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Care Instructions

Intro

Intro

To help ensure every aspect of your surgery and recovery go smoothly, please follow the pre-op guidelines below. If you have any questions or concerns before your surgery, please do not hesitate to contact us. To download a PDF of these instructions, click here.

  • Eat breakfast and lunch on the day of surgery.
  • Take all medications as directed that you would normally used for other medical reasons. Be sure Dr. Gina is aware of all medications you have taken in the preceeding 24 hours.
  • Discontinue taking aspirin, products containing aspirin, or vitamin E, 5-7 days prior to surgery unless prohibited from doing so by your physician. If the latter situation arises, please, inform Dr. Gina immediately.
  • Patients taking Warfarin (Coumadin) must stop taking the medication 3-5 days in advance of surgery. The discontinuation of this drug must be coordinated closely with your physician and Dr. Gina.
  • Have all prescriptions filled. Take the medications before surgery as directed and bring them with you to your surgery appointment.
  • When sedative drugs are used during surgery, you must have someone pick you up to drive you home and stay with you for several hours. The effect of the sedative drugs lasts 2-6 hours following surgery.
  • Be sure to wear comfortable, open collared, loose clothing to the surgery appointment.
  • Do not ignore a head or chest cold when oral surgery is to be performed. Please, call the office if you have any symptoms because we may have to reschedule your appointment.

To ensure a smooth recovery, our office will provide you with post-op instructions. Additionally, we below are some common concerns and you may have after dental surgery. Please click on the plus (+) to expand and follow the related guidelines to ensure proper care. To download a PDF of these instructions, click here.

If you have any other questions or concerns, please don’t hesitate to call us at 310.264.5557.

Activity

Rest as much as possible and limit physical exertion for 2 to 3 days after surgery. Strenuous exercise should be avoided for one week.

Do NOT drive for 18 hours following general anesthesia.

Bleeding

It is not unusual to have minor, persistent or intermittent, bleeding for up to 24 hours following tooth and extractions.

Bite firmly on a gauze sponge placed directly on the extraction site for 30 minutes, then remove the gauze. This procedure may be repeated as needed. A teabag moistened in warm water may be used in the same manner should the oozing continue.

Avoid rinsing your mouth on the day of surgery as this may stimulate bleeding.

When reclining, elevation of the head with two or three pillows (rather than lying flat) will help to minimize the bleeding.

Diet

You may eat immediately after surgery. A soft diet is recommended for at least the first 24 to 48 hours. Foods should be cold, room temperature, or lukewarm.

You may progress to a normal diet when you feel comfortable chewing.

Avoid the use of a straw for 24 hours.

The following are examples of healthy “non-chew” foods:

• Gatorade
• Juices
• High-protein milkshakes
• Fruit smoothies
• Instant breakfast
• Yogurt
• Custard
• Pudding
• Jell-O
• Soup
• Pasta
• Mashed potatoes

Discomfort

The degree of postoperative discomfort will vary from person to person, with the complexity of the procedure, and with the passage of time. Dr. Gina has prescribed an appropriate medication which should be taken as directed.

You may also use aspirin, ibuprofen, or Tylenol instead of your prescription, if you are accustomed to these medications.

WARNING: Do NOT drive, operate machinery, or consume alcoholic beverages after taking prescription narcotic material.

Fever

After surgery, it is normal for the body temperature to be slightly elevated for 24 hours. If you have a fever that lasts more than 24 hours, please call our office right away.

Nausea

It is not uncommon for nausea to result from a general anesthetic or the drugs prescribed for pain. Drinking a small glass of a carbonated beverage will generally control mild nausea.

Oral Hygiene

Do not rinse your mouth or brush your teeth the day of surgery.

Beginning the morning following surgery, you may brush and floss your teeth, avoiding the surgical site(s). Also, rinse your mouth with warm salt water (1 tsp. of salt in an 8 oz. glass of water). Do this 3 to 4 times a day, for one week.

Pain & Medication

Pain is best controlled by the medications recommended by Dr. Gina Gonzalez. They are most effective when taken before the local anesthesia diminishes and normal sensation returns to the area.

Do not take pain pills on an empty stomach.

Narcotic pain medication such as codeine, oxycodone, or hydrocodone may cause nausea, vomiting, drowsiness, dizziness, itching or constipation. If these side effects occur, discontinue the medication.

You may take an alternative over the counter pain medication as necessary or call our office for assistance.

Smoking

Smoking slows healing and increases the risk of complications. It is advisable to avoid smoking for several days following oral surgery.

Swelling

Swelling after surgery is expected and usually increases slowly, reaching its maximum at about 48 hours.

To minimize the swelling and relieve discomfort, apply an ice pack to the face, over the area of surgery: 20 minutes on and 20 minutes off.

After the first 48 hours you may apply moist heat on the outside of the face to help relax stiff muscles and reduce swelling.

Cosmetic Reconstruction

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 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 begin 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.

Crowns & Onlays

TEMPORARY CROWNS & ONLAYS

• Temporaries are not strong. Be careful with hard or sticky foods in order not to pull off or break the temporary. Generally do not floss around your temporary crown unless instructed otherwise.

