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Please note that email is not a secure method for transmitting private or protected medical information (“protected health information” according to the Health Insurance Portability and Accountability Act, “HIPAA”). Dr. Hess Dentistry cannot guarantee the security or privacy of information transmitted via email. If you are concerned about the privacy of your medical information please call our office at 317-535-5665 for secure methods of communication.

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Post Operative Instructions

Thank you for trusting your care to Dr. Hess Dentistry. We want you to be as comfortable and informed as possible following treatment in our office. Below you’ll find instructions for care after dental procedures, as well as information about what is normal to expect following dental treatment.

If you are concerned at all, please don’t hesitate to call us. After hours our answering service will direct you what to do.

Download a PDF of these instructions

You will be numb until the anesthetic wears off.

We routinely numb your teeth, tongue, lips, and/or cheek in order to place fillings, crowns, bridges, and implants, or to perform a root canal or extraction. Treatment done on upper teeth will typically require that only one to three teeth be numbed. Treatment done on lower teeth will typically require that one half of the lower jaw be numbed, including half the tongue and lip. Depending on the type of procedure done, the numbness may last for an additional one to six hours following treatment. Dr. Hess will often use a long-lasting anesthetic for procedures that are anticipated to result in more post-operative discomfort (i.e. extractions and root canals). Otherwise numbness typically lasts for a total of 1.5 to 3 hours. While the area remains numb be careful that you don’t bite or chew on your lip or tongue.

In very rare cases dental anesthetic may cause side effects including dizziness, drowsiness, restlessness, or nausea. Although exceedingly rare, dental anesthetic may also cause an allergic reaction, with symptoms such as chest pain, irregular heartbeat, difficulty breathing, trembling, shaking, or seizure. If you experience any of these symptoms after leaving our office, please seek medical treatment immediately, and call our office to notify us of the situation.

Download a PDF of these instructions

Your tooth may feel different.

After the numbness wears off from having a filling placed you may notice that the tooth feels different. It is common for any tooth to feel a little sore or sensitive immediately after a filling. This soreness shouldn’t last more than 24 to 48 hours. You may also notice that the shape of your tooth feels a little different. This is normal.

If you experience lasting pain after a filling, or pain that is increasing in severity, contact our office to schedule an exam. This may be a sign that the pulp inside the tooth is irritated and needs additional treatment. When the decay in a tooth is very deep, or close to the pulp, we often place medicine at the bottom of the cavity before filling it, to help sooth the pulp. However, this medicine is not 100% effective at preventing post-op pain, so there is always a chance of symptoms arising after treatment. Contact the office if you are experiencing this.

If your bite doesn’t feel right the filling may require extra adjustment. Typically what you notice in this case is that the tooth feels “too tall,” or your teeth don’t come together the same way as they did before the filling was done, or it might feel like the tooth with the filling is bearing all of force when you bite down and chew. If you are experiencing any of these, contact the office and we will get you in ASAP to adjust your bite.

Download a PDF of these instructions

You will have to be careful with your temporary crown or bridge.

Following your first crown appointment you will have a temporary plastic crown protecting the tooth. The plastic crown is not as strong, smooth, or pretty as the final crown will be, and it is held in with weaker temporary cement. Due to these factors temporary crowns sometimes break or fall off. So try to “baby” the tooth as much as possible while it has a temporary crown on it:

  1. Chew on the opposite side of your mouth.
  2. Avoid using the temporary crown to bite on any food that is very sticky or hard.
  3. When flossing by the temporary, “pop” the floss down between the teeth, but then thread the floss out from between the teeth (i.e. do not “pop” the floss back up, as this may dislodge the temporary crown).

If your temporary crown comes off you may experience sensitivity to hot, cold, sugar, or acid while the tooth is exposed. If you still have the temporary crown you can try to re-cement it with temporary cement (available at any pharmacy), or bring it in to have Dr. Hess re-cement it. If the temporary crown is lost or broken, call the office and we will make a new one for you.

The final crown or bridge will make your tooth feel different.

After your final porcelain crown has been cemented you may notice that your tooth feels different. The gums around the tooth may be a little sore from cleaning up the excess crown cement. You also might feel pressure in the flossing areas between the new crown and its neighboring teeth. This pressure typically resolves within a few days. However if it persists call the office and we can adjust the crown to relieve that pressure.

If your bite feels “high” after cementing a new crown, please schedule with Dr. Hess to have the bite adjusted on the crown. While we always check the bite on a new crown before and after cementing it, you may notice discrepancies in your bite later after leaving. These cases typically only require a quick and easy adjustment.

Download a PDF of these instructions

Your tooth may be sore or tender.

Your tooth may be tender or sore following a root canal. To some degree, this depends on the condition of the tooth before the root canal (i.e. if the tooth was very painful to begin with, it is more likely to be sore following a root canal; if it was painful to bite on before the root canal, it will still be a little tender to biting after). Because soreness is a known risk of root canal treatment, Dr. Hess frequently uses a long-lasting anesthetic to keep the tooth numb as long as possible following the root canal. If the pain is more than a mild annoyance after the numbness wears off, ibuprofen or Tylenol can be used for pain relief (as long as they are not prohibited by your physician).

While rare, you may experience extreme toothache symptoms (intense throbbing pain, aching pain, sensitivity to cold, pain on biting, etc.) after a root canal. If you have any of these symptoms, or especially if you experience swelling in the area of the root canaled tooth, call the office immediately for follow up care.

The root canal treated tooth may require a crown.

Any back tooth (molar or premolar) is recommended to have a crown after it has been root canaled. This is to protect it from future risk of fracture. A crown may also be recommended for a front tooth following root canal, depending on how extensive the decay or previous fillings were. Typically we recommend waiting at least two weeks after the root canal to ensure any symptoms have resolved before starting a crown. We also want to begin the process of crowning a tooth within about two months following the root canal, to ensure the canal does not get infected again.

