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Post Op Instructions


Extraction After Care Instructions

How do I care for my mouth after an extraction? 

Wound care: Bite firmly on gauze pack that may have been placed for 15-20 minutes then remove it gently.  Replace new gauze if heavy bleeding persists.  Do not smoke for at least 12 hours, smoking will promote bleeding and interfere with healing.  Keep tongue and fingers away from the area of extraction.

Bleeding: It is normal to have slight bleeding for 2-3 days after extraction.  It might be advisable to use an old pillowcase the first night following an extraction.  Keep your head elevated with several pillows.  Try not to spit.  Do not drink through a straw because this promotes bleeding.  If bleeding begins again, place a damp tea bag directly over the site and bite firmly for 20 minutes.

Bruising: You may experience some mild bruising in the area of your extraction.  This is a normal response for some and should not be a cause for alarm.

Discomfort: Some discomfort is normal after surgery.  It can be controlled with pain medication (i.e. Advil, Motrin, or Tylenol).  Take the pain medication before the "numbness" wears off.  Make sure to take any prescribed medications as directed.  Do not drive and do not drink alcohol if you take prescription pain pills.  

Diet: Do not eat until the "numbness" wears off to ensure you won't bite your lips, tongue, or cheek.  Do all chewing on opposite side of mouth for 1 week.  It is important to drink a large volume of fluids.  Start with a modified diet consisting of cool or warm foods (i.e. ice cream, yogurt, warm soups).  Nothing HOT.  Return to normal diet as you feel comfortable.

Oral hygiene: Avoid rinsing your mouth or brushing your teeth in the extraction area for the first 12 hours.  After 12 hours you may rinse gently with warm salt water (1/2 teaspoon of salt in 8 oz. of warm water) every 4-6 hours.  Brush your teeth gently but thoroughly.

Swelling: Swelling after extraction is a normal body reaction.  It reaches its maximum about 48 hours after extraction and usually lasts 4-6 days.  Apply ice packs over the area of extraction for the first 12 hours (alternating every 20 minutes).  Sometimes 2-3 days after your extraction you may develop a "dry socket".  If you experience an increase in pain and a foul mouth odor, contact our office.

Rest: Avoid strenuous activity for 3 days after your extraction.

Stiffness: After extraction you may experience jaw muscle stiffness and limited opening of your mouth.  This is normal and should improve within 5-10- days.

Stitches: If stitches have been place in the area of your extraction, you may need to have them removed.  Your doctor will advise you. 




Scaling and Root Planing After Care Instructions


What do I need to know after scaling and root planing?  

Care of the Mouth: All areas should be brushed and flossed as usual as long as they do not cause you discomfort.  You may find rinsing with warm salt water is soothing (1/4 tsp. salt in 1 glass of warm water). Do not use any alcohol-containing mouth rinses.

Discomfort: You can expect little to no discomfort in your gums.  Discomfort will vary according to the extent of your periodontal infection. The best method to maintain comfort is to take 600-800mg of ibuprofen every 6-8 hours; do not wait until it hurts.  Discomfort is made worse by smoking and poor diet.

Tooth Sensitivity: On occasion, some patients may have increased sensitivity to temperature or sweets.  If this happens to you, please let us know at your next visit.  It usually resolves by itself, but there are some medications that can be applied to the tooth that can help reduce sensitivity.

Fever and Chills:  On rare occasion, some patients develop a low-grade (100 degree F or less) fever and chills in the first 24 hours after scaling and root planing.  If this happens, take Tylenol and drink plenty of fluids to reduce the fever.  

Jaw Muscle Discomfort:  On rare occasion, some patients can have an earache, headache, and/or discomfort in the jaw muscles after dental treatment.  This happens more often in patients who grind or clench their teeth.  Ibuprofen should help, but if it doesn't let us know at your next visit.

