Post-op Instructions

Dental Implants

BLEEDING: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. 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 will retard healing, causing increased discomfort and increased chance of dry sockets. We strongly discourage smoking during the healing phase.

PAIN: Some discomfort is normal after any surgery.You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.

ACTIVITIES: Avoid driving or operating heavy machinery, bending, lifting or any strenuous activity which can result in increased bleeding, swelling and pain. Do not drink alcohol while taking prescription pain medications. Keeping blood pressure lower will reduce bleeding and aid healing.

NAUSEA: Nausea and vomiting can occur as a result of swallowed blood, discomfort, anesthesia or pain medicines. Post-operative nausea is usually self-limiting and sipping on flat cola or ginger ale often helps.Reduce nausea by preceding each pain pill with soft food

SWELLING: Swelling is a normal occurrence after surgery and will not reach its maximum until 2-3 days after surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.

NUMBNESS: The local anaesthetic will cause you to be numb for several hours after you leave the clinic.. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the implant procedure 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.

ORAL HYGIENE: It is important to keep the mouth clean. You should brush your teeth on the night of surgery, but be gentle around the surgical sites. If there is minimal bleeding, saltwater rinses may begin 24 hours after surgery (mix 1 tablespoon of salt +1/2 teaspoon soda with 8 ounces of water.) Swish gently and allow the water to drip into the sink. Rinses should be done 2-3 times a day, especially after eating. You may be instructed to use a prescription antimicrobial mouthrinse.

DIET: Eat soft foods for the first two days. Maintain a good, balanced diet.Drink plenty of water.. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first days intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) Avoid chewing food until tongue sensation has returned. It is best to avoid foods like rice, nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical areas. Over the next several days you may gradually progress to solid foods.

SORE THROAT: This is not uncommon after oral surgery. The muscles get swollen and this may make swallowing painful. This should go away on its own in 2-3 days.

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call us.

STIFF JAW MUSCLES: This may cause a limitation in opening the mouth wide for a few days after surgery. This is a normal post-operative event that usually resolves during the week after surgery. Stretching these muscles may help to speed up resolution of this problem.

DISCOLORATION OR BRUISING: The development of black, blue, green or yellow discoloration is due to bruising beneath the tissues. This is a normal post-operative occurrence that might appear 2-3 days after surgery. Beginning 36 hours after the surgery, moist heat applied to the area may speed up resolution of the discoloration

ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed.

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.

REMOVABLE APPLIANCES, DENTURES: Your dentist will give you specific instructions about your prosthesis. To avoid putting any pressure on the new implants before they have healed, your denture might be adjusted or significantly modified. In certain cases you will need to go without your dentures for a period (days or weeks) after the implants are placed. Sometimes a temporary removable appliance is made for cosmetic purposes, until a new non-removable one can be made.

FOLLOW-UP APPOINTMENTS: You may need to return to the office within the first 14 days to have sutures removed, or just for a brief follow-up healing check. You may need to return after the implant has integrated for a small second procedure to expose it in preparation for the final restoration.

Please call us on 040 42000024 (Punjagutta) or 040 29804422 (Hitec city) if you have:

  • uncontrollable pain
  • persistent bleeding
  • marked fever
  • excessive warm swelling occurring a few days after the procedure
  • reactions to medications, especially rash, itching, or breathing problems

Dentures:

  • When handling dentures, stand over a cushioned surface or basin of water. Dentures may break if dropped.
  • Don't let dentures dry out. Place them in a denture cleansing solution or in plain water when you're not wearing them. Never use hot water, it can distort dentures.
  • Brushing dentures daily will remove food and dental plaque, and help prevent them from becoming stained. Use a soft brush with liquid soap instead of tooth paste which may stick to the dentures making it difficult to clean.
  • Also brush your gums, tongue and palate every morning with a soft-bristled brush before you insert dentures. This stimulates circulation in your tissues and helps remove debris if any.
  • Make sure you remove the dentures every night before sleep to provide enough rest for the tissues bearing the dentures.
  • See your dentist if dentures break, chip, crack, or become loose. Do not attempt to adjust them yourself. This can damage them beyond repair.
  • Over time, your mouth naturally changes shape due to ageing. These changes cause your dentures to loosen, making chewing difficult and irritating your gums. In such a case, your denture will need to be relined, remade or rebased as a result of normal wear. Rebasing requires making a new base, while keeping the existing denture teeth.
  • At a minimum, you should see your dentist annually for a check up.

