Post Operative Instructions

Post Operative Instructions

Please select the procedure you underwent to read about a summary of post operative instructions and please call us if you have any questions.

• Dental Implant Surgery
• Extractions
• Periodontal Surgery
• PAOO/Soft Tissue Graft Surgery
• Root Canal Therapy
• Fillings
• Crown and Bridge
• Veneers

Post Operative Instructions- Dental Implant Surgery

• Placement of dental implants usually does not create a great deal of pain. General postoperative instructions apply, with the exception of rinsing.
• Remember DO NOT rinse with the warm salt water. Use the prescription rinse chlorhexidine, an antibacterial medicine to assist in the healing and keep the site healthy.
• Make sure that you get rid of any toothpaste residue prior to rinsing and then DO NOT eat or drink for 30 minutes after rinsing. This will maximize the potency of the medication.
• Some degree of discomfort and pain arises a numbness subsides. At the first sign of pain or discomfort, take the prescribed medications. As an alternative you may take 2-4 Advil. If you cannot take aspirin products, then take two Tylenol. If the pain you are having, is not controlled by the Advil or "Advil-like" prescription, you may take the prescribed severe pain medicine [typically Vicodin ES], but only after eating some food. Any pain medications 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. Allowing the tissues to rest undisturbed assists the healing process. Avoid vigorous chewing, excessive spitting, or aggressive rinsing during the healing phase. Initial healing may be delayed, active bleeding restarted, or infection introduced, otherwise.
• Expect minor bleeding or oozing. If bleeding persists, continue pressure on a fresh sponge for an additional 30 minutes to an hour. Biting on a moist teabag wrapped in gauze may help control persistent oozing from the surgical site. Tea contains tannic acid, which helps promote blood clotting.
• Firm pressure for 15-30 minutes usually controls the problem. If you check too frequently, (every few minutes), the blood clot will not form properly and bleeding will continue. Should active bleeding persist, please call the office or the doctor's emergency number.
• Limit physical activity during the first 24-48 hours after surgery. Over exertion may lead to postoperative bleeding and discomfort. When you lie down keep your head elevated on a pillow. You may wish to place a towel on your pillowcase to avoid staining from any blood-tainted saliva.
• Pain following oral surgery will be most severe within the first 6-8 hours after the operation. Please do not drink alcoholic beverages while taking prescription 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 48 hours. And mild discomfort usually diminishes after the third day. Please contact us if you experience prolonged severe pain so that we can help make you more comfortable.
• Swelling related to the surgical procedure may occur following certain types of procedures. An ice pack should be placed on the side of your face for 20 minutes then taken off for 10 minutes and repeated. Anti-inflammatory medications, such as Advil, also help decrease swelling.
• Drink many fluids. Clear beverages, ginger ale, water, teas, soda, broth, soups, or juices are all suitable. Avoid hot liquids until the numbness has worn off, and the bleeding has stopped.
• AVOID USING A STRAW FOR SEVERAL DAYS. It may dislodge the blood clot and delay healing.
• Soft, cool foods are most easily tolerated. A nutritious diet is most important to your comfort and temperament. Remember that eating can prevent nausea sometimes associated with certain medications. Supplements such as Ensure, Carnation Instant Breakfast and/or yogurt supply excellent added nutrition.
• DO NOT EAT ANY POPCORN, POPPY SEEDS, SESAME SEEDS OR SEEDED FRUITS. THEY CAN GET STUCK AND CAUSE INFECTION!
• Take any special medication we have prescribed on the special 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 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.
• Try to avoid smoking completely, as it tends to delay healing and interfere with regeneration. The Day Following Surgery and Thereafter On the day following the surgery, rinse your mouth carefully with 1/2 teaspoon of salt to a large glass of warm water. Repeat three times a day until remaining soreness subsides. 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. Should any undue reaction or complications arise, notify the office immediately.

