Post Operative Instructions

Click on any of the Post Operative Instructions below to find more about a specific issue:

Fillings and Crowns

I just had a filling and/or a crown placed and my tooth is sensitive.  What do I do?

  • For many reasons it is normal for a tooth recently worked on to be slightly sensitive to cold or mildly sore for 1-3 days.  These symptoms normally subside.
  • If the soreness or cold sensitivity persists and/or worsens 2-3 weeks after the work was done, call our office to schedule a follow-up visit.
    • Most commonly the “bite” or occlusion needs adjusting.  Why?  Because when a filling or a crown is placed, a new chewing surface for your tooth is created.  And because your tooth sits in a ligament, your bite can spring up, changing the position of the bite, even after you leave the office!!
  • A tooth that receives a new filling or crown may very rarely but sometimes need a root canal.  Why?  Despite our best efforts to fix a broken tooth or deep cavity, sometimes the damage done by bacteria is too much for the nerve to bear.  In this case, root canal treatment is the only way to relive the symptoms.

I have a single temporary crown that fell out.  What can I do?

  • If you still have your temporary crown you can attempt to put it back in place with a temporary cement purchased from the pharmacy; just make sure you try it in first!  Other sticky things that work well to hold a temporary crown in place for a few days until you visit the office:  Fixodent, toothpaste, Vaseline.
  • If your temporary crown is cracked, broken, or lost, call our office to schedule a visit and a new temporary crown can be made for you. 
Tooth Extraction
  • After a tooth extraction, you may feel some pain and/or swelling. Before you leave the office, Dr. Hirshberg will prescribe any necessary medications and send you with an ice pack to reduce any swelling. The following is further information regarding this procedure.
  • Bleeding - After an tooth extraction, a folded gauze pack is placed over the extraction site to assist the blood clot to form.   Keep pressure on it for 30 to 45 minutes and replace if bleeding continues. Slight bleeding may occur up to 2 days. Avoid activities that could apply a suction action to the blood clot such as smoking or drinking through a straw.
  • If excessive seeping of blood persists, bite on a moist tea bag for 30 minutes to 1 hour to help with clotting. (This will also help stop bleeding)
  • Exercise - Limit vigorous physical activity for 24 hours after the tooth extraction.
  • Rinsing - Do not rinse your mouth today. Tomorrow you can rinse your mouth gently with a glass of warm water mixed with 1 teaspoon of salt. You can do this 3-4 times a day especially after meals.
  • Swelling - Following a tooth extraction, some swelling and skin bruising may occur. A cold moist cloth or an ice bag applied to the cheek will keep it to a minimum. Place on affected area for about 15-20 minutes of every hour for the next 6 hours.
  • Medications - If ibuprofen or acetaminophen taken as directed doesn't relieve the discomfort you may experience, a stronger medication can be prescribed. If antibiotics are prescribed to you, it is imperative that you take them for the time indicated, even if you are no longer feeling any symptoms.
  • Food - A light diet with plenty of fluids is recommended the first day. Chewing should be done away from the extraction site.
  • Oral Hygiene - Continue brushing and flossing and being extra gentle near the extraction site.
  • Bony Fragments - During healing you may notice small bony fragments working their way through the gums. This is normal. Please call your specific doctor from The Hirshberg Dental Group at 617-542-8808 for an appointment to remove these if they do not dislodge on their own. We can easily remove them if they are too annoying.

Signs of an Infection
If your face or jaw swells up noticeably and/or if you develop a fever, you may have a dental infection.   Please call our emergency line and a prescription or an antibiotic would be appropriate.

Emergency Products Available at Your Pharmacy

  • For loss of fillings- temporary fill
  • For loose crown (either temp or perm)- temporary cement
  • For broken tooth- temporary material that can cover the tooth and make a temporary cap
  • For tooth pain- have various medications to apply that will temporarily relieve tooth pain
  • For canker sores- various medications that are topical applications to relieve pain

All products vary from $5 to $15.

Periodontal Gum Surgery
  • When the anesthesia wears off, you may experience some discomfort. In order to help you during this period, please take the prescribed medication if needed. Anti-inflammatory medications such as Advil or Motrin are most useful when taken regularly for 5 days.
  • If a post-operative antibiotic was prescribed, please complete the prescription, unless instructed otherwise. If you experience a reaction such as a rash, stop taking the medication and please call.
  • It is common to notice light bleeding for up to 3 days after the surgery.  If there is more considerable bleeding, apply pressure by squeezing a moist gauze pad over the area for 10 minutes (a moist non-herbal tea-bag can be used). Repeat this up to 45 minutes. Do not rinse vigorously as this will increase the bleeding.
  • Post-operative swelling increases three days after a procedure and may last for two or three days. To help reduce this, for 4 hours after surgery, an ice-pack may be applied to the cheek, alternating on and off for periods of 5-10 minutes. Often bruising is noted a few days after the procedure and warm moist heat is helpful. This can be accomplished by the use of a moist wash-cloth or a gel-pak from a pharmacy.
  • Please limit yourself to a soft diet for 3 to 5 days. Try to maintain a balanced diet and increase clear fluids. Do not drink through a straw for 24 hours as this creates suction which may cause or increase bleeding.  Try to avoid extremely hot or cold foods and drinks, carbonated beverages, highly seasoned and sticky foods.
  • You may rinse your mouth gently every 3-4 hours with a glass of warm water mixed with 1/2 teaspoon of salt.  This is to promote healing and removes food which accumulates. This can be repeated as needed.
  • Do not brush the surgical area for at least one week and resume there when instructed. You should brush in your regular routine the other areas of your mouth. If a prescription mouthwash was given, 1/2 capful should be used after brushing, as directed. It is very important that your mouth be kept as clean and plaque-free as possible.

