Post-Operative Instructions

Dental Crowns and Bridges

• Temporary Crowns and Bridges

Temporary crowns are usually made of soft plastic material and can be easily broken by pressure. That is why, avoid chewy and hard foods (gums, crusty bread, taffy, etc.) on the temporary crowns. Try to chew on the opposite side until the permanent crown/bridge is put in place. It is possible that you will experience some sensitivity and soreness around the gum for the first few days after the placement. Brush your teeth as usually, but floss gently. If regardless of your precautions, the temporary crown or bridge is dislodged and feels uncomfortable, calls for consult appointment. Never try to “glue” the temporary restorative devices by yourself. It is recommended to use a special over-the-counter denture adhesive to hold the crown or bridge until you get to our dental office.

• Long-term Care of Permanent Crowns and Bridges

After the permanent crowns or bridges are finally  placed, you may experience some discomfort and increased sensitivity. For the first days your bite may feel uneven. All listed inconveniences are normal if last no more that 2-4 days after the treatment. To maintain your permanent restorative work, it is essential to keep daily oral hygiene because crowns and bridges tend to be more susceptible to decay than natural teeth. To provide an additional care and decay prevention, use a fluoride toothpaste or gel. In case of sensitive teeth, a sensitivity toothpaste is your helper until it gets better. If sensitivity or discomfort increase after day 4 please call our office for evaluation.   

In spite of being very strong and color stable, porcelain-fused-to-zirconia crowns are not everlasting and can be damaged. As a rough guide, avoid doing anything with crown or bridge that could  potentially break your natural teeth: avoid chewy and hard foods and extreme temperatures. In case of fixed bridges pay special attention to cleaning under the pontic (area where you are missing teeth). For this purpose, a bridge threader available in all pharmacies is usually used. The durability and beauty of zirconia crowns depends on your proper dental cleaning technique: it is recommended to use electric toothbrush and floss to remove all plaque and avoid abrasive toothpastes to prevent any micro scratches. Pigments don’t influence zirconia crowns, so you can eat and drink freely. Our zirconia crowns are strong and unlikely to crack. However, observing precautions (avoiding hard and chewy foods, wearing mouth guards in risky situations, etc.) and maintaining proper oral hygiene will help save your crowned teeth healthy for many years to come.

White Fillings

Once you have white filling placed in your mouth, it should function beautifully for many years. However, proper aftercare is necessary to maintain your fillings in a good state as long as possible.

• Some time after the treatment (usually 1-3 hours) your mouth will be numb. That is why, don’t chew on the numbed side to avoid biting your lips or tongue. If your child has been undergone anesthesia, be especially careful. The feeling of numbness is a new experience for children, so they often “play” with it trying to bite or chew on the numbed area on purpose. After day 1-2 if you feel your bite is not correct please call our office and come in for bite adjustment.
• Once the anesthetic effect wears off, you may feel discomfort in the area for some time. When habitual feelings are back, check your bite. If your teeth are not touching properly when you bite down, you need to adjust this imbalance.
• If you are having a sedative filling, it means that the decay is very deep and has damaged dentin structure close to the nerve. A sedative filling is made in hope that the tooth will heal and won’t need a root canal. If you experience any pain, gum swelling or other permanent discomfort feelings, don’t hesitate to contact your dentist immediately.
• Unlike amalgam fillings, with white fillings you can chew immediately after the procedure or when the numbness decreases. Nevertheless, try to avoid chewing hard and sticky foods during at least 24 hours.
• It is possible that you will feel pain and sensitivity around the injection site. In case of deep feeling when it is performed close to the nerve, you may have a continued pain for a few days. To help yourself, use over-the-counter pain relievers. To reduce sensitivity and discomfort, avoid hard and sweet foods and extreme temperatures. Usually, the situation resolves within a few days-weeks. However, if you continue experience severe pain and sensitivity, contact us.
• Proper regular brushing and flossing and healthy diet will help maintain your fillings in tip-top condition. You can use a sensitivity toothpaste to decrease sensitivity. Home remedies such as rinsing mouth with salt water may also bring relief.

