Scaling and Root Planing
Post-Op Instructions: Oral Surgery and Tooth Removal
We would like to thank you for choosing us to perform your surgical procedure. We have provided some basic post-operative instructions to make your recovery as comfortable as possible. If you have any questions or concerns, please contact our office and a member of our surgical team will return your call in a timely fashion.
Some degree of discomfort and pain arises as the numbness subsides. We recommend that you start taking a non-steroidal anti-inflammatory once you arrive home. Advil/lbuprofen/Motrin/Aleve are such medications and should be taken as directed on the bottle (usually 400 mg every 4-6 hours). If you are unable to take anti-inflammatory medications, take Tylenol or acetaminophen as directed on the bottle (usually 650 mg -1000 mg every 6 hours). If the pain is not relieved, then you may take the prescribed pain medication as directed. All pain medications have the ability to cause severe nausea and vomiting, so try to have some food in your stomach before you take them.
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 24-72 hours, sometimes peaking on the 3rd postoperative day. Relief should begin on the 4th post-operative day.
Expect minor bleeding or OOZING from the operative site. This bleeding may continue throughout the first day. Keep firm pressure on the surgical site by biting on a gauze sponge for 30 minutes at a time until bleeding subsides. Once the oozing has slowed down, try to avoid placing gauze or any other irritant near the surgical site as this will only lead to continued bleeding and discomfort. Biting on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site.
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 and a member of our surgical team will return your call promptly.
The surgical site
The first stages of healing are aided by allowing tissues to rest. Avoid vigorous chewing, excessive spitting, or rinsing for the first 24 hours as initial healing may be delayed, active bleeding restarted, or infection introduced.
AVOID USING A STRAW to ingest liquids as it may cause the blood clot to dislodge and delay healing.
Try to avoid smoking completely, as it tends to slow the healing process and may also contribute to infection & prolonged discomfort.
Do not worry about the stitches if they start to come out. The sutures usually dissolve in 5-7 days and typically do not require removal.
Swelling usually develops during the first 12-24 hours following surgery, often peaking on the 3rd post-operative day. It should begin to subside by the 4th day after your surgery. Swelling can be minimized by placing an ice pack on the affected side at 30 minute intervals during the first 48 hours after surgery.
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 48 hours.
Limit activity during the first 24-48 hours after surgery. Excessive exertion may lead to postoperative bleeding and discomfort. When you lie down, keep your head elevated at least 45 degrees on a pillow.
Do not drive an automobile if you are taking prescription pain medication.
FLUID INTAKE IS VERY IMPORTANT. We suggest you start with clear liquid beverages, such as water, ginger ale, 7-Up, or Sprite. You can advance to soft foods and other fluids as tolerated. Please avoid hot liquids until the numbness has worn off, and the bleeding has stopped.
FOOD SELECTION is largely a matter of your choice. Soft, cool foods that require little or no chewing are most easily tolerated. Do not consume alcoholic beverages.
Start cleaning your mouth 24 hours after surgery by using warm salt water rinses (1/4 teaspoon table salt with a small cup of water). Repeat 3 times daily for one week. BRUSH your teeth starting on the first postoperative day being careful not to irritate the surgical site.
Take any regularly scheduled medication on your regular schedule unless advised to do otherwise. Patients taking blood-thinners (ie. Coumadin) should restart those medications after surgery unless there is any sign of continued bleeding.
Post-Op Instructions: Scaling and Root Planing (Deep Cleaning)
Please read and follow these instructions following your Scaling and Root Planing Procedure. Patients have found these recommendations to be helpful.
Indications for scaling and root planing
Periodontal Disease sometimes known as "gum disease" which is a bacterial infection of the gums, is an indication for Scaling and Root Planing. The main cause of Periodontal Disease is dental plaque, the sticky film of bacteria that gets below your gum line and causes the infection. You can remove plaque by daily brushing and flossing teeth. The plaque that is not removed becomes calculus sometimes referred to as "tartar" and can accumulate along and under your gums. If left untreated Periodontal Disease can damage the tissues surrounding and supporting the teeth including the bone. Symptoms of Periodontal Disease include gums that are red, swollen, bleed easily during brushing and flossing, bad breath, and may even be painless and symptom free. The Scaling and Root Planing procedure will remove plaque and calculus on the teeth and root surfaces that will help stop progression of disease and prevent future damage and bone loss.
