RECEIVE COMPREHENSIVE DENTAL CARE FOR EVERY TREATMENT AND PROCEDURE

PROCEDURAL & SURGICAL INFORMATION

At Liberty Hill Dental, we strive to provide comprehensive and personalized care from the moment you schedule your appointment with us until your complete healing or desired cosmetic results have been achieved. Please use the following resources as needed as you prepare for your upcoming dental appointment, procedure or during your recovery period.

As always, if you have any questions, please contact our office. Our friendly and knowledgeable staff will be happy to answer your questions and ensure that we provide you with every resource you need for optimal oral and dental health.

┃Root Canal (Endodontic) Therapy - Aftercare Instructions
┃Complete Dentures - Care & Expectations
┃Implant Surgery - PRE-Operative Instructions
┃Implant Surgery - POST-Operative Instructions
┃Oral Surgery - POST-Operative Instructions
┃Anesthesia - POST-Anesthesia Instructions
┃Temporary Crowns & Bridges - Information
┃Occlusal Bite Splint - Use & Care

What can I expect after my root canal therapy?

It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root canal therapy. This should subside within one week. Your tooth will be sensitive to biting pressure and may even appear to feel loose. The feeling is a result of the sensitivity of nerve-endings in the tissue just outside the end of the root, where we cleaned, irrigated, and placed filler and sealer material. This feeling will go away. You may feel a depression or rough area (on the top of a back tooth or on the back of a front tooth) where our access to the canal of the tooth was made. There is a soft, temporary filling material in that area, which may wear away to some degree before your next visit.

What should I do after my root canal therapy?

We recommend that you take something for pain-relief within one hour of leaving our office, to get some medication into your blood system before the numbness begins to subside. Generally, only one dose is needed. We recommend ibuprofen (Advil, Motrin) – 800 mg (usually four tablets). If you have a medical condition or gastrointestinal disorder that precludes ibuprofen, acetaminophen (Tylenol) is a substitute, although it does not contain anti-inflammatory properties.

You may have been prescribed a stronger pain medication. This is primarily to be used at night. You should not expect to be 100% pain or discomfort free for a few days.

Whenever possible, try to chew on the opposite side from the tooth we have just treated, until you have a crown or onlay placed, or until the access area has been restored. Until that time, your tooth is still weakened and still could fracture.

Please avoid chewing gum, caramels, corn nuts or any other sticky or hard material that could dislodge the temporary filling or fracture your tooth.

Please call us if you are concerned or if you have symptoms that are significantly worse than described above. Call also if you lose all of the temporary filling, have significant swelling, or if the tooth feels “high”. You should be able to squeeze your teeth together without this tooth hurting. If this is not the case, the temporary filling is “high” and should be adjusted.

How to Care For Your Mouth With Dentures

1. The denture should be left out of the mouth one to two hours each day. Ideally, you would leave out while sleeping.
2. Use a soft toothbrush to massage and cleanse all of the gum tissues which are covered by the denture. Another method is to use a wash cloth while showering.
3. Scrub your tongue with a soft toothbrush.
4. If you need to use adhesive, use only the minimal amount necessary for the situation.

How to Care For Your Dentures

1. Thoroughly cleanse the inside as well as the outside of the denture using a denture brush and liquid detergent or non-abrasive bar soap. You may also use toothpaste. Ensure the tooth brush is wet before you apply the toothpaste.
2. Brush the denture over a basin of water. If the denture should slip and fall, the water will prevent damage to the denture.
3. Soak the denture overnight (or as possible) in a commercial denture cleaner
4. Never let the denture dry out. When it is not in your mouth, it should be kept in a cleaning solution or water.

What to Expect When Using Dentures

1. A denture does not chew like your real teeth. The more you can chew evenly on both sides and on back teeth, the better the denture will perform. Foods such as corn-on-the-cob or whole apples will tend to dislodge the denture.
2. If any problem whatsoever arises with your denture, return to your dentist for help. DO NOT adjust, reline or repair your denture. Your dentist’s responsibility and obligation ends and the denture may be ruined if you attempt to adjust or repair your own denture.
3. No denture is permanent. Changes will continue to occur in the bones and soft tissues of the mouth. Only your dentist can determine if your mouth is in healthy condition and if new dentures are needed.
4. Return to our office for regular checkups and maintenance of your denture, at least once a year. Dr. Gillespie will always perform a cancer screening examination at this time as well.