Sealants

  • The success of sealants on your child's teeth will depend on the care they get at home. Here are some important things that you as parents can do to help ensure the long-term success of sealants:
  • Supervise good brushing habits with no more than a tiny drop of fluoride-containing toothpaste. Poor oral hygiene can affect the sealants. The acids produced by plaque can etch them, causing sealants to break down over time.
  • Reduce sugar intake. Sticky foods such as Fun Fruits, Fruit Rolls, candy, sugar, caramel, taffy, chewing gum, etc. eaten too frequently will etch the sealants in the same way as poor oral hygiene.
  • Avoid chewing on ice, "jaw-breakers," or other hard substances. This habit can chip the sealants. After the sealants are applied, the teeth may feel funny to your child (like he/she is biting on something). The sealants will adjust within a few days.
  • If we work together, we can help your child's sealants last for years!
    • Eat soft food for the remainder of the day. Avoid foods such as popcorn, hard candy, ice, etc.
    • Resume a normal diet the following day.
    • Resume normal brushing and oral hygiene today.
    • Your child may mention that the bite feels different. This is normal and will subside over the next few days as the excess material wears off, leaving only what is needed in the deepest grooves.
    • The approximate life span of a sealant is two to five years, yet there is always the possibility that a portion or all of the material may be lost before that time. Numerous factors can contribute to possible early loss (saliva contamination during application, continuous poor eating habits, aberrant enamel quality, or very poor oral hygiene). Poor oral hygiene and diet can also result in recurrent decay (cavities around the sealant material in adjacent enamel).
    • Should the sealant be lost, please inform us as soon as possible. If this occurs, there is no harm to the tooth (other than loss of the protection which the sealant had previously provided) or risk to the patient.
  • We will examine the sealants during your child’s recall visits and replace or repair them as needed. There is no replacement charge for this service as long as you have adhered to our recommended recall schedule.

White Fillings

  • There is no eating or drinking restriction after having white fillings unless local anesthetic was used.
  • Flossing and brushing after filling placement is extremely important, teeth that have had cavities are more vulnerable to more cavities, even after they have a filling.
  • The fillings might feel slippery which after a few meals this feeling should go away.
  • The filling should not, however, feel taller than the surrounding teeth. They often feel taller than the surrounding teeth while numb but the bite feels normal after the numbness wears off.
  • If this is not the case, please call our office so that we can polish the filling down a bit.
  • Sticky and hard candies (i.e. Taffy, Jolly Ranchers, etc ) should be avoided after having white fillings. These fillings can chip or break with this kind of candy.
  • White fillings on front teeth are vulnerable to fracture, please avoid biting into hard food and food that needs to be “pulled” (i.e. pizza crust). Cut this food up before eating.

Post Gum Surgery Instructions:

  • You may experience some pain, swelling and bleeding after the surgery.
  • Take all the prescribed medications based on given instruction.
  • Apply an ice pack on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.
  • Keep your next appointment on time for removal of sutures and follow up checks.
  • DO NOT raise your lips with your fingers to inspect the treated area.
  • DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.
  • There is often a temporary loss of feeling in the operated area and the tooth may feel loose.
  • Do not smoke, spit or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).
  • Should any difficulties occur, do not hesitate to call our clinic on 42000024 anytime.
  • After suture removal, use massage cream, interdental brush & floss daily at night.
  • Brush twice daily.
  • Sheduling appointments for routine Scaling/Cleaning every 6 months is (a must) advisable.

Follow up Protocol

  • Periodic check ups required ,once in 15 days for the first 1 month , monthly once for the next 5 months and once in every 4-6 months or as advised by your doctor.
  • Please learn the correct method of flossing and follow regular flossing and interdental brushing routine at home.. Our dental hygienist will be happy to help you !.

Fillings

  • Do not eat on your new filling for one hour and until your numbness is gone.
  • If you are supervising children who had fillings done, make sure they don't bite on their numb lips or tongue (it can cause serious injury to their soft tissue).
  • Do not bite hard or chew on silver Amalgam fillings for 24 hours.
  • You may experience cold and heat sensitivity and some soreness on your gum, this usually subsides in few days.
  • You may experience a foreign body feeling in the mouth for few days.