After Scaling and Root Planing, your gums may be tender, light bleeding and soreness is common from the cleaning itself but could also be from the amount of time your mouth was open, jaws may be sore. Any non-aspirin medication taken for minor discomfort should be helpful. Root sensitivity to cold, heat, sweets or air may temporarily occur. The use of toothpaste for sensitive teeth will usually reduce or stop the sensitivity.
After care of your mouth
Rinse 2-3 times per day with warm salt water by dissolving one teaspoon of salt in an 8-oz glass of water. You may use your preferred mouth rinse unless it contains alcohol which may be too harsh on tissues following treatment. Do not be concerned if mild bleeding during brushing occurs for a few days following procedure. Brush your teeth very lightly in treated area the first night, begin flossing lightly and increase to normal force by the weeks end.
Since you are numb from the Scaling and Root Planing procedure it is advised to use extreme caution during eating, talking etc. due to high risk of self-injury to lips, cheek, tongue etc., due to anesthesia. It is advised that you wait to eat for at least an hour or until the numbness has worn off. After numbness has worn off you may eat as tolerated but avoid spicy, harsh or brittle foods. If you choose not to wait to eat choose soft foods and chew very slowly! Also use caution with temperature of foods such as hot soup.
Tobacco and alcohol
Refrain from drinking and smoking until the area is healed or at least 48 hours because both delay the healing process. Considering quitting altogether is also recommended.
What is next?
Once all four quadrants have had Scaling and Root Planing a 4-6 week re-evaluation visit is needed to examine how gums are responding to treatment. After that visit it is necessary to have Periodontal Maintenance cleanings every 3-4 months to ensure that the infection to your gums has not returned or worsened at all. Once you have had periodontal disease you are much more susceptible to getting it again. You do not have to be numb for Periodontal Maintenance cleanings and it will feel like regular cleaning to you, with the exception of added aids to help prevent the need for Scaling and Root Planing again.
Several days after treatment your gums should begin to appear pinker and less swollen, these are signs of healing and improved periodontal health.
I hope this information is helpful to you and I look forward to taking care of your oral health needs.
If any questions or concerns arise, feel free to call our office.
Post-Op Instructions: Crown and Bridge Appointments
Crowns and bridges usually take two or three appointments to complete. On the first appointment the teeth are prepared. Temporary crowns or bridges are placed to protect the teeth while the custom restoration is being made. After each appointment when anesthetic has been used, your lips, teeth, and tongue may be numb for several hours after the appointment. Avoid any chewing until the numbness has completely worn off.
On rare occasions temporary crowns come off. Call us if this happens, and keep the temporary so we can re-cement it. It is very important for the proper fit of your final restoration that temporaries stay in place.
It's normal to experience some hot, cold, and pressure sensitivity after each appointment. Your gums may be sore for several days. Rinse three times a day with warm salt water (a tsp. Of salt in a cup of warm water, rinse-swish-spit) to reduce pain and swelling. Use medication as directed.
To help keep your temporary in place, avoid eating sticky foods (especially gum}, hard foods, and if possible, chew only on the opposite side of your mouth. It's important to continue to brush normally, but floss very carefully and remove the floss from the side to prevent removal of the temporary crown.
If your bite feels uneven, if you have persistent pain, or you have any other questions or concerns, please call our office.
Post-Op Instructions: Root Canal
Root canal therapy often takes two or more appointments to complete. After each appointment when anesthetic has been used, your lips, teeth and tongue may be numb for several hours. A void any chewing on the side of the treated tooth until the numbness has completely worn off.
A temporary filling or crown is placed by your dentist to protect the tooth between appointments.
Between appointments, it's common (and not a problem) for a small portion of your temporary filling or crown to wear away or break off. If the entire filling falls out, or if a temporary crown comes off, please call our office so it can be replaced.
To protect the tooth and help keep your temporary in place:
-Avoid chewing sticky foods (especially gum).
