After Cosmetic Reconstruction

Periodontal

Remember that it will take time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed it takes several days for the brain to recognize the new position of your teeth or their thickness as normal. If you continue to detect any high spots or problems with your bite, call our office at (212) 725-2020 so we can schedule an adjustment appointment.

It is normal to experience some hot and cold sensitivity. The teeth require some time to heal after removal of tooth structure and will be sensitive in the interim. Your gums may also be sore for a few days. Warm salt water rinses (a teaspoon of salt in a cup of warm water) three times a day will reduce pain and swelling. A mild pain medication (one tablet of Tylenol or Ibuprofen (Motrin) every 3-4 hours) should ease any residual discomfort.

Don’t be concerned if your speech is affected for the first few days. You’ll quickly adapt and be speaking normally. You may notice increased salivation. This is because your brain is responding to the new size and shape of your teeth. This should subside to normal in about a week.

Daily brushing and flossing are a must for your new dental work. Daily plaque removal is critical for the long-term success of your new teeth, as are regular cleaning appointments.

Any food that can crack, chip or damage a natural tooth can do the same to your new teeth. Avoid hard foods and substances (such as beer nuts, peanut brittle, ice, fingernails, or pencils) and sticky candies. Smoking will stain your new teeth. Minimize or avoid foods that stain such as coffee, red wine, tea and berries.

If you engage in sports let us know so we can make a custom mouthguard. If you grind your teeth at night, wear the night guard we have provided for you. Adjusting to the look and feel of your new smile will take time. If you have any problems or concerns, please let us know. We always welcome your questions. 

Periodontal (Osseous) Surgery After Care

Medications

After osseous surgery, take any prescribed antibiotics or pain pills as directed. Reduce upset stomach from antibiotics by taking it with food and plenty of water. Pain pills usually work better if taken before numbness wears off. After that, take as needed. Take all narcotic pain pills with food and plenty of water. Do not drive after taking any type of narcotic and do not take with sleeping pills or alcohol.  Do not take aspirin products 7 days before or after surgery. Aspirin is a blood thinner and can cause excessive bleeding.

Swelling

Swelling usually occurs within 48-72 hours after surgery. Use a cold compress to the face over the area where the procedure was performed for 10 minutes at a time, twice an hour, for 6 hours. Using the ice pack as directed, should reduce swelling. Do not use a hot compress or hot water bottle.

Sleep

For the first 2 nights, sleep in a semi upright position. A recliner is best or having the head propped up with pillows. Keeping the head above the heart significantly reduces post-operatory swelling.

Oral Hygiene

If you use a water-pik or an electric toothbrush, you cannot use them around the surgical area for 4 weeks after the procedure. You can brush the unaffected areas with your normal toothbrush. Do not floss around the tooth or teeth worked on for one week, so to not take out any of the stitches.

Salt-water rinses

Rinse your mouth with warm salt water (1/2 tsp. salt to 8 ounces of water). Do not swish. Hold in your mouth for 30 seconds and spit out. Repeat this 4-5 times a day for 1 week.

Exercise

Avoid strenuous exercise for the first 7 days because strenuous physical activity may increase post-operatory pain, bleeding and swelling.

Bleeding    

Pink colored saliva is normal for a few days. If any bleeding occurs, apply pressure. First, clean any blood clots and apply gentle, continuous pressure to the check and tongue side of the surgical area for 10 minutes with a soaking wet tea bag. (Black tea preferred) You may also use a soaking wet gauze pad or clean wash cloth. Make sure the tea bag, gauze or wash cloth are soaking wet to prevent them from sticking to the clot when you pull it away.

Food

Stay on a soft foods diet for 3 weeks and chew away from the area of surgery. Avoid any foods that would be more likely to get stuck in the surgery site. (IE popcorn, nuts, corn, seeds, fruits with small seeds like strawberries.) You may feel discomfort if you consume food or beverages that are highly acidic or carbonated. (IE citric juices, tomatoes etc) These items will not hinder the healing process. Avoid really hot food and drinks. It’s advisable to drink food supplements like Carnation Instant Breakfast or Ensure for the first week or two. After 3 weeks, there should be no eating restrictions. Avoid using straws as the sucking action can disturb the healing of the surgical site or even loosen the stitches.

Nightguard

If you require the use of a nightguard, continue using it during the healing time. If you experience extreme discomfort, discontinue until it’s comfortable to begin using it again.

Smoking

Smoking can cause higher pain intensity and prolong the first 3 weeks of healing.  If you smoke, keep it to 5 cigarettes or fewer per day and only smoke half the cigarette. Absolutely no pipes or cigars.

After Crown and Bridge Appointments

Crowns and bridges usually take two or three appointments to complete. In the first visit, the teeth are prepared and molds of the mouth are taken. Temporary crowns or bridges are placed to protect the teeth while the custom restoration is being made. Since the teeth will be anesthetized, the tongue, lips and roof of the mouth may be numb. Please refrain from eating and drinking hot beverages until the numbness is completely worn off.

Occasionally a temporary crown may come off. Call us at (212) 725-2020 if this happens and bring the temporary crown with you so we can re-cement it. It is very important for the temporary to stay in place, as it will prevent other teeth from moving and compromising the fit of your final restoration.

To keep your temporaries in place, avoid eating sticky foods (gum), hard foods, and if possible, chew on the opposite side of your mouth. It is important to brush normally, but floss carefully and don’t pull up on the floss which may dislodge the temporary but pull the floss out from the side of the temporary crown.

It is normal to experience some temperature and pressure sensitivity after each appointment. The sensitivity should subside a few weeks after the placement of the final restoration. Mild pain medications may also be used as directed by our office.

If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office at (212) 725-2020.

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, place 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 at (212) 725-2020 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 2-3 days, or a reaction to the medication, call our office immediately at (212) 725-2020.

After Composite Fillings (white fillings)

When an anesthetic has been used, your lips and tongue may be numb for several hours after the appointment. Avoid any chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue or lip while you are numb.

It is normal to experience some hot, cold & pressure sensitivity after your appointment. Injection sites may also be sore. Ibuprofen (Motrin), Tylenol or aspirin (one tablet every 3-4 hours as needed for pain) work well to alleviate the tenderness. If pressure sensitivity persists beyond a few days or if the sensitivity to hot or cold increases, contact our office at (212) 725-2020.

You may chew with your composite fillings as soon as the anesthetic completely wears off, since they are fully set when you leave the office.

If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office at (212) 725-2020.