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1438 Main Street Tewksbury MA 01876
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Post Operative Instructions

Please click the links below to get to your individual Post Operative Instructions:

Oral Surgery

Post Operative Instructions – Extractions
To Promote Healing, Prevent Complications and Heal with More Comfort, please follow these Post-Operative Instructions.
After Your Surgical Procedure:

First Half Hour: Apply pressure by biting on sterile gauze.

When You Get Home: Approximately thirty minutes after surgery, remove the gauze and apply an ice bag or cold towel to your cheek or jaw. Apply for ten minutes and remove for twenty. Repeat this sequence for eight hours.

24 Hours After Surgery: Dissolve one teaspoonful of salt in six ounces of warm (not hot) water. Rinse gently to avoid dislodging the blood clot. Rinsing flushes away food particles which may lodge in the surgical site.

Bleeding: A little bleeding is normal. If it is bothersome, use gauze or cotton to apply pressure to the surgical area for about thirty minutes. If bleeding persists, soak a cotton ball in strong tea and place it firmly on the area and apply pressure.

Swelling: If swelling persists for 24 hours after an extraction, continue applying ice for five to ten minutes every half hour. Over-the-counter Advil (ibuprofen) will usually reduce the swelling.

Sharp Edges: If you feel something hard with your tongue, it is likely to be bone. It will heal if you leave it alone and keep the area clean.

Diet: A nutritionally balanced diet is very important. During the first 24 hours eat warm (not hot) soups and soft foods. Meats, vegetables, and fruit can be liquefied in a blender. Progress gradually to solid food. Do not skip meals. Regular nourishment will help you heal faster.

Avoid Smoking, Alcohol, Very Hot Foods, Drinking Through Straws and Strenuous Athletic Activities.

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Immediate Dentures

Post Insertion Instructions
Understanding of the Biology of Healing after you get an Immediate Denture:

After you have had your teeth removed and a new immediate denture inserted you will have to get used to your new teeth – chewing will be different, the fit will be different, and adjusting to this new ‘set of teeth’ will require patience.

When this denture is inserted after your teeth are removed, please be aware that it will feel loose. This is deliberate. Why?
After extractions your gums will swell (increase in size) as they heal … and having extra space for swelling makes you more comfortable. When the swelling decreases the dentures will then feel loose. This is normal. We’ll tighten it.

Yet, during that first period we will simply adjust sore spots to accommodate any changes – and the denture will be loose. We will give you samples of different adhesives to help.

What to Expect?

Once your gums have healed the swelling will be reduced and we can then reline (add to the inside of the denture) and create a better fit.

When?

The longer you wait for the reline the longer it will last.

Your gums continuously shrink over time – with most shrinking taking place in the first three months. If you reline in the first month you will feel comfortable – and then it will usually feel loose again a few weeks later. If you reline the denture after three months it will often feel tight for two, three or even five years or more.

After the Reline?

Relining with our particular ‘in office’ processing technique makes certain the denture fits right up against the tissue – and with proper adjustments we can make it fit without sore spots.

At that point we feel that a good fitting denture will either require some very minimal powder adhesive or, often, none at all. We will advise you according to the actual fit after the denture has been relined.

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New Dentures

Post Insertion Instructions
Getting Used to New Dentures

They say that an old denture is like an old pair of shoes – wearing out and yet still comfortable. You know you need a new one and yet emotionally it is difficult to accept and even harder to adjust to.

Denture Adjustments: During the first few days your new denture or partial will settle. Because of this, we will see you daily for the first week to adjust any sore spots which often develop. If we decide we can improve the actual fit, we will make those adjustments during the second week. The first week is meant to keep you comfortable.

Care: To keep your denture or partial clean, please rinse it after meals and brush it before bedtime with a soft, non-abrasive brush. Please also brush the roof of your mouth and the area under it to keep your gum tissue clean and odor free. You can soak the denture in Efferdent occasionally to remove stain.

Relined Dentures or Partials: The care is the same as above except we do not recommend soaking at all for the first six weeks.

Night Time: Please remove the denture when you go to sleep. Keep it in cold water at night. If the plastic becomes too dry it may distort somewhat.
Tongue Space: For a short time after you get a new denture /partial your tongue may feel crowded and you might have slight difficulty speaking clearly. By reading aloud or talking before a mirror for a few minutes each day, your speech will return to normal.

Eating: If eating feels awkward, practice privately to gain confidence. Place food equally on both sides and chew with your back teeth. Begin with a soft diet and eat slowly. Take small bites and avoid hard or sticky foods. Before long, you will be eating most foods with ease.

The bone and gum tissue that supports your denture is constantly under pressure and will slowly shrink and change shape. For this reason dentures and partials require occasional refitting or relining.
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Grafts – Periodontal Surgery

Post Operative Instructions
To Promote Healing, Prevent Complications and Heal with More Comfort, please follow these Post-Operative Instructions.
After a Graft Procedure:

You have just had a surgical procedure done to replace missing gingival (gum) tissue around one or more of your teeth. Tissue has probably been taken from the roof of your mouth and placed elsewhere.

Soreness can be more common on the surgical site on the roof of your mouth (the donor site) than where the graft was placed. Your upper stent is meant to alleviate that discomfort. Please wear it for the first 24 hours and then after that when eating or as much as you are comfortable. It protects the surgical donor site.

By the fifth day the discomfort will start to decrease as the nerve endings slowly recover from the procedure.

Surgical Dressing: At the time of surgery, a periodontal dressing (“pack”) was placed over the graft to protect the area. If it comes off prior to the third day, please press it back into place (if you are able) and call the office. We may have to repack the area. Please try to keep the dressing in place until your suture removal appointment.