Porcelain Veneers

You may experience some pain and discomfort after the porcelain veneers procedure. Below, we will provide you with some after care tips:

• Temporary veneers

Before getting the permanent veneers, you will have to wear temporaries for some period of time. They are made of acrylic material to protect exposed dentin and minimize tooth sensitivity. As temporary veneers are placed with the help of easily come-off cement, you should avoid chewy food (gums, taffy, etc.) Brushing and flossing can be performed but very gentle. In case the temporary veneers are fused, you may need a floss threader to properly clean in between your teeth. If temporary veneer falls out, try to put it back with the help of dental over-the-counter paste and contact our office. Be ready to experience some level of increased sensitivity during the treatment process. To minimize discomfort, we recommend to avoid extra cold and hot food and drinks. If your gums sore, rinse the mouth gently with warm salt water. If you can’t stand it, take your prescribed or over-the-counter pills to relieve pain and sensitivity and call our office.

• Permanent veneers

When you have your permanent veneers cemented to your teeth, it may take some days to get used to them. Your bite can feel different especially if you have changed the length and shape of your teeth. It is also normal to experience some level of sensitivity to cold and hot. Your teeth and gums need some time to fully heal. To ease any discomfort, take mild pain-meds. To prolong the life and beauty of your new veneers smile, it is essential to keep a good home oral care. Remember that the underlying teeth are still susceptible to decay and cavities. The most vulnerable parts are those where the tooth and veneer meets. Perform regular brushing and flossing, keep a healthy diet excluding chewy, hard food and minimizing sugar-containing foods and beverages. Would be recommended to stay away from biting with teeth that are veneered, for example biting into apple or having corn on the cob. In some cases it is recommended to wear a nightguard to protect your porcelain veneers from grinding and clenching.

Tooth Extraction

Following post-operative guidelines after emergency tooth extraction is very important, as it speeds up the process of recovery. Some discomfort, swelling and bleeding may be expected after the surgery.

• Your mouth will feel numb within some hours after the surgery. Be careful when eating to avoid injuring your cheeks or tongue.
• Please NO Smoking after surgery for at least one week.
• Bleeding can happen or not. If you experience bleeding with pink or bloody-red saliva, use gauze with pressure to stop oozing. If needed, change the gauze several times. You could also use cold moisten cold black tea bag to help with bleeding. In case the situation gets worse, please call us.
• If you are experiencing swelling use cold packs and ice.
• The main post-care instruction after extraction is not disturbing the surgical site during the first days after the procedure. It is important to avoid rinsing and tooth brushing on the day when surgery occurs. Very important to keep your tongue away from the surgery site. A day after surgery gentle rinsing with warm salt water for 1-2 minutes after each meal and careful brushing are encouraged. As for the sutures, they usually dissolve and don’t need to be removed.
• Keeping the mouth clean encourages the healing process and suppresses bacteria growth. During first days after the procedure, brush and floss your teeth gently without disturbing the surgical site.
• If you experience pain or severe discomfort, take your prescription medications as directed. If you have been prescribed antibiotics its very import to start the antibiotics same day and finish completely as directed even if you are not in any pain, as long as there are no adverse reactions.
• On the surgery day, avoid intensive physical activities and smoking. Once the bleeding stops, you can drink non-carbonated fluids without using a straw. Cold and soft food is the most ideal and comfortable choice during the first days after the extraction. Till the end of the healing process, avoid such foods as popcorn, nuts and seeds – all food that may be lodged in the surgical site.
• Important: Driving or operating dangerous equipment while taking narcotics could be very dangerous. Also, you should not consume alcohol while taking medications prescribed.

Bone Graft

A proper care after bone grafting is very important as it helps prevent complications in the form of infection and swelling. Moderate pain and discomfort are normal for a few days after surgery. You can also experience bleeding in small amounts of blood in your saliva. Increased sensitivity to hot and cold temperatures is a also a variation of the norm.

