Post Care Instructions

Your filling(s) is set and it is okay to eat and drink. If you choose to eat before the freezing wears out, you need to be careful of your lip and tongue. On average, freezing lasts 2 to 4 hours; however, everyone’s metabolism is different, so it varies.

Following a procedure to restore/fill your tooth, you should realize that there is a certain amount of trauma/irritation that the nerve may encounter. This is usually due to the amount of decay and the size of the previous filling. Following the new filling(s) on your tooth/teeth, you may experience some of the following:

• Temperature sensitivity to cold and/or hot for 2 weeks to 2 months. The first 2 weeks being about the same, and then slowly improving over time.
• Biting sensitivity. The most common cause is that the bite is high. Sometimes it can be hard to duplicate the correct bite when you are still frozen.
• Sore gums or muscles. The tissue around the tooth that was filled or around the injection site may be sore and tender. Rinsing with warm salt water will help these tissues heal faster. Continue to brush and floss the area.
• Jaw pain and headaches. This is usually a sign that the bite is high, and you are grinding/clenching on the new filling(s).
• Prolonged temperature sensitivity and/or throbbing pain. This may be a sign that the irritation to the nerve was more than it could endure.

After a procedure, if you feel that the bite is not correct, we ask that you let us know within a week. If you ignore this sign, then you risk further trauma to your tooth; as well as, possible fracturing of the new restoration.

Now that your crown or bridge prep has been completed, a temporary crown has been placed. This temporary crown serves several purposes; it reduces sensitivity, protects the tooth during function, promotes healthy gums, and provides esthetics. The colour, shape, and size of your temporary does not necessarily represent the final restoration.

It is important that this temporary crown stays on your tooth. Please AVOID eating HARD and STICKY foods while you have a temporary crown.

When FLOSSING, pull floss down towards the gums and pull out to the side. DO NOT pull the floss back up to the tooth surface; this could dislodge the temporary crown.

The tissue around the tooth that was worked on or around the injection site may be sore and tender. Rinsing with warm salt water will help the tissues around the tooth heal faster. Continue to brush and floss the area.

*If your temporary crown comes off, place Vaseline or toothpaste inside, and put it back on your tooth. CALL our office to have it re-cemented. *

We recommend you take a basic anti-inflammatory agent such as Advil/Ibuprofen; 400mg every six hours for three days, in order to greatly reduce any postoperative discomfort.

***Only take medication if you have no allergies or contraindications to the medication. If you are unsure, do not take the medication, and call our office ***

Now that your teeth have been prepared for veneers, temporary veneers have been placed. These temporary veneers serve several purposes; they reduce sensitivity, protect the teeth during function, promote healthy gums, and provide esthetics. The colour, shape, and size of your temporary does not necessarily represent the final restoration.

It is important that the temporary veneers stay on your teeth. Please AVOID eating HARD and STICKY foods while you have temporary veneers.

You will NOT be able to FLOSS between the temporary veneers as they are attached together for strength. If your temporary veneer comes off, call our office to have it re-cemented.

The temporaries may discolour at the edges; especially if they are on for an extended period of time. The tissue around the tooth that was filled or around the injection site may be sore and tender. Rinsing with warm salt water will help the tissues heal faster. Continue to brush the area.

We recommend you take a basic anti-inflammatory agent such as Advil/Ibuprofen; 400mg every six hours for three days, in order to greatly reduce any discomfort.

***Only take medication if you have no allergies or contraindications to the medication. If you are unsure, do not take the medication, and call our office. ***

Following your root canal procedure, you should expect all temperature sensitivity for that tooth to disappear. For 95% of all root canal treated teeth, all symptoms should begin to disappear and subside within three days. 5% of root canal treated teeth will show postoperative sensitivity resulting in pain on biting, as well as, possible swelling. This may occur even in the event that the root canal procedure was entirely successful.

We recommend you take a basic anti-inflammatory agent such as Advil/Ibuprofen; 400mg every six hours for three days, in order to greatly reduce any postoperative discomfort.

***Only take medication if you have no allergies or contraindications to the medication. If you are unsure, do not take the medication, and call our office. ***

In the event that you are experiencing rapidly progressing pain and swelling after a root canal procedure, we recommend that you call our office as soon as possible. It is very likely that antibiotic therapy will be required at this point. Please have the phone number of your local pharmacy; the dentist will need to phone in your prescription. In the event that your call is after hours and your dentist is away from the office, please remind the dentist if you have any antibiotic allergies. Usually, the pharmacist will have this information on hand anyways.