Emergency number to call: 202 256 5798
Office number to call: 202 912 9200 or 703 299 4614

Post Operative Instructions- Tooth Extractions

• Wound Care
  • Bite firmly on the gauze pack that has been placed for, at least, thirty minutes then remove it gently.
  • DO NOT SMOKE for 12 hours following the surgery. This will promote bleeding and interfere with healing.
• Bleeding
  • Some blood will ooze from the area of surgery for several hours, this is normal.
  • Do not spit or suck. This will promote bleeding.
  • If bleeding begins again, place a rolled up piece of damp gauze directly over the tooth socket and bit firmly for another 30 minutes.
  • Keep your head elevated on several pillows or sit in a lounge chair for 12 hours following the surgery.
  • If bleeding continues after 3-4 attempts with direct pressure, do not hesitate to telephone the numbers provided.
• Discomfort
  • .Some discomfort is normal after surgery. It can be controlled by taking the pain medication your oral surgeon has prescribed.
  • Start taking your pain pills before the numbing medication has worn off. This will give the medication time to work and will decrease any discomfort you may experience.
  • Take your pain medication win an 8 oz. glass of water and/or a small amount of food to prevent nausea.
  • Do not drink alcohol if you take prescription pain pills.
• Diet
  • It is important to drink a large volume of fluids. Do not drink through a straw because this may promote bleeding.
  • Avoid hot food for the first 24 hours after surgery. This promotes bleeding.
  • Eat a soft diet for a day following surgery. You can resume a normal diet the after the surgery.
• Oral Hygiene
  • After that, rinse gently with warm water and half a teaspoon of salt four times a day, for three days.
  • Brush gently, avoiding the area of surgery.
• Swelling
  • .Swelling after surgery is a normal body reaction. It reaches its maximum about 48 hours after surgery, and usually lasts 4-6 days.
  • Applying ice packs over the area for the first 24 hours (no longer than 20 minutes at a time), helps control swelling and may make you more comfortable.
• Bruising
  • You may experience some mild bruising in the area of your surgery. This is a normal response in some persons and should not be cause for alarm. It will disappear within one to two weeks.
• Stitches
  • If stitches were placed in the area of your surgery, your surgeon will tell you if and when they need to be removed (usually in about one week.) Many times stitches are used which are self-dissolving and do not require removal.
• Call Dr. Singer if.
  • a.You experience discomfort that you cannot control with your pain medication.
  • b.You have bleeding that you cannot control by biting on gauze.
  • c.You have increased swelling after the third day following surgery.
  • d.You have a fever
  • e.You have any questions

Emergency number to call: 202 256 5798
Office number to call: 202 912 9200 or 703 299 4614

Post Operative Instructions- Periodontal Treatment

For pain or discomfort you may take over-the-counter pain medication, i.e., Advil, Aleve, Tylenol. It is advisable to eat only soft food for the first 24-hours, and avoid any hard or spicy foods which could cause irritation. Drink plenty of water during the first 24-hours-at least 8 glasses are recommended. Place cold towels or an ice pack to the outside of your face in the treated area. Apply for 15 minutes, then remove for 15 minutes during the first 4-6 hours. On the morning after the treatment, rinse mouth with warm salt water (1/2 teaspoon salt to a glass of warm water). Repeat this several times daily. Brush teeth gently to help remove plaque that has started to form. We suggest using fluoridated, tartar control toothpaste. Don't use floss or other home tooth care products, such as toothpicks or electric brushes, until the dater after your treatment. Begin very gently at first. Because it is very common for periodontal disease to recur, patients should have regular checkups to monitor progress and prevent recurrence. Please follow these home care instructions carefully and call us if you have any questions or concerns.