• Right after the bone grafting procedure, you should bite on the gauze pad that is changed every 30 minutes. This is needed to control bleeding.
• Don’t forget to take prescribed medications before the local anesthesia has worn off. It is advisable to eat something before taking medications to minimize possibility of nausea.
• Be very careful with eating, drinking and rinsing. Don’t vigorously touch the wounded area, as it may cause bleeding.
• Please keep tip of your tongue away from the area of the sutures and where bone graft was placed.   
• To minimize swelling, use ice packs to the place where bone graft has been performed.
• Try to limit any physical and emotional activities the day after the surgery, because it will make you heart beat more often and can potentially cause bleeding and throbbing.
• It strictly forbidden to smoke at least 72 hours after the procedure. Smoking slows down the healing process and in many cases may become the reason of a dry socket. If after 72 hours you still experience severe pain and have a desire to take some pain-killers, it means that the clot has not grown enough to close the bone and it can be risky to smoke.
• Keep a healthy diet. Drink plenty of fluids without using a straw. During the first days, eat soft foods, avoid chewing hard objects. Return to your normal diet gradually.
• Scrutinous oral hygiene is important to speed up the healing process. Brush and floss your teeth daily as you used to, but avoid intense rinsing on the same day when the procedure is performed. Next day after the procedure, you should rinse your mouth with warm salt water after each meal. Be careful with the alcohol-contained mouthwashes.
• The reasons for concern and calling your dentist: pain that doesn’t go away, severe bleeding, permanent fever, excessive swelling after a few days after bone grafting, rough breathing, reactions to prescribed medications

Dental Implants

• The first and most important recommendation is not disturbing the wounds. Avoid rinsing and touching the wound during first days after surgery. Be ready to feel a metal healing abutment stick out the gum.
• Very important to start your antibiotics and completely finish all antibiotics prescribed to you.

• Light bleeding is normal during first 24 hours after the procedure. If you have excessive bleeding, use a gauze pad to stop oxygen delivery to the wound. If bleeding persists, call us immediately.

• It is important to maintain a healthy diet which includes drinking a lot of fluids, avoiding hot food and beverages. Don’t eat crunchy and hard food. During first days after surgery, soft food (such as: yogurt, mashed potatoes, oatmeal, soup, bananas, pudding, etc.) is preferable Try to chew away from the surgical area.

• Gums’ swelling is absolutely normal for up to 1-2 weeks, especially on 2-4 days after surgery. To minimize discomfort, apply ice bag on the cheek.

• Unfortunately, almost all oral surgery is accompanied by some level of pain and discomfort. Once the local anesthetic wears off, take prescribed pain medications. For moderate pain you can use over-the-counter medicines, such as Ibuprofen. Don’t hesitate to take the prescribed antibiotics: they help prevent infections.

• Keeping proper oral hygiene is crucial. The day after surgery, salt water rinse should be used twice a day. Rinsing with warm salt water after each meal helps prevent infections and eases swelling. Brush your teeth and healing abutments as usual, but be gentle with the surgical areas. If you experience some oozing after brushing, apply a gauze as described above to stop bleeding.

As for your physical activity, it is advisable to have rest for the first 24-48 hours after the procedure. During the healing process, bad breath is a common thing. Usually, implants are ready for restoration 4-8 months depending on the implant site. If you used to wear some prosthetic devices such as partial or full dentures, flippers, don’t wear them at least 7 days after surgery. Discuss this issue with your dentist during the preoperative visit.

Maxillary Sinus Complication and Percussions

Certain difficulties may happen during tooth extraction, maxillary sinus complication is one of those. The upper tooth molars and premolars have roots close to the sinus. The probability of complications increases in case of apical infection (the bone between the tooth root and sinus have been destroyed long term by infection) In most cases, the perforation is very small and the area is healing successfully. If there is a small opening, the treatment will include sutures placement across the socket and bone graft. Large openings are closed with buccal flaps. Some treatments may require an addition of some packing materail to seal the hole in the sinus cavity.

