Oral Surgery

Things To Expect

• Bleeding: Bleeding or "oozing" for the first 12 to 24 hours.
• Swelling: This is normal following a surgical procedure in the mouth. It should reach its' maximum in two to three days, and should begin to diminish by the fifth post-operative day.
• Discomfort: Any discomfort you will experience will occur after the anesthesia has worn off. This should diminish within 1-3 days.

• Bleeding: Place gauze over extraction sites and maintain pressure by biting for at least 2 hours. Replace gauze every 30 minutes within these 2 hours. Keep head elevated and rest. Do not suck or spit excessively. (Also please refrain from blowing into musical instruments.)
  Note: Some oozing and discoloration of saliva is normal. If bleeding persists, replace the gauze with a clean folded gauze placed over the extraction site, and maintain the pressure until the bleeding stops.
• Rinsing: 24 hours after the surgery, rinse with warm saltwater (or prescription mouth rinse) three-to-five times per day for seven days.
• Swelling: Place ice or cold compresses on the region of surgery for ten minutes every half-hour for the first eight to twelve hours.
  Note: Ice bags or cold compresses should be used only on the day of surgery.
• Smoking: Avoid smoking during the healing period.
• Discomfort: Begin taking pain medication immediately after surgery as directed. The medicine will require 45 minutes to one hour to take effect.
• Diet: A nutritious liquid or soft diet may be necessary for the first weeks after the surgery. A fluid intake of at least two quarts a day is needed.
• Physical Activity: For the first 24 to 48 hours, you should REST. Patients who have sedation should refrain from driving an automobile or from engaging in any task requiring alertness for the next 24 hours.

The Days After Surgery:

• Brush teeth carefully.
• Use WARM SALT WATER (or prescription mouth rinse) as a mouth rinse, three to five times per day.
• If ANTIBIOTICS are prescribed, be SURE to take ALL that have been prescribed, AS DIRECTED.
• Use WARM, MOIST HEAT on face for swelling. Continue until the swelling subsides. A warm, wet washcloth or heating pad will suffice.
• If SUTURES were used, return to the office in five to seven days for removal.
• DRY SOCKET is a delayed healing response, which may occur during the second to fourth post-operative day. It is associated with a throbbing pain on the side of the face, which may seem to be directed up toward the ear. In mild cases, simply increasing the pain medication can control the symptoms. If this is unsuccessful, please call our office at 734-427-7555.

CONTACT THE DOCTOR IF:

• Bleeding is excessive and cannot be controlled.
• Discomfort is poorly controlled.
• Swelling is excessive, spreading or continuing to enlarge after 48 hours.
• Allergic reactions to medications occur which are causing a generalized rash or excessive bleeding.

CONTACT EMERGENCY MEDICAL SERVICES OR CALL 911

Root Canal Treatment

What should I expect following endodontic treatment?

During treatment, the doctor thoroughly cleaned the root canal system inside your tooth, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone.  The molecules that have caused some of the soreness take some time to be removed from the area by your immune system and thus it is normal to feel some tenderness over the next few days; your body is undergoing the natural healing process.
You may also feel some tenderness in your jaw from keeping it open for an extended period of time or from where the anesthetic was injected. These symptoms are temporary and usually respond very well to over-the-counter pain medications. Our team will describe a good regimen.  It is important for you to follow the instructions on how to take these medications. Remember that if you take any narcotic medications, they may make you drowsy, and caution should be exercised in operating dangerous machinery or driving a car after taking them.
Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, contact us.

Guidelines

• Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue.
• Do not chew or bite on the treated tooth until you have had it restored by your dentist.
• Be sure to brush and floss your teeth as you normally would.
• If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, contact us.
• Contact us right away if you develop any of the following:
1. a visible swelling inside or outside of your mouth;
2. an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction)
3. a return of original symptoms
4. your bite feels uneven

Contact us if you have any problem with which you are uncomfortable at 734-427-7555.

Scaling & Root Planning

Periodontal therapy involves continuous self-maintenance and ongoing treatment. Scaling is performed to remove plaque and tartar deposits and root planing is done to smooth the root surface, allowing the gum tissue to heal and reattach to the tooth.
What to expect:
Discomfort: Discomfort immediately after treatment is usually associated with slight throbbing or aching and occasionally may be uncomfortable. This discomfort usually subsides in about four hours. Any discomfort due to brushing should get better in one to several days. Your gums may become “itchy” or uncomfortable and your doctor may recommend ibuprofen to allviate discomfort. Swelling or jaw stiffness occur very rarely, however if it does, apply warm, moist towels to the face in the area of the stiffness.
Sensitivity: Sensitivity to temperature changes and/or sweets may temporarily occur. Removing all plaque from the tooth with a tooth brush or Q-Tip, placing a dab of sensitive toothpaste or fluoride toothpaste on the tooth should stop sensitivity within a few days. If tooth sensitivity persists, use desensitizing toothpaste such as Sensodyne, and avoid Tartar Control Tooth Paste. If a local anesthetic was used, avoid chewing foods until feeling returns to avoid injury to the tongue or cheeks. If the sensitivity is severe and prolonged, professional application of a desensitizing agent may be required. The sensitivity to temperature may be intense the first several days and usually diminishes quickly.
Bleeding: Some slight bleeding may occur during the next several brushings but the bleeding should steadily decrease after two or three days. If you have heavy non-stop bleeding contact the office.
Appearance: Root surfaces may be more exposed as the swelling of the inflamed gum tissue goes away. This may result in more space between the teeth.
Although this treatment is necessary, please understand that this is not a cure. Risks associated with scaling and root planing includes, but is not limited to, the following:

• Hot & cold
• Sensitivity
• Sweet sensitivity
• Discomfort
• Pain
• Abscess
• Injection pain
• Numbness
• Bleeding
• Throbbing
• TMJ
• Infection

Diet & Eating: If extensive root planing was performed, chewing hard foods, such as meat or raw vegetables may be uncomfortable. Avoid any hard foods such as potato chips, fritos, popcorn, etc. for the next 3-4 days. This should last no longer than a few days. A diet of a softer consistency would be advised until chewing becomes more comfortable. Your first meal should be soft. The worse thing you could have is hot soup. No hot food or beverages for 2 days.
Oral Hygiene: It is recommended that patients who have received this type of treatment return for a 6-week re-evaluation and then cleanings every 3-4 months for the first year.

