POST OP CARE

Susie Shin Dental Care
Crown Post Op Care
  • Avoid biting your lip/cheek/tongue while you are numb. If you need to eat, choose something that is soft and doesn’t require chewing (for example a smoothie). Also avoid hot foods (like soup), because you may burn yourself and not know it. 
  • It is important that the temporary acrylic crown remain intact on the tooth until the final crown is cemented. The temporary crown protects the tooth, and prevents the natural tooth from shifting. If the tooth shifts the final crown will not fit, and a new one will have to be made, delaying final cementation.
  • Avoid biting on hard, crunchy foods with the acrylic crown. The acrylic temporary tooth can easily break. If the temporary crown has broken, or come off in one whole piece, another will need to be placed immediately. If the temporary crown is intact, bring it with you to the appointment so it can be re-cemented, or a new one can be made if it is broken.
  • It is important to keep flossing while a temporary crown is on to keep the gums healthy. Very inflamed gums make it difficult to successfully place the final crown, and may delay the final crown cementation. When you floss, slide the floss out sideways, rather than straight up through the chewing surface. Pulling the floss through the chewing surface can pull the temporary crown off.

You may experience some of the following after having a crown prepared:

  • Tooth sensitivity

Depending on how close the decay reached to the nerve, temperature and biting sensitivity may be felt for weeks to months after a crown was placed. A decay or infection can cause the nerve to be inflamed, and it can take some time for the inflammation to subside. The tooth may also have gum recession, which causes teeth to feel sensitive “zings” sometimes. High-concentrate fluoride toothpaste can help alleviate recession-related sensitivity.

An acrylic temporary crown will be placed until the final is cemented. Since the acrylic does not insulate the tooth much as the final crown, you may notice more sensitivity while the temporary crown is on. The final restoration will insulate the tooth more, and sensitivity should improve.

  • Jaw soreness/tenderness

Having jaw tenderness is common after having dental work done. We often require you to keep your mouth open for extended periods of time, exhausting the jaw muscles and joint. Alternating hot and cold compresses to tired jaws, and taking anti-inflammatory medications (such as Ibuprofen), and eating soft foods can help alleviate jaw discomfort.

  • Injection site soreness/tenderness

If you received anesthetic injections for your treatment, you may notice some tenderness or bruising at the site of the injection, especially if multiple injections were needed. Anti-inflammatory medications (such as Ibuprofen) can help alleviate injection-site tenderness.

  • Gum feel irritated or sensitive

Gums may feel irritated after a crown preparation because the gums are slightly compressed during the procedure. This allows for a highly accurate crown impression, but can cause some discomfort once numbness has worn off. Gum irritation may also be caused by the margin of the temporary crown and cement. The temporary crown is usually much rougher than natural enamel. This traps more plaque and food, irritating the gums. Focus your toothbrush for a little longer around the gums while a temporary crown.

  • Crown feels too high

Once a crown is placed, we do our best to adjust it so it is comfortable to bite on. Typically patients are still numb as we check the bite, and may have a difficult time sensing if the bite feels completely normal. It is common for crowns to need a final adjustment once numbness has completely worn off. If your crown feels even slightly high, please contact our office to have it adjusted.

  • Possible eventual need for a root canal

In some instances, decay reaches very close to the nerve, or the tooth was damaged in an injury. When this happens, the nerve becomes chronically inflamed, and can slowly die over a long period of time. Even if the decay is completely removed and a crown is placed, the nerve itself may already be inevitably slowly dying. This is something that cannot be detected in an X-ray initially, and usually presents itself over time, after other restorative efforts have been made.

