happens please contact our office and we can cement it If a temporary falls off on a weekend, many drugstores and retail stores have a temporary cement that you can apply until you can get back to the office. Good news though, Cerec technology is coming soon that will allow us to fabricate bridges also eliminating these circumstances entirely.

Occasionally a temporary bridge may come off. Call us if this happens and bring the temporary bridge with you so we can re-cement it. It is very important for the temporary to stay in place, as it will prevent other teeth from moving and compromising the fit of your final restoration.

To keep your temporaries in place, avoid eating sticky foods (gum), hard foods, and if possible, chew on the opposite side of your mouth. It is important to brush normally, but floss carefully and don’t pull up on the floss which may dislodge the temporary but pull the floss out from the side of the temporary bridge.

It is normal to experience some temperature and pressure sensitivity after each appointment. The sensitivity should subside a few weeks after the placement of the final restoration. Mild pain medications may also be used as directed by our office.

If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office at 1-888-227-1859.

Post Operative Instructions for Tooth Extraction (Printable version)

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times. You want the blood to go into the gauze rather than going down your throat into your stomach. Blood in the stomach will make you nauseous. If you feel nauseous please call our office as we can prescribe something for this.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aides healing. Do not rinse vigorously, suck on straws, drink hot beverages, eat spicy foods, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours to avoid infection or a painful dry socket. These activities will dislodge or dissolve the clot and slow the healing process.

You will want to eat soft foods and swish water into your mouth and let it fall out into the sink, rather than spitting it out, to clean your mouth. After 24 hours, start gently washing with warm, salt water four times a day for one week.

Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

If our Doctors prescribe medicine for pain, do not drive or operate machinery while taking the medication. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone and even after the tooth has been removed. Removing the tooth did not remove all of the bacteria that we are fighting with the antibiotics. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately at 1-888-227-1859.

After Composite Fillings (white fillings)(Printable version)

When an anesthetic has been used, your lips and tongue may be numb for several hours after the appointment. Avoid any chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue or lip while you are numb. It is normal to experience some hot, cold & pressure sensitivity after your appointment. Injection sites may also be sore. Ibuprofen (Motrin), Tylenol or aspirin, whichever you can take, work well to alleviate the tenderness. If pressure or sensitivity persists beyond a few days or if the sensitivity to hot or cold increases, contact our office.

You may chew with your composite fillings as soon as the anesthetic completely wears off, since they are fully set when you leave the office. If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office at 1-888-227-1859.

Make sure children do not chew their cheeks or their tongue while they are numb because their mouth “feels funny” as the tissues may become raw and will hurt when they are no longer numb.

Instructions for Home care Following the Placement of Dental Implants (Printable version)

The placement of implants with or without removing teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gingival (gum) tissue.

Bleeding:

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed with pressure directly on the bleeding wound for 30 minutes. If bleeding appears excessive, or continues after the third post- operative day, please call for further instructions. Changing out gauze frequently before it is completely saturated can help blood from being swallowed. Blood swallowed upsets the stomach and may make you feel nauseous.

Swelling:

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice pack, or a plastic bag filled with ice on the cheek in the area of surgery. Apply ice continuously, as much as possible, for the first 24-48 hours.

Diet:

After general or IV sedation, liquids should be taken at first. Drink plenty of fluids but do not use a straw. The sucking motion can cause more bleeding or dislodge a blood clot. Drink from a glass. Avoid hot liquids or hot food for the first 24-48 hours. Some liquids or soft food should be eaten on the day of surgery. Cool or cold liquids such as ice cream, frozen yogurt, or a milkshake may be soothing to the mouth. You may eat anything soft by chewing away from the surgical site. Nourishment should be taken regularly. High calorie, high protein intake is very important during the healing phase. Your solid food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat. The return to a normal diet is generally achieved after three weeks of healing, or as directed by your Doctor.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. Therefore immediately following surgery, if you are lying down, make sure you sit for a minute or so before standing. Be especially cautious if you have been sedated for your procedure. You will want to have someone help you balance yourself if you are groggy from sedation or medication and get up to move about or go to the restroom. Sometimes you will still be a little sleepy and you will feel like you have your balance when you may not yet, so you really should let someone know when you need to get up so they can be there to offer an arm of support if needed.