Your Braces

Caring for your braces is pretty easy if you follow a few guidelines.

Brushing: The first thing to consider when cleaning your teeth is that there are three surfaces of each tooth that need to be brushed. These surfaces are: The Outside, The Inside, The Chewing Side.

The Outside: When brushing the outside of your teeth you should try to make a 45 degree angle toward the gum line between the head of your toothbrush and the tooth itself It is especially important to make sure the area between the brace and the gum stays clean. Try to focus on a few teeth at a time. Make sure these teeth are completely free of food and plaque before moving to the next few. Once you're done with the outsides of the top and bottom teeth you can move to the insides

The Inside: When brushing the inside surfaces of your teeth try to maintain the 45 degree angle towards the gum line as you did with the outside surfaces. Again, focus on just a few teeth at a time and make sure that they are clean before moving on.

The Chewing Side: Cleaning the chewing sides of the teeth should be straight forward. Remember to focus on a few teeth at a time prior to moving on to the next ones.

Flossing: Flossing with braces takes a few minutes to master, but the effort is well worth it. The first step to flossing is getting the floss under the wire that connects the braces together.

Once the floss is under the arch wire it can be wrapped around the tooth on one side. The floss is then pushed up toward the gum line and then pulled down toward the wire. This should be repeated four to five times to ensure all plaque is removed. Be careful not to put too much pressure on the wire as you pull down. Then wrap the floss around the neighboring tooth. Once both teeth are done, the floss is pulled out and the process repeated for the next two teeth.

Foods to Avoid : Because the braces are not indestructible there are foods that need to be avoided. Hard foods may do damage by breaking the braces off of your teeth and bending the wires that are carefully designed to straighten your bite. Sticky foods may loosen your bands or get caught in the braces. Foods to avoid include:

  • Ice (even if you're careful)
  • Caramels
  • Hard candies
  • Gum of any kind
  • Hard chips like Doritos
  • Carrots, apples, pears, etc. should be cut into small pieces
  • Stay away from the bottom of the popcorn bag - the hard kernels are bad news
  • Meat should not be chewed off of the bone, it should be cut off
  • Corn on the cob should be sliced off
  • Pizza crust, and French bread should be broken into bite size pieces
  • Pens, pencils, and fingernails should not be bit down on as they will also damage the braces

When patients take care of their braces things progress very nicely for them. Many times our most conscientious patients finish their treatment ahead of schedule

WHAT TO DO IF THERE’S A PROBLEM

While true orthodontic emergencies are rare, occasionally a minor problem can pop up. What follows is a list of problems that may be encountered and the remedies for them.

Loss of a Spacer: If a spacer falls out it can be replaced very easily. The first step is to thread a piece of dental floss through the center of the spacer. The next step is to double the floss back on itself. Repeat this with one more piece of floss. Hold one piece of floss on either side of the spacer .slide the floss between the teeth where the spacer has come out. Pull the spacer through the contact. Keep a finger on top of the newly placed spacer. Gently pull one end of a doubled back piece of floss out of the mouth. Repeat with the other side.

Initial Soreness: After the initial placement of braces or following an adjustment, the teeth may be tender for a couple of days. This occasionally happens and will pass. An over the counter pain reliever may be helpful in alleviating this initial soreness.

Mild Tooth Mobility: Occasionally one may notice mild tooth mobility. This is normal and makes sense when one realizes that as a tooth moves the bone around it becomes softer. After the tooth has moved to its correct position the bone around I there calcifies and becomes hard again.

Wire Poking: Early on in treatment as the teeth move, it is possible for the wire to protrude from the back brace. This problem can be solved by taking a nail clipper and snipping the wire as close as possible to the brace. If you cannot clip the wire, placing some wax on it will help to keep you comfortable.

Wire out of a Brace: Just as a wire may protrude from a brace early on in treatment it is possible for a wire to come out of a brace. The solution to this problem is to simply reinsert the wire in the brace using a pair of tweezers.