After this procedure, the patient should not:

• Blowing the nose:  
  • For one week try not to blow or pinch your nose. Wipe nasal secretion carefully.

• Sneezing:
  • Keep mouth open when sneezing and not to  pinch your nose when sneezing
• Sucking:
  • No smoking!! Don’t drink though a straw.
• Blowing:
  • Not to blow up balloons or play any instruments with your mouth.
• Bending over:
  • Keep your head elevated above your heart.
• Avoid rinsing vigorously and try to have a soft food diet for about a week.
• If you have a nose bleed, increase sensitivity to bright light or severe headaches please call our office or visit your nearest emergency room.  

It is very important to treat sinus communications and avoid further complications (when, for example, a patient drinks something and it comes out of the nose). In most cases, professional dentists can predict the possibility of a sinus lift procedure based on the X-rays and 3D CT-scan before surgery.

Teeth Whitening

To keep your smile white for a longer period of time, you should follow some simple instructions:

• First days after bleaching are crucial for achieving the long-standing results. This is the time when your teeth are most susceptible to having stains. So, try to avoid any intense-coloured and acidic food and beverages in your diet these days. It is preferable to avoid consumption of the following products: coffee, tea, ketchup, red wine, berries, tobacco – all darky, red and yellowish staining substances. If possible, don’t smoke during at least 48 hours after the procedure.
• Sometimes, whitening causes gum inflammation. It is a temporary side effect that usually subsides in a few days after the procedure.
• Be careful when flossing and brushing, as your teeth may be very sensitive right after the procedure. If you are prone to sensitivity, use a special anti-sensitivity toothpaste to reduce discomfort. Usually, sensitivity doesn’t linger more than 72 hours. If sensitivity persists, it’s time to contact your dental professional.
• Keeping proper home oral hygiene will help you save a white color of your teeth. The whitening effect will greatly depends on your everyday habits and genetics. In order to maintain the desired color, you will need follow-up treatments every 6-12 months. You can also use a home whitening trays to maintain the desired shade.
• Remember, that because of dehydration process the results of whitening may be mismatched. It is absolutely normal. The color usually tones down a little after the treatment. Note: if you have fillings, crowns, veneers or other restorative dentures, they won’t be whiten.
• If you have white spots on your teeth (fluorosis) that would get much whiter then rest of your teeth and after would rehydrate back to its natural color after 24-48 hours.

Root Canal Therapy

It is normal to feel some pain, gum soreness and increased tooth sensitivity after root canal treatment as your body is undergoing the healing process. These unpleasant feelings will loosen gradually within several days-weeks. Follow these guidelines to prevent any complications and minimize side effects:

• After the root canal treatment, a temporary filling is usually set in. Be careful with it: avoid eating hard foods until the numbness wears off. Thus, you will prevent your cheeks and tongue from biting and will save your temporary restoration.
• Don’t eat chewy or hard food on the treated mouth side until your tooth is fully restored with permanent restoration.  
• Taking prescribed or over-the-counter medications can help relieve the pain and discomfort. If you have been prescribed antibiotics its very import to start the antibiotics and finish completely as directed even if you are not in any pain.  
• Continue proper oral hygiene: brush and floss your teeth on a daily basis. However, if you have a temporary filling placed in the space between teeth, don’t floss it.
• In case of certain symptoms (fever, increasing pain that doesn’t go away after painkillers, increased gum swelling, allergic reaction to medications, uneven bite or new filling that falls out), immediately contact our office.  
• If you feel comfortable within a few days after root canal therapy, then you can call us to schedule the final restoration.
• When your tooth is finally restored with a crown, take care of your teeth by cleaning and flossing them and having regular dental check-ups.