• If your temporary comes out, save the temporary if possible and please call the office and make an appointment to have it replaced. Generally no harm will be done to the tooth for a couple of days if the temporary is not in place, although the prepared tooth may be sensitive to hot or cold. Please do not leave the temporary out of your moth for for than two or three days because the teeth will move and the final restoration may not fit. The size, shape, and color of the temporary does not resemble the final restoration.

• Temporary restorations do not seal the tooth as well as the permanent restoration will. Sensitivity to hot or cold, pressure, or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.

• The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site. Fell free to take Advil or Tylenol to help with the soreness.

PERMANENT CROWNS & ONLAYS

• After the cementation of your restoration, it may take a few days to get used to the new crown or bridge. Hot and cold sensitivity is possible for a few weeks and occasionally lasts for several months. As with temporary, if the bite does not feel balanced, please call us.

• Do not chew hard or sticky foods on the restoration for 24 hours from the time they were cemented. The cement must set up during this time to have the optimum strength.

• Proper brushing, flossing, and regular cleanings are required to help you retain your final restoration. The only area that a crowned tooth can decay is at the edge of the crown at the gum line. Often, small problems that develop around the restoration can be found at an early stage and corrected easily, but waiting for a longer time may require replacing the entire restoration.

Extractions

After an extraction, it is 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 to 45 minutes after the extraction. If bleeding or oozing continues after you remove the gauze pad, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times. If bleeding hasn’t stopped within a few hours, call our office to speak with Dr. Gina Gonzalez.

After the blood clot forms, it is important to protect it especially for the next 24 hours. The following activities will dislodge the clot and slow down healing.

Do NOT:
• Smoke
• Suck through a straw
• Rinse your mouth rigorously
• Spit
• Clean the teeth next to the extraction site

Limit yourself to calm activities for the next 24 hours. This keeps your blood pressure lower, reduces bleeding and helps the healing process.

• After the tooth is extracted, you may feel some pain and have some swelling. You can use an ice bag to keep this to a minimum. The swelling usually starts to go down after 48 hours.

• Use pain medication only as directed, and call our office if it doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

• Drink lots of fluids and eat only soft nutritious foods on the day of the extraction. (Do not use alcoholic beverages and avoid hot and spicy foods.)

• You can begin eating normally the next day or as soon as it is comfortable.

• Gently rinse your mouth with salt water three times a day, beginning the day after the extraction (a tsp. of salt in a cup of warm water, rinse-swish-spit). Also, rinse gently after meals—it helps keep food out of the extraction site.

• It is very important to resume your normal dental routine after 24 hours. This should include brushing your teeth and tongue and flossing at least once a day. This speeds healing and helps keep your breath and mouth fresh

• Call us right away if you have heavy bleeding, severe pain, continued swelling after 2 or 3 days, or a reaction to the medication.

• After a few days you will be feeling fine and can resume your normal activities.

Fillings


• As with natural teeth, avoid chewing excessively hard foods on the filled teeth (hard candy, ice, raw carrots, etc.) because the resin material can break under extreme forces.

• Composite fillings set up hard right away. There is no waiting time to eat. Children should be observed until the anesthetic wears off. Due to the strange feeling of the anesthetic, many children will chew the inside of their lips, cheeks, or tongue, which can cause serious damage.

• Sensitivity to hot or cold will occasionally occur for a few weeks following the dental restoration. Usually, the deeper the cavity, the more sensitive the tooth will be. It is important that the bite is correctly balanced in order for the sensitivity to improve. If the bite does not feel even with the other teeth, please call for an appointment for a simple adjustment.

• The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site. Feel free to take Advil or Tylenol to help with the soreness.

• The finished restoration may be contoured slightly different and have a different texture than the original tooth. Your tongue usually magnifies this small difference, but you will become accustomed to this in a few days.

• If the sensitivity lingers longer than a few weeks, please call the office to have it examined.

Invisalign

Congratulations! You are on your way to the beautiful smile that you’ve always wanted. Here are some simple instructions for the proper care and use of your Invisalign aligners.

Aligners should be worn 21-22 hours per day. They should only be removed for eating and brushing. After eating, we recommend that you brush, floss, and insert your aligners as soon as possible.

When brushing your teeth, brush off your aligners as well. Additionally, clean your aligners every day with “Retainer Brite” (www.smileshop.com), the Invisalign Cleaning System (www.invisalign.com), or Efferdent denture cleanser. Never place them in boiling water or soak them in mouthwash.

When inserting aligners begin with your front teeth.

When removing aligners begin with your back teeth.

When not wearing your aligners, always store them in the Invisalign storage case. NEVER WRAP YOUR ALIGNERS IN A NAPKIN!!!

Keep your aligners away from pets. Dogs and cats love to chew on used aligners.

Never discard your aligners. When finished with a set, clean them and place them back in their original pouch.

If one of the bonded attachments falls off your tooth during treatment it is not necessary to return to the office to have it replaced. Simply notify us at your next scheduled visit and we will replace it at that time.

