Emergency Procedures and Post-op Instructions 

* ALL OF THESE SITUATIONS REQUIRE YOU TO SEE YOUR DENTIST SOON *

A toothache
Try Tylenol, Advil or Aspirin to alleviate the pain for a few hours. Please use as directed by the manufacturer.
Do not ignore the dental pain, as this could lead to many serious complications.
A toothache can be caused by many different reasons.

A broken tooth
The Prognosis can range from mild to severe.
You should see your dentist immediately. Broken teeth can hurt very badly or not at all. Prompt treatment will usually avoid serious complications, and even losing the tooth. Often times the nerve of your tooth can be exposed and very painful You can use wax or sugar less bubble gum to cover the area till you see a dentist.

Mouth sores
Can be caused from simple pizza burns to bacterial or viral infections. Generally, a prompt visit to the dentist with some follow up will help to solve the problem.

Broken dentures, plate or bridge
Do not attempt to glue any of these appliances together.
See your dentist and bring all of the pieces with you.

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*ALL OF THESE SITUATIONS REQUIRE YOU TO SEE YOUR DENTIST IMMEDIATELY*

A severely fractured tooth
If at all able to apply soft wax on the damaged tooth you should.

Acute jaw injury
Your jaw may be broken, fractured or you might have dislocated it if you are unable to move your jaw, or if it hurts when you are closing your mouth normally.
You need to go to the closest emergency room and contact your dentist as well, as your bite can be permanently altered.

A tooth that has been knocked out
Do not handle the tooth unnecessarily. You should try to put your tooth back into place or hold it between your lips and teeth. If you cannot hold it, place it into a container, fill it with milk or water and contact your dentist immediately.

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POST- OPERATIVE INSTRUCTIONS

Post -Op Instruction
Implant Surgery

The recently treated area is highly susceptible to damage during the first two weeks following surgery. Best result are obtained by ensuring that no pressure or pulling is endured by the surgical site.  Avoid pulling on the surgical area to see what is happening as tends to pull on stitches and open the wound.  Also, avoid eating anything in the area and do not create any internal air pressure such as blowing into a straw. Please be aware that even vigorous facial expressions can cause wounds to open.  The opening of wounds will cause the area to take longer to heal and may require additional surgical procedure to correct.  Any significant force applied to the area of your surgery may lead to the failure of that surgery procedure.

Immediately After Surgery:

1. Continue with your medications as they have been prescribed.
2. Place a bag of crushed ice or frozen peas against the area of surgery for 15 minutes at 15 minutes interval for a period of 72 hours.
3. Rest for the balance of the day, preferably lying down and head elevated.

First week after Surgery:
1. Maintain a soft diet, and eat in the side of the mouth that has not been treated. Do not put any pressure in the area of your surgery.
2. Do not brush the teeth in the area of the surgery, but carefully clean the rest of your teeth without toothpaste.
3. Rinse your mouth with salt water or a Chlorhexidine rinse that has been prescribed each time you clean your teeth unless otherwise instructed. Do this three (3) times per day after your regular oral hygiene procedures.
4. Continue with your medications as they have been prescribed.
5. Avoid any work or exercise that will elevate your blood pressure.

Second Week After Surgery

1. Only slightly firmer food may be taken, but ensure that they are cut into small pieces before placing them in your mouth. Do not put any pressure in the area of your surgery.
2. Your teeth in the area of the surgery can be gently cleaned with a toothbrush tipped into a cap-full of Chlorexidine mouth rinse.  The balance of the cap-full can be used as a mouth rinse when you have finished brushing your teeth.
3. Unless otherwise directed, return to the dental office for removal of your stitches after one or two weeks.

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Post – Op Instructions
Crown and Bridge Work – Preparation and Cementation

“If you have any questions or concerns please contact the office”

• Expect the area worked on to be tender for a few days. The gum tissue, as well as the tooth itself, may be sensitive. For pain management, Advil or Tylenol is recommended. Please avoid any medications that you may have allergies to.
• A temporary restoration has been placed to cover the area until the final restoration is returned from the lab. If this temporary happens to fall off prior to the cementation date, call the office and schedule a short appointment to replace it. Be careful not to chew sticky foods such as toffee, as this will take the temporary off.
• You may begin to eat whenever you feel comfortable eating. Avoid chewing on the side where the work was done. Soft foods are recommended for the first while. Be sure to keep yourself well hydrated.
• The area worked on will remain anesthetized (frozen) anywhere from 2-4 hours. In some cases, drinking carbonated beverages may reduce the effective length of anesthesia. Be very careful no to bite your lips/cheeks, as this could cause severe sores.
• If a severe toothache results after procedures is done, contact the office. Any tooth which has been exposed to dental work may require root canal treatment if the nerve is unable to heal on its own.
• Brush the area as usual. When flossing the temporized teeth (if possible), always pull the floss through the contact – instead of popping it up. This will help keep the temporary in place.
• Once the permanent restoration is in place follow the same maintenance steps as above. Never chew sticky foods, or the crown may come loose. Always pull the floss through the contact when flossing the area. Brush as usual. For bridge work, special products are recommended – please ask our staff about these products.
• Maintaining a healthy diet, as well as having good oral hygiene, is essential once crown and bridge work is completed. Although the finished result is strong, the underlying teeth are still vulnerable to dental decay caused by carbonated cola drinks, such as Coke or Pepsi, and Ice Teas.