These guidelines will help you prepare for and recover from implant surgery. While there is no guarantee that any surgery will be totally successful, our entire staff is committed to making your treatment as painless and as effective as possible. Following these instructions will give you the best chance to have the best result.

Preparing for Implant Surgery

1. Start prescribed antibiotic one day before surgery. On the day of surgery, please take antibiotic as follows: Morning appointments are to take antibiotic a couple hours after surgery. Afternoon appointments are to take antibiotic first thing in the morning. Finish all antibiotics prescribed. No alcohol during antibiotic series.
2. Use prescribed pain medication as needed.
3. Start chlorhexidine mouth rinse the day after surgery and continue for 6-8 weeks after surgery. No brushing on implant.
4. The office tends to be cool, please wear loose comfortable clothing for your appointment.
5. Women can wear light lipstick or makeup.
6. Do not plan any physical activity for the day of surgery or the day after. Prepare to take off work if you feel it necessary.
7. NO smoking 12 hours before surgery and 48 hours after surgery.
8. For 48 hours after surgery, no drinking through a straw, spitting, and limited talking. You may talk, but kept it to a minimum.
9. Have ice packs available to reduce swelling on the day of surgery only if necessary.
10.For 48 hours after surgery, you will be on a cold liquid diet only. Items such as ice cream, yogurt, Jell-O, fruit juices, and applesauce are appropriate. Supplement shakes like Ensure, Boost, and Slim Fast are also good.
11.Please advise us if taking aspirin or any blood thinners.
12.Plan to sleep with your head elevated for the first night following surgery.

If you have any further questions, concerns, or an emergency, please call our office at 512-515-0171. The doctor or his assistant will call you at home on the evening of your surgery to answer any questions you might have about the procedure or medications you are taking.

These guidelines will help you prepare for and recover from implant surgery. While there is no guarantee that any surgery will be totally successful, our entire staff is committed to making your treatment as painless and as effective as possible. Following these instructions will give you the best chance to have the best result.

Post-surgical Care

1. Very limited talking the first 48 hours after surgery. No drinking through a straw and no spitting.
2. Slight bleeding is to be expected for at least the first 12 hours. If heavy persistent bleeding occurs, call for instructions.
3. Take the prescribed pain medication one hour following the surgical procedure as well as one before bedtime.
4. Diet: The day of surgery and the day after, your diet should consist of milkshakes, ice cream, yogurt, Jell-O pudding and plenty of cold fluids (diabetics may substitute with sugar-free items, protein enriched shakes, etc.) We recommend you begin your cold diet approximately one hour following surgery. You may begin a warm soft diet for two to four weeks after surgery. a. Eggs in all forms b. Soups, bouillons, chowders and pasta c. Soft meats such as baked fish, canned tuna, salmon, potted meats and finely ground boiled chicken d. Soft, pureed vegetables (potatoes, peas, beans, carrots, asparagus, etc.) e. Fortified low fat milk, buttermilk, cottage cheese, yogurt f. Unsweetened juices and protein milkshakes g. Eat three meals a day and drink at least 6-8 glasses of water per day
5. Cleaning the mouth: a. Use only gentle salt water rinses the remainder of the surgery day and entire week after surgery, mix 8 ounces of water with 1 tsp of salt. The day of surgery and the day after, the rinses should be with ice cold water. b. On the third day begin rinsing with warm saltwater rinses. You should rinse 3-4 times a day.
6. It is common to run a low-grade fever for the first day. If this continues or is a high fever, please call our office.
7. Patients who take aspirin or other blood thinners daily may resume taking medication immediately following surgery.
8. Continue with chlorhexidine rinses and do not brush implants until instructed to do so.
9. Plan to sleep with your head elevated for the first night following surgery.