Antibiotics: If you were prescribed antibiotics, please take as directed until all are gone:

  • For women who are pregnant or who could be pregnant, do not take any medications without consulting your physician.  Birth control pills may not work effectively when you take certain antibiotics.  To be safe, use an alternative contraceptive method when taking antibiotics and for 2 weeks afterward.
  • Side effects: On occasion, some people have unfavorable reactions to antibiotics such as nausea, vomiting, diarrhea, itching, rash, hives, difficulty breathing or other side effects.  If this should happen to you, STOP taking your medications and go to the emergency room, if needed.

Bleeding:  A slight amount of bleeding for several hours following is common.  If you take a nap, cover your pillow with a towel.  If the bleeding persists, please call.

Smoking: Smoking can dramatically affect healing and cause premature loss of teeth.

Post surgery diet suggestions: Have only cool to warm liquids (not hot) to drink after your surgery until the numbness has worn off.  This is to prevent you from burning your lips, cheeks, or tongue.

Do not eat until the numbness has worn off.  This is to prevent you from biting your lips, cheeks or tongue.

VERY SOFT FOOD SUGGESTIONS:

     - Eggs (scrambled, soft boiled or poached)

     - Yogurt (avoid seeds)

     - Cottage cheese

     - Creamy soups

     - Mashed potatoes and gravy

     - Hot cereals

     - Applesauce

     - Ice cream

     - Jello

     - Pudding

     - Custard

     - Milk shakes (DO NOT JUST EAT SWEETS)

SOFT FOOD SUGGESTIONS:

     - Spaghetti

     - Macaroni and cheese

     - Ravioli

     - Soups with chunks of meat and vegetables

     - Egg salad

     - Tuna salad

     - Ground meat

FOODS TO AVOID FOR AT LEAST 3 WEEKS:

     - Popcorn

     - All nuts

     - All seeds

     - Chips (taco, tortilla, potato, etc.)

     - Granola

     - Any hard or crunchy foods





LANAP After Care Instructions 

 DO NOT BRUSH OR FLOSS FOR 1 MONTH FROM TREATMENT

 

  • Do not be alarmed with any color changes or appearance of gum tissue following laser therapy. Gum tissue can turn gray, yellow, red, blue, purple, and “stringy” and reflects a normal response to laser treatments.
  • Do not apply excessive tongue or cheek pressure to the treated area.
  • Do not be alarmed if one or all of the following occurs:
    • Light bleeding
    • Slight swelling
    • Some soreness, tenderness, or tooth sensitivity
    • Medicinal taste
  • Swelling may possibly occur. To keep this at a minimum, gently place an ice pack on the outside of the face for 20 minutes each hour until you retire for sleep that night. Do not continue using the ice bag beyond the day of the surgery.
  • Some oozing of blood may occur and will appear to be greatly exaggerated when it dissolves in saliva.
  • Please call the office at 1-951-683-3030 so that we may render further treatment if any of the following occurs:
    • Prolonged or severe pain
    • Prolonged or excessive bleeding
    • Considerably elevated or persistent temperature.
  • If medication has been prescribed, please take exactly as directed. Antibiotic pills are prescribed. The entire bottle or prescription should be taken for the stated number of days or weeks. If you are not allergic to Motrin – Generic Ibuprofen (eg. Advil, Nuprin), we will most likely prescribe it primarily to minimize tissue swelling, and local inflammation that is a natural side effect of minor surgery. Ibuprofen is also good to reduce post-operative pain and sensitivity. Ibuprofen is non-narcotic and does not affect your ability to drive. Never place aspirin directly on the tissue of a painful area.
  • Reduce physical activity for several hours following the surgery to maximize healing.
  • Try to keep your mouth as clean as possible in order to help the healing process. Only brush and floss the untreated area of your mouth. Do not brush or floss the treated area for 1 month or as directed by Dr. Rice.
  • Do not rinse, brush, or floss the day of treatment.  The very next day you may brush and floss the untreated area. For the treated area you may rinse gently with the rinse prescribed to you for 60-90 seconds 3x a day.
  • You may need to be on a liquid diet for 3 days, then a diet of mushy/soft foods for the rest of the month, it is very important to maintain your food and fluid intake. Try to eat soft but nutritious food such as eggs, yogurt, cottage cheese, malts, ice cream, etc., until you can comfortably return to a normal diet. Please refer to the Post Laser® Treatment Diet Instructions (on the next page).
  • Avoid spicy or excessively hot foods during the initial 3 day liquid diet period.
  • When eating do not chew on the side of your mouth which has been treated.
  • Do not be alarmed that beginning with just 2 weeks after therapy and extending as long as 1 year or more, the teeth may become sore and tender as the bone and ligaments around the teeth regenerate and become more firm. This is a sign of healing, but also indicates the presence of a bite imbalance that may need to be adjusted. Please let Dr. Rice know at your post-operative visits.
  • “Spaces” between your teeth can result from reduction of inflammation, swelling, and the removal of diseased tissue after the Laser® treatment. These spaces usually fill in over time, and again, bite adjustment is critical to making sure the teeth and the “papilla” is not traumatized and can regrow.
  • After you complete the program follow up care and periodontal maintenance visits are extremely important to preserve the work that has been done.