If after treatment symptoms are severe or persistent, or an abscess (gum boil) should appear, please call the office immediately at 734-427-7555.

Temporary Crown/Bridge

It is extremely important for the temporary crown/bridge to remain on the tooth until we seat your permanent crown. If your temporary crown becomes loose or comes off at any time, please call the office immediately. Your tooth can shift within a few hours if your temporary is missing, which can inhibit the placement of your permanent crown. You may also experience sensitivity if your temporary comes off. Please note: With your temporary, avoid hard and chewy foods (such as ice, hard candy, gum, taffy). These are known to pull temporaries off the prepared tooth. If your temporary comes off or becomes loose, please gently replace your temporary back onto your prepared tooth and call the office (you cannot put your temporary back on incorrectly because it will only fit one way). It is important to floss your temporary. However, instead of pulling the floss back up through the teeth, release one end of the floss and pull it through the side of the tooth. Once the anesthesia has worn off and you feel as though any of the teeth we worked on are hitting first, please give the office a call immediately. This imbalance with your bite may cause further discomfort and should be adjusted.

Teeth Whitening

Follow instructions included in your kit.
Total treatment time is usually 2 – 3 weeks. Some cases may take longer, especially if treatment is interrupted.
Make sure you brush and floss thoroughly prior to each treatment. The bleaching gel can work better if it is in contact with the tooth rather than plaque buildup.
Mild sensitivity to cold liquids or air may occur. This usually passes a few days after treatment is completed. If the sensitivity is severe or persists, discontinue using the gel and contact our office.
If you experience any gum irritation, let us know. Your custom tray may need to be adjusted.
Teeth Whitening works best on yellow stained teeth. Gray teeth are more difficult to whiten, or may not respond to treatment. Such cases may require porcelain veneers to achieve the desired result.
Results can be quite dramatic. However upon completion of the teeth whitening process, the color will “tone down” somewhat. This is normal and actually looks more natural.
Long term results vary from patient to patient. This can depend on many factors including habits such as smoking or coffee, tea, wine, or cola consumption.
“Touch-up” treatments may be needed every 3 – 6 months. This can usually be accomplished in 1 or 2 treatments of 1 – 2 hours each. A special touch-up kit is available at our office.
Existing fillings, crowns, bonding, etc. will not whiten. Therefore, these restorations may need to be changed in order to match your new smile.
It is important to keep you 2-week follow-up appointment so we can assess the results or make changes in treatment as needed.
If you have unsightly old silver fillings as us about changing them to invisible white fillings. Old crowns with dark gumlines can be changed to more natural looking metal-free porcelain crowns.
If your friends wonder why you are smiling so much, tell them about us. It would be our pleasure to help them improve their smiles, too!

Tooth-Colored Fillings

Your anesthesia will wear off in approximately 1 to 3 hours after the procedure. It is very important not to chew on the numb side (to prevent biting tongue, lip, etc.) until the anesthesia wears off.
Your tooth (or teeth) may be sensitive to hot, cold or pressure from this procedure. This is COMPLETELY normal. The more invasive the procedure, the more sensitivity you may experience. The possible symptoms of hot, cold or pressure will cease within a few days to a couple of weeks. In very few instances, this sensitivity could last longer than a couple of weeks. As long as your teeth or gums are continuing to feel better, (not staying the same, or getting worse) everything is fine. There is no need for concern.
We have prescribed ibuprofen (Motrin). This IS NOT for pain. Ibuprofen is to reduce the inflammation in the area worked on, and will further eliminate hot, cold and pressure sensitivity if taken as directed. If you are allergic to or cannot tolerate ibuprofen (Motrin, Advil, etc) please advise us. If discomfort continues for more than a couple of weeks, please call our office at 734-427-7555.
Once the anesthesia has worn off and you feel as though any of the teeth we have worked on are hitting first, please give the office a call immediately. This imbalance with your bite may cause further discomfort and should be adjusted.

Veneers, Crowns and Bridges

Your anesthesia will wear off in approximately 1 to 3 hours after the procedure. It is very important not to chew on the numb side (to prevent biting tongue, lip, etc.) until the anesthesia wears off. Your tooth (or teeth) may be sensitive to hot, cold or pressure after this procedure. Your gum tissue may also be tender. This is COMPLETELY normal. The more invasive the procedure, the more sensitivity you may experience. The possible symptoms of hot, cold or pressure will cease within a few days to a couple of weeks. In a very few instances, this sensitivity could last longer than a couple of weeks. As long as your teeth or gums are continuing to feel better (not staying the same, or getting worse) everything is fine. There is no need for concern. We have prescribed ibuprofen (Motrin). This IS NOT for pain. Ibuprofen is to reduce the inflammation in the area worked on, and will further eliminate hot, cold and pressure sensitivity if taken as directed. If you are allergic to or cannot tolerate ibuprofen, (Motrin, Advil, etc) please advise us. If discomfort continues for more than a couple of weeks, please call our office at 734-427-7555.