It is important to note that root canal treatment has a 98% success rate on the first treatment. Approximately 0.5% of root canal treated teeth will require extraction at some point. This is an inescapable statistic as with all other medical treatments.

To increase the prognosis of your tooth, once root canal treatment is completed, further restorative treatment will be required. This may include a post/core buildup and crown; without the tooth may be susceptible to fracture.

If you are in doubt about anything, please contact our office. Post-extraction care is important, and your recovery may be delayed if instructions are neglected.

The day of the operation: NO SPITTING OR SMOKING FOR 24 HOURS MINIMUM

1. Keep gauze in place with biting pressure for 2 hours
2. If more than slight bleeding persists, repeat this procedure
3. Do not rinse mouth or brush teeth
4. Apply Vaseline to lips if sore
5. Do not eat immediately after the surgery
6. TAKE IT EASY
7. If advised by the dentist, on the first day place ice to the area; 20 minutes on and 20 minutes off

The following day:

1. Brush gently after meals
2. Add ½ teaspoon of salt to a glass of warm water to rinse the area at least 4 times daily; always after you eat and right before bed
3. Maintain good nutrition. If you cannot chew, then drink

**TAKE PRESCRIBED MEDICATION AS DIRECTED**

Dry socket. This follows an extraction whereby the blood fails to clot in the formed socket. Onset occurs within 2 to 4 days of the extraction. You will be aware of this by the dull throbbing pain that is not alleviated by pain medication. Please contact the office if you are experiencing these symptoms.

The following can be expected to occur normally in proportion to the type of extraction involved:

Swelling: Should be the greatest on the second or third day after the surgery, and then slowly receding.
Discoloration: Black, blue or yellow areas may develop. These are bruises: the result of bleeding into the tissues and are of little significance.

Bleeding: A very slight, oozing of blood may occur for several days.

Discomfort: Difficulty of opening the mouth wide may occur. This should return to normal within a week.

Diarrhea: If taking antibiotics, please report all incidences of diarrhea or soft stool to our office as soon as possible.

Try to exercise your treated muscles for 1 to 2 hours after treatment (e.g. practice frowning, raising your eyebrows, or squinting). This helps to work BOTOX Cosmetic into your muscles. Although this is thought to help, it will NOT impact your treatment negatively if you forget to do this.

Do NOT rub or massage the treated areas for 2 hours after your treatment. Do NOT do strenuous exercise for 4 hours after treatment. Also avoid facials or saunas for 4 hours after your treatment.

Do NOT lie down on the area for 4 hours after treatment.

Be assured that any tiny bumps or marks will go away within a few hours. If you need to apply make-up within 4 hours after treatment, only use a GENTLE touch to avoid rubbing the treated area.

Results of your treatment may take up to 14 days to take full effect. Please wait until the 14 days have passed before assessing whether or not you are pleased with the result.

BOTOX Cosmetic is a temporary procedure. At first, you may find that your treatment results will last approximately 3 to 4 months. If you maintain your treatment appointments with the frequency recommended by Dr. Michele, the duration of each treatment result may last longer than 4 months.

If you allow BOTOX Cosmetics to completely wear off, it is difficult for Dr. Michele to be able to see how your individual muscles reacted; consequently, the optimal results for your face can be more difficult to achieve.

Aligners need to be worn a minimum of 22 hours a day, and should only be taken out to eat, brush, and floss.

Change your aligners every 2 weeks; unless advised otherwise by Dr. Michele or Dr. Doug.

In the morning, take out your aligners and thoroughly brush them to remove the plaque; in order to avoid it staining or hardening on the aligners.

If you wish to soak your aligners, you can use either Invisalign crystals (these can be purchased from their website) or Listerine Whitening rinse. Do not use this rinse on your teeth as it is too abrasive. Do not soak your aligners in any coloured solution as it will discolour them.

Do not eat or drink HOT foods or food that is dark in colour with your aligners in. This will cause the aligners to distort or discolour.

If your attachments come off, it is not an emergency just call our office, so that we can decide if you need to come in before your next scheduled appointment.

You will receive four sets of retainers. The first set will arrive at the office and will be seated by Dr. Michele or Dr. Doug. The remaining three will arrive at your house. You do not need to change to the new retainers until your current pair is broken, worn, discoloured, or no longer fitting snug.

Retainers should be worn full time for three months following Invisalign treatment. Following that time period, they can be worn solely at night.

Call us as soon as possible if your retainers are not fitting.

It is important to realize that all treatments have a statistical possibility of an expected outcome; as well as, an outcome that is less than expected or even undesirable. This is referred to as the Prognosis. There is no getting around this statistic; however, we can certainly improve it in your favour.

