Postoperative Instructions

After Implant Surgery

After implants have been placed, it's important to follow these recommendations to ensure their long-term success.

General Care

• To control minor bleeding, apply moderate pressure with gauze pads or a clean, moist tea bag wrapped in a gauze pad.
• Limit yourself to calm activities for the first three to five days to keep your blood pressure stable and reduce bleeding.
• If you usually wear a removable denture or partial denture, we will give you specific instructions about wearing it while your implants heal.

Tobacco use

• Don’t use tobacco for at least 24 hours, and avoid tobacco as much as possible for several months. Tobacco slows healing and increases the risk that your body will reject the implants, and it’s the leading cause of implant failure.

When to call us

• Call us right away if you have heavy or increased bleeding, you have pain or swelling that increases or continues beyond two or three days, or you have a reaction to medication.
• Call us if the implants gradually show through the gums, so we can check them.
• You can also call us with any questions or concerns.

Chewing and eating

• Avoid chewing until the numbness has worn off completely. If we placed a temporary restoration, avoid chewing for one half-hour to allow the temporary cement to set.
• For the first 24 hours, drink lots of liquids and eat soft, nutritious foods, chewing on the opposite side of your mouth.
• After the first 24 hours, you can begin to return to your usual diet, but continue to chew on the opposite side. Avoid very hot or spicy foods until your gums are healed. We’ll evaluate your situation to determine how soon you can chew on the implant.

Brushing and flossing

• For the first 14 days, gently wipe the implant site with the gauze or a cotton swab. After that, brush the area gently with a soft toothbrush.
• Don’t floss the site for four weeks. We will evaluate the healing and adjust your brushing and flossing timetable as necessary.
• Brush and floss your other teeth normally.
• If we have recommended a mouth rinse, use it as directed.

Medication and discomfort

• If antibiotics or other medicines are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
• To control discomfort, take pain medication before the anesthetic has worn off or as recommended. It’s normal to experience some discomfort for several days after surgery.
• To reduce discomfort or swelling for the first 24 hours following surgery, use ice packs, 20 minutes on and 20 minutes off.
• To reduce discomfort after the first 24 hours, apply moist heat.
• To further reduce discomfort after the first 24 hours, you can rinse your mouth very gently three times a day with warm salt water. Use about one teaspoon of salt per glass of warm water.

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Extractions

Follow these instructions carefully to ensure the successful healing of your tooth extraction.

When to call us

It is normal to experience some discomfort for several days after a tooth extraction, but call us right away if you have:

• Heavy or increased bleeding
• Pain or swelling that increases or continues beyond two or three days
• A bad taste or odor in your mouth
• A reaction to the medication

During the first 24 hours

• It is important that a blood clot forms on the extraction site to stop bleeding, reduce pain, and speed healing. To protect the clot and avoid the pain of dry socket:
• Bite on a gauze pad firmly for 30-60 minutes. Blood and saliva mix in the mouth and make it look like there is more bleeding than there really is. Some oozing is normal; however, after 1 hour, repeat with a clean gauze pad if oozing for as long as 24 hours.
• Don’t spit, and don’t suck on candies or through a straw.
• Don’t rinse your mouth, and don’t brush or floss next to the site.
• Don’t smoke or use tobacco. Avoid tobacco for at least 72 hours because it slows healing.
• Don’t sneeze or cough, so have sinus or allergy medications on hand if necessary.
• Limit yourself to calm activities and elevate your head with pillows when you lie down to reduce bleeding.
• Don’t drink hot, carbonated, or alcoholic drinks, and avoid hot or spicy foods.

To control discomfort , take pain medication before the anesthetic has worn off or as recommended.

To keep swelling to a minimum , use an ice bag over the area, 20 minutes on and 20 minutes off.

When the numbness has worn off completely , drink lots of fluids and eat only soft nutritious foods, chewing on the opposite side.

After the first 24 hours

• Begin to eat normally as soon as it’s comfortable.
• Resume brushing and flossing, but clean gently around the site for about a week.
• If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
• Reduce soreness or swelling by applying moist heat. Swelling usually starts to go down after 48 hours.
• Further reduce swelling by rinsing your mouth very gently with warm salt water. Use about one teaspoon of salt per glass of warm water. Rinse two to three times a day for the week following the extraction.

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Invisalign

Taking care of Invisalign clear aligners is very simple. Every time you brush your teeth you can brush your aligners as well, but please use water only on aligners (no toothpaste). They can also be soaked and cleaned in a denture cleaner while you are busy eating.