If you have any questions or concerns, please contact us or call 415-986-6900

Extraction Post-Operative Care
  • You may still be numb for a few hours after the extraction. Avoid biting your lips, cheek, and tongue until numbness wears off.
  • Swelling and bruising are common after tooth extractions, especially wisdom teeth. Doing cold compresses for 15 minutes on, 15 minutes off can help reduce this.
  • Do not be alarmed if you are seeing blood after the extraction. After a tooth is extracted, some mild bleeding is normal. This usually subsides within an hour if you keep gentle pressure on the site. Blood may mix with saliva, giving the appearance of a lot more than there really is. Try to remain calm and follow post-operative care instructions to stop remaining bleeding.
  • You may feel little fragments of bone work their way out of the extraction site. This is perfectly normal, and usually come out on their own. If there is a piece that won’t come out, or it hurts for you to remove yourself, your dentist can comfortably remove them for you.
  • Sometimes, dissolvable stitches leave small remnants. If these stitches don’t resolve, your dentist can comfortably remove them for you. 

Dos:

  •  Start taking painkillers/anti-inflammatory medications immediately to “stay ahead” of possible discomfort.
  • The day of surgery, apply ice packs for 15 minutes on, 15 minutes off until bedtime. The worst inflammation and swelling occurs 2-3 days after surgery, this can help reduce it.
  • After the extraction, keep pressure on the site for 30-60 minutes. You may need to change the dressing during this time, moisten gauze before you place it on the site to keep it from sticking to the tissue. If you still have bleeding after an hour, brew a black tea bag, fold it in half and bite down on it for 30 minutes.
  • Stick to a liquid or soft food diet for the first 2 days after surgery (soups, mashed potatoes, oatmeal, for example). Do not eat foods/drinks through a straw.
  • Keep your head elevated. If you need to sleep, try to prop your head up on some pillows.
  • Take antibiotics as directed for the full course of the prescription. Do not stop taking them even if the extraction feels fine.
  • For 3-4 days, gently clean the site with moist gauze instead of a toothbrush to prevent dis-lodging the healing blood clot. Begin gently brushing the area with a soft toothbrush 3-4 days after the extraction.
  • Gradually and gently try to open your mouth to stretch your jaw, within your comfort level. Inflammation and jaw discomfort after extractions can prevent you from wanting to open your mouth wide. Not stretching the jaw after surgery can result in permanent limited jaw opening (Trismus).
  • Some patients are given a prescription mouth rinse to use for 10 days following surgery. Only use this rinse as directed. Do not use over the counter mouth rinses (like Listerine) during healing.

 Don’ts:

  •  Do not swish or rinse with mouth rinse for 24 hours after the extractions. This will dislodge the healing blood clot, and re-expose the nerve to air and bacteria, and cause infection (dry socket).
  • Do not smoke, drink through a straw, blow your nose hard, or spit forcefully. Pressure changes in your mouth can disclosed the blood clot, and re-expose the nerve to air and bacteria, causing dry socket.
  • While you are numb, avoid hot foods. You may burn yourself and not know it.
  • Do not take aspirin. This can thin your blood, causing excessive bleeding. OTC medications or prescription medications may be recommended. If you are taking blood thinners or high blood pressure medications, ask your medical doctor if you should avoid taking them prior to surgery.
  • Do not exercise for at least 24 hours, bend over, or do heavy lifting for 2-3 days. Too much exertion and blood pressure can dislodge the blood clot and cause dry socket.
  • Do not drink alcohol. It is very harsh to the tissues that are healing, and may delay the healing process.

When To Call The Doctor

  • Pain that starts to get worse after 2 days is considered abnormal, and may be a sign of an infection or dry socket.
  • If you are still numb after 6 hours contact your dentist.
  • If bleeding does not stop while following post-operative care after 2 hours.

If you have any questions or concerns, please contact us or call 415-986-6900

Dental Filling Post-Operative Care

Avoid biting your lip/cheek/tongue while you are numb. If you need to eat, choose something that is soft and doesn’t require chewing  (for example a smoothie). Also avoid hot foods (like soup), because you may burn yourself and not know it.

You may experience some of the following after having dental fillings placed:

  • Tooth sensitivity

Depending on how close the decay reached to the nerve, temperature and biting sensitivity may be felt for weeks to months after a filling was placed. A cavity can cause the nerve to be inflamed, and it can take some time for the inflammation to subside.

