Post Operative Instructions | Tewksbury Dental Associates


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:


Post Operative Instructions

Local Anesthesia: Your numbness should wear off within two to four hours. Be careful not to bite your cheek or tongue 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 temperature for more than two minutes. If you do experience any of these symptoms, please call the office and we will schedule an evaluation.

Nightguards and 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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Crowns and Bridges

Post Insertion 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.

Temporary Crowns: 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 temperature or spontaneous throbbing for more than one minute please call us. You may need further treatment before the crown is permanently cemented

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 and keeps your gum tissue healthy.


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Occlusal Guards

Post Insertion 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, consider the first week 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 goal is to help you keep your teeth for a lifetime of good health. Wearing this appliance helps decrease pressure on your teeth, joints and bone.

Cause for Concern:

  • 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.

Cleaning: Occlusal guards will discolor over time. This is not a problem. Rinse it or brush it with liquid hand soap and a soft bristled brush

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 for a dog!

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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 – sometimes 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 two to three days. 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 sometimes 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.

A soft diet sometimes is necessary for the first few days. Use the level of discomfort you are experiencing as your guide.

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 with a crown as soon as possible.

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New Dentures

Post Insertion Instructions
Getting Used to New Dentures

Denture Adjustments: During the first few days your new denture or partial will settle. Because of this, we will see you as needed for the first few weeks to adjust any sore spots which often develop.

Care: To keep your denture or partial clean, please rinse it after meals and brush it before bedtime with a soft, non-abrasive brush and liquid hand soap. 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.

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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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.

After extractions your gums will swell. When the swelling decreases the dentures will then feel loose. This is normal.

During that first period we will adjust sore spots to accommodate any changes.

What to Expect?

After an appropriate amount of healing we will re-fit the immediate denture with a soft reline material. This will add to the inside of the denture.


Your gums continuously shrink over time – with most shrinking taking place in the first six 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 six months it is likely to feel tight for much longer.

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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 damp 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 as needed.

24 Hours After Surgery: Dissolve one teaspoonful of salt in six ounces of warm (not hot) water. Rinse gently but do not swish 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 damp gauze or cotton to apply pressure to the surgical area for about thirty minutes. If bleeding persists, use a cool, damp tea bag and place it firmly on the area and apply pressure for approximately 30 minutes.

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 cool, cold or room temperature 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.

For extractions sites that have been bone grafted, tenderness is likely to last longer, particularly on the cheek side of the gums. This is your body’s normal response to the new bone and membrane. Rest assured it should heal well.

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Peridontal or Implant

Post Operative Instructions – Homecare

Avoid brushing or flossing your teeth in the surgical areas until your first follow-up appointment. All other areas may be cleaned in the usual manner. The day after the procedure, you may use the prescription mouth rinse as directed. Avoid any rinses that contain alcohol.

What to expect: Mild discomfort including tenderness, inflammation, and soreness to surgical area can be expected. The use of medication to aid in healing and comfort may be necessary. See recommended medication section below.

It is normal for grafted areas to appear red or white during the healing process.

Parts or all of the pack may fall off within the first few days. This is of no concern. You do not need to have the packing replaced.

Sutures may have been placed- these are both resorbable and non-resorbable. They will get loose over time. Try to avoid touching or tugging on sutures. They will be removed at your follow up visit.

Occasionally, blood stains in the saliva may be experienced for the first 24 hours. Should bleeding continue, take a cool, moist, non-herbal, tea bag and form it into a “U” shape. Hold it between your thumb and index finger and apply pressure to both sides of the teeth for 20 minutes. If you notice any swelling, apply a cold compress to the face every half hour for fifteen minutes as needed.

Full healing can take weeks to months. A follow up visit will be made for you approximately 7-14 days after the procedure.

Medication: If an antibiotic is prescribed, take the entire allotment until it is completed. Mild discomfort can be expected.  Take Tylenol or Advil as needed.  If this is not helpful, take the medication that was prescribed to you.  Do not take aspirin or products containing aspirin.

Diet: A soft diet sometimes is necessary for the first few days. Use the level of discomfort you are experiencing as your guide.

Call us if you have any questions or concerns: 978-851-7890

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Dermal Filler Treatment

Post Operative Instructions

Do Not:  touch, press, rub or manipulate the implanted areas for the rest of the day after treatment.  Avoid kissing, puckering and sucking movements for the rest of the day as these motor movements can undesirably displace the implanted dermal filler material. You can cause irritation, sores, and/or problems, and possible scarring if you do.

Avoid: Aspirin, Motrin, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A, Vitamin E, or other essential fatty acids at least 3 days after treatment.

Avoid:  Alcohol, caffeine, niacin supplement, high sodium foods, high sugar foods, refined carbohydrates (you may eat fruit), spicy foods, and cigarettes 24-48 hours after your treatment.

Avoid:  Vigorous exercise and sun and heat exposure for 3 days after treatment.

Discontinue:  Retin-A until 2 days after treatment. It is best to wear no makeup or lipstick until the next day.  Earlier use can cause pustules.

One side may heal faster than the other side.

You can expect some bruising and swelling around the areas that were injected.  Apply ice for the first hour after treatment for ten minutes on and ten minutes off.

You must wait 2 weeks before any touch ups.

Please report any redness, blisters, or itching immediately if it occurs after treatment

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