Post Op instructions: Composite Fillings
Once we have restored your teeth with tooth-colored materials, these restorations will serve you well for several years. The resin (plastic) material used contains small "filler" particles of glass-like material for strength and wear resistance. They contain the finest and most up-to-date materials available today. However, you should be aware of the following information about your new restorations:
- As with natural teeth, avoid chewing excessively hard foods on the filled teeth (hard candy, ice, raw carrots, etc.) because the resin material can break under extreme forces.
- Composite fillings set up hard right away. There is no waiting time to eat. Children should be observed until the anesthetic wears off. Due to the strange feeling of the anesthetic, many children will chew the inside of their lips, cheeks, or tongue which can cause serious damage.
- Sensitivity to hot and cold is not uncommon for a few weeks following a dental restoration. Usually, the deeper the cavity, the more sensitive the tooth will be. As discussed before in rare cases of severe, persistent sensitivity a root canal treatment might be needed. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.
- The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site.
- The finished restoration may be contoured slightly different and have a different texture than the original tooth. Your tongue usually magnifies this small difference, but you will become accustomed to this in a few days. Also, patients who clench or grind their teeth typically have longer more difficult healing period. Properly designed bite guard might be needed to alleviate these problems.
When a tooth has a cavity the Dentist removes the decay and fills the hole with a filling material, the tooth supports the filling. The ideal filling is no more than 50% of the tooth. This leaves half the tooth to support the filling. When you get a cavity that takes up 60%or more of the tooth, a crown is indicated. A crown covers the entire tooth and holds the tooth together. Sometimes we place a filling thinking there is enough tooth to hold the filling when actually there is not. The tooth then starts to break away because it can no longer support the filling. In this case, if it happens with in a year, we will credit the cost of the filling towards the cost of a crown.
Post Op instructions: Immediate Dentures
You have just had an immediate denture placed in your mouth. The following information will assist you to understand the sequence of events during the healing period.
- Teeth have been removed from your mouth. Stitches may have been placed to help the mouth heal. If so, they will dissolve by themselves, unless we tell you differently.
- Dentures have been placed to replace your missing teeth and gum tissue. Today these dentures will feel large and bulky. The dentures may cause your speech to be altered for a few days. They will also be difficult to chew with at first. Take small bites of soft food until you learn to chew with them.
- Do not take the dentures out of your mouth today. We will do so tomorrow. The new dentures serve as a bandage similar to a cast on a broken arm during initial healing. After the initial denture removal and adjustment, you should remove the dentures as needed for cleaning and overnight.
- Some discomfort is usually present when teeth are removed and immediate dentures are placed. The discomfort is due to one or two reasons:
- The trauma of removing teeth. This will heal rapidly and go away by itself.
- The denture may have a pressure spot. If so, that will be observed and removed by us as soon as you tell us about the discomfort. It will not go away by itself.
- If you have been given antibiotics, take them as directed until they are gone.
- Use the pain relieving pills only until the discomfort has gone.
- Your dentures may have been relined today with a soft material that makes them easier to wear and speeds healing. That material may be replaced during the initial 6-week or more healing period. It is not the final denture material. Be careful not to dislodge it when cleaning.
- As soon as convenient, place some ice cubes in a plastic bag and place the bag externally on the area where the teeth were removed. This will reduce the chances of swelling and bruising. However, some swelling and bruising may still occur for a short time.
- Your dentures will become looser as your gums shrink after surgery. Usually, after your 1-week post-op appointment, you can begin to use denture adhesive.
- After 3-6 months your denture will be relined to refine its fit to the healing supporting tissues. At this time the denture will appear, fit, and function as it was intended. Before that time it is not in its final state.
- If the doctor has recommended mini dental implants (MDI) to help support your denture, this will happen after 3-4 months and will also include a relining of your denture.
- Healing from tooth extractions continues for up to 18 months. Shrinkage of gums and bone is obvious during that time, but it slows thereafter. You may elect to have a second reline of the denture 18 months after the initial surgery.
- Immediate dentures are a major change to your body. Don't worry if you are slow to adapt. Millions of others have been through this experience. We expect your eventual denture to serve well for many years.