IMPORTANT: Did you know that under the DENTIST’S ACT, we are not allowed to guarantee our treatments? Nonetheless, we will give you our very best and stand behind our treatments. Making your treatments last as long as possible is not only our professional responsibility, but a matter of pride to us. At Steveston Smiles, Drs. Doug and Michele Nielsen proudly stand behind their work. As a regular active recall patient who is up to date with your oral care, dental check-ups and cleanings you will benefit from their continued goal to strive for excellence. If a filling needs to be redone due to fracture, material defect or even decay within the first 2 years, we will repair it at no charge. If a crown fails due to fracture, material defect or decay and needs to be replaced within 5 years, we will replace it for you no charge. Exceptions to this policy, compromised treatment plans and poor prognosis treatments will be clearly stated before any work is started.

If you However, we cannot stand behind our treatments in the event that you do not follow our treatment recommendations, fail to complete treatment, do not show up for your regularly scheduled visits, and fail to follow our maintenance recommendations, i.e. daily home care program. Another example of this is when it is recommended that you wear a grinding/brux guard in order to reduce stress on the teeth during sleep. By not having one or not wearing it as required, you greatly increase the chances of tooth or ceramic fracture as well as root sensitivities, notching, and recession.

The following are some common prognoses and what you need to know about them:

Sensitive teeth following a restorative procedure. When you have a filling, crown, or bridge placed, there is a certain amount of trauma to the nerve(s) (also known as pulp) of the tooth/teeth involved. The deeper the decay or existing filling, the greater the chance of nerve inflammation and sensitivity. If the situation progresses to a toothache, a root canal procedure may be required on the affected tooth. Consider that this might need to be done through a recently crowned or filled tooth. The worse the existing shape of the individual tooth prior to treatment, the less the prognosis may be.

Tooth or cusp fracture. This is very common, and is due to continued loading of the individual cusps (the pointed parts of the teeth). The bigger the existing filling and/or decay, the greater the chance of fracture. Most teeth that fracture can be restored with a crown; however, occasionally a tooth may fracture in such a way that it is not restorable (unfixable), and will consequently require extraction.

Root fracture and subsequent tooth loss. In the event that a tooth has been root canal treated, it may not be as strong as the original tooth. With constant wear and tear, a root canalled tooth is more likely to fracture under repeated loading. Essentially, the top of the tooth is hallowed to access the canals. The older a tooth is, the more likely it will be to fracture. Having a crown placed on the tooth with increase its prognosis.

Recurrent decay or gum disease. Despite our best efforts, decay or gum disease can return. There are many reasons for this.

Prosthetic (crown/bridge/veneer) Failure. The more complex a prosthesis becomes, the less load it will be able to withstand. Simply, the fewer teeth you have supporting a bridge and the longer the span of the bridge, the less load it will be able to withstand. The same goes for the condition of the supporting teeth. Whenever root canalled teeth are used to support a bridge, the more likely they are to fail.

Please consider that any treatments we recommend for you are to improve the long-term prognosis of your dental health. We would advise against treatments that have a poorer prognosis than other treatments. How can your prognosis be improved? Consider the following:

Treatments should be done in a timely fashion. The longer you leave decay or any other condition to progress, the worse the condition becomes. As far as teeth are concerned, the more tooth structure you are left with, the better off the tooth remains.

A maintenance schedule should be followed. If you neglect professional care and/or neglect proper recommended home care (flossing, brushing, etc), the greater chance you will have of gum disease, tooth decay, and other problems. We urge you to keep your regular appointments, so that we can discover problems before they advance further.

Basic health recommendations should be followed. Smokers and uncontrolled diabetics will be more prone to dental disease. You should follow the advice of your physician, and make sure that you take your recommended medications.

Grinding and clenching habits should be controlled. The more you grind and stress your teeth, the more likely they are to break or crack. If you grind on a root canalled tooth, it will be more likely to fracture. If you are a grinder/clencher, make sure you check out the site. If recommended, you should be wearing your brux (grinding or night) guard as suggested.

Implants. When implants are used to replace missing teeth, they have a better long-term prognosis as opposed to fixed bridges. We prefer not to prepare the adjacent teeth for a bridge. As a general rule, the bigger the bridge, the less the prognosis. Implant retained teeth allow all teeth to support their own load; hence, a better prognosis.

Prognosis will always be a part of all treatments. We will advise you based on the preferred treatments, so that your prognosis for any treatment is kept as ideal as possible. Let us know if you have any questions or concerns about your treatment.