Pre/Postoperative Information

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Pre/Postoperative General Information

Emergency Treatment: Avulsed tooth.. bite on gauze as pressure will help the bleeding stop and induce clotting. Put the tooth in a container of milk or if not available hold it in your cheek and head to the dentist. Sometimes we can put it back in!
Post op : Dental Extraction : no chewing for 24 hrs. once you are done biting on gauze, keep the area cold with ice chips. No rinsing or brushing till the next day
PreOp Zoom : in office Dental Bleaching: take 400-600mg of ibuprofen 1 hour before visit…..not too much coffee as you have to sit in the chair undisturbed for about 2 hours
Post op: Zoom : In Office Dental Bleaching : you may have some electric zings in your teeth for that evening, Ibuprofen helps but does not completely eliminate the pain but it will go away

POST OPERATIVE INSTRUCTIONS

I. Oral Hygiene Instructions

Brush twice a day for two minutes each time. Divide your mouth into four areas: upper right, upper left, lower left and lower right; thirty seconds in each quadrant, outside, inside and biting surface.

Floss at least once if not twice a day. Use a C-shaped flossing motion, gently go under the gum tissue hugging the tooth surface.

Toothpaste : use a fluoridated toothpaste or make sure if you are dry brushing to use a fluoride rinse or gel.

Waterpiks, interdental cleaners (softpiks, or proxibrushes), postop toothbrushes, rinses, gels, use what works best for you consult your dental hygienist and dentist.

II. Crown and Bridge Post Operative Instruction and Care of Temporary Restorations

Preparing your tooth for a crown ( or a bridge if a missing tooth is involved generally involves two or more appointments. During treatment, your dentist will remove a portion of the tooth or teeth to fit the crown or bridge. An impression is made to provide an exact model of the prepared teeth. A temporary crown or bridge may be placed while the permanent one is made.

What to Expect after Treatment

Because temporary restorations eventually loosen, be sure to return to our dental office at the appointed time.
Temporary cement allows you to wear the temporary restoration for a short period of time and to have it removed for further adjustment if needed.
If you find the temporary crown or bridge feels “high”, call the dental office.
Occasionally, the nerve of a tooth may die after a crown or bridge is permanently cemented, or even the temporary placed. If you experience continued discomfort, please call the office.
While wearing the temporary restoration you may choose to not floss around the area to avoid accidentally pulling off the temporary. Please refrain from consuming anything “sticky”, “chewy” that would pull off , or “too hard or crunchy” that would pull off the provisional restoration.

Taking Care of Your New Restoration

To prevent damaging or fracturing the crown or bridge, avoid chewing hard food, ice, or objects such as pens and pencils.
Brush twice a day and clean thoroughly between teeth with floss or an interdental cleaner. Clean around a crown the same as you would your natural teeth.
Take special care to clean around and under the artificial teeth in a bridge. Thorough cleaning will remove plaque as well as odor-causing food debris.
Help your gums and remaining natural teeth healthy by scheduling regular visits.

III. Scaling and Root Planning Post Operative Instructions

If anesthetized wait to eat until the local anesthetic wears off. If sensitive take 400mg or 600mg Ibuprofen, warm salt water rinses and soft foods for a day or so. Often the site where the anesthetic was placed is the most sensitive.

IV. Root Canal Treatment Post Operative Instructions

Your root canal treatment may take one or more visits to complete. During treatment, your dentist will remove the diseased pulp, then clean, shape and fill the root canal to prevent recontamination.

What to Expect after Treatment

Because cleaning the root canals may cause inflammation of tissue surrounding the tooth, you may experience some discomfort for a day or so.
Over-the counter analgesics usually alleviate the discomfort. Talk with your dentist about which medication to take. If the discomfort continues, or if you have severe pain or swelling, call your dentist.
Between appointments a temporary filling or crown is placed. Because temporary restorations will eventually loosen, see your dentist promptly following completed root canal treatment for a final restoration to prevent irreversible tooth damage and/or potential tooth loss.
Sometimes antibiotics are prescribed to help control infection. Please take all medication as directed.

