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POST-OPERATIVE INSTRUCTIONS

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These instructions are written for the use of dental assistants. Dental assistants have the
responsibility of teaching the patient these points after treatment is rendered. But while
dental assistants are primarily responsible for communicating these instructions to the
patient, all dental office staff should be familiar with them, since all will be asked questions
by patients.
General Post-Operative Procedure
1. Dental assistants should always show the patient the work that has been done. Dont
ask if they want you to show them just show them. Have the patient reclined, with the
operating light on. Make sure they get as clear a view of the work as you can, using a dental
mirror and something to point with. Show them every tooth that was worked on, and as you
let them see the work, then give the instructions as listed below.
2. Inspect the chart to see if todays work is entered. If it has, pack up the chart. If it
hasnt, leave the chart in the room, open, so that the doctor will remember to write in it.
3. The dental assistant should either walk the patient to the business desk to check out,
pay, and make their next appointment; or the dental assistant should direct them to the
business desk.
POST-OPERATIVE INSTRUCTIONS FOR ENDODONTIC TREATMENT:
Will be tender tenderness will go away as the body heals this irritated ligament that
attaches the tooth to the jaw.
Could be very sore. The tooth could flare up with pain and swelling. If it does, the patient
needs to call.
The tooth is weakened until the crown is done, and unless it has a temporary crown on it,
they should be careful with it. Minor chipping of the tooth or slight loss of the Cavit is no
problem; but, if the tooth has a large hole, biting normally on the tooth before it is fully
restored could cause a serious fracture that would jeopardize the life expectancy of the
tooth. They need to be especially careful if the tooth is missing both the mesial and distal
surfaces, because a fracture down the middle could ruin the tooth.
POST-OPERATIVE INSTRUCTIONS FOR EXTRACTIONS:
Familiarize yourself with the instructions in the post-extraction brochure Tooth
Extraction by the American Dental Association.
The patient needs to sit still for a few minutes immediately after an extraction to be sure
a blood clot has formed. Recommended rest times:
partially resorbed deciduous tooth

0-2 min.

deciduous tooth with full root


permanent tooth simple extraction

5-10 min.
abt. 10 min.

flap extraction

abt. 30 min.

patient with a lot of bleeding

abt. 45 min.

After simple extractions, the dental assistant should tell the patient
1. After leaving the office, be somewhat still, without strenuous activity and without
sucking or spitting, for about two hours. If thick bleeding (pink saliva is normal real, red
bleeding with blood clots, etc. isnt) recurs, use the gauze packs according to the
instructions in the post-extraction brochure.
2. For pain, take Tylenol or ibuprofen.
After any kind of flap extraction , the dental assistant should tell the patient
1. The same instruction as above on bleeding.
2. There will be some swelling. The more extensive the flap and the more extensive the
procedure, the more swelling there will be. (Never underestimate the amount of swelling or
discomfort the patient can expect.) Use ice packs by the surgical site today and maybe
tomorrow, but not past tomorrow. Keeping the head somewhat elevated overnight with
something like an extra pillow will also help to keep the swelling down.
3. Gently rinse the mouth after meals tomorrow with warm salt water according to the
directions in the pamphlet.
4. There will be pain and it will be hard to open your mouth very far. Generally these
patients are given prescription pain medication. Take the pain medication according to the
instructions given with the prescription.
5. Brush and floss most of your teeth today. Starting tomorrow, also brush the teeth next
to the extraction site, but do it gently.
6. Eat only soft things today. After today, eat what you feel like you can handlelisten
to your body.

POST-OPERATIVE INSTRUCTIONS FOR COMPOSITE FILLINGS:


Posterior or Anterior Composites:
Be sure the patient understands the benefits of composite restorations over amalgams.