Emergency number to call: 202 256 5798
Office number to call: 202 912 9200 or 703 299 4614

Post Operative Instructions- PAOO/Soft Tissue Graft Surgery

Work, Exercise & Sedation: Return Home immediately and Relax. If you took an oral sedative, it takes some time to completely wear off, possibly as much as 24 hours. It is normal to sleep a good deal during this period. Do not try to drive or operate any machinery for 12 hours, as your reaction time is slowed. It is advised to not use alcohol while on sedatives. We suggest complete rest for the first 6-12 hours, as this will reduce discomfort, decrease swelling and speed healing. Work can be resumed the following day, but you may choose to wait several days. Do not undertake any strenuous exercise for several days.

Diet: Soft and cool for the first 24 hours after surgery. We encourage you to restrict your diet to soft, nourishing foods, and plenty of liquids, as this will aid in healing. It is advisable to chew only on the side opposite surgery. Bland foods lacking high seasoning are less irritating and are encouraged during the healing phase as well. Some suggested foods: Dairy products, eggs, instant breakfast, ice cream, gelatin, pudding, yogurt, milkshakes, blended or pureed foods, and/or dietary supplements ('Ensure, Boost, etc.)

For 24 hours after surgery, hot foods and drinks should be avoided because heat can cause swelling around the surgical site. An ice pack, or crushed ice in a plastic bag, covered with a thin towel, held on the lip or cheek over the surgical site for 20 minutes on, and 1 hour off will help reduce swelling (during the initial 12-24 hours). If swelling appears to be increasing beyond the initial 72 hours please call our office.

Home Care: Plaque control procedures must not be neglected, even during the post-operative phase of treatment. Beginning the day after surgery, all teeth NOT surgically treated must be brushed and flossed as you normally do. Teeth treated are not to be brushed until you return for post-surgical care. Toothpaste may be irritating to the healing tissues. Start the prescription mouth rinse the following morning after surgery.

Pain Medication: Pain medication may or may not be prescribed depending on the severity of your surgical procedure. If it is not prescribed or if you do not need it, Ibuprofen (Advil) (3-4 tablets every 6-8 hours_ or Acetaminophen (Tylenol) may be used (2 tablets every 8 hours) will generally keep you comfortable. Do not take pain medication if it is not needed.

Periodontal Dressing: If you had a graft, the graft is held in by sutures that will be removed approximately 7-10 days following surgery. A periodontal dressing (pack) has been placed over the graft. The dressing will harden to a firm, plastic-like consistency. It will also protect the grafted area, and allow it to be undisturbed during healing. If it comes out after 3-4 days, do not worry, generally it will stay until your post op appointment. If it becomes loose, do not try to remove it as it may be attached to sutures. Try to push it back into the original position.

If you were given a plastic covering (stent) for your palate, wear it as much as possible. It will be removed at your post-operative appointment. It is for your comfort and to protect the wound.

Bleeding: Slight bleeding, oozing, or redness in the saliva is not uncommon. Your saliva may be tinged with blood for the remainder of the day. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If excessive bleeding does not subside, call for further instructions.

General Information: Smoking should be avoided, however, if this is not possible, refrain from smoking during initial healing phase, as it slows the healing process. Smoking also irritates the surgical areas. Do not use straws for drinking after any dental surgical procedure.

Swelling: The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body's normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling can be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling

Discomfort: Your jaw and lip will remain numb for approximately six hours. You should begin taking the medication prescribed for discomfort while you are still numb to prevent the onset of pain. If you should begin to experience more that mild discomfort, you may take the medication every two-three hours as necessary. If this is not sufficient, please contact our office. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. Therefore, immediately following surgery, if you are laying down, make sure you sit for one minute or so before standing

Fever: A slight elevation in temperature is common on the evening of the surgery. However it should not exceed 101 degrees. If this occurs, please contact our office.

Infection: Infections may occur a day or even several; days following surgery. A sudden increase in swelling, throbbing pain, high fever and /or a foul tasting drainage may indicate infection. If you suspect an infection, please contact our office as soon as possible.

Bruising: Bleeding into the tissue around the jaws results in purplish bruises a few days following surgery. Do not be alarmed. Some patients have more bruising than others. These areas will become yellow as they move toward the neck and shoulders a week later.