  • Jaw soreness/tenderness

 Having jaw tenderness is common after having dental work done. We often require you to keep your mouth open for extended  periods of time, exhausting the jaw muscles and joint. Alternating hot and cold compresses to tired jaws, and taking anti-inflammatory medications (such as Ibuprofen), and eating soft foods can help alleviate jaw discomfort.

  • Injection site soreness/tenderness

 If you received anesthetic injections for your treatment, you may notice some tenderness or bruising at the site of the injection, especially if multiple injections were needed. Anti-inflammatory medications (such as Ibuprofen) can help alleviate injection-site tenderness.

  •  Filling feels too high

Once a filling is placed, we do our best to adjust it so it is comfortable to bite on. Typically patients are still numb as we check the bite, and may have a difficult time sensing if the filling feels completely normal. It is common for fillings to need a final adjustment once numbness has completely worn off. If your filling feels even slightly high, please contact our office to have it adjusted.

  • Possible eventual need for a root canal

 In some instances, decay reaches very close to the nerve. When this happens, the nerve becomes chronically inflamed, and can slowly die over a long period of time. Even if the decay is completely removed and a filling is placed, the nerve itself may already be inevitably slowly dying. This is something that cannot be detected in an X-ray initially, and usually presents itself over time, after other restorative efforts have been made.

If you have any questions or concerns, please contact us or call 415-986-6900

 

LANAP Post-Operative Care Instruction

First whole week after LANAP treatment:

NO BRUSHING, NO FLOSSING, NO SMOKING! To clean, place chlorhexidine mouthrinse on clean gauze and very gently dab the  area instead of brushing with a toothbrush.It is very important that you do not disrupt the scab that has formed.Follow a strict  liquid-only diet. Anything that can be put into a blender to drink is ideal. The purpose of this is to prevent dislodging the healing blood clot that acts like a band-aid. Do not drink anything through a straw.After 4 days, foods that are very soft, or “mushy” are  recommended. See our list of soft-diet suggestions.

1 Week After LANAP:

After 1 week, at home you may begin VERY GENTLY brushing your teeth with a non-electric toothbrush. At this one-week office visit, your bite will be slightly adjusted. Continue to eat very soft, nutrient-dense foods to promote healing.

1 Month After LANAP:

At one month, we will take impressions for the necessary hard-plastic splint. This splint helps to stabilize teeth as the tissues and bone are healing, and is a crucial part of successful LANAP therapy. A slight adjustment is made to the teeth at this time, and teeth are lightly cleaned. Continue to eat very soft, nutrient-dense foods to promote healing.

2 Months After LANAP:

At home you may begin very gently flossing your teeth above the gums after 3-4 weeks. At this point, do not floss under the gums like you may have been instructed in the past. At your 2 month office visit, your teeth and nightguard will be slightly adjusted. IT IS VERY IMPORTANT TO ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD SO IT CAN BE ADJUSTED!

3,4 and 5 Months After LANAP:

ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS! At these next 3 visits, your teeth will be lightly cleaned and adjusted, and your nightguard will also be slightly adjusted. At 8 weeks after LANAP, you can begin using an electric toothbrush with light pressure on a very gentle setting.

6 Months After LANAP:

ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS! At 6 months, you will have a Periodontal Maintenance cleaning, with a slight adjustment to your bite and nightguard. After 6 months, you may begin using an oral irrigator (Waterpik) on a low setting above the gums. Do not blast the water under the gums.

7 and 8 months after LANAP:

ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS! At these next 2 visits, your teeth will be lightly cleaned and adjusted, and your nightguard will also be slightly adjusted.

9 Months After LANAP:

ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS! At 9 months, you will have a Periodontal Maintenance cleaning, with a slight adjustment to your bite and nightguard.

12 Months After LANAP:

ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS!You will have a Periodontal Maintenance cleaning, with a slight adjustment to your bite and nightguard. At this time, we will re-measure your periodontal pockets, and take x-rays to monitor bone levels as they continue to heal.

After 1 Year:ALWAYS REMEMBER TO BRING YOUR NIGHTGUARD TO YOUR APPOINTMENTS!It is crucial that you continue to come every 3 months for your periodontal maintenance cleanings to continue the healing process, and prevent recurrence of periodontal infection. Not adhering to these explicit instructions could result in re-infection, and needing further dental treatments.