Post – Op Instructions
Extraction Procedure

“If you have any questions or concerns please contact the office”

• Bite on gauze pad for 1/2 hour, keeping steady pressure and not disturbing the blood clot. After 1/2 hour, take out gauze pack. If light bleeding persists, repeat. *a moistened tea bag can substitute gauze* Avoid looking at the area frequently, as only pressure over time will stop the bleeding.
• Avoid spitting, sucking on a straw, and smoking. If you must smoke, do so only 12 hours after appointment. Do not probe area with tongue or finger, and take extra care when brushing. This will ensure a good blood clot and minimize your chances of healing complications.
• Do not rinse your mouth for 24 hours. After a whole day, you may rinse with lukewarm salt water, while still avoiding spitting. Continue the rinses for a few days.
• For pain medication, use an anti-inflammatory medication such as Advil or Tylenol. Dr. Lalani suggests one of each every four hours. If necessary, the doctor will prescribe stronger medication for you.
• Avoid strenuous work or physical activity for 24 hours. Try to avoid lots of speaking/conversation. Be careful not to bite your lips/cheeks-while area is still anesthetized.
• It is very important to stay well hydrated. Have only liquids for the first 6-8 hours, making sure they are not hot in temperature. "Boot" energy drinks provide great nutrition during this time. Soft foods containing protein, and vitamin B&C are suggested.
• Cold packs may be applied for the first 4-6 hours, alternating 20 minutes on, 20 minutes off. After 24 hours, heat packs may be applied if desired.
• If required, sutures (stitches) will be removed in office, 5-7 days after extraction. A short appointment will be scheduled for you.
  

Post -Op Instructions
Periodontal "Gum " Surgery

“If you have any questions or concerns please contact the office”

• As we have just deep cleaned the teeth, roots and bone of the area, expect it to be quite sore and sensitive for a few days. Allow 4-6 weeks for complete healing.
• Advil or Tylenol are recommended for pain management. If a stronger pain medication is required, the doctor may prescribe something for you.
• Avoid spitting, smoking, or drinking through a straw – as not to disturb the blood clot. You may rinse out your mouth with lukewarm salt water after one day, avoiding the urge to spit.
• Avoid strenuous work or physical activity for 24 hours.
• If necessary, sutures (stitches) will be removed in the office 5-7 days after surgery. If stitches are not required, a short post-op appointment should be scheduled to review healing process and assure all is well.
• A protective packing has been placed on the area to assist with the healing. This packing may fall off 1-3 days after surgery. If you found the packing helpful, and would like another put on, contact the office and we will gladly replace it for you. If not, it’s not a problem, and at this point does not affect the healing process.
• Brush and floss your other teeth as usual, avoiding the area worked on. If you must rinse, simply use a warm salt water rinse instead of mouth wash.
• Avoid eating hot and spicy foods/liquids. Remember to keep yourself well hydrated.

Post – Op Instructions
Denture Care

“If you have any questions or concerns please contact the office”

• Expect there to be an adjustment period. With new dentures, the amount of bite opening is significantly different from your old dentures or natural dentition. This is because your facial muscles must learn to re-adapt to the new vertical jaw relation.
• You may notice right away that your new dentures seem very large in your mouth, be patient. In time, with a little practice you will adjust naturally to this initial fullness.
• When you first receive your dentures, you may notice an increase is salivary production. Again this is a normal response to the unfamiliar object in your mouth.
• A basic fact of denture life is that you will not be able to bite down as hard as you could with natural teeth. With dentures, you must take smaller bites and learn to chew on both sides of the mouth at the same time to prevent from rocking and dislodging. It is very common for you to experience a sore. If the sore area persists for more than 3 days don’t hesitate to call and book an adjustment appointment. Let your dental professional relieve the area.
• The supporting bone and tissue in your mouth need regular rest from denture wearing. Therefore it is important that you take your dentures out every day or a brief time or overnight. The best place to store them is in a special water filled container. This will prevent your dentures from drying out, which can, in time, adversely affect their fit.
• Keeping you dentures clean is the most important patient responsibility in good oral health. Dentures, like natural teeth, attract plaque, become stained, and collect food particles that can cause bad breath. The most effective methods to clean your dentures safely are soaking you dentures with an effervescent tablet and brushing your dentures with a special denture brush and denture cleaning paste.
• To protect the health of your denture-bearing tissues, it is an excellent idea to brush the supporting ridges with a super-soft toothbrush to generate blood flow into the area and remove residual food particles.