Post Operative Instructions

POST-OPERATIVE INSTRUCTIONS – White Fillings

When anesthesia 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. It is easy to bite or burn your tongue or lip while numb.
It is recommended that you take some ibuprofen (Motrin or Advil, 1-2 tablets every 4-6 hours as needed) before the anesthetic completely wears off. This will help with any swelling or pain at the injection sites where your anesthetic was administered.
It is normal to experience some hot, cold and pressure sensitivity after your appointment. Your gums may be sore for several days.
Rinse your mouth three times a day with warm salt water (put a teaspoon of salt in a cup of warm water, rinse and spit) to reduce pain and swelling.
Your new composite fillings are fully hardened before you even leave the office and you can chew shortly after the numbing goes away!
One of the most common problems following filling placement with anesthesia, is an uneven bite. It is simply because its hard for the patient to feel correct bite due to numbness. Most of the time it resolves within few days by it self. However, if it does not and if you have persistent pain, or if you have any other questions or concerns, please contact our office at 704-837-7701
When decay is deep, a medication is placed under the filling to help preserve nerve vitality to avoid root canal. This procedure has very good success rate, but occasionally root canal might still be required.

POST-OPERATIVE INSTRUCTIONS – CROWN OR BRIDGE

Crowns and bridges usually take two or three appointments to complete to achieve high esthetic outcome. 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 at all times.
It’s normal to experience transient 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 (1 OR 2 teaspoon salt + 8 ounces warm water) 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. Use floss threader to get under splinted temporaries or bridges.
If your bite feels uneven, if you have persistent pain, or you have any other questions or concerns, please call our office.

POST-OPERATIVE INSTRUCTIONS – TOOTH EXTRACTION

DO NOT DISTURB THE AREA: For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start natural healing process.

DO NOT: Swish, suck through a straw, spit or smoke, it can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils).

Be sure to chew on the opposite side until the area heals completely.

Understand that any food caught inside the extraction socket (place where tooth used to be) can cause infection, pain and additional surgery, so stay on soft or liquid food diet and give your body enough time to heal.

After 24 hours you may begin gentle rinsing with a saltwater solution (1 or 2 teaspoon salt + 8 ounces warm water). Be sure to RINSE AFTER EACH MEAL OR SNACK! Avoid commercial mouthrinses that contain alcohol if you can.

BLEEDING: When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 to 60 minutes. Don’t change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on another gauze or a tea bag for another 30 minutes if you feel it is still bleeding. Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
DIET: Eat soft foods until the area is healed. Maintain a good, balanced diet, you need proper nutrition to heal. Drink plenty of water. Avoid alcohol for 48 hours. Keeping the area clean from food debris will promote good healing.

SMOKING: Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful condition called “Dry Socket”, which can hurt worse then a toothache and there is no cure for it. You must quit for at least 5 day to allow initial healing.

PAIN: Some discomfort is normal after surgery. To minimize pain, take Tylenol, Motrin or Advil, or similar non-aspirin pain reliever to maintain comfort. Start take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications. Strong pain medications, like Norco, must be only taken before bedtime.

NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer. Contact our office if you experience these symptoms.

BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you must brush your teeth to reduce bacteria amount, but avoid the area of surgery for few days.

RINSING: Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1 or 2 teaspoon salt + 8 ounces warm water) after each meal or snack. Avoid commercial mouth rinses that contain alcohol.

ACTIVITY: After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

SUTURES: If you had resorbable sutures placed, then they will dissolve on its own in 7-10 days and you do not need to worry about suture removal.

SPECIAL CONSIDERATIONS – Trismus (stiffness) in the face muscles may cause difficulty in opening your mouth for a period of days. Moist heat compresses can minimize this condition. You may experience aching from other teeth. This discomfort is caused by referred pain and is a temporary condition. It is not unusual to develop bruising in the area of the extraction. There may be a slight elevation in temperature for 24-48 hours. If the fever persists, please contact our office.
FOLLOW-UP APPOINTMENTS: You may need to return to the office for a brief follow-up healing check.

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.

POST-OPERATIVE INSTRUCTIONS – DENTAL IMPLANT PLACEMENT

DO NOT DISTURB THE AREA: For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process.
DO NOT: Swish, suck through a straw, spit or smoke, it can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side until the area heals completely. Understand that any food caught at the surgery site can cause infection, pain and swelling, so stay on soft or liquid food diet and give your body enough time to heal.

DIET: Eat soft foods until the area is healed. Maintain a good, balanced diet, you need proper nutrition to heal. Drink plenty of water. Avoid alcohol for 48 hours. Keeping the area clean from food debris will promote good healing.

NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you must brush your teeth to reduce bacteria amount, but avoid the area of surgery for few days.

RINSING: Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water). Avoid commercial mouthrinses that contain alcohol.

ACTIVITY: After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

SUTURES: If you had resorbable sutures placed, then they will dissolve on its own in 7-10 days and you do not need to worry about suture removal.

FOLLOW-UP APPOINTMENTS: You may need to return to the office for a brief follow-up healing check.

POST-OPERATIVE INSTRUCTIONS – DEEP CLEANING (Scaling and Root Planing)
To minimize the discomfort and encourage proper healing following your scaling and root planing, follow these instructions:

After the procedure, take aspirin, acetaminophen (Tylenol®), or ibuprofen (Advil®) before the anesthetic wears off. Continue to take over the counter pain medication for the next two days even if you do not have any discomfort.

A saltwater solution (1 OR 2 teaspoon salt + 8 ounces warm water) swished in your mouth for 2 to 3 minutes every hour may make your mouth more comfortable.

Use a soft toothbrush and floss at least two times a day. Be gentle and clean thoroughly. Plaque (Bacteria) will start to grow and removing it with brushing and flossing at least twice a day will promote a positive outcome of the treatment.