 

Post Laser® Treatment Diet Instructions

  • If instructed for the 3-day liquid diet following Laser Therapy, follow only a liquid- like diet to allow healing. Anything that could be put into a blender to drink is ideal. The purpose of this is to protect the clot that is acting as a “band-aid” between the gums and the teeth. Do not drink through a straw, as this creates a vacuum in your mouth that can disturb the “band-aid”. Take daily vitamins.
  • After the instructed 3-day liquid diet, you can start the mushy/soft foods for the remainder of the month. (Recommendations listed below.)
  • If NOT instructed 3-day liquid diet, follow a strict mushy/soft diet for 1 month after your last treatment 
  • You will start to notice white material start to form around treated area. Do not be alarmed this means the tissue is starting to heal. It was explained to you that you must leave this material alone until it naturally heals and disappears. Once the white material has disappeared, then soft foods can be introduced. Soft foods have the consistency of pasta, fish, chicken or steamed vegetables. You may then, gradually add back your regular diet choices.
  • Please remember first month following treatment you should continue to make smart food choices. Softer foods are better.

 

*“Mushy” Diet Suggestions

DAILY VITAMINS!

  1. Anything put through a food blender
  2. Cream of wheat, Oatmeal, Malt O Meal
  3. Mashed Avocado, Applesauce
  4. Mashed Potatoes or Baked Potatoes – OK with butter/sour cream
  5. Mashed Banana or any mashed/blended fruit except berries with seeds
  6. Broth or Creamed Soup
  7. Mashed steamed vegetables
  8. Mashed Yams, Baked Sweet Potato or Butternut squash
  9. Cottage cheese Cream or Soft cheese
  10. Creamy peanut butter without solid pieces
  11. Eggs any style, with or without melted cheese
  12. Omelets can have cheese and avocado
  13. Jell-O, Pudding, Ice Cream, Yogurt
  14. Milk shake/smoothies – DO NOT blend with berries containing seeds (do not use a straw)
  15. Ensure, Slim Fast -nutritional drinks

 

DON’T

Chew gum, candy, cookies, chips, nuts, anything hard or crunchy, anything that has seeds or hard pieces, meat that shreds and can lodge under the gum and between teeth, raw vegetables/salad.

Post Laser OHI

Healing occurs at an individual’s own rate and is affected by outside influence such as mechanical or bacterial trauma.  For example, when you cut yourself and a scab forms, it will fall off as the tissue matures and becomes stronger and more resistant. How long does this process take for you, your father, your brother, your best friend and your son? It’s all different.

Please remember these are guidelines and Dr. Rice and her assistants will make further recommendations depending on how the tissue looks. 