Thanks to the removable nature, you can eat and drink whatever you want while in treatment. In fact, you're required to remove your aligners to eat and drink. So, unlike undergoing traditional treatment using wires and brackets, there is no need to restrict your consumption of any of your favorite foods and snacks unless instructed otherwise. Also, it is important that you brush your teeth after each meal and prior to re-inserting your aligners to maintain fresh breath and proper hygiene.

We discourage smoking while wearing aligners because it is possible for the aligners to become discolored. You cannot chew gum while wearing your aligners. It will stick to the aligners.

Trays May Cause Some Irritation To The Lips, Tongue, And Cheeks - If this occurs try using a small scissor or emery file to smooth sharp area or report the problem to us as soon as possible.

Things TO DO During Invisalign Treatment:

• Wear each set of trays for at least 2wks, unless otherwise instructed
• Wear each set of trays for at least 20 hours a day, unless otherwise instructed
• Always place trays in case when not in your mouth.
• Always place trays in from the front of your mouth first, and then move to the back molars.
• You may drink water only while wearing trays.
• If possible, brush or rinse before placing trays back in your mouth.
• Cleanching into trays w/ your aligner chewies during the first 2-3 days helps teeth move faster and relive pressure.
• Wear trays as instructed in sequential order.

Teeth may begin to feel slightly mobile or loose during treatment, but this is normal.

Non-compliant wear of aligners may result in the need for new impressions and additional fees or us needing to end your treatment.

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Partial Dentures

• New dentures always require a period of adjustment. First-time denture patients may require several weeks to get used to their new appliance. Speech may be altered and may require adaptation of the tongue and lips.
• For the first few days, you should wear your dentures for as long as possible, and chew soft food in small bites. Remember, dentures do not have the same chewing efficiency as natural teeth and may affect your taste of food. If your bite feels uneven after several days, we can adjust the way your teeth contact at follow-up visits.
• It is not unusual for sore spots to develop in isolated areas of the mouth. These areas can be relieved easily at follow-up appointments. If a severe sore spot develops which prevents wearing the denture and an appointment is made for adjustment, please wear the denture for 24 hours prior to the appointment. This will greatly aid in locating the exact location of the area and make adjustments significantly easier and more predictable.
• Proper cleaning of your denture is important to prevent stains and bacteria from accumulating on your appliance. We recommend brushing your denture with water or soap and thoroughly rinsing. Do not use toothpaste as it can scratch. Soaking with denture tabs at night usually works well also.
• Do not wear your complete or partial dentures to bed. It is important to allow your gum tissues and jawbones to rest in order to prevent further tissue irritation, infection, and future bone shrinkage.
• Over time, or with weight loss or gain, the supporting gum tissues and bone may change shape and size. Periodic relines of your dentures may be necessary to ensure a retentive fit. Denture teeth may wear or chip over time. For this reason, an annual check of your tissues and denture is recommended.

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Porcelain Veneers

Do not eat for at least 2 hours and until the anesthesia has worn off.

Temporary:

A temporary is an acrylic veneer that is placed on the prepared teeth for protection during the time the permanent veneer is constructed in the lab. The patient may wear the temporary from 2-4 weeks. The temporary serves several important purposes: it protects the exposed dentin to minimize sensitivity, helps to prevent recurrent caries, prevents the tooth from shifting, and last but not least, restores tooth contour and appearance. The temporary is placed with cement that is designed to come off easily, so avoid chewing sticky foods such as gum or taffy. Use your toothbrush to clean the temporary as you normally do your other teeth. You may also floss or, if there is more than one veneer and the temporaries are fused, you may need a floss threader. To avoid possibly loosening the temporary, it is best to pull the floss out below the contact rather than lifting up to remove it

lf your temporary comes off between appointments, slip it back on and call our office in order to recement it for you.

A little denture adhesive placed inside the veneer can help to hold it in place in the interim.

Sensitivity:

Sensitivity, especially to cold, is common for a time following treatment.

For the first few days avoid extremely hot or cold foods and beverages. lf your gums were recontoured during treatment they may be tender after the anesthesia wears off.

Rinsing with warm salt water by dissolving % teaspoon of salt in 8 oz. of warm water will help. An analgesic such as Tylenol or Advil will also increase your level of comfort.

Final Veneers:

After the final cementation of your permanent restoration, it may take a few days to get used to the new veneers. Your bite and the way your teeth come together, may feel different, lf your bite feels unbalanced, please be sure to call our office for an appointment to make the adjustment.