Pain:

You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, two 200mg tablets of ibuprofen (Motrin or Advil) may be taken every four hours with something to eat as needed and as long as you have no allergy to ibuprofen. For patients who are allergic to Aspirin or cannot take ibuprofen, one or two tablets of regular or Extra Strength Tylenol may be taken every four hours as needed and as long as you have no allergy to acetaminophen products.

For severe pain take the tablets prescribed for pain as directed. The prescribed medicine may make you groggy and will slow down your reflexes. Do not drive or work around heavy machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain or swelling persists or worsens after the third post-operative day or if unusual symptoms occur, it may require attention and you should call the office.

Oral hygiene:

Good oral hygiene is essential to good healing. No rinsing of any kind should be done until the day after surgery! The night after surgery, you may rinse gently by taking water into your mouth and letting it fall back out into the sink without swishing or spitting. The day after surgery, a non-alcohol based oral mouth rinse should be used twice daily, after breakfast, and before bed. A q-tip may be used to clean the healing abutments. Dip the q-tip into the cap of the mouth rinse, and gently clean the healing abutments twice a day prior to rinsing. Be sure to rinse for at least 30 seconds then spit. Warm salt water rinse (a teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day as well, especially after meals. Gently brushing your teeth at least one tooth away from the implant sites is no problem. A soft bristled brush is best. The area of the implants or healing abutments should only be brushed when instructed by your doctor.

Discoloration:

In some cases, discoloration of the skin (bruising) may occur. The development of blue, black, green, or yellow discoloration is due to blood spreading beneath the tissues. This is normal post-operative occurrence, which may occur 2-3 days post operatively. Moist heat applied to the area may speed up the removal of discoloration.

Antibiotics:

Be sure to take the prescribed antibiotics as directed to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed and for the full course. Antibiotics given are to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have a concern.

Nausea or Vomiting:

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including prescribed medication. You should sip on small amounts of cola, iced tea, or ginger ale. You should sip slowly over a fifteen minute period. When the nausea subsides you can begin taking solid foods slowly and the prescribed medications. Smaller amounts of the pain medication (i.e. ½ tablet) taken more frequently with food helps reduce the incidence of nausea and pills can be readily broken or carefully cut with a sharp knife.

Other Complications:

If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb you could bite it and not feel it so be careful. Call our office if you have any questions about this.

Slight elevation in temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen, for those not allergic to them, should be used to reduce fever.

You should be careful going from a lying down position to standing, as you are not able to eat or drink anything prior to surgery, and taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for a minute or two then get up.

Occasionally patients may feel hard projections in the mouth with their tongue where teeth have been removed. These are not roots; they are bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by the Doctor.

If the corners of your mouth are stretched, they may dry or crack. Your lips should be kept moist with an ointment such as Vaseline.

Sore throats and pain while swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.

Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Activity:

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you further and may limit your ability to exercise.

Wearing your prosthesis:

Partial dentures, flippers, or full dentures should be used only as discussed by your doctor in the pre-operative consultation. If you have any questions about this, please feel free to contact our office.

Dry Socket:

A dry socket is caused when the blood clot gets dislodged prematurely from the tooth socket where a tooth has been removed. Symptoms of pain at the surgical site radiating to the ear may occur 2-3 days following surgery. There is a low incidence of dry socket in our office, but it can occur. Not smoking and not sucking through a straw will help this painful condition from occurring. If you think you have a dry socket, contact our office.

Finally:

Sutures may be placed in the area of surgery to minimize post-operative bleeding and help healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the suture from the mouth and discard it. The sutures will either dissolve themselves or will be another type placed which will be removed by the Doctor approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So, it’s really nothing to worry about.

Cheat Sheet for Your Driver (Printable version)

You will want to make sure you have the following as you leave our office:

Any personal belongings of yours or the patient’s
Any prescriptions needed- antibiotics or pain medications
A follow up appointment
Gauze to be changed out frequently

*Encourage the patient to get comfortable and take a nap when you get them home*

The following will be needed when the patient gets home or wakes up from napping:

Watch for them to wake so you can help them walk to the bathroom if they need to go
Cool liquids-remember don’t give them a straw!-Cola if they are nauseous
Any medications from the pharmacy
Non-alcoholic mouth wash with a q-tip and warm water and salt for rinsing-NO rinsing today!
Something soft to eat cold pasta/jello/ice cream-remember nothing HOT to eat or drink today!
cold pack or a baggy filled with ice if the patient complains of swelling