Download a PDF of these instructions

You will have pinkish saliva. Don’t panic, but be alert for excessive bleeding.

It is normal to have pinkish or reddish spit for a few days. This is nothing to be concerned about. However, if bleeding starts from the socket again this is a concern. What you would notice is lots of bright red or dark red blood gushing from the socket, or swallowing so much blood it upsets your stomach. If this happens follow these directions to control the bleeding:

  1. You were given extra gauze when you left our office. Take a few squares of the gauze and fold them up until they make a wad that will cover the socket.
  2. Moisten the gauze, then cover the socket with the wad of gauze and bite down on it. The biting pressure on the socket will help control the bleeding.
  3. Keeping biting like this for 45 to 60 minutes. If this does not control the bleeding, repeat this process for another 45 to 60 minutes. If there is still bleeding, call the office for further instructions.
  4. You can also bite on a wet tea bag to control bleeding; the tannins in the tea help to stop bleeding.

Call 911, or go immediately to a hospital emergency department, if the amount of bleeding makes you feel faint, sweaty, cold, or woozy; if you pass out from bleeding; or if the above procedures have not slowed the bleeding at all.

Avoid strenuous exercise, especially lifting, for the next 24 hours.

Bending over, lifting heavy objects, or exercising vigorously can cause a temporary spike in blood pressure that could cause the socket to start bleeding again. This is much less of a risk after about 24 hours.

Pain management: The area will be sore for several days.

Following a tooth extraction, the area will be sore for several days. Dr. Hess will typically administer a long-lasting anesthetic to keep the extraction site numb for as long as possible following an extraction (sometimes as long as seven hours). BEFORE the numbness wears off we recommend taking something for the pain. The best options are ibuprofen and acetaminophen (Tylenol), as long as those are not prohibited by your physician. A normal healthy adult can take 600 mg of ibuprofen every six hours as needed for pain. This can be supplemented with extra strength acetaminophen (Tylenol), either 500 mg or 1000 mg, every six hours as needed for pain (again, for a normal healthy adult). Dr. Hess frequently recommends alternating ibuprofen and tylenol every three hours for a more steady pain management. This pain management plan has been shown to be more effective than morphine for controlling dental pain. You shouldn’t need this pain management for more than 24 to 48 hours. If Dr. Hess prescribed any other pain killer for you, take it as prescribed.

You may have some facial swelling for a few days.

You may experience some facial swelling in the area where the tooth was removed. This shouldn’t last more than a few days. To prevent swelling, you can ice the area immediately following the extraction. Take an ice pack (or a bag of frozen vegetables) wrapped in a towel, and hold this on the area for no more than 20 minutes at a time; then leave the ice pack off for the same amount of time. During winter months avoid using an ice pack for at least 20 minutes prior to going outside to avoid risk of frostbite to the iced area.

You will need to modify your diet for a few days.

You will have an open wound in your mouth while the extraction socket heals. As much as possible, try to keep from getting food into the socket. You’ll want to eat softer foods (mashed potatoes, applesauce, milk shakes, etc.), and eat them cold or at room temperature. Avoid hot or spicy foods. These don’t pose a danger to your health, but can be very uncomfortable on a healing extraction socket. Also avoid hard or crunchy foods for a few days.

You may develop dry socket.

Dry socket most often shows up as intense pain three or four days after a tooth has been extracted. It is more common for lower teeth than upper teeth, and more common for back teeth than front teeth. If you think you are experiencing dry socket, call the office and we will help you.

Unfortunately the only treatment for dry socket is to manage the pain until the area heals. For this reason we highly recommend that you avoid doing things that increase your risk of dry socket. The main thing to avoid is any sucking force with your mouth, such as dragging on a cigarette, drinking through a straw, or forcefully clearing your nose or sinuses (i.e. “hocking a loogie”). Try to avoid doing these things for the first four days after a tooth extraction. If after four days you have not experienced symptoms of dry socket you are most likely “out of the woods,” and can return to your regular activities.

Download a PDF of these instructions

The new denture will be uncomfortable at first.

A new set of dentures will feel like a pair of flip flops in your mouth at first. Try to wear them for 12 hours per day while you’re getting used to them. They will eventually feel more comfortable.

You will probably find some areas of the new denture that rub in an uncomfortable way, or even rub raw an area in your mouth. This is common with any new denture, even the best dentures possible. When you were given the new denture we made every effort to make it comfortable, but as Dr. Hess says, “Your mouth is more sensitive than my eye.” As you find areas of the denture that make your mouth sore, come back in to the office to have it smoothed and adjusted. Once all of those areas have been smoothed you should be able to wear the denture for 12 to 18 hours per day.

Nobody likes a lower denture.

Lower dentures are notoriously annoying. Even the best-made lower denture will shift and move whenever your tongue touches it (i.e. chewing, drinking, talking, swallowing). Allow some time to adjust to a new lower denture. If after a few months it is still driving you crazy, ask Dr. Hess if you might be a candidate for an implant-retained lower denture. Anchoring the denture to implants will help to hold it in place while you’re living your life.

Your partial might move when you chew.

Depending on which teeth your partial is replacing, you might feel it move slightly when you chew. This is normal. Allow some time to adjust to it. If after a few months it is still driving you crazy, ask Dr. Hess if you might be a candidate for an implant-supported partial denture. Anchoring the partial to one or two implants will help to hold it in place.

Soak your denture or partial whenever it is not in your mouth.

Take your denture or partial out every night before you fall asleep, and be sure you store it in water. If the denture acrylic dries out it can warp and distort, in which case it might not fit correctly anymore.