The doctor or his assistant will call you the day of or the day after surgery. If you have any questions about the surgery or your medications, please write them down so you can remember to ask these questions when we call. If you have any questions, concerns, or an emergency, please call our office at 512-515-0171.

BLEEDING

1. Keep gauze pack in place 30 minutes with constant pressure. Avoid chewing on the gauze and just hold it in place without opening or closing. Talking should be kept to a minimum for 3-4 hours. Some oozing and discoloration of saliva is normal. If bleeding persists, replace the gauze used to stop bleeding with moist fresh gauze. You may also use a wet tea bag with pressure on the surgical site if there is a problem with continued bleeding.
2. Keep head elevated and rest, avoid any strenuous work or exercise for the next 48 hours.
3. Do not suck or spit excessively for the first 48 hours (this includes smoking or drinking through a straw).
4. Avoid carbonated drinks or drinks containing alcohol for the first 48 hours.

SWELLING

1. During the first 24-36 hours, Ice bags or cold compresses may be applied to the region of surgery for 20 minutes and then left off for 20 minutes.
2. Never use heat during the first 3 days.

PAIN

1. Take 800mg(four 200mg tablets) ibuprofin before the numbness subsides--- and rest. The pain is much more difficult to overcome if administration of the medication is postponed until the pain begins.
2. Continue pain medication in the days following if needed. The goal of the medication is to control the pain and not to eliminate the soreness.

DIET

1. A high-calorie and a high-volume liquid diet is best for the first 12 –24 hours (you may have to grind up your food).
2. Food in the first 12 hours should be soft and cool (ice cream and milkshakes); this will sooth the area and prevent trauma that would cause any bleeding episodes. Absolutely no hot foods for the first 24 hours only. An adequate intake of fluid is typically 2 quarts during the first 24 hours. The fluids should be juices, milk or water. After 48 hours, you may return to your normal diet as possible. If you are diabetic, you should return to your normal insulin and diet routine as soon as possible.

SMOKING

Smoking is not advisable for the first 48 hours. This is one of the main causes of dry sockets.

TEMPERATURE

Some elevation in temperature may occur after surgery. The ibuprofen will help. If there is an increase in temperature associated with swelling, please call Dr. Gillespie.

BRUSHING AND FLOSSING

Continue to brush and floss your teeth. Try and avoid the site of the surgery until instructed by the staff or Dr. Gillespie.

RINSING

Do not rinse on the day of surgery. Beginning the day following surgery use warm salt water as a mouth rinse 3-5 times per day (one-half teaspoon of salt in an 8-ounce glass of warm water). Use the Clorahexidine rinse twice a day.

ANTIBIOTICS

If antibiotics are prescribed, do not quit taking until all have been taken.

NAUSEA AND VOMITTING

Nausea and vomiting are usually caused by the medications used for sedation, the narcotic in pain medication, and swallowing blood after surgery and are not uncommon. These symptoms will usually pass within 6 to 12 hours after surgery. Nausea and vomiting may be relieved by staying in a semi-reclined position and remaining as motionless as possible. Medications should not be attempted on an empty stomach.

SEDATION

If you have been sedated, have someone stay with you the rest of the day. You should not be left alone. Do not drive a vehicle, operate machinery, or carry an infant or a child for the remainder of the day. Use common sense when choosing other activities, keep in mind the medication may still be on board.