Please do not do anything listed below unless Dr. Rice or her assistant informs you to do so. 

  • Manual brush in a Roll Technique only at 1 month (unless instructed otherwise)
  • Floss at 1 month (unless instructed otherwise & above gums only)
  • Electric toothbrush 3 months (no sub-gingival attachment(s))
  • Oral irrigators 6+ months (above gums only)
  • Keep patients on the prescription rinse the entire time you are not brushing (about 1 month) and switch to a non-staining antimicrobial rinse indefinitely as preventative OHI (such as NeutraSal)


-If there is fibrin or red thrombus still present or if the tissue does not look right, DO NOT brush yet. The tissue needs to be mature and strong enough for flossing and electric toothbrush.

 

Smokers/Tobacco Users Warning

Tobacco has a very large effect on your gums and the disease you have in them. Tobacco is associated with an increased disease rate in terms of loss of the bone and gums that are holding your teeth in, as well as an increase in the space between the gums and teeth. Tobacco is a major factor for chronic gum disease.

Any type of smoking and/or chewing tobacco will have an adverse effect on the progress of your healing and may cause the gum disease to re-occur after treatment. If you are a smoker or chew tobacco we highly recommend not doing so while you are healing or any time after that.




Periodontal Surgery After Care Instruction 

 

CARE OF THE MOUTH:  Do not brush or floss areas where we did surgery.  All other areas should be brushed and flossed with a manual toothbrush (not electric).  Gently rinse mouth with the prescription mouth rinse as instructed.  Do not use any alcohol-containing mouth rinses. 

 

DISCOMFORT:  Discomfort will vary in intensity according to the extent of the surgery.  The best method to maintain comfort is to take the 800mg of Ibuprofen prescribed every 6-8 hours; do not wait until it hurts.  If this is inadequate, take 2 extra strength Tylenols (1000 mg total) alternating with the Ibuprofen.  Discomfort may be more severe on the second, third or fourth day and is made worse by smoking and poor diet. 

 

SWELLING:  Apply ice (do NOT push, gently place) to the face over the operated areas for 4 to 6 hours following the surgery; on and off for 20-minute periods.  Avoid strenuous physical activity for 4 days.  This will minimize the post-operative swelling.  The swelling may be more pronounced on the second, third or fourth post-operative days.

 

BLEEDING:  A slight amount of bleeding for several hours following the surgery is common.  If you take a nap, cover your pillow with a towel.  Do not rinse and drink through a straw.  If the bleeding persists, please call.

 

DIET:  Adequate nutrition is essential for normal healing.  A high protein diet is desirable (milk, eggs, cottage cheese, yogurt, ground meat).  Eat a semi-soft diet and avoid hard crunchy foods.  When possible, chew on the other side of the mouth.  Please see the other side of this page for diet suggestions. 

 

NUMBNESS:  For several hours after surgery, there may be numbness of the lip and/or tongue. Be careful to not chew to avoid trauma.

 

MEDICATION:  Should nausea, vomiting, diarrhea, rash, itching, difficulty breathing, or other side effects occur, STOP taking all medications we prescribed and contact the office or go to the emergency room if needed.  Antibiotics are prescribed to prevent infection.  If antibiotics are prescribed, please take as directed until all are gone.  For women, on birth control pills, antibiotics can reduce their effectiveness.  An alternative birth control should be used while taking antibiotics and for 1 month afterwards. 

 

SMOKING:  Smoking can dramatically affect healing and cause premature loss of teeth.

 


POST SURGERY DIET SUGGESTIONS

1.    Have only cool to warm liquids (not hot) to drink after your surgery until the numbness has worn off.  This is to prevent you from burning your lips, cheeks, or tongue.