You may drink fluids while wearing your aligners. After drinking, we recommend that you rinse off your aligners and brush your teeth.

If you misplace a set of aligners, wear the previous set or the next set in the series. Choose the set that fits most comfortably. Notify the office as soon as possible so we can determine the best way to proceed.

Exercise with your aligner “chewies” for at least 20 minutes per day or as directed by your orthodontist. This will ensure that your teeth respond optimally for the best result possible.

Night Guards

PURPOSE

The purpose of splint therapy is to help your lower jaw function more properly. This appliance will help relax any of your jaw muscles which are in spasm and to reduce any muscle pain by evenly distributing your bite forces, as well as removing interferences.

There are many situations that may cause your lower jaw to malfunction including accidental trauma, developmental defects, peculiar oral habits, naturally occurring malocclusion (poor bite), psychological stress, clenching or bruxing of teeth, and other problems.

RATIONALE

You may have received an acrylic bite splint (occlusal splint). This treatment has been used for many years to keep the teeth from contacting while you sleep and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth.

It is essential that you wear your nigh guard every night and you may also wear it during the day if you find yourself clenching or grinding your teeth.

• Cleaning the Splint: Food will accumulate under the splint. After brushing and flossing your teeth very thoroughly, brush and rinse the inside and outside of the splint and return it to your mouth. Using a dental soak cleanser, such as Polident™ on a monthly basis will help keep the splint fresh.

• If your pain increases after wearing the splint, please call the office for an appointment for and adjustment of the splint.

• Keep the splint away from dogs—they really love these things!

Root Canal

Following root canal treatment it is possible to experience any of the following symptoms: sensitivity to hot and/or cold, sensitivity to pressure, possible swelling, and pain.

If you experience swelling, please call our office immediately as additional medication may be required.

• Normally we will recommend the appropriate pain medication for your treatment before you leave our office. We commonly will advise two ibuprofen tablets (Advil) combined with two Tylenol tablets, taken no more than every 6 hours as needed for comfort. If this is not adequate, please call our office.

• One common occurrence with a newly root-canalled tooth is for the tooth to feel high when you bite your teeth together. If this occurs it will cause your tooth to stay sensitive for a longer period of time. Please call us if your bite feels “high” as this problem is easily rectified with a simple bite adjustment.

• A temporary filling may be used to temporarily seal the tooth between visits.

• Be gentle on the tooth while eating until the final restoration is placed.

• The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site.

• During endodontic treatment, the nerve, blood, and nutrient supply to the tooth is removed. This will cause the tooth to become brittle and prone to fracturing which could result in the need to extract the tooth. A full coverage crown is recommended to prevent this from happening.

Periodontal Therapy

The first two weeks after your periodontal therapy are critical. Healing gum tissue is very susceptible to bacterial (germ) growth on the tooth roots.

Your teeth need to be cleaned thoroughly twice daily to keep the bacteria under control. (If plaque bacteria are left undisturbed for 24 hours, it forms a more tissue destructive bacteria family.)

• Be careful eating until the anesthetic wears off (about and hour or so).

• You may rinse your mouth with warm salt water. Use 1 tsp. of salt, 5 oz. of warm water, stir well and swish around entire amount in mouth.

• You may take Ibuprofen/Motrin for any tenderness that may follow the procedure.

• Your teeth may be sensitive to hot or cold. Over time this will usually improve, but to reduce this, use desensitizing toothpaste such as Sensodyne™ or other toothpaste for sensitive teeth. Fluoride rinses are also beneficial in reducing the sensitivity.

Veneers

TEMPORARY VENEERS

• Plastic temporary restorations will serve you for a short period of time while your permanent veneer is being made. They are attached only slightly to the underlying tooth so they can be removed easily.

• If a veneer comes off, call us and we will replace it immediately. If you are in a situation that will not allow you to come in, place the temporary back in place with some Fixodent™ (denture adhesive) or Den-Temp that you can get from the pharmacy. You must still see us as soon as possible.

• The size, shape, and color of the temporary does not resemble the final veneer.

• Temporary veneers may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure, or sweets is not uncommon. You may also see stains under the temporaries. These will be removed prior to final cementation.

• Avoid heavy duty brushing of the temporaries and do not floss between them because you may pull them off.

• Your final porcelain veneers will be as close to the natural beauty and function of teeth as possible. They look and feel normal in every way.

PERMANENT VENEERS

We place our veneers with the finest materials and techniques available today. However, you should be aware of the following information about your restorations:

• As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, raw carrots, etc.) because the porcelain material can break under extreme forces.

• Proper brushing, flossing, and regular cleanings are essential to the long-term stability and appearance of your veneers. Often, problems that may develop with the veneers can be found at an early stage and repaired easily, while waiting for a longer time may require replacing entire restorations.

• The gums may recede from the veneers, displaying the discolored tooth structure underneath. This situation usually takes place after many years and requires veneer replacement.

If you have any questions, or if you would like to schedule an appointment with Dr. Gina Gonzalez, please contact Heart Centered Dentistry at

(310) 264-5557.
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