If you have any questions or concerns, please contact us or call 415-986-6900

 

“Mushy” And Soft Diet Suggestions

(Depending on your individual case, it may be recommended you stay on the soft-food diet for longer than 4 weeks. This will be determined at post- operative visits.)

Liquid Diet (First Week)

  • DAILY VITAMINS TO PROMOTE HEALING
  • Anything that can be blended in a blender
  • Broth or Cream Soups
  • Milk-shakes/ Smoothies (Smoothies NOT containing fruit with seeds, DO NOT DRINK THROUGH A STRAW)
  • Ensure/ Slim Fast Liquid Nutritional Drinks

Soft/ Mushy Foods (Weeks 2-4+)

  • Cream of Wheat, Oatmeal, Malt O Meal
  • Mashed Potatoes, Baked Potatoes, Mashed Yams, Baked Sweet Potatoes, Butternut Squash
  • Mashed Fruit (that does not contain seeds) Applesauce, Mashed Bananas, Mashed Avocado
  • Jell-O
  • Mashed Steamed Vegetables
  • Creamy-consistency peanut butter (not chunky)
  • Cottage cheese, cream or soft cheeses, yogurt, pudding, ice cream
  • Eggs Any Style

Foods To Avoid:

  • Raw Vegetables/Salad
  • Chewing Gum
  • Candy
  • Cookies
  • Chips
  • Nuts
  • Meat that shreds or lodges under the gums/ between teeth
  • Foods/Fruits with small seeds or hard crunchy pieces

If you have any questions or concerns, please contact us or call 415-986-6900

 

Surgery Post-Operative Care

You may experience some of the following after dental surgery:

Bleeding:

It is normal to have some light bleeding for up to 24 hours after surgery. Gauze should be left in place with firm biting pressure for at least 2 hours after surgery. After 2 hours, change the dressing by moistening a clean piece of gauze and place directly over the surgery site with moderate biting pressure for 30 minutes. Repeat if necessary. Blood may mix with your saliva, making it appear that there is more blood than there actually is. Note: Sinus surgery patients may experience some bleeding through the nose for the first 24 hours. Do not swish with mouthrinse or spit forcefully for at least 24 hours after surgery.

Pain:

It is common to have some pain or discomfort the first few days after surgery. Pain medications are more effective when they are taken while you are still numb, before normal sensation returns. Follow medication and prescription instructions very carefully.

Swelling:

After surgery, swelling around the mouth, cheeks, eyes, and side of the face is very common. This is part of the body’s natural healing process. Swelling usually becomes apparent the day after surgery, and reaches it’s maximum about 2-3 days after surgery. Swelling can be minimized by immediately using cold compresses after surgery. Place the ice pack on the side of your face for 15 minutes on, 15 minutes off for the first 24 hours. Keep several ice packs ready by wetting some washcloths, put in a sealable plastic bags and keep in the freezer. Keep your head elevated above heart-level for the first 2 nights after surgery to help minimize swelling.

Bruising:

Bruising is very common after dental surgery, and may extend to surrounding areas. This is normal after surgery. Most of the bruising happens 2-3 days after the surgery. Bruising can take up to two weeks to go away. After 2-3 days, warm moist compresses can be applied to speed up removal of discoloration.

Nausea:

Anesthesia medications and prescribed medications can cause your stomach to feel nauseous. To minimize this possibility, do not take medication on an empty stomach. If you feel nauseous, you can drink clear liquids (such as apple juice or water), drink chicken broth, or try eating a small amount of toast or crackers.

Fever:

After surgery, it is normal to have a slightly elevated body temperature for the first 24 hours. Remember to drink plenty of clear liquids to keep your body hydrated. Contact the office if there is a high temperature, or if a low-grade fever persists past 24 hours.