Rinsing: No rinsing of any kind should be done until the day following surgery. You can gently brush your teeth the night of surgery-avoid the surgical site. The day after surgery you should begin gentle rinsing at least 5-6 times a day, especially after eating. Use approximately 1/2 teaspoon salt in 8 ounce glass of warm water. The use of commercial mouthwashes during the healing period should be avoided.

Denture Wear: If you wear a denture, your denture or partial should NOT be worn until it has been properly adjusted. The time you will be instructed to refrain from wearing your denture will be determined by the surgeon, and will vary from patient to patient. The success of your implants will depend on your compliance with this. Whenever dentures or partials are worn, they must be worn for appearance only, not eating or chewing. Chewing will cause implant loss.

Emergency number to call: 202 256 5798
Office number to call: 202 912 9200 or 703 299 4614

Post operative Instructions- Root Canal Therapy

It is normal for the surgical area to swell following an operation. Such swelling may last from a few hours to several days. Following surgery, an ice pack should be applied to the swollen area at 10 minute intervals (10 minutes on then 10 minutes off) until bed time. By sleeping with the head elevated swelling will be minimized.

It is normal to experience some pain following surgery. Using the ice and taking two aspirin, Tylenol, or Advil every 3 to 4 hours will help reduce this pain. If necessary a prescription can be written. If further medication is required, please call the office.

It is normal for blood to seep from the site of a surgical procedure for several hours after the operation. Mouth rinses may stimulate bleeding and should be avoided on the first day.

Careful tooth brushing is desirable and promotes healing but the bristles of the brush should not contact the survival area. Brush only the teeth and make every effort to avoid the gums. Mouth rinses may be started 24 hours after the surgery. You can use mouthwash or a mild salt water solution (½ teaspoon salt to ½ glass of warm water).

Postoperative infection is unusual but possible. Signs of infection may be increased pain, increased swelling and tenderness, elevated body temperature, chills and other flu-like symptoms. An objectionable odor and taste may also be experienced. When these conditions exist, begin rinsing with warm salt water and call the office.

It is normal for the patient to experience a loss of appetite following surgery. T he teeth may be tender and certain foods may be difficult to chew. However, nourishment after surgery is extremely important.

An appointment has been made for the removal of the stitches. If for any reason the sutures loosen or fall out do not be concerned unless there is a persistent bleeding. If you are unsure as to whether there is a problem do no hesitate to call the office.

Emergency number to call: 202 256 5798
Office number to call: 202 912 9200 or 703 299 4614

Post operative Instructions- Fillings

A new filling may be sensitive to hot and cold from a few days to a few weeks. If the sensitivity does not fully subside, call the office. After the anesthesia wears off and you feel pain when biting down, the filling may need to be adjusted to fit your bite. Call the office to make an appointment for an adjustment. Brush your teeth and floss regularly to make your filling last as long as possible. Fillings can last for a long time depending on use and care.

Post operative Instructions- Crown and Bridge Treatment

If you have had Novocaine, please be careful not to bite your tongue or the inside of your cheeks. Avoid eating hard, chewy and sticky foods on the temporary crown to reduce the likelihood of breaking or dislodging the temporary crown. Gently brush and floss the rest of your teeth as usual. After the permanent crown/bridge is placed, you may feel slight pressure for a few days. Call our office if you experience pain or discomfort for more than a week after the crown/bridge is cemented, or if you have any questions.

Maintenance of Porcelain Veneers

Some sensitivity to hot and cold may be experienced after the placement of the veneers. The use of Sensodyne toothpaste will ease the sensitivity. Some sensitivity is absolutely normal and usually dissipates after one-two weeks. If this sensitivity should remain or concern you at all, please call the office. The nightly use of an occlusal or night guard will minimize the stresses placed on the teeth while you sleep if you clench or grind your teeth. Flush and brush daily. A good home care regimen will insure the esthetic success of your porcelain restorations for years to come.
Visit us regularly for periodic checks and cleanings.