-Avoid biting hard foods and hard substances, such as ice, fingernails and pencils.
-If possible, chew only on the opposite side of your mouth.
It's normal to experience some discomfort for several days after a root canal therapy appointment, especially when chewing. It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root canal therapy. This should subside within a few days (or even weeks). Even if you were not experiencing any discomfort prior to treatment, it is normal for you to experience some degree of discomfort for a few days after. The tenderness is normal and is no cause for alarm.
To control discomfort, take pain medication as recommended by your dentist. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
If you were not prescribed a pain medication by us but are experiencing pain after your appointment, we recommend taking over the counter pain medication. We recommend ibuprofen (Motrin, Advil, Nuprin) or naproxen (Aieve, Anaprox). Should you experience discomfort that cannot be controlled with pain medications or should swelling develop, please call our office.
To further reduce pain and swelling, rinse three times a day with warm salt water; dissolve a teaspoon of salt in a cup of warm water, then rinse, swish, and spit. It's important to continue to brush and floss normally.
Usually, the last step after root canal treatment is the placement of a crown on the tooth. A crown covers and protects the tooth from breaking in the future. Unless otherwise noted by the dentist, it is critical to have a crown placed on your root canal therapy treated tooth as soon as possible.
Delay in obtaining final restoration (crown) may result in fracture and/or possible loss of the tooth.
If your bite feels uneven, you have persistent pain, or you have any other questions or concerns, please call our dental office.
Post-Op Instructions: Teeth Whitening
Post-Op Instructions After In-Office Whitening or Take Home Kit Whitening
Sensitivity and soreness following whitening is very common. Your teeth may be especially sensitive to cold air and drinks and if any of the whitening agent gets on your gums, it may cause them to be tender. Sensitivity and soreness will gradually subside after a couple of days. If you are more prone to sensitivity, you may choose to use anti-sensitivity toothpaste before, during, and after whitening.
Try to avoid any darkly or reddish colored foods and beverages (red sauces, coffee, red wine, tea) and smoking for a few hours following whitening. This is when your teeth are most susceptible to absorbing new stain. To maintain your shade for as long as possible, avoid colorants (dark food and drinks, tobacco), use a whitening toothpaste, and have regular cleanings. You may need to use home whitening trays a few times a month to maintain your shade.
Tooth-colored fillings will not whiten. If the filling matches your current color, bleaching will result in miss-matched shades with your natural teeth. You may need to have your old fillings replaced to match your newly whitened teeth.
The best way to maintain your white teeth after in-office whitening will be to utilize a take home teeth whitening kit.
Post-Op Instructions: White Fillings
How long will I be numb?
Your lips, teeth, cheek and/or tongue may be numb for several hours after the procedure. To avoid injury, you should avoid any chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue, cheek or lip while you are numb.
Is it normal for my gums or jaw to be sore?
Irritation to the gum tissue can occur from dental work. Rinsing your mouth 2-3 times per day with 1/2 tsp of warm saltwater can help to alleviate discomfort. Injection sites can be sore for several days after your appointment. Over-the-counter pain medications work well to alleviate the tenderness.
Do I have to be careful with my filling?
Your white filling is as hard as it will be when you leave the office. Immediately following the appointment, you can brush, floss and chew as you would normally. Please use the precaution as stated above if you are numb.
If you experience any throbbing or sharp pain, please call our office.
My bite feels off, is this normal?
If your bite feels uneven, please call our office so we can make a quick adjustment to the filling. Do not assume your bite will get better after time. The tooth may become irritated and a toothache may occur, if this is not done. It may also cause an increase in temperature sensitivity with the tooth.
Is it normal for my tooth to be sensitive?
It is normal to experience some sensitivity to heat, cold, sweets and pressure after your appointment. This sensitivity may last from several weeks to several months after treatment. Usually, the deeper the cavity, the more sensitive the tooth will be. Again, make sure that your bite feels even.
Why does the filling feel different?
The filling may be contoured differently and have a different texture than your original tooth or restoration. Your tongue may magnify this slight difference and you should become accustomed to this "new feel" in just a few days. If not, please call the office.
If you have any issues or concerns, please do not hesitate to call the office.