Post Op instructions: Night Guards
Purpose: The purpose of splint therapy is to help your lower jaw function more properly. Since the treatment you are to receive is mainly orthopedic in nature, we have fabricated an orthopedic appliance to help reposition your lower jaw. This appliance will help to relax any of your jaw muscles which are in spasm and to reduce any muscle pain. There are many situations that may cause your lower jaw to malfunction including accidental trauma, developmental defects, peculiar oral habits, naturally occurring malocclusion (poor bite), psychological stress, clenching or bruxing of teeth, and other problems.
- Rationale: You have received an acrylic bite splint (occlusal splint). This treatment has been used for many years to keep the teeth from contacting while you sleep and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth. It is essential that you wear your night guard every night and you may also wear it during the day if you find yourself clenching or grinding your teeth. When it's not in your mouth, make sure your splint is placed in water to avoid warping.
- Cleaning the Splint: Food will accumulate under the splint. After brushing and flossing your teeth very thoroughly, brush and rinse the inside and outside of the splint and return it to your mouth. Dental decay can be stimulated if you are not careful about the cleanliness of your mouth and splint. Fluoride containing rinses or gels is useful when placed in your splint once per day if you have a high dental decay rate. Using a dental soak cleanser (ex: Polident) on a monthly basis will help keep the splint fresh.
Post op instructions following oral surgery and tooth extraction
THE DAY OF SURGERY
- Some degree of discomfort and pain arises as numbness subsides. At the first sign of pain or discomfort, take the pain medication prescribed. Please make sure you read the directions carefully before taking the medication. Any pain medication can cause nausea and vomiting. It is very important that you have some food in your stomach before you take them.
- DO NOT DISTURB THE AREA OF SURGERY. The first stages of healing are aided by placing tissues at rest. Avoid vigorous chewing, excessive spitting, or rinsing as initial healing may be delayed, active bleeding restarted, or infection introduced.
- Expect minor bleeding or oozing from the operative site. This bleeding may continue throughout the first day. For the first hour, keep firm pressure on the area of surgery by biting on the gauze sponge placed in your mouth at the office. If bleeding persists, continue pressure on a fresh sponge for an additional 30 minutes to an hour. Biting on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site. Tea has an ingredient that promotes blood clotting.
If active bleeding should recur at any time, carefully rinse your mouth with cold water and apply a fresh gauze sponge to the bleeding site. Firm pressure for 15-30 minutes usually controls the problem. Should active bleeding persist, please call the office.
- LIMIT PHYSICAL ACTIVITY during the first 24-48 hours after surgery. Overexertion may lead to postoperative bleeding and discomfort. When you lie down, keep your head elevated on a pillow.
- PAIN FOLLOWING ORAL SURGERY will be most severe within the first 6-8 hours after the operation. If you have to take the prescribed severe pain medication, remember to have some food intake prior to that and to start slowly. Please do not drink alcoholic beverages while taking prescription pain medication. Do not wait for the pain to become unbearable before using some form of pain medication, as then it will be more difficult to control. Moderate to severe pain usually does not last longer than 24-48 hours, and there should be no more than the slight pain or discomfort after the third day. Persistent or increasing pain 3-4 days following oral surgery may be caused by early loss of the blood clot (dry socket) or infection. If you feel that this may be happening to you, please contact us so that we can help make you more comfortable.
- SWELLING RELATED TO THE SURGICAL PROCEDURE usually develops during the first 12-24 hours following surgery, often increasing on the second day. It should begin to subside by the third day. Swelling can be minimized a great deal by wearing an ice pack on the side of your face for 15-30 minutes every hour while you are awake during the first 24 hours following the surgery, unless you receive special instructions. Anti-inflammatory medications, such as Motrin or Advil, also help decrease swelling.
- FLUID INTAKE IS IMPORTANT. We suggest you start with clear beverages. Once your stomach has settled, you can advance to other fluids such as soda, broth, soups, or juices. We suggest avoiding dairy products initially, such as milk, milk shakes, and eggnogs. Also avoid hot liquids until the numbness has worn off, and the bleeding has stopped. It is important to drink plenty of fluids.
- AVOID USING A STRAW FOR SEVERAL DAYS as it may cause the blood clot to dislodge and delay healing.
- FOOD SELECTION is largely a matter of your choice. Soft, cool foods that require little or no chewing are most easily tolerated at this time. A nutritious diet throughout your healing process is most important to your comfort and temperament. Hungry people become irritable and less able to deal with discomfort which can follow surgery. Since you will be taking medication, it is important to remember that eating can prevent nausea sometimes associated with certain medications. Once your stomach is settled, soups, broiled fish, stewed chicken, mashed potatoes, macaroni and cheese, and cooked vegetables can be added to your diet as your comfort indicates. Ensure, Carnation Instant Breakfast and/or yogurt supply excellent added nutrition.
