Although most dental procedures require little or no follow-up care on your part, it is still a good idea to be aware of certain signs and symptoms following any dental restorative or scaling procedure.

Should anything occur that does not seem normal,
please do not hesitate to call the office as soon as possible.

• Tooth Extractions
• Temporary Crowns
• New Crowns and Bridges
• New Restorations (Fillings)
• Arestin Placement
• Periodontal Scaling and Root Planing

Tooth Extractions:

• Do not disturb the wound: In doing so you may invite irritation, infection and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (i.e. eating utensils etc.)
• Do not smoke for 12 hours: Smoking will promote bleeding and interfere with healing.
• Brushing: Do not brush the area for the first 8 hours after surgery. After, you may brush your teeth gently, but avoid the area of surgery for the next day or so.
• Mouth Wash: Avoid all rinsing for 24 hours after extraction. This is to insure the formation of a healing blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. If the clot is lost, a painful condition called dry socket may occur. You may use warm salt water or mild antiseptic rinses after 24 hours only if prescribed.
• Do not actively spit or suck through a straw: This will promote bleeding and may dislodge the blood clot causing a dry socket.
• Bleeding: Before you left the office, you were given verbal instructions regarding the control of postoperative bleeding. A rolled up gauze pad will be placed on the extraction site and you will be asked to change this dressing every 20 minutes or so depending on the amount of bleeding that is occurring. It is normal for some blood to ooze from the area of surgery. We also gave you a package of gauze to take with you to use at home if the bleeding should continue. Should you need to use the gauze at home, remember to roll it into a ball large enough to cover the wound. Hold firmly in place, by biting or with finger pressure, for about 20-30 minutes. If bleeding still continues, you may fold a tea bag in half and bite down on it. Tea contains Tannic Acid , a styptic, which may help to reduce the bleeding.
• Pain: Some discomfort is normal after surgery. Non-steroidal Anti-inflammatory tablets ( i.e. Advil, Motrin, Aleve etc. ) may be taken as described by Dr. Dave or Dr. Nick. Prescription medication, which may have been given to you, should also be taken as directed. If pain continues, call us immediately.
• Swelling: To prevent swelling, apply an ice pack or a cold towel to the outside of your face in the area of the extraction during the first 12 hours. Apply alternately, 20 minutes on then 20 minutes off, for an hour or longer if necessary.
• Diet: Eat normal regular meals as soon as you are able after surgery. Cold, soft food such as ice cream or yogurt may be the most comfortable for the first day. It is also important to drink plenty of fluids.

• Gum Irritation: It is normal to have some soreness around the areas where we were working follow the placement of a temporary crown.  In fact it may take up to a week before the area begins to feel normal again.
• Site of the Injections: Occasionally, the area where we administered the local anesthesia (novocain) will be sore as well.  In extreme cases, you will have some difficulty opening your jaw.  This may even get worse over the first 3 days!  Swelling will begin to subside after the 3^rd day.  Anti-inflammatory medications (noted above) will help your body resolve this normal reaction.  Again, please call us for advice or an evaluation if you feel tha Monday, January 5, 2009> When you are numb from the local anesthesia, it is difficult for both you and the doctors to perfectly evaluate your bite.  If the anesthesia has worn off and you feel that your bite is hitting to heavily on the new temporary crown, please call us for an adjustment.  Waiting until your next appointment will only allow the tooth to become very sore or possibly cause the tooth hitting it to fracture and break!
  
• Oral Hygiene:  During your appointment, the doctor or the assistant explained and demonstrated the proper way to floss around your new temporary crown.  Pass the floss through the contact between it and your next tooth, floss up and down on each of the two surfaces and then slide it out the side toward your cheek.  DO NOT bring the floss back up the way it went in as this may dislodge the temporary. If this happens, place it back on if you can and then call our office to have it re-cemented. Brush the area normally even though is may be sore for the first few days.
• Diet: Please try to avoid chewing on the side of the temporary crown(s) if possible.  We realize that this is not possible in all cases.  You should refrain from chewing sticky foods like taffy or gum while your temporary crown is in place. If you forget this rule and pull it off with something good, like a caramel, be sure to tell the assistant that you flossed the crown off and see if she believes you.