Braces

There are some important rules to follow after the orthodontic treatment. Below are some of them:

• It is normal to feel your braces as if they stick out. You will need some time to get used to new feelings. Although all modern braces are made smooth, they may cause some irritation to cheek tissues during the first weeks. In this case it is recommended to use small pieces of wax put around the brackets to cease irritation as well as rinsing the mouth with warm salt water. Increased teeth and gum sensitivity are also reported by the patients, but these side effects usually disappear within a week. Over-the-counter pain remedies will help relieve pain and discomfort.
• A dental adhesive used to attach braces to your teeth cures momentally, so you can start eating or drinking right after the procedure. However, be mindful when choosing foods to eat. It is better to keep soft food diet (soup, yogurt, mashed potatoes, cheese, pudding, etc.) until you get used to your braces.
• With braces, you have to avoid doing several things: chewing gums of any kind and other sticky food (caramels, gummy candies, etc.); biting hard food such as nuts, taco chips, pizza crusts, ice, whole apples, carrots and corn (they should be cut into pieces); drinking acidic beverages (lemon juice) as it destroys your tooth enamel. All listed products can be potentially harmful for your braces. Although braces are attached with the help of strong adhesive, they can be dislodged because of enormous eating force.
• To maximize the results of your orthodontic treatment, it is important to have a healthy diet with reduced amount of sugar-content products. Teeth move better when there is an overall healthy environment. Have a proper brushing and rinsing right after you eat sweets to avoid the potential of cavities.
• Brushing and flossing may be challenging but is very important. Before starting cleaning procedures, remove elastics, bands and all removable parts of braces. First, clean your braces and each wire. Then, pass on brushing your teeth. You can use basic brushing tools – a soft, middle-soft brush or electric brush. Be careful with the latter: your electric toothbrush should have a moderate power mode to avoid hitting the braces. Use a usual and fluoride toothpaste. Pay a special attention to the areas between braces’ wires and teeth as well as brackets and gums. To make the brushing more easy and effective, try special brushing tools such as an interdental toothbrush or an oral irrigator. And don’t forget about flossing: use a standard floss and a dental threader for hardly accessible areas.

Dentures

It is absolutely normal for you to feel awkward and uncomfortable in your new dentures during first days-weeks. Your smile and speech have changed, and you can feel as if your mouth is too full. Don’t worry, you need time to adjust. A little bit of patience and training, and you will learn how to relax your facial muscles and get used to your new appearance.

• During first days, you should wear your dentures as long as you can. Eat soft foods, cut it into pieces. It is important, because dentures don’t provide you with the same chewing strength as your natural teeth. Such “difficult” food as carrots and steak will require you some practice.
• Careful maintenance of your dentures is essential: you should clean them carefully to avoid bacteria growth and stains creation. Brush the dentures gently as they are very delicate. Spreading the folded towel or having a basin of water when handling your dentures is a good idea. It is better to use a special brush with soft bristles for dentures and a denture cleaner. Rinse the dentures between your meals. To save their original appearance, dentures should always be moist.
• During the first nights, it is usually recommended to wear dentures to bed. But after the adjustment period, don’t wear dentures when sleeping. Your gums and jaw need a rest. Wearing dentures permanently may cause tissue irritation, infections and bone shrinkage.
• When everything is healed after your dental treatment, continue brushing your gums, tongue and palate with a soft brush. This is needed in order to remove plaque and stimulate circulation.
• You may feel some looseness if your teeth have been removed right prior dentures placement. The discomfort may persist until the gums and bone heal – usually it takes 3-6 months. During the healing period, you can use a temporary liner to help dentures fit more precise. After the healing process, a permanent liner is placed.
• One of the possible side-effects after the dentures placement is the appearance of sore spots in the mouth. This happens because of uneven pressure on the gums created by dentures. To get rid of sore spots, it it recommended to wear dentures at least during 3-6 hours before the adjustment visit to your dentist. Thus, it will allow to see which gum areas are suffering from soreness and to correct your dentures from the inside with trimmer.
• With your new dentures you will need to learn speaking normally again. Keeping patience, practicing as well as reading aloud will help you return to a confident speech.