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Post-Operative Instructions for Gum Surgery/Tooth Removal Surgery/Implant Surgery

Do NOT eat anything until the anesthesia wears off, as you might bite your lips, cheek, or tongue
and cause damage. You will probably have some discomfort when the anesthesia wears off; take
your non-aspirin pain medication(s) as directed, whether it is prescribed or over-the-counter.

Medications:
* Please take Ibuprofen or Advil 800 mg (equal to 4 tabs of over-the-counter Ibuprofen
or Advil) every 4-6 hours for the next 3-5 days.
o Please take it as instructed, whether the area hurts or does not hurt!!!
o Do NOT exceed 2400 mg (12 tabs) in a 24 hour period!!!

AND/OR (You may alternate Ibuprofen and Tylenol pain medications for better pain
coverage)

* Please take Extra Strength Tylenol 1000 mg (equal to 2 tabs of over-the-counter Extra
Strength Tylenol) every 4-6 hours for the next 3-5 days.
o Please take it as instructed, whether the area hurts or does not hurt!!!
o Do NOT exceed 4000 mg (8 tabs) in a 24 hour period!!!
o AVOID OVERDOSE! If and when you are taking Vicodin / Tylenol #3 /
Percocet / Tramadol, please only take 1 tab of Extra Strength Tylenol. These
prescription medications contain Tylenol.

* You may have been given a prescription for a stronger pain reliever. This may be
filled at any pharmacy if the over-the-counter pain medication does not relieve your
discomfort.
An antibiotic may have been prescribed to prevent or minimize infection. Please take the
antibiotics as instructed until all tablets / pills are finished.

Discomfort:
Slight swelling of the operated area is not unusual. Even bruising and chapped lips may occur.

* A reusable ice bag or a frozen vegetable bag, wrapped in a soft towel, may be applied
to the area of surgery to help minimize the swelling of your face. Alternating 20
minutes on and 20 minutes off will usually be adequate during the first 24-48 hours
after surgery.

* Keeping your head elevated above your heart will also help. Most swelling can occur
in the morning and up to 3 days after surgery. Avoid sleeping / laying on the side that
surgery was performed.
* Two days after surgery, moist heat will help resolve minor swelling. Major swelling
should be reported to the doctor at once.
You may experience some tooth sensitivity after surgery, especially to cold. Sensitivity usually
decreases within several weeks after surgery and can be minimized by keeping the area as free of
plaque as possible. If the sensitivity is extreme, contact the doctor for recommendations or
medications to relieve the discomfort.

Bleeding:
Minor bleeding, such as a pinkish tinge to your saliva, may occur during the first 48 hours
following surgery. Avoid extremely hot foods for the rest of the day and do NOT rinse out your
mouth, as these will often prolong the bleeding. If bleeding continues, apply light pressure to
the area with a moistened gauze or moistened tea bag. Keep in place for 20-30 minutes
without looking to see if bleeding has stopped. (NO PEEKING!) Do not spit or rinse
forcefully. If bleeding increases or occurs past the initial 48 hours, please call our office as soon
as possible to notify the doctor and receive further instructions. Avoid any strenuous physical
activity for the next 2-3 days to prevent or minimize severe bleeding.

Eating / Diet:
Please follow a soft food diet, taking care to avoid the surgical area(s) when chewing. Chew
on the opposite side and do NOT bite into food if the procedure was done in the front of the
mouth. Avoid sticky, hard (such as ice cubes, nuts, popcorn, chips), brittle, spicy, highly
seasoned, or acidic foods in your diet. Foods such as soups, pasta, scrambled eggs, mashed
potatoes, macaroni & cheese etc. are best. Be sure to maintain adequate nutrition and drink
plenty of fluids.

Avoid alcohol (even beer and wine) and smoking until after your post-operative

appointment.

Smoking is not advised during the 7-14 days following surgery.

Homecare:
Maintain normal oral hygiene measures in the areas of your mouth not affected by the surgery. In
areas where there is dressing, lightly brush only the biting surfaces of the teeth. After you have

eaten or you have snacked, please use lukewarm salt water rinse 4-6X a day; 30 seconds of
swooshing with each use. Vigorous rinsing should be avoided!