How to Take Care of Your Mouth

Avoid chewing or biting directly on the treated tooth until your dentist replaces the temporary restoration.
If medication is prescribed, take it only as directed.
Return for a follow – up exam after treatment, usually with a recall visit, as directed to make sure there has been proper healing of the tissues surrounding the tooth root.

Retreatment May Occasionally be Necessary

Even though the pulp of the tooth was removed, the tooth is still nourished from surrounding tissues. As with any living tissue, treatment is occasionally unsuccessful ( in that the body does not heal as expected) and retreatment , or removal of the tooth may be necessary.

V. Invisalign Post Operative Instructions and Aligner Care

Use the hard toothbrush, denture cleanser (Efferdent, or Stain Away) or distilled white vinegar-soak in lukewarm water for 10 to 15 minutes and place back in your mouth.

Wear the aligners at all times unless eating or performing oral hygiene.

Follow the schedule given and if you need to make adjustments , inform the dentist.

You will be invited to a virtual confidential program, accept the invitations. Here you can take photos and ask questions along the way between appointments. Your dentist with respond with instructions to help guide you.

Use munchies as directed every time you put your aligners in.

If spaces develop at the top of the aligners do not change to the next aligner continue to wear that aligner until the space disappears or call your dentist. Sometimes the spaces are inherently there and sometimes they develop if the aligners are not worn long enough.

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VI. Occlusal Guard Post Operative Instructions and Care

Congratulations on getting your new occlusal guard! This appliance will help in protecting your teeth, jaw, gums and what we call the stomagnathic system from destruction that can be caused by the forces produced by bruxism and clenching. This guard is made custom to fit your teeth and should fit securely and comfortably. If you feel too much pressure from the appliance, we may need to make adjustments.

Care and Instructions of use for your Guard

When first getting used to your appliance wear the guard during the day for short periods of time and slowly increase the time you are wearing it until you feel comfortable to sleep with it. This could take less or more than 24 hours. Do not be alarmed: just continue to wear it as much as possible.
The guard can be worn during the day if needed ( unless speaking or eating) in addition to night time wear while sleeping.
Remove your occlusal guard in the morning and clean it with a denture cleanser (stain-away, efferdent, polydent) in lukewarm tap water or distilled white vinegar. Do not use toothpaste. We give you a hard denture brush to be used only on your appliance, not your teeth 🙂
Keep your appliance in its case when not in your mouth so it is not misplaced or mistaken as a toy by pets or young children.

VII. Discus Zoom and Opalescence Boost In Office Bleaching Post Operative Care

Discus Zoom In Office Bleaching is an in-office professional whitening treatment performed in the dental office with a light in approximately two hours.

Opalescence Boost is an in-office professional whitening treatment performed in the dental office without a light and in less that two hours.

Post-Treatment Care Instructions for both Zoom and Boost In Office Whitening

Your teeth will continue to whiten for 24-48 hours after your treatment. During this time, avoid foods and beverages that could stain your teeth. Some examples include:

Coffee, Tea, Dark Sodas, Red Wine, Tobacco, Red Sauces, Soy Sauce, Dark Berries.

Avoid desensitizing products that contain stannous fluoride for about two weeks. These can cause dark stains on your teeth.

Note: the nicotine in cigarettes leaves brown deposits, which are difficult to remove.

Your achievable whitening shade may not be apparent after just one in-office treatment. Additional in-office or take home treatments can be done as prescribed.

Tooth sensitivity may occur following your in-office whitening treatment, but it will subside. If whitening-related tooth sensitivity persists after 24 hours, contact your dentist.

You may have sensitive white spots on your gums immediately after your in-office whitening treatment. These are temporary and should disappear after 20-30 minutes. If needed, over-the-counter oral pain relief products ( such as Orajel, or topical vitamin E oil) can be used to alleviate discomfort while the irritation subsides. Please follow all directions and avoid any allergens when using any additional products.

It is important to continue brushing and flossing to keep your teeth and gums healthy. Continue to see your dental professional for regular check-ups and cleanings.