Broken Brace: If a brace breaks off of a tooth it can be left there if it is not uncomfortable to you. If the brace does become bothersome the tie that holds it on can be removed with a pair of tweezers or an unbent paper clip. The most common cause of a broken brace is eating foods that are too hard or too sticky. Chewing on pens, pencils, or fingernails may also cause a broken brace. Regardless of how the brace broke please call our clinic to schedule an appointment to have it repaired.

Broken Wire: Again, eating hard or sticky foods can cause a wire to break. If this happens take a pair of nail clippers and cut the wire as close as possible to the next brace it is attached to.

Tie has come off of a Braces: If a tie comes off of a brace all should be fine. Often times it can be replaced with a pair of tweezers. If this is not possible please call our clinic so we can set up a time for you to run in and have it replaced.

Expander is Loose: If an expander becomes loose we do not want you to activate it until you are seen. Usually the expander can be pushed back onto the tooth until you can get back into our office. Sticky foods are usually the cause of this.

Poking Wire Tie: Sometimes to secure the brace to the wire we twist a very small stainless steel ligature around it. Infrequently it is possible for the twisted end of the ligature to move and start to feel sharp. If this happens simply use a pencil eraser to gently push it into a comfortable position.

Sharpness Felt on the Tongue Side of a Brace: Occasionally the tongue side of a back brace may feel sharp. This may be caused by the rubber band attachment on the brace. To solve this problem take a spoon and push the rubber band attachment back in toward the brace.

CROWN AND BRIDGE (ALSO INLAYS AND ONLAYS)

  • Crown and bridges usually take 2 or 3 appointments to complete. On the first appointment the tooth/teeth are prepared and impressions are taken and a temporary crown is placed on your tooth/teeth.
  • You may experience sensitivity, gum soreness and slight discomfort on the tooth / teeth, it should subside after the placement of permanent crown.
  • Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.
  • Temporary crown is usually made of plastic based material or soft metal. It could break if too much pressure is placed on it like chewing on hard foods etc. The crown also may come off; if it does, save the crown and call our clinic. The temporary crown is placed to protect the tooth and prevent other teeth to move. If it comes off it should be replaced. To avoid losing your temporary, avoid chewing on sticky and hard food (chewing gum, ice). Try to chew on the opposite side of the treatment as much as possible.
  • After the permanent restoration is placed you may feel slight pressure for a few days. Also, the bite may feel different for a day or two. But if the bite feels uneven or you feel discomfort on chewing on the tooth after 2-3 days, call our clinic. Delaying the necessary adjustments may damage the tooth permanently.
  • Continue your normal brushing but be careful while flossing around the temporaries (remove the floss gently from the side).
  • Bridge/Crown may become loose after few years. We can be fix it back but delaying the visit to us for more than 2-3days can affect the fit.
  • It is good to floss between the crown or bridge and natural tooth. Special floss is available to clean under the bridge.
  • Call our clinic on 4200 0024 if you are in pain.

EXTRACTION

  • When your procedure is completed, bite on the gauze that is placed in your mouth for at least 1 hour. Bleeding or oozing is to be expected in the first 12- 24 hours. If you have excessive bleeding, place a cold moist tea bag over the extraction area and bite carefully. If the bleeding has not subsided in a few hours, please call the clinic.
  • Swelling on and after a day of the extraction, place an ice pack on cheek, fifteen minutes on and fifteen minutes off. Repeat for two to three hours.
  • In order to protect the fragile blood clot and promote quicker healing, we ask that you do not smoke for at least three days.
  • Do not suck through a straw for at least three days. Do not drink any carbonated beverages in the first 24-48 hrs.
  • Be careful when brushing. Keep the toothbrush away from the extraction area, and do NOT spit/rinse vigorously for at least three days. Let the water run out of your mouth with your head tipped over the sink. You can begin gentle rinsing 24 hrs after the extraction.
  • If you are not careful, you may lose the blood clot forming in the open wound. This condition is called "dry socket", and is very painful. It can be treated with medication, and it is temporary.
  • It is important that you eat. A liquid or soft diet may be necessary for a few days. Curds, soft rice, bread, mashed potatoes, milkshakes make a good soft diet.
  • Avoid strenuous activity for the first 24 hours.
  • Take all medications as directed. Medications are prescribed to control pain or prevent infection.
  • Please be sure to inform the dentist if you are on blood thinners or any other medication.