1. If you are taking any prescribed medications (such as blood pressure, heart or seizure medications, etc.), these should be resumed on the normal schedule unless instructed otherwise.
2. You should be in a lying down position for the ride home and should remain lying down for the reminder of the day, the ONLY exception is going to the restroom. You must have someone accompany you into the restroom in the event you feel dizzy or loose your balance. Excessive motion (or even sitting up) may cause dizziness and/or nausea.
3. It is important you make sure to drink fluids approximately every 30 minutes for the first three hours, if you are asleep have someone wake you up at the intervals. Large amounts of liquids (especially those with substantial calories such as juice, soup, milkshakes, protein drinks, Slim-Fast, Gatorade, etc) are encouraged for the first 48 hours, in addition to other food. Nausea may occur infrequently after the procedure, if this does, wait a short time (i.e. 15 min), take some more fluids and then try again. Solid food may be given as desired. If nausea persists, please contact me so appropriate treatment can be given.
4. You should get plenty of rest the first 24 hours. There should be no outside activity for the remainder of the day. After that time, activity may be resumed based upon the surgery and other post-treatment considerations. A small percentage of patients may still feel tired after the first day. No operating machinery or potentially dangerous toys (i.e. bicycles, scooter, etc) for 24 hours. Additionally, no alcoholic beverages are to be consumed for at least 24 hours or while taking pain medication.
5. A small percentage of patients may experience post-treatment tenderness and/or redness in the area of the intravenous site due to inflammation in the vein. To reduce this possibility, you should keep the arm that had the intravenous infusion elevated and apply moist heat as much as possible. If this does occur, please call the office. In addition to moist heat (which should be started at the first sign of discomfort), an anti-inflammatory medication may be prescribed, or an over the counter anti-inflammatory such as Advil or Motrin may be taken. The inflammation may occur several days to weeks after the procedure. It may manifest itself as merely discomfort or may exhibit firmness of the vessel, red streaking, small lumps, bruising, or other characteristics.

Again, please call the office if any unusual characteristic at or around the intravenous site develop. If at any time there are any questions or concerns, do not hesitate to call. At Liberty Hill Dental, we want to make your recovery as easy and quick as possible.

A temporary crown or bridge has been placed while a final crown or bridge is being made for you. The color of the temporary crown or bridge does not resemble the final crown or bridge in any way. The temporary crown or bridge, while custom made for every individual, does not have the exact shape and size of the final crown or bridge. Your temporary crown or bridge is made to protect the tooth while the final restoration is being fabricated at the lab. It also holds the space so the final crown or bridge will fit properly. You may notice sensitivity to heat, cold and sweets. This should go away when the final restoration is placed.

Here are some other things you need to know about your temporary crown or bridge:

1) The temporary cement requires about 30 minutes to set. Please do not chew anything during that period of time or before the anesthetic has worn off.
2) Certain foods will stick to the temporary crown or bridge. So please refrain from chewing gum or other foods that might stick to the crown –or even pull it out.
3) Temporary crowns and bridges are not strong. They may occasionally break or come off. If this should happen to you, please contact our office immediately, bring your crown or bridge with you and we will replace it. Should you be unable to contact us, simply go to a pharmacy and purchase Fixodent. Replace the temporary crown or bridge on your tooth using a small amount of Fixodent to hold it in place until you can contact us.
4) Please do not leave the temporary crown or bridge out of your mouth. Without the temporary crown or bridge your teeth may move and then the final crown or bridge may not fit!
5) Do not brush or floss too vigorously around your temporary crown or bridge. Remember it is important to keep the area clean –but use caution and a gentle touch.

The occlusal bite splint you have received serves to aid in reduction of muscle tension, decrease painful symptoms, protect the teeth, and/or maintain the teeth in one position.

Following is a list of information and helpful hints concerning your splint.

· The splint should be worn regularly as instructed.
· Saliva flow will increase during approximately the first two weeks of wearing the splint. This is normal.
· Each time the splint is placed over your teeth, it will feel somewhat tight for a few minutes. This is normal.
· When the splint is not to be worn for more than 1-2 hours, it should be kept moist.
· Regular periodic check-ups should be made of the adjustment and fit of your splint. If no ongoing appointments are made, do not wear your splint more than 4-6 months without having the fit and adjustment checked.
· Your splint should be kept clean just as your teeth should. Bad breath and/or a bad taste may result from neglect in this area. Brush your splint with toothbrush and toothpaste after each wearing. You may also use denture cleanser periodically to help keep it fresh.
· You may find it difficult to pronounce certain words when the splint is first worn. After a few days, speech will return to almost normal. Practice reading a news paper aloud in private to help learn new speaking skills.
· You should not continuously bite or clench on the splint. It is to help you relax, not exercise.