VIII. At Home Bleaching: Opalescence Go Trays (10% and 15%)

Brush and floss before placing the trays on.

Place the trays on U-upper arch, L-lower arch.

Do not squeeze the trays on so the gel does not go on your tissue.

Wear the trays 20 minutes to 45 minutes each.

Brush and floss your teeth after taking and discarding the trays.

Avoid dark colored food or drinks for the duration of bleaching.

If sensitive take a day off, use sensedyne, or put Vaseline on gum tissue prior to placing the trays on.

At Home Bleaching Instructions

IX. At Home Bleaching: Custom Trays

See the Opalesence Go tray instructions.

Timing is half an hour to 45 minutes per session.

Clean the custom trays with cool water and a toothbrush.

X. Denture and Removable Partial Care

Even if this is your second or third set of dentures or partials, there will be a period of adjustment. Some of the things to remember include:

Keep appliances in their cases safe and away from animals when they are not in your mouth.
Clean them with a hard tooth brush and appliance cleaner ( Stain Away, Efferdent) or Distilled white vinegar.
Fullness sensations may be felt. Adjustments in eating may happen initially getting use to a full set of teeth.
Sometimes speech can be temporarily impaired. A good idea is to practice reading aloud. Your speech will soon return to normal.
Tender soft tissue can get pinched between the denture and bone as the denture settles sore spots may develop. The dentist can locate these areas and provide relieve. Do not adjust them yourself. Dentures should be worn at least a couple hours prior to returning to the dental office for a sore spot adjustment.

At night: It is best to give your gums a rest. Take the dentures out, clean them and keep them in the denture case somewhere safe.

Bring appliances to be checked and cleaned at each dental visit.

XI. Oral Surgery Post Operative Care

Basic Instructions:

Maintain continuous firm pressure on gauze pad placed over the wound for one hour. Changing the gauze every twenty minutes.
Do not rinse or disturb the wound in anyway.
Do not use a straw for a week.
Do not brush the area.
Do not engage in excessive activity (athletics etc) for two days.
Take medication as directed.
Soft foods for the first 24 hours and then after increase as comfortable.
Cold and ice inside the mouth for the first 24 hours, and cold compresses as indicated outside the oral cavity.

PAIN

You may expect a small amount of bleeding during the first 24 hours. If bleeding becomes excessive:

Gently wipe out your mouth with a clean gauze pad.
Fold clean gauze into a thick pad ( a lightly moistened teabag may be use) and place directly over the bleeding area. Maintain continuous firm pressure for at lease 30 minutes.
Repeat if necessary.
It may help to keep your head elevated while resting.
AVOID: Rinsing, poking with tongue or fingers, sucking or excessive activity.
DO NOT: Smoke, drink alcoholic beverages or hot liquids. If you are still unable to control bleeding, contact your dentist. Or go to the hospital (nearest emergency room).

SWELLING

Swelling to varying degrees may occur following oral surgery. To minimize swelling, apply an ice pack (cold compress) to affected side of face- on 10 minutes – off 10 minutes for 3-4 hours following the surgery. DO NOT APPLY HEAT. It may take 48 hours before swelling begins to subside; contact your dentist if the swelling increases after that time.

DISCOLORATION

A bruising of the skin sometimes occurs. This will disappear without treatment in 5-7 days.

MOUTH CARE

Do not rinse mouth for 24 hours following surgery. Provided there is o bleeding, you may rinse after this time with warm salt water ( ½ teaspoon of salt dissolved in approximately 6 oz. of warm water). Afterwards, clean your mouth as usual, avoiding the wound.

DIET

Adequate nutrition is important for proper healing. Eat soft nutritious foods as: Eggs, smoothies, custards, juices. Avoid Hot foods and liquids.

DIFFICULTY IN OPENING MOUTH

Difficulty in opening the mouth occasionally occurs and should begin to disappear gradually within 2-3 days.