Home Care:

To maintain the veneers and your new smile, it is important to remember that the underlying teeth are still vulnerable to decay, especially at the gumline where the tooth and veneer meet. lt is important to resume regular brushing and flossing immediately. Daily home care and regulating your intake of sugar-containing foods will increase the longevity of your new restorations.

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Scaling and Root Planing

The following guidelines will make you more comfortable and prevent possible complications.

CARE OF YOUR MOUTH

If you feel discomfort, rinse 2-3 times per day with warm salt water (1 tsp with 8 oz water.) Then if it continues, you may use an anti-inflammatory pain reliever (Aleve or Advil). You may do your regular brushing, flossing, or irrigating (such as the Waterpik) beginning the next morning following treatment.

EATING

Avoid eating until numbness goes away. Meals should be soft. Avoid any hard, chippy foods such as potato chips, popcorn, corn, seeds, etc for the next 3-4 days.

TO PROMOTE BONE HEALING

If you are not allergic to anti-inflammatory medication, take 400mgs (Advil) or 220mgs (Aleve) in the AM and PM for the next 24 hours.

SENSITIVITY

It is common for your teeth to be sensitive to cold/hot foods and liquids following scaling and root planing. Using a sensitivity toothpaste can help reduce temperature sensitivity.

SMOKING

Avoid smoking after scaling and root planing procedures. Tobacco smoke is an irritant to healing. Refrain from smoking 24 hours or longer.

SWELLING

Swelling or jaw stiffness occurs very rarely. If it does, however, place warm, moist towels to the face in the area of stiffness.

MEDICATIONS

Continue Peridex until gone and continue antibiotic for 12 weeks.

***If any problems arise please call the dental office***

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Caring for your Dental Bridge

Dental bridges need regular cleaning

• When you have a dental bridge, it is important to keep the adjacent teeth and gums healthy so they can continue to provide support for the bridge.
• At first, it may be challenging to keep your bridge and the adjacent gums and teeth plaque-free, but a variety of tools and techniques can dramatically improve the effectiveness of your homecare routine.

Brushing and flossing

• Brush and floss your teeth and gums normally after each meal to keep your mouth healthy. Make sure to brush and floss the abutment teeth carefully to keep them strong and healthy.

Superfloss and floss threaders

• Use superfloss and floss threaders to keep the area between the artificial tooth and your gums free of plaque. Superfloss has a stiff end that helps you pass it through tight areas. It also has a fuzzy, tufted segment that removes plaque and food particles from your gums and the bridges as you floss. Just insert the superfloss between the bridge of your gums, and floss the area completely.
• A floss threader has one thin, stiff end and a loop through which you can thread dental floss. To use a floss threader, pull about 18 inches of floss through the floss threader, and then insert the threader into the tight spots between the bridge and your gums. Pull the threader until the floss is under your bridge, remove the threader from your mouth, and then use the dental floss as you normally would.

Other tools and techniques

• Depending on the situation, we may recommend additional tools and techniques to help keep all the areas around your bridge plaque-free. These may include an oral irrigator, small brushes, or other devices. We also set up regular dental checkups to maintain the success of your bridge.
• With time, your bridge and your new oral hygiene routine will become familiar and comfortable.

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Fillings

• Fillings on front teeth are the most delicate, because they are placed on the most thin teeth. Avoid biting hard and sticky foods with your front teeth. Keep away from biting out of an apple, corn on the cob, or pizza crust. These types of food can break off front teeth fillings.
• You can resume brushing twice a day and flossing daily immediately.
• You may be sensitive to hot and cold foods and beverages for up to 3 weeks after a filling has been placed. A tooth is more likely to be sensitive if it had a deeper cavity.
• If you have pain with biting after a few days, call our office. The filling may need to be adjusted.
• Your gums may be sore for a few days after treatment, depending on the location of the filling.
• For pain, take an over the counter medication as directed. Choose an over the counter medication that is appropriate to your dental condition and does not interfere with any medical conditions you may have.

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Night Guards/Occlusal Guards

Purpose: We have prescribed and custom-made for you an occlusal guard, otherwise known as an orthotic device. The purpose of this appliance is to reduce the stress and strain on your teeth, jaw joints, jawbones, and the muscles of your head and neck.

Rationale: This appliance has the dual purpose of protecting your teeth from wear attributed to clenching and/or grinding as well as serving to remind your muscles to keep your teeth apart. Most people will instinctively reduce their day time issues with grinding and/or clenching after "training" their muscles through night time wear.