Diet & Smoking: Please maintain a soft diet for the first few days after the graft has been placed. Avoid products which contain alcohol (such as mouthwash) and alcoholic beverages. Very hot foods may delay healing and should be avoided. Smoking is especially harmful.

Brushing: Avoid brushing the packing in the area where the new graft was placed until after your follow up appointment. If the packing comes off after the third day and the surgical site is not sensitive, please keep the teeth clean with very gentle brushing and rinse the graft area with warm salt water (one teaspoon salt in six ounces of water). A clean surgical site will facilitate the healing process.

Please call our office if you have any questions.

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Endodontic Treatment

Post Operative Instructions
To Promote Healing, Prevent Complications and Heal with More Comfort, please follow these Post-Operative Instructions.
After a Root Canal Procedure:

Most of the time root canals are done to alleviate discomfort – sometime severe discomfort. And yet Immediately After Endodontic (Root Canal) treatment the area is still sore. Why?

Soreness is related to the fact that the area is infected and in the process of healing. As it heals it is normal to have a dull throbbing feeling for at least two to three days – and occasionally. Rarely, you have some feeling for a month or two. It depends on the extent of the infection that is in the bone and the length of time that infection has been there before it became symptomatic. It takes time for bone to heal.

Antibiotic Therapy is often recommended to control and reduce any infection in the bone. It is really important that you take all of the prescribed antibiotic – leave nothing in the bottle please. Why?

Early antibiotic treatment kills the most fragile bacteria – and the discomfort disappears. Taking the full amount of tablets kills the more resistant bacteria – and prevents a recurrent infection that is much more difficult to control. If you have read about resistant bacterial strains this reasoning will probably make sense to you.

Facial Swelling is a negative sign – an unexpected complication after a root canal procedure. Call us immediately – have the doctor on call paged.
Teeth that need endodontic (root canal) treatment are more brittle than normal teeth because they have had no healthy blood supply for some period of time. To protect the tooth from fracturing in the future it is important to have it completed restored – usually with a preventive crown – within a year.
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Nightguards

Occlusal Guards
Post Operative Instructions

Getting Used to the Occlusal Guard: If you are concerned about getting used to your occlusal guard, especially if this is your first appliance, then consider the first week as an adjustment
period.

After dinner each night, wear the nightguard for several hours. At first you may salivate more than normal. Once you find you no longer notice it, you will be able to wear it comfortably while you sleep.

Our Concerns:

  • If it binds on a tooth (teeth), we should adjust it.
  • If you attempt to wear it after it has been “out” for a period of time, you may find that it no longer fits. Your teeth have shifted. We need to adjust the appliance.
  • If you have any concerns about the occlusal guard, please call our office. We want you to be comfortable.

Our Goal is to help you keep your teeth for a lifetime of good health. Wearing this appliance helps decrease pressure from your teeth, joints and bone.

Rationale: While the appliance does protect your teeth from grinding and clenching, it is actually meant to remind you to keep your teeth apart. If it gets so comfortable that you find yourself grinding into it, please tell us and we will adjust it.

Cleaning: Occlusal guards will discolor over time. This is not a problem. Rinse it or brush it with toothpaste.

Please bring your occlusal guard with you for all dental appointments. We will examine and clean it for you.

Warning: Dogs love to chew nightguards!It’s an Expensive Snack.

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Crowns and Bridges

Post Operative Instructions

Tender Gum Tissue: It is normal to experience tenderness in the gums adjacent to the treated teeth immediately after treatment. Rinsing with warm salt water and gently massaging the gum tissue with your finger will facilitate healing. It is very important that you keep the gums clean even if the area is sensitive to brushing or flossing.

Brush normally with a soft bristle brush. However, when you floss, be certain to pull the floss through to the side to avoid pulling off the temporary crown.

Normal Sensitivity: Fleeting tooth sensitivity to cold or heat is normal immediately after the initial treatment. However, if the nerve of the tooth was not healthy prior to treatment, it may become symptomatic at this time. If you have sensitivity to heat or spontaneous throbbing for more than one minute please call us. You may need endodontic therapy (root canal treatment) before the crown is permanently cemented.

Temporary Crowns: If your temporary crown does come off, please reset it and push it firmly into place. Then schedule an appointment for a replacement as soon as possible. The temporary crown prevents your teeth from shifting.

YOUR BITE SHOULD FEEL COMFORTABLE AFTER THE PLACEMENT OF BOTH THE TEMPORARY CROWN AND THE FINAL PORCELAIN OR GOLD CROWN. IF YOU FEEL THAT YOUR BITE NEEDS CORRECTION, PLEASE SCHEDULE AN ADJUSTMENT APPOINTMENT RIGHT AWAY.

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Fillings

Post Operative Instructions

Local Anesthesia: Your numbness should wear off within two to four hours. Be careful not to bite your cheek while numb. Please expect to have some initial soreness on the tooth and gum tissue in the area of treatment. You may have muscle soreness from having your mouth open during treatment or from the anesthetic.

The Bite: After the anesthetic wears off, if your bite feels different and/or if you feel that certain teeth are hitting prematurely, it is very important to call the office. Schedule an appointment for a ‘bite adjustment’.

Causes for Concern: By the end of the day following your treatment we do not expect you to experience any significant discomfort. Any tooth sensitivity to cold should continually decrease and disappear within ten days. Causes for concern would be throbbing, being awakened out of a sound sleep by tooth discomfort, or prolonged sensitivity to heat of more than two minutes. If you do experience any of these symptoms, please call the office and we will schedule an evaluation.

Nightguards & other appliances: Bring your nightguard or other dental appliance to every appointment. If your appliance fits directly over the teeth that were treated, it must be adjusted before you can wear it. If you did not have it with you when your teeth were treated, please set up a short appointment and we will adjust it.
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