Instructions
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Click on the links below for more information regarding what to do before and after your procedure.
After Wisdom Teeth Removal:
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
   
Immediately Following Surgery
Bleeding
Swelling
Pain
Diet
Keeping Mouth Clean
Discoloration
Antibiotics
Nausea & Vomiting
Other Complications
Finally
After Placement of Dental Implants:
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery.
There will be a metal healing abutment protruding through the gingival (gum) tissue. 
Bleeding
Swelling
Diet

Pain
Antibiotics
Oral Hygiene
Activity
Wearing Your Prosthesis
Before Conscious Sedation:
  • You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
  • No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
  • A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
  • The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
  • Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
  • Contact lenses, jewelry, and dentures must be removed at the time of surgery.
  • Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
  • If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
  • If you take routine oral medications, please check with Dr. Chang prior to your surgical date for instructions.
After Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, insert another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.
 
After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.
 
After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working.
If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable. 
 
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.
 
After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for two to three days, or a reaction to the medication, call our office immediately at 703-385-2772.

After Removal Of Multiple Teeth

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
 
Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.
 
For mild discomfort, use aspirin, Tylenol or any similar medication; two tablets every three to four hours. Ibuprofen (Advil, Motrin) 200mg can be taken two to three tablets every three to four hours.
 
For severe pain, use the prescription given to you. If the pain does not begin to subside in two days, or increases after two days, please call the office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
 
Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced.
 
Drink at least six glasses of liquid the first day.

Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt-water rinse every four hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse three to four times a day.

Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
 
The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur (all of which are considered normal):

  • The area operated on will swell, reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 24 hours only).
  • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in two to three days.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify the office.  

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Before Endodontic Treatment

This procedure will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work.   Our doctors are available for consultation at all times should a problem arise after your treatment.  Please call our office to get in touch with our 24 hour answering service should a problem arise.Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment. 
 
Please eat a full breakfast or lunch as applicable. 

If you have been advised by your physician or dentist to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment. If you can take ibuprofen (Advil or Motrin) or naproxen sodium (Aleve), it does help reduce inflammation when taken pre-operatively. We recommend 2 tablets of either medication 2 hours before endodontic therapy.
 
What should I expect following endodontic treatment?
The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone. It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time. These symptoms are temporary and usually respond very well to over-the-counter pain medications. It is important for you to follow these instructions specifically:
 
Please take Ibuprofen (Advil or Motrin), three 200mg tablets(600mg total) 3-4 times a day (Breakfast, Lunch, Dinner and if necessary at Bedtime). Please take this no matter what for the next 4-7 days. If you are allergic, have medical conditions or are taking prescribed medicine that prevents you from taking Ibuprofen (Advil or Motrin) then please takeTylenol Extra-Strength (Aspirin Free), two 500mg tablets(1000mg total) 3 times a day (Breakfast, Lunch, Dinner). Please take this no matter what for the next 4–7 days.
 
Remember that narcotic medications, if prescribed, may make you drowsy, and caution should be exercised in operating dangerous or driving a car after taking them. Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, please contact our office.
 
Guidelines for Post-Treatment Care
Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue. Do not chew or bite on the treated tooth until you have had it restored by your general dentist. Be sure to brush and floss your teeth as you normally would.
If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, please contact our office.
 
Contact our office immediately if you develop any of the following:

  • a visible swelling inside or outside of your mouth
  • an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction)
  • a return of the original symptoms
  • your bite feels uneven.

Taking Care of Your Tooth
Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is extremely important in ensuring long-term success. Contact your general dentist within two weeks to arrange your next appointment.
 
What the Future Holds
The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you only need to practice good oral hygiene, including brushing, flossing, regular checkups and cleanings.
We will periodically see you for follow-ups that will include taking x-rays of the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

 

 

Michael W. Chang, DDS, MAGD   |   Phone: 703-385-2772   |   3903 Fair Ridge Dr., Suite 207 Fairfax, VA 22033   |   Created by Dental Branding