Instructions:

• After brushing and flossing your teeth at night, please put your appliance in and wear it during sleeping hours. If we have identified other specific times of need, such as weight bearing exercise or times of intense concentration, please wear as instructed.
• When you wake or finish wearing your appliance, please clean your appliance and keep it in the case provided.
• It is normal for your bite to feel different for the first 30 minutes when you remove your appliance in the morning. This is due to muscles, not tooth movement.
• Please bring your appliance with you to all future appointments so that we may clean it for you and make sure that it still fits following any dental work.

Cleaning your Occlusal Guard:

• Please brush your appliance with a toothbrush and water. For stubborn stains, you may want to use soap and water and then rinse thoroughly.
• Please DO NOT USE TOOTHPASTE as this may scratch your appliance encouraging it to retain stain and odor.
• You may soak your appliance in solutions designed to clean dentures or oral appliances if you wish.

Our concerns:

• With any new appliance please be patient with concerns such as increased or decreased saliva or awkwardness. These generally pass.
• If the aligner is cutting your gums or soft tissue please let us know.
• If your teeth are sore after a few days please let us know.
• In the rare case that you have increased muscle tension in your head and neck, we ask you to consider trying it for a week or two and this should pass.
• If you have any other concerns please call our dental office. We want you to be comfortable.
• Dogs love to chew nightguards! It's an expensive snack.

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Permanent Crowns

Now that we’ve placed your permanent crown, it’s important to follow these recommendations to ensure its success:

Chewing and eating

• If we used an anesthetic during the procedure, avoid chewing until the numbness has completely worn off.
• To protect your crown, avoid chewing ice or other hard objects.

Brushing and flossing

• Brush and floss normally, but if your teeth are sensitive to hot, cold, or pressure, you can use a desensitizing toothpaste. If sensitivity increases or persists beyond a few days, call us.

Medication and discomfort

• Take antibiotics or other medications only as directed.
• To reduce any discomfort or swelling, rinse your mouth three times a day with warm saltwater. Use about one teaspoon of salt per glass of warm water. It’s normal for your gums to be sore for several days.

When to call us

• Call our dental office if your bite feels uneven, you have persistent sensitivity or discomfort, or if you have any questions or concerns.

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Root Canal Therapy

Caring for a temporary restoration

Now that you have had a root canal therapy, it is important to follow these recommendations to ensure healing.

If we placed a temporary filling or crown on your tooth, avoid chewing for at least one-half hour to allow the restoration to harden.

To keep your temporary restoration in place, avoid eating hard or sticky foods, especially chewing gum. If possible, chew only on the opposite side of your mouth.

It is not a problem for a small portion of a temporary filling to wear away or break off, but if the entire filling wears out, or if a temporary crown comes off, call us so that it can be replaced.

Chewing and eating

• If we used an anesthetic during the procedure, avoid chewing until the numbness has completely worn off. Your lips, teeth, and tongue may be numb for several hours.

Brushing and flossing

• Brush and floss normally.

Medications and discomfort

• If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
• To control discomfort, take pain medication before the anesthetic has worn off or as recommended. It is normal to experience some discomfort for several days after a root canal appointment, especially when chewing.
• To further reduce discomfort or swelling, rinse your mouth three times a day with warm saltwater. Use about one teaspoon of salt per glass of warm water.

When to call us

• Call our dental office if your bite feels uneven, if you have sensitivity or discomfort that increases or continues beyond three or four days, your temporary filling or crown comes off, or you have any questions or concerns.

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Whitening Instructions

Brush and floss (to remove any food or plaque)

1. Place a single drop (about the size of a BB) amount of whitening gel into the inside of the tray, putting it into each individual tooth.

2. Place whitening tray into the mouth, press gently using your fingertips to evenly spread the gel across your teeth.

3. Take your finger or toothbrush to remove any excess gel that may have gotten onto your gums (if gel is left on gums it can cause redness, bleeding, and sensitivity).

4. Wear whitening trays 30 minutes to 1 hour every day for 14 days. For best results, wear every day. If sensitivity occurs, switch to every other day (still wearing your whitening trays for a total of 14 days).

5. While wearing whitening trays, DO NOT eat, drink or smoke!

6. After whitening, remove trays from the mouth, brush teeth with water or toothpaste, and brush trays well with water.

You may have a melon taste while wearing your trays. This is the flavor of the gel; it will not harm you.

***Store whitening gel in refrigerator***

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