- Take any special medication such as ANTIBIOTICS we have prescribed on the specified dosing schedule. Yogurt with active cultures or acidophilus should be taken while on antibiotics to prevent diarrhea. It is important to take the antibiotics to completion. If you are given antibiotics and take birth control pills, you should be aware that the birth control pill may become ineffective, therefore take appropriate precautions.
- Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule unless advised to do otherwise.
- AVOID SMOKING COMPLETELY, as it tends to slow the healing process and may also contribute to development of a dry socket.
- DO NOT DRIVE AN AUTOMOBILE for 24 hours following surgery if you have had intravenous sedation, or if you are taking prescription pain medication.
- IF YOU WERE INFORMED THAT A SINUS COMMUNICATION OCCURRED DURING SURGERY, as a result of the close relationship between the roots of your upper teeth and your sinuses, or if you have had some surgery that involved work near your sinuses or in your sinuses, please follow these instructions: DO NOT blow your nose. DO NOT sneeze through your nose. If the urge to sneeze arises, sneeze with your mouth open. DO NOT smoke or use a straw. AVOID swimming and strenuous exercise for at least one week. It is not uncommon to have a slight amount of bleeding from the nose for several days. Please remember that occasionally a second procedure may be required if there is a persistent sinus communication.
THE DAY FOLLOWING SURGERY AND THEREAFTER
- On the morning of the day following surgery, rinse your mouth carefully with the solution made by adding 1/2 teaspoon of salt to a large glass of warm water. Repeat three times a day until remaining soreness subsides. Resume brushing any remaining teeth and your regular oral hygiene as soon as possible. Do not avoid brushing the area as this will cause more inflammation in the area. Please do not use a syringe or Water Pik® to aggressively rinse during the first week. This can dislodge the blood clot.
- DO NOT WORRY ABOUT STITCHES. Stitches (also known as sutures) are usually placed to control bleeding, aid healing and help prevent food from collecting in the surgical site - - especially for lower teeth. The sutures we use dissolve on its own and DO NOT HAVE TO BE REMOVED.
- ANY SWELLING, SORENESS, OR STIFFNESS IN THE JAW MUSCLES can be relieved by applying a warm moist towel to the affected side of the face several times a day. Moist heat should be used after the first 24 hours. If swelling, tenderness, or pain should increase after the first few days, call the office.
- Sometimes a soft diet may be necessary for the first few days following surgery. Most patients are able to resume regular food intake within a short time.
- Bruising marks may appear on the skin of the face during the first few days after surgery. Moist heat application will help relieve this condition.
WHAT ARE DRY SOCKETS? Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket and affect approximately one out of five patients. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin. It frequently begins in the middle of the night, and the Motrin medication usually doesn't help. Treatment involves placing a medicated dressing in the "empty" tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and usually will require dressing changes every day or two for five to seven days. Dressings usually are removed when you have been pain free for 2-3 days. The dressing doesn't aid in healing. The only reason to place a dressing is for pain control. If Motrin is controlling the pain, the socket will heal without a dressing. An irrigation device will be given to you to help keep food particles from lodging in the extraction site following removal of the dressing.
Faithful compliance with these instructions will add to your comfort and hasten your recovery. Be sure to follow these instructions carefully. Only in this way will you avoid the complications which lead to unnecessary discomfort and delayed recovery. Should any undue reaction or complications arise, notify the office immediately.
If you need to contact us after office hours, please call the office at (940) 383-3300. We make every attempt to answer the emergency pager as promptly as possible. Occasionally, your messages do not reach our pagers. If you do not hear from the doctor on call within one hour, please call back and ask them to page the doctor again. If for some reason, we still do not respond and you think this is an emergency situation, please contact your local emergency room.
Post Op Instructions for Crowns, Onlays, Veneers and Bridges
The E4D Dentist system is an easy-to-use chairside CAD/CAM system that is revolutionizing modern dentistry. With it's ability to create SAME DAY crowns, inlays, onlays, and veneers, the E4D Dentist system provides patients with extraordinary convenience and without messy impressions or temporaries.