COMPLICATIONS

Even with proper care, complications sometimes arise following oral surgery. The most common problems described in the preceding sections, but in unusual disturbances, do not hesitate to consult your dentist. Or if medical emergencies arise, call 911 and or go immediately to the nearest emergency room.

SEDATIVES

Depressant type drugs (sedatives, tranquilizers, etc.) are sometimes administered before surgery. The effects of these drugs may seen to wear off within the first hour or two but reflexes may be impaired for up to 24 hours. Therefore, you should not drive a car; operate machinery, take care of young children or the elderly or physically/ mentally impaired dependents, or travel unescorted anywhere for the period of time.

SUTURES AND PROTECTIVE DRESSINGS

Sutures (stitches) are sometimes placed during surgery. It is usual to remove them after one week if they are not the dissolving type. Occasionally one may come out spontaneously before then. This is usually not significant.

XII. Home Irrigation Suggestions (Anti-Microbial Treatment for Managing Periodontal Disease and Care around Implant Crowns and Fixtures)

Current research has provided growing information which tells us how benefits are obtained by irrigating under the gum line and around implant crowns and fixtures. As you know, bacteria hide under the gum line causing low grade periodontal infection which can lead to bone and eventually tooth or implant loss. The treatment we have done was designed to disrupt, detoxify, devitalize and disperse those bacteria which grow under the gums, and to seal the gums back to the teeth where possible.

Simply using household bleach (Clorox) is an effective way to manage this infection. It is a strong and effective antiseptic, but be careful, and WATCH GETTING IT ON CLOTHES.

We recommend a mix of one (1) teaspoon of regular (Blue cap) Clorox in 200-300 ml of water in your Water Pik reservoir. This dilutes to a concentration that is totally safe when used as directed. Note: A fresh mix must be made each time.

It is recommended that you use this only two times per week with the irrigator set to medium, or lower if more comfortable, and that you use the small Pik Pocket Tip available for Water Pik brand products, or similar small tips are available for ViaJet from OraTec.

Pik Pocket Tip styles for Teledyne WaterPik devices:

PP-100 for newer models of irrigator
PP-70 for older Classic models of irrigator

Aim it down into the gums. Hold for 5 seconds between each tooth or longer in problem areas ( implant crowns, fixtures, periodontal pockets, wisdom teeth and areas or bone loss.) Be sure to put the irrigator tip in your mouth before turning on the unit, and bend over the sink, allowing the water to flow into the sink.

We also urge the daily use of Fluoride when on this program ( a nightly gel or rinse).

Note: Bleach will cause the Water Pik to break down sooner and may require replacement every year or two. After the use with the bleach solution, run a water solution through the machine to clean it. A longer lasting water irrigator is ViaJet from Oratec.

An alternative to irrigating with the Clorox is RINSING. It is almost as effective as irrigation. If you prefer this method mix with 1 teaspoon of 7.25% Clorox, or 1.5 teaspoon of 6% Clorox to a large 8 oz glass of water (fresh each time).

NOTE: The American Dental Association has designated this dilution of bleach as a “mild antiseptic mouth rinse that is safe.”

A few drops of Pepperment liquid flavor from the baking isle can help with taste.

XIII. Myo-Facial Pain Suggestions

Wear occlusal Guard in the day as well as while sleeping (amounts may vary).
Soft or liquid diet for 24 hours (no gum, ice, crunchy or food that requires wide opening or excessive chewing).
Hot moist towels (washcloths) on outside of face, neck muscles.
Antinflammatory Diet and or supplements ( in some cases Ibuprofen prescribed by DDS or MD).
Physical Therapy
Referral if above modaltiesdo not solve the issue to an Oral Surgeon, Myofacial Specialist, or other Medical Specialty that applies to your situation.

XIV. Emergency Treatment: Avulsed Tooth

Bite on gauze as pressure will help the bleeding stop and induce clotting. Put the tooth in a container of milk or if not available hold it in your cheek and head to the dentist. Sometimes we can put it back in 🙂

2901 Wilshire Boulevard Suite 301, Santa Monica, CA 90403

Your Santa Monica Family Dentists