Sutures:

Often sutures are placed after surgery to minimize bleeding and help healing. If a suture comes out on it’s own, there is no need to be alarmed, just discard it. Dissolvable sutures should dissolve between 3-10 days. If they are still present at your post-op appointment, your dentist can remove them at that time.

Some of the bone grafting material coming out:

It is normal for some of the bone grafting material to work it’s way out through the surgical site while it is healing. This is nothing to be alarmed about, and there is still a lot of bone grafting material in the surgical site. Call the office if a lot of the grafting material seems to be coming out.

 

Instructions for care after surgery:

Oral Hygiene:

Do not neglect your oral hygiene while you are healing from surgery. Leftover food and plaque in your mouth can cause the surgical site to become infected. You may gently rinse with warm salt-water (or chlorhexidine if it is prescribed to you), and gently brush your teeth the day AFTER surgery. Wait 4-5 days to brush the actual surgical site.

Diet:

After surgery, drink lots of clear liquids and eat soft, nutritious foods. Avoid hot foods, especially while you are numb. You may burn yourself and be unaware. Hot foods can also irritate healing tissues. Avoid acidic foods (tomatoes, citric fruits and juices, soda, etc.) for at least 2 weeks until the surgical site is healed. DO NOT DRINK ANYTHING THROUGH A STRAW FOR AT LEAST 48 HOURS AFTER SURGERY.

 

Smoking/Alcohol:

Do not smoke or drink any alcohol for at least 2 weeks until the surgical site is healed. Alcohol and tobacco will damage the tissues and potentially cause a bone graft or implant to fail. Smoking and drinking dramatically slow down the healing process of all surgical procedures. Long term, smoking can even cause a healed implant to fail. Having a dental implant is one more great reason to quit using tobacco.

Medications:

It is very important to follow all medication instructions very carefully. DO NOT DISCONTINUE OR MODIFY ANY MEDICATION ROUTINE INSTRUCTED BY YOUR DENTIST. Take all antibiotics for the full course of the prescription, even if the surgery site feels fine. Each medication serves a specific purpose in your healing after surgery. Discontinue medication and call your medical doctor if you have an allergic reaction (hives, swelling, trouble breathing) to any of the medications you take. If the medication causes severe nausea/vomiting, call your dentist for an alternate medication. **WOMEN PLEASE NOTE: ANTIBIOTICS WILL MAKE YOUR BIRTH CONTROL SIGNIFICANTLY LESS EFFECTIVE, ALTERNATIVE METHODS MUST ALSO BE USED TO ENSURE YOU DON’T BECOME PREGNANT.**

Activity:

For the first 2-3 days, avoid exercise, strenuous work, bending over, or lifting heavy objects. These activities may cause excessive bleeding, dislodge blood clots, or dislodge bone grafting material.

Wearing Removable Prosthesis:

Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment (unless specifically directed to do otherwise). If you are given a temporary flipper, do not wear it until numbness is completely gone. A temporary flipper also should not touch the gums or sutures, this may cause ulceration of healing tissues or suture margins.This can lead to the loss of implant or bone grafting material.

If you have any questions or concerns, please contact us or call 415-986-6900

 

Veneer Post- Operative Care

For the first 2 weeks after your veneer appointment:

  • Avoid biting your lip/cheek/tongue while you are numb. If you need to eat, choose something that is soft and doesn’t require chewing (for example a smoothie). Also avoid hot foods (like soup), because you may burn yourself and not know it. Do not bite into foods with your front teeth.
  • It is important that the temporary acrylic veneer(s) remain intact on the tooth until the final veneer is cemented. The temporary veneer protects the tooth, and prevents the natural tooth from shifting. If the tooth shifts the final veneer will not fit, and a new one will have to be made, delaying final cementation.
  • Always avoid biting on hard, crunchy foods with the acrylic (AND PERMENANT) veneers. Veneers are thin porcelain that can break easily if you bite into hard foods with your front teeth. If the temporary veneer has broken, or come off in one whole piece, another will need to be placed immediately. If the temporary veneer is intact, bring it with you to the appointment so it can be re-cemented, or a new one can be made if it is broken.
  • It is important to keep flossing while a temporary veneer is on to keep the gums healthy. Very inflamed gums make it difficult to successfully place the final veneer, and may delay the final veneer cementation. When you floss, slide the floss out sideways, rather than straight up through the chewing surface. Pulling the floss through the chewing surface can pull the temporary veneer off.

