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Crowns, Implants, Bone grafting, Extractions and Deep Cleanings
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Crowns and bridges usually take two or three appointments to complete. On the first appointment the teeth are shaped. Temporary crowns or bridges are placed to protect the teeth while the custom crown is being made. After each appointment when anesthetic has been used, your lips, teeth, and tongue may be numb for several hours after the appointment. Avoid any chewing until the numbness has completely worn off. On rare occasions temporary crowns come off. Call us if this happens, and keep the temporary so we can re-cement it. It is very important for the proper fit of your final restoration that temporaries stay in place. It’s normal to experience some hot, cold, and pressure sensitivity after each appointment. Your gums may be sore for several days. Rinse three times a day with warm salt water (a tsp. Of salt in a cup of warm water, rinse-swish-spit) to reduce pain and swelling. Use medication as directed. To help keep your temporary in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of your mouth. It’s important to continue to brush normally, but floss very carefully and remove the floss from the side to prevent removal of the temporary crown. If your bite feels uneven while with a temporary or after the permanent crown has been placed, if you have persistent pain, or you have any other questions or concerns, please call our Hillside Team.
Please see below for Extractiosn and Bone grafting. Those pertain to implant placement. Following your implant surgical procedure, extreme care should be exercised in avoiding placing any biting pressure on the implant or implant site(s), no matter how light the biting force. If a removable denture was placed, it should not contact the implant or tissue in the area of the implant placement AT ALL. If a temporary was placed on the implant immediately, all biting contact with or without food should be avoided. If you feel any contact on the temporary when your teeth come completely together, please contact our office immediately and schedule an appointment right away. Premature pressure on an implant prior to three months of healing may result in implant failure and/or healing complications.
Your bone graft is composed of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. The socket is over packed to allow for the loss of a small amount of particles. It is normal to have some of them come out of the graft site and into your mouth.
PAIN: Before the anesthetic wears off it is recommended you take 400-800 mg of Ibuprofen/ Advil or Motrin every 6 hours to relieve any post op discomfort. If you are allergic or can not take the above meds you can take 1000mg of Acetaminophen / Tylenol every 6 hours. If more severe discomfort occurs please contact our office.
SWELLING: Some swelling of the lip or cheek may occur. What to do following surgery: After leaving the office, rest and avoid strenuous activities for the remainder of the day. This will help reduce bleeding and aid in the healing process. Take your meds as described above. Be sure to take them before the anesthesia wears off. Nausea can occur and most often is due to taking your meds on an empty stomach. Take your meds with a large glass of water or with some soft food. Eat soft foods for the first 2-4 days. Maintain a good, balanced diet. Drink plenty of water. Avoid chewing hard foods on the graft sites. Chewing forces during the healing phase can decrease the body’s ability to heal around the graft. Do not use a straw. Avoid alcohol for 48 hours. For the first day, it is advisable to let the blood clot stabilize by not rinsing your mouth. Following the first day, gentle rinsing would be advised; avoid vigorous rinsing. Do not rinse vigorously because you can disturb some of the bone graft granules. Do not use any mouthwash. Use only water or warm salt water if desired. Smoking should be avoided for a minimum of 1 week as it slows down the healing process. Do not apply pressure with your tongue or fingers to the grafted area because the material is movable during the initial healing. Do not lift or pull the lip to look at the sutures as this can actually damage the site or tear the sutures and cause damage to the wound site. Avoid poking the site with your tongue. Return to the office as directed for removal of the sutures or follow-up check as directed.
Do not avoid cleaning the area. You can take a q-tip and dip it in hydrogen peroxide or just water and gently clean the site. Do not avoid brushing your teeth but stay away from the site with the toothbrush. Let comfort be your guide. If a partial denture or a flipper was placed in your mouth, you will probably have to have it adjusted and learn how to remove and replace it appropriately. In some cases you will be advised not to wear it during the healing process. Most times the sutures that are placed need to remain for 2-4weeks and in some cases even longer. If a CollaPlug was placed during your procedure it will come out several days later. As the area begins to heal the plug will come out. Its appearance is a jelly-like substance. This is normal and to be expected. If a non-resorbable barrier membrane was placed this is to stay in place until the doctor removes it along with the sutures. It is a white sheet that wraps over the site to aide in the healing process.
To minimize the discomfort and encourage proper healing following your scaling and root planing (deep cleaning), follow these instructions:
After the procedure, take aspirin, acetaminophen (Tylenol®), or ibuprofen (Advil®) before the anesthetic wears off. Continue to take one tablet every four hours for the next two days. A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda water + 8 ounces warm water) swished in your mouth for 2 to 3 minutes every hour may make your mouth more comfortable. Use a soft toothbrush at least two times a day. Be gentle and clean thoroughly. Slight bleeding may occur while brushing as the tissues begin to heal.Avoid strong spicy seasonings, and hard crunchy for the next few days.Smoking should be stopped. Success of the treatment will be substantially reduced by the cigarette smoke chemicals in your body.As the tissues heal, some temporary sensitivity to cold may occur. Use a desensitizing toothpaste (such as Sensodyne®), or fluoride gel (such as Prevident® or Gel-Kam®) frequently (at least 4 times/day) for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.Faithfully use any other oral hygiene aids that have been recommended (floss, Perio-Aid®, rubber tip, Sonicare®, Proxabrush®, Gel-Kam® fluoride, Peridex® mouthrinse, etc).If you have any questions or concerns, please call our Hillside Dentistry team.
DO NOT DISTURB THE AREA: For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process. Swishing, sucking through a straw, and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side for 24 hours.
BLEEDING: When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 minutes. Don't change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on another gauze or a tea bag for another 30 minutes if you feel it is still bleeding. Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
SMOKING: Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful Dry Socket.
PAIN: Some discomfort is normal after surgery. To minimize pain, Take two Tylenol, Advil, or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving, vigorous activity or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.
NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.
SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.
NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer.
BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.
RINSING: Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda water + 8 ounces warm water). Avoid commercial mouthrinses.
DIET: Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.
ACTIVITY: After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.
ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.
FOLLOW-UP APPOINTMENTS: You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.Please call our dental team if you have:uncontrollable painexcessive or severe bleedingmarked feverexcessive warm swelling occurring a few days after the procedurereactions to medications, especially rash, itching, or breathing problemsFollowing these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.