Post-Operative Instructions for Socket Bone Grafting


In addition to the general postoperative instructions, we would like to emphasize a few points.
Your bone graft is made up of many particles. You may find some small granules in your mouth
for the first several days. Do not be alarmed by these. It’s normal to have some of them come out
of the graft site and into your mouth. There are some things you could do to minimize the
amount of particles that become dislodged:
* Do not vigorously rinse or spit for 3-5 days.
* Do not apply pressure with your tongue or fingers to the grafted area, as the material is
movable during the initial healing.
* Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the
wound site and tear the sutures.
For the first day, we would suggest letting the blood clot stabilize and not even rinse your mouth.
Following the first day, gentle rinsing would be advised but not too vigorously as you can again
disturb some of the bone graft granules. If a partial denture or a flipper was placed in your
mouth, you will probably have to see your restorative dentist to have it adjusted and learn how to
remove and replace it appropriately.

Post-Operative Instructions Following sinus Grafting/Sinus manipulation Procedure


If you had a sinus grafting procedure performed, the general postoperative instructions still apply, but I would like to emphasize a few important points about your particular procedure and remind you of some instructions:
Do not blow your nose.
If you must sneeze, do so with your mouth open to avoid any unnecessary pressure on the sinus area.
Do not smoke or use smokeless tobacco. Smoking greatly inhibits the healing, especially in the sinus graft.
Do not take liquids in through a straw.
Do not lift or pull up on your lip to look at the stitches, as this may actually create damage and tear the stitches.
Take your antibiotics as directed and until finished.
You may have some bleeding from the nose. This is not uncommon and should pass quickly.
You may be aware of small granules in your mouth for the next few days. This is not unusual, as your graft is mainly made of small particles and some of these are lost in the healing process.
If you feel congested, you may need to use antihistamines or decongestants. If you do, use over-the-counter products such as Tavist-D or Dimetapp. I would also suggest that you avoid nasal sprays unless they are saline. Most of the time, patients do fine without any nasal sprays, antihistamines, or decongestants.


After Root Canal / Endodontic treatment:


Your endodontic (root canal) treatment is now complete. Taking an analgesic before the numbnesswears off may help maintain an acceptable comfort level. Please wait to eat or drinkon the affected side until after the numbness has worn away. Please do not chew or attempt to eat on the affected side while you are still numb.
Discomfort:
Discomfort or soreness in the area is normal for a few days (or even weeks) and range from mild to severe. This occurs because of existing infection and inflammation of the gum and tooth ligaments as well as the manipulation of the tooth during treatment. The gums may be sore and the tooth is often tender to biting or chewing. Over the counter analgesics such as Ibuprofen, Advil, Aleve, Aspirin, Motrin, Excedrin, and Tylenol should relieve most of the discomfort. Rinsing with warm salt water (1 teaspoon of salt per glass of warm water) will help. Discomfort in the area in no way affects the successful outcome of treatment. DO NOT TAP THE TOOTH WITH YOUR FINGER AND DO NO USE YOUR TONGUE TO PUSH ON THE TOOTH.
Try to brush and floss as usual immediately after treatment to prevent infection. Electric toothbrushing is good.
If antibiotics and/or pain medications were prescribed, please take them as directed. If you were given a prescription for pain, it is meant to help you with more serious discomfort only for a couple of days. In the unlikely event that swelling, fever, or severe pain should occur, please call the office promptly.
Temporary Filling:
IF A temporary filling has been placed in the entry made into your tooth. It is normal for a thinlayer of the temporary filling to be chewed away between appointments. An unusual taste can beexpected. Should all of the temporary filling come out, please call our office. It’s important that your temporary filling stays intact until the placement of a permanent restoration. Most the time, a permanent filling has been done at the same time as the root canal treatment completion.
Final Restoration/crown:
IF AN APPOINTMENT TO PLACE A FINAL RESTORATION / CROWN HAS NOT BEEN MADE, PLEASE TELEPHONE TO SCHEDULE THIS APPOINMENT PROMPTLY WITH YOUR RESTORATIVE DENTIST. Endodontically treated teeth have been weakened by previous decay and fillings. It is necessary for these teeth toreceive additional protection in the form of a cast restoration (onlay or crown). This will protectthese teeth against future fracture and decay, and protect the root canal filling from possiblecontamination. Delay in obtaining a final restoration may result in fracture and/or possible loss of the tooth or require a retreatment or a root canal.
If you have any questions or concerns about the crown treatment process, your restorative dentist, your restorative dentist's office can be consulted.