In the event that we need to send your work to an outside lab and we need to place a temporary in your mouth, please pay attention to the following directions:
Temporaries are not strong. They may break or come off occasionally. If so, slip it back on the tooth with some Fixodent™ (Denture Adhesive) and call us for an appointment, please be careful until you come to us so as not to swallow it. If you don't feel comfortable, don't put the temporary back in with Fixodent, just bring it to us in a zip lock bag. We will re-cement the temporary ASAP. Please do not leave the temporary out of your mouth because the teeth will move and the final restoration will not fit. Please floss as directed.
- The size, shape, and color of the temporary do not resemble the final restoration.
- Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.
Permanent Crowns, onlays, veneers and bridges
- After the final cementation of your restoration, it may take a few days to get used to the new crown or bridge. Hot and cold sensitivity is possible for a few weeks and occasionally lasts for several months. Usually the deeper the cavity, the longer the sensitivity. In rare cases of severe persistent sensitivity a root canal treatment might be needed. As with the temporary, if the bite doesn't feel balanced please call us.
- Do not chew hard or sticky foods on the restoration for 24 hours from the time they were cemented. The cement must set up during this time to have optimum strength.
- Proper brushing, flossing, and regular 6-month (minimal) cleanings are required to help you retain your final restoration. The only area that a crowned tooth can decay is at the edge of the crown at the gum line. Often, small problems that develop around the restorations can be found at an early stage and corrected easily, but waiting for a longer time may require redoing the entire restoration.
- The gums may recede from the veneers, displaying discolored tooth structure underneath. This situation usually takes place after many years and requires veneer replacement.
Important Information on Crowns
Gold and Porcelain, composite, Crowns are the same for practically all cases except that porcelain ,composite can chip and gold crowns can come off . Approximately 1 out of every 100 porcelain crowns chip and need replacement. This should be taken into consideration when choosing between a porcelain and gold crown. Although rare, this mostly happens, in cases where patients have severe clenching /grinding or other harmful habits, or have extremely heavy bite and might have to be redone with gold.
Post Op Instructions for Partials
Sore Spots: Usually, your mouth will have a few "sore spots" after wearing the partial for 24 hours. These areas can be relieved with very little effort during your next appointment.
- Chewing: The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surfaces of your teeth after the partials have settled into place.
- Cleaning the Partial and your Mouth: Your partial can be cleaned easily by using a denture brush and green Palmolive soap. We recommend leaving your denture out of your mouth at night and soaking in water.
Use special care to clean parts of the denture that contact any natural teeth. Both the partial and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting (Remember to use Green Palmolive soap ONLY).
We have done our best to provide you with well-fitted, functional, and esthetic partials. We feel confident that after a few weeks of becoming adjusted to the new partials, you will have years of satisfaction from them. Over time, your jawbone and gums shrink when there are teeth missing. When this occurs, your partials will feel loose and may require adjusting. Wearing ill-fitting partials for too long without refitting can cause severe bone loss and very serious oral disease. Please call our office if these symptoms occur.
Post Op Instructions for Root Canals
Endodontic treatment can take 1, 2, or 3 appointments depending on the case. It is possible to experience any of the following symptoms after any of these appointments: sensitivity to hot and/or cold; sensitivity to pressure; possible swelling. If you experience swelling, please call our office immediately as additional medication may be required
- One common occurrence with a newly root-canalled tooth is for the tooth to feel high when you bite your teeth together. If this occurs it will cause your tooth to stay sensitive for a longer period of time. Please call us if your bite feels "high" as this problem is easily rectified with a simple bite adjustment.
- A temporary filling may be used to temporarily seal the tooth between visits.
- Be gentle on the tooth while eating until the final restoration is placed.
- The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site.
- During endodontic treatment, the nerve, blood and nutrient supply to the tooth is removed. This will cause the tooth to become brittle and prone to fracturing which could result in the need to extract the tooth. A full coverage crown is recommended to prevent this from happening.
- Do root canals always work? NO! A root canal is a therapy not a cure. It has a high success rate but almost 4% of them fail. If your root canal fails within a period of 3 years from the date of service, we will either refund the cost of your root canal or retreat your failed root canal. In addition, if the tooth cannot be saved, the cost of the crown placed in our office will be refunded during that 3-year period. This warranty is null and void if the patient does not maintain their 6 month continuing care cleaning appointments.