Long term Veneer Success

  • It is crucial that you protect your final veneers with a custom hard-splint nightguard. Even very slight, mild, infrequent, or isolated clenching or grinding can eventually break your final veneers.
  • Do not ever bite into firm or hard foods with your front teeth. Veneers have a natural appearance due to their thinness, but will easily break if you bite into hard things, or use your teeth for other purposes (breaking a thread, holding objects between your teeth, opening packages, etc.). You will have to be very aware of what kinds of foods you choose, and how use your front teeth from now on.
  • Flossing and good oral hygiene are crucial when you have veneers. The edge of a veneer is slightly rougher than your own natural enamel. This will trap more food and plaque. Food and bacteria can easily cause a cavity at the margin, requiring the veneer to be replaced, and possibly even needing a root canal if the decay is deep.

You may experience some of the following after having a veneer prepared:

  •  Tooth sensitivity

 If there was decay that reached close to the nerve, temperature and biting sensitivity may be felt for weeks to months after a veneer was placed. A decay or infection can cause the nerve to be inflamed, and it can take some time for the inflammation to subside. The tooth may also have gum recession, which causes teeth to feel sensitive “zings” sometimes. High-concentrate fluoride toothpaste can help alleviate recession-related sensitivity.An acrylic temporary veneer will be placed until the final is cemented. Since the acrylic does not insulate the tooth much as the final crown, you may notice more sensitivity while the temporary veneer is on. The final restoration will insulate the tooth more, and sensitivity should improve.

  • Jaw soreness/tenderness

 Having jaw tenderness is common after having dental work done. We often require you to keep your mouth open for extended periods of time, exhausting the jaw muscles and joint. Alternating hot and cold compresses to tired jaws, and taking anti-inflammatory medications (such as Ibuprofen), and eating soft foods can help alleviate jaw discomfort.

  • Injection site soreness/tenderness

 If you received anesthetic injections for your treatment, you may notice some tenderness or bruising at the site of the injection, especially if multiple injections were needed. Anti-inflammatory medications (such as Ibuprofen) can help alleviate injection-site tenderness.

  • Gum feel irritated or sensitive

Gums may feel irritated after a crown preparation because the gums are slightly compressed during the procedure. This allows for a highly accurate crown impression, but can cause some discomfort once numbness has worn off. Gum irritation may also be caused by the margin of the temporary crown and cement. The temporary crown is usually much rougher than natural enamel. This traps more plaque and food, irritating the gums. Focus your toothbrush for a little longer around the gums while a temporary crown.

  • My bite feels wrong

 Once a veneer is placed, we do our best to adjust it so it is comfortable to bite on, and make sure other teeth are not touching. Typically patients are still numb as we check the bite, and may have a difficult time sensing if the bite feels completely normal. It is common for veneers to need a final adjustment once numbness has completely worn off. If yourbite feels even slightly off, please contact our office to have it adjusted to prevent damage to the veneer.

  • Possible eventual need for a root canal

 In some instances, decay reaches very close to the nerve, or the tooth was damaged during an injury. When this happens, the nerve becomes chronically inflamed, and can slowly die over a long period of time. Even if the decay is completely removed and a veneer is placed, the nerve itself may already be inevitably slowly dying. This is something that cannot be detected in an X-ray initially, and usually presents itself over time, after other restorative efforts have been made.

If you have any questions or concerns, please contact us or call 415-986-6900

 

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Susie Shin Dental Care

450 Sutter St., Suite 1823
San Francisco, CA 94108

Monday: 9-6pm (Open 1st & 3rd Mon.)
Tuesday: 9-6pm
Wednesday: 10-7pm
Thursday: 9-6pm
Friday: 8-4:30pm (Open 2nd & 4th Fri.)
Saturday: 9-4pm (Open 1st Sat.)

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