• Gum Irritation: It is normal to have some soreness around the areas where we were working follow the placement of your new crown.  In fact it may take up to a week before the area begins to feel normal again.
• Site of the Injections: Occasionally, the area where we administered the local anesthesia (novocaine) will be sore as well.  In extreme cases, you will have some difficulty opening your jaw.  This may even get worse over the first 3 days!  Swelling will begin to subside after the 3^rd day.  Anti-inflammatory medications (noted above) will help your body resolve this normal reaction.  Again, please call us for advice or an evaluation if you feel that this condition is getting worse.
• Bite Feels High: When you are numb from the local anesthesia, it is difficult for both you and the doctors to perfectly evaluate your bite.  If the anesthesia has worn off and you feel that your bite is hitting to heavily on the new crown, please call us for an adjustment.  Waiting for it to get better will only allow the tooth to become very sore or possibly cause the tooth hitting it to fracture and break!
• Tooth Sensitivity:  After we cement your new crown to your tooth, you may experience hot and/or cold sensitivity.  It is normal for a tooth to take some time adjusting to a new crown and all of the work that was performed on it.  Give the tooth a week or two for symptoms that are mild and appear to be getting better.  If you feel that the sensitivity is staying the same or even getting worse, please call us so we can evaluate your bite on the new crown. It may be as simple as a slight bite adjustment.

• Gum Irritation: It is normal to have some soreness around the areas where we were working follow the placement of your new filling.  In fact it may take up to a week before the area begins to feel normal again.
  
• Site of the Injections: Occasionally, the area where we administered the local anesthesia (novocain) will be sore as well.  In extreme cases, you will have some difficulty opening your jaw.  This may even get worse over the first 3 days!  Swelling will begin to subside after the 3^rd day.  Anti-inflammatory medications (noted above) will help your body resolve this normal reaction.  Again, please call us for advice or an evaluation if you feel that this condition is getting worse. 
  
• Bite Feels High:   When you are numb from the local anesthesia, it is difficult for both you and the doctors to perfectly evaluate your bite.  If the anesthesia has worn off and you feel that your bite is hitting to heavily on the filling, please call us for an adjustment.  Waiting for it to get better will only allow the tooth to become very sore or possibly cause the tooth hitting it to fracture and break!
  
• Tooth Sensitivity:  After removing all of the decay from your tooth and placing a new filling, you may experience hot and/or cold sensitivity.  It is normal for a tooth to take some time adjusting to the removal of tooth structure the placement of the new filling.  Give the tooth a week or two for symptoms that are mild and appear to be getting better.  If you feel that the sensitivity is staying the same or even getting worse, please call us so we can evaluate your bite on the new crown. It may be as simple as a slight bite adjustment or re-hardening the filling with our light curing instrument. (Tooth colored fillings require us to shine a high-intensity light on the tooth to harden the bonding materials and the filling.)

• After placement, please avoid eating hard, crunchy or sticky foods in the area for one week
• Postpone brushing the area for 12 hours as well as touching the area.
• Avoid flossing the area for a period of 10 days.
  
• Although some mild to moderate sensitivity is expected in the area for the first week, call our office if you feel the pain is increasing, if swelling occurs or if other problems occur.

Scaling And Root Planing:

Site of the Injections: Occasionally, the area where we administered the local anesthesia (novocain) will be sore as well.  In extreme cases, you will have some difficulty opening your jaw.  This may even get worse over the first 3 days!  Swelling will begin to subside after the 3rd day.  Anti-inflammatory medications (noted above) will help your body resolve this normal reaction.  Again, please call us for advice or an evaluation if you feel that this condition is getting worse.

• Pain or Discomfort:  Based on the amount and type of scaling and root planning that was performed, you can expect some mild to moderate discomfort for the first 24 to 48 hours following the procedure.
• Medications: Gernerally, non-steriodal anti-inflammatories (NSAIDs) such as Advil, Motrin or Alleve can help with any discomfort.  If these medications are not sufficient, call our office number and we can prescribe something stronger for you.
  
• Bleeding: You can expect some blood-colored saliva for the first 24 to 48 hours.  If you feel that it is increasing or the area is still actively bleeding, apply pressure for 5 full minutes.  If this does not solve the bleeding, repeat the pressure application for 5 additional 5 minute increments for up to one-half hour.  If it is still bleeding after this, call our office and one of the doctors will call you right back to discuss your next step.
• Swelling: Some swelling is normal depending on the level and amount of scaling and root planning that we performed.  In fact, the swelling may continue to increase over the first 72 hours.  Following this, the area should subside.  If you feel that this area is still increasing in swelling after this period, call our office and one of the doctors will call you right back.