2.   Do not eat until the numbness has worn off.  This is to prevent you from biting your lips, cheeks, or tongue. 

3.  VERY SOFT FOOD LIST:

  1.  Eggs (scrambled, soft boiled, or poached)
  2. Yogurt (avoid seeds)
  3.  Cottage cheese
  4. Creamy soups
  5. Mashed potatoes and gravy
  6. Hot cereals
  7. Apple sauce
  8. Ice cream
  9. Jello
  10. Pudding
  11. Custard
  12. Milk shakes (DO NOT JUST EAT SWEETS)

4.  SOFT FOOD LIST:

  1. Spaghetti
  2. Macaroni and cheese
  3. Ravioli
  4. Soups with chunks of meat and vegetables
  5. Egg salad
  6. Tuna salad
  7. Ground meat


 5.   FOODS TO AVOID FOR AT LEAST 1 month:

  1. Popcorn
  2. All nuts
  3. All seeds
  4. Chips (taco, tortilla, potato, etc.)
  5. Granola
  6. Any hard or crunchy foods
  7. Fruits with seeds like strawberries.



 

 After Dental Implant Surgery Instructions 

Sometimes the after-effects of surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office. Please note that there is no additional charge for your post-operative care in this office!

 

Bleeding

In most cases, there will be minimal bleeding since the wound is often closed with sutures. If used, the sutures are usually the dissolving type which will fall out on their own 5–10 days after surgery. Some bleeding and oozing may be expected during the first 24 hours. Please keep firm biting pressure on the gauze pack over the surgery site for about one hour. Remove the gauze and then check the site for bleeding. If significant bleeding continues, a new gauze pack should be placed and firm pressure should be applied for one hour. Repeat as necessary. A tea bag can be used if your gauze supply runs low. Avoid vigorous chewing, spitting, or rinsing your mouth or sucking through a straw for 24 hours. Allowing the tissues to rest undisturbed assists the healing process. Avoid continually pulling at your lip to check the operative site.

 

Swelling

Depending on the procedure, you may or may not experience swelling. Swelling may be at a maximum about 2 or 3 days after surgery. Keeping your head elevated (in a recliner or on several pillows) will reduce swelling. Ice packs applied continuously are helpful for the first day or so.

 

Oral Hygiene

The day following your procedure, it is recommended that you begin rinsing your mouth with warm saltwater rinses (1 teaspoon of salt in a glass of warm water). Continue rinsing with the saltwater mixture approximately 3 or 4 times a day over the next few days following your surgery. Brush your teeth and gums as normal except be gentle in area where procedure was performed. Do not use a Waterpik® or like device or hydrogen peroxide rinses for at least 2 weeks following surgery. If so prescribed by your doctor, a chlorhexidine rinse may be used twice daily instead of salt water.

 

Diet

The day of your surgery, start with nourishing liquids and soft/colder foods, such as ice cream, pudding, yogurt, etc. Avoid extremely hot foods, foods with sharp edges (chips, pretzels, etc.), and do not chew immediately over the surgery area. Avoid straws for the first 24 hours. Gradually return to your normal diet as tolerated.

 

Activity

Limit physical activity during the first 24–48 hours after surgery. Overexertion may lead to post-operative 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.

 

Smoking

It is advisable that you refrain from smoking for at least 3 days after the surgery, as this increases the risk of infection and may delay healing.


Pain

Initially, you may have some discomfort. Tylenol® or a non-steroidal anti-inflammatory (ibuprofen, Advil®, Motrin®, or Aleve®) may be used for pain. The pain will gradually diminish. If medication was prescribed, use it according to the directions as needed. Make sure you get some type of food or a drink in your stomach before taking your prescription pain medication, as otherwise, it can make you feel nauseated.

 

Dental Prosthesis

As was discussed at your pre-operative consultation, partial dentures, flippers, or full dentures should not be used after surgery unless otherwise advised by your doctor. These may need to be adjusted at or after your first post-operative return visit.

 

Post-Op Visits

It is important to return for your post-op visit, generally scheduled 1–2 weeks after treatment. Contact our office if you have questions or problems before that time.



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