1. Unlike amalgam, composites are at their full strength at the end of the appointment.
They are strong enough to chew on right away, as long as the numbness has worn off (so
they dont inadvertently chew their tongue or something.)
2. With an amalgam, the tooth will always be more sensitive to cold (because metal
conducts cold so well). The composite, however, is an excellent insulator, so the only
sensitivity we expect is the irritation to the tooth from our having worked on it, which
should last only a couple of days. If there is sensitivity that doesnt get any better after a
couple of weeks, or if any sensitivity occurs that seems to get worse, they should call the
office.
3. Composites are so hard that they will not mold to the bite after the appointment. If
they feel high after the anesthetic wears off, they should call to have the bite adjusted.
4. Point out that with a composite restoration, most of the original strength of the tooth
is restored, and the tooth is much less likely to break than with an amalgam.
5. Check the tooth with floss before dismissing the patient. If they have any difficulty
flossing, or if floss snags around the filling, or if there are any rough or sharp places, they
should call the office and have it smoothed.
Preventive Resin Restorations (and Sealants)
1. Be sure patient is aware of the superiority of this conservative filling technique as
opposed to the old-style amalgam filling. The preventive resin is a very small filling that only
fills the area of decay, and is usually less than th the size of what an amalgam would have
been.
2. For no additional cost, a milky white plastic layer has been placed over the grooves
(rather than have amalgam fill all the grooves as we used to do). This may make the tooth
feel high to the bite. If a patient is under 20 years old, the bite will adjust itself in time,
and it is better not to grind away this protective plastic coating in order to adjust the bite.
Older patients may require adjusting if the bite later feels high.
Anterior Composite Bonding
1. If bonding develops spots that snag the floss, they should contact the office.
2. It is important to keep the edges of bonding clean by brushing, flossing, and keeping
plaque amounts down by avoiding between-meal sugary or starchy snacks.
3. If bonding extends onto the biting edges of front teeth, the patient needs to be aware
that these edges are not as strong as their natural teeth. Avoid biting directly on these
edges, especially biting on hard objects such as bones, pins, etc.
POST-OPERATIVE INSTRUCTIONS FOR TEMPORARY CROWNS
1. Its important to keep the tooth and temporary crown clean between appointments by
brushing and flossing. If the tissue gets too irritated because the tooth has not been kept
clean, it will be hard to keep the bleeding off the tooth when we try to bond or cement the
permanent crown.

2. Brush normally. When they floss around a temporary crown, be sure to pull the floss
out sideways rather than snapping it out through the contacts as this could risk loosening
the temporary.
3. Because of the shape of some teeth, some temporary crowns can be difficult to keep
on. While we try to make them so they dont come off between appointments, we also try to
make them so they will come off easily when we want them to. If it does come off before its
time, the patient should come in right away to get it put back on. Going two days or more
without a temporary crown will probably cause the tooth to move. If it moves enough, the
permanent crown may not fit.
POST-OPERATIVE INSTRUCTIONS FOR PERMANENT CROWNS
1. Crowns are a very durable restoration, and we ordinarily look for at least ten to fifteen
years of trouble-free service out of a crown. They should be able to chew without sensitivity
with a crown. If there is any chewing sensitivity, they should come in for an adjustment.
2. They need to give the cement one hour to fully harden before chewing, then they can
eat what they want.
3. They need to floss around the crown and brush well, as the part of the tooth that is
not covered by the crown, especially the margin where the tooth meets the crown, is still
susceptible to decay. There is no need to worry about pulling the crown off if they floss
our doctors crowns are very secure.
4. The tooth could be sensitive to cold for a few weeks. If it is sensitive for longer than
that, or if there is any increase in sensitivity over time, they should come in and have the
tooth checked.
POST-OPERATIVE INSTRUCTIONS FOR PORCELAIN VENEERS
1. The veneer may make the tooth feel thicker. The veneer, however, is only as thick as a
fingernail, except in those places where a tooth was crooked, and extra thickness of
porcelain was used to make the tooth look straight. It usually seems thicker right when the
veneer is placed because we made the teeth slightly thinner in preparing them.
2. For the most part, the patient can chew normally. However, it would be wise to be
careful with activities that stress the teeth, such as chewing ice or metal objects.
3. Patients involved in contact sports, or who clench or grind their teeth at night should
wear a protective mouthguard or nightguard to help prevent chipping of the veneers.
4. Brush and floss conscientiously to protect your investment. Special cleaning
procedures by the hygienist can help keep the margins of the veneers bright and extend
their life. We recommend twice yearly veneer maintenance in addition to the twice yearly
regular cleanings.
POST-OPERATIVE INSTRUCTIONS FOR FULL DENTURES

1. Familiarize yourself with the instructions in the ADA brochure Your New Dentures.
Know this information backwards and forward and be able to explain the reasons for all of
the instructions.
2. Explain to the patient how to clean the dentures and how to adjust to wearing them.
Answer all of the patients questions.
3. We assume that the denture will need a couple of adjustments. Be sure the patient is
scheduled for the adjustment dont just tell them to call in case they need an adjustment.
Dont create the expectation that there may be no sore spots or adjustments required. In
preparation for the adjustment appointment, they need to be sure we can see the sore
place. Therefore, its important for the patient to continue to wear the denture in spite of
the sore spot, or we may be unable to help them.
POST-OPERATIVE INSTRUCTIONS FOR PARTIAL DENTURES
1. Again, be totally familiar with all of the instructions in the brochure, Removable Partial
Dentures. Be prepared to explain these items fully to the patient, and be sure you
understand all of the reasons for the instructions.
2. Again, if there are sore places, the patient needs to continue to wear the partial so
that we can identify those places. They need to be scheduled for the first adjustment dont
wait till it hurts.
3. The partial will move a little bit during chewing, but there should be no major shifting
or rocking during use. The difference between normal movement and major shifting would
be that in major shifting, the position of the clasps on the teeth may change. Major shifting
requires an office visit for an adjustment.