Slight bleeding may occur while brushing as the tissues begin to heal and is normal up to 4 weeks following treatment.

Avoid strong spicy seasonings, and hard crunchy foods for the next few days.

Smoking should be stopped. Success of the treatment will be substantially reduced by the cigarette smoke chemicals in your body.

As the tissues heal, some temporary sensitivity to cold may occur. Use a desensitizing toothpaste (such as Sensodyne® without whitening), or fluoride gel (such as Prevident® or Gel-Kam®) frequently (at least 4 times/day) for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.

Faithfully use any other oral hygiene aids that have been recommended (floss, waterpick, chlorhexidine, rubber tip, Sonicare®, Proxabrush®, Peridex® mouthrinse, etc).

If you had antibiotics like Arestin or Atridox applied at the time of deep cleaning, do all the recommended post op instructions but DO NOT floss or waterpick the treated teeth with antibiotics for at least 10 days.
Always Follow Up. Because the bacteria that cause periodontal disease are persistent, the infection can return. Please be sure to make follow-up appointments with your dental professional to maintain healthy gums and teeth.

Keep Your Scheduled Appointments. It is important to keep all of your dental appointments so that your dental professional can re-examine your gums, make sure the infection is under control, and measure the success of your treatment.

If you have any questions or concerns, please call our office at 704-837-7701

POST-OPERATIVE INSTRUCTIONS – TAKE HOME TEETH WHITENING

While bleaching or whitening your teeth, normal oral hygiene measures should be followed (flossing and brushing).
Bead the bleaching gel into your custom tray, using caution not to overload the tray. Insert the tray into your mouth over teeth and gently wipe any excess gel from around the edges of your tray, taking extra care not to leave any gel on your gums. Irritated gums usually means you have used too much gel in your tray.
Wear the tray for brief time to see how your mouth reacts to it. If you feel comfortable, then wear the trays as directed to you at your delivery appointment. The time of wear is based on the concentration and type of bleaching material utilized for your case. If the sensitivity is too uncomfortable, stop and reduce time and/or frequency. Usually sensitivity stops after several days.
While bleaching, do not rinse your mouth, since this may dilute the bleaching agent.
Do not swallow the whitening gel.
Never drink, eat, or smoke while wearing your tray.
Do not consume any red, black or staining foods like: coffee, sodas, red wine, etc.
After completing your bleaching session, remove the tray and gently clean it with a toothbrush and tap water without toothpaste. Rinse it completely, and let dry thoroughly before the next session.

If you develop severe sensitivity or pain stop bleaching and please contact our office at your convenience.

POST-OPERATIVE INSTRUCTIONS –NEW PARTIAL OR COMPLETE DENTURES

New dentures always require a period of adjustment. First-time denture patients may require several weeks or months 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 on both sides of your mouth. 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, please let us know, 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 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. Since cleaning procedures differ for various types of appliances, please follow the directions given to you at your insertion appointment.
DO NOT wear your complete or partial dentures to bed. It is important to allow your gum tissues and jaw bones to rest in order to prevent further tissue irritation, infection, and future bone shrinkage.
Over time, or with weight change, the supporting gum tissues and bone will change shape and size. Periodic relines of your dentures may be necessary to ensure a retentive fit. Denture teeth will wear or chip over time. For this reason, an annual check of your tissues and dentures is recommended.

POST-OPERATIVE INSTRUCTIONS – INVISALIGN BRACES CARE

Taking care of Invisalign clear aligners is very simple. Every time you brush your teeth you can brush your aligners but without a toothpaste. The best way to clean your aligners is to use the Invisalign cleaning kit. They can also be soaked and cleaned in a denture cleaner.
It is not advisable to remove your aligners at night.
Thanks to the removable nature though, 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 by Dr. Denisovich.
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.
Dr. Denisovich discourages 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.
We recommend removing your aligners for all meals and snacks.

Trays May Cause Some Irritation To The Lips, Tongue, And Cheeks
If This Occurs

Use wax to stop the irritation
Rinse with warm salt water to help irritation heal
Products like Zilactin-B or a peroxide based rinse can be helpful, and are available over the counter

Things TO DO During Invisalign Treatment:

Wear each set of trays for at least 2 weeks, unless otherwise instructed
Wear each set of trays for 18- 20 hours a day, unless otherwise instructed
Use denture cleaner tablets to clean trays at least once a day
Always place trays in case when not in your mouth
Always remove trays by starting from the back molars
Always place trays in from the front of your mouth first, and then move to the back teeth
You may drink water while wearing trays or use a straw for dark liquids
If possible, brush or rinse before placing trays back in your mouth
Clenching into trays w/ your aligner chewies during the first 2-3 days helps teeth move faster and relieve pressure. Only clench for 30-40 sec each quadrant, and repeat for 5-10 min, but only do this if you have no history of jaw problems
Wear trays as instructed in sequential order
Keep 2 to 3 of your previous trays in a clean plastic bag

Things NOT TO DO During Invisalign Treatment:

Throw away trays
Leave trays out of mouth for long periods of time
Chew gum with aligners in your mouth
Leave trays in hot vehicle, or boil them (They are plastic!)
Leave trays sitting out for pets or small children to chew on
Wrap trays in a napkin (You will throw them away acidently!)
Place trays in your pocket without a case
Have dental work done while in treatment, EXCEPT for regular checkups and cleanings
Eat while wearing trays
Remove trays from the front teeth first
Drink dark teas, coffee or soda with trays in (Use a straw)
Set trays on table at a restaurant
Bite trays into position, this may damage them
Use mouthwash or toothpaste on trays

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

Post Operative Instructions

for all patients