You may resume your regular activities but should avoid excessive exertion for one week. Exercise should be limited to light aerobic activity without elevating your blood pressure.

Implants

We have done our best to provide you with a well-fitted, functional, and esthetic implant prosthesis. We feel confident that you will adjust to these artificial teeth rapidly, and that you will have many years of satisfaction from them.

1. Your First Few Weeks: For several days, please chew more carefully than normal on these restorations. We will adjust the bite (occlusion) on future appointments until the teeth are well balanced. After you have adjusted to the prosthesis, it should function in a similar manner to natural teeth.

2. Cleaning the Implants and Prosthesis: The continuing success of the implants and prosthesis is up to you. Please do the following (items are checked):

a. Visit us for examination and cleaning of the teeth and prosthesis at least once every ______months.
b. Clean the implant(s) and prostheses daily, especially before bedtime using:
_____ Toothbrush
_____ Mechanical toothbrush
_____ Floss
_____ Bridge cleaner
_____ Water Pik
_____ Peridex

Please ask us about anything that is unclear relative to proper cleaning.

3. The Future:Your examination and professional cleaning appointments are very important to the long-term success of your implants and prosthesis. If your personal and professional cleanings and your examination appointments are accomplished routinely, your restorations should serve many years. Please contact us if any of the conditions below occur:

• Awareness of looseness
• Peculiar taste
• Clicking or metallic snap while eating
• Breakage of a piece of the prosthesis
• Redness in the gum tissue around the implant
• Feeling of the bite being different
• Pain

We look forward to helping you enjoy your new implant supported prosthesis.

Fixed Bridges
  • A typical bridge procedure involves two (2) visits. The first appointment is to prepare your tooth/teeth for a permanent restoration. The second appointment is the permanent placement of your restoration.
  • Following the first appointment for a bridge procedure, it is normal to experience some hot and cold sensitivity. Ibuprofen or acetaminophen taken as directed will help alleviate these symptoms. Your gums may also feel sensitive and warm salt water rinses (one teaspoon of salt dissolved in 1 cup of warm water) 3 or more times a day will ease this discomfort.
  • For about an hour after the cementation of your temporary crown, avoid eating any hard, sticky or chewy substances. If this temporary crown comes off between appointments, slip it back on or call our office immediately for recementation.
  • Permanent Seat appointment of your crown: After the final cementation of your fixed restoration, it may take a few days to get used to the new bridge. You may experience some discomfort that ibuprofen or acetaminophen should alleviate.
  • If you feel the bite is not correctly balanced, be sure and call for an appointment for a simple adjustment.  Do not overlook calling us, even if it appears that the bite is off slightly. This slight amount can make the tooth sensitive to pressure, hot, and cold, and also potentionally cause pain in the neck, head and jaw.  Please avoid this pain by calling us immediately for a simple adjustment appointment.
  • Proper oral hygiene such as brushing, flossing, and rubber tipping is recommended to help you retain your final restoration.
  • Please call the office if you experience any unusual or lingering symptoms.
Removable Bridges

We have done our best to provide you with well-fitted, functional, and esthetic removable partial dentures. We feel confident that after a few weeks of becoming adjusted to the new partial dentures, you will have years of satisfaction and use from them.

1. The First Few Weeks: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.

2. Sore Spots: Usually, your mouth will have a few “sore spots” after wearing the dentures for 24 hours. Don’t worry about these areas. They can be relieved with very little effort during your next appointment. Another appointment about 7 days later will usually eliminate any other sore areas.

3. Chewing: The new bite will not feel comfortable for a period of days. We will adjust the contacting surfaces of your teeth in 24 hours and again about one week after the dentures have “settled” into place.

4. Cleaning the Dentures and Your Mouth:Your dentures can be cleaned by using a soft bristle toothbrush and a mild denture cleaning paste. Use special care to clean the parts of the partial denture that contact natural teeth. Both the partial denture and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting. Use fluoride-containing toothpaste for the natural teeth. If suggested by us, use high fluoride-containing toothpaste such as PreviDent (Colgate) as a brush-on material on a daily basis. This product requires a prescription from us.

Denture soaks or cleaners are also useful to help in removing debris from the denture. Please ask us if you are interested in small “sonic” cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water to avoid dehydration and warping.

5. The Future:Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This shrinkage is one of the main disadvantages of artificial dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us at least once every 6 months. We will inform you when refitting of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and serious oral diseases.

We look forward to helping you enjoy your new partial dentures.

Root Canal
  • Endodontic treatment can take 1, 2 or 3 appointments depending on each case.  It is possible to experience any of the following symptoms after any one of these appointments:
  • - sensitivity to hot and/or cold
    - sensitivity to pressure
    - possible swelling
    It is difficult to predict which symptoms, if any, you may experience and to what extent. In complicated cases, pain medication may be necessary.
  • If you experience swelling. It may be necessary to prescribe an antibiotic for you.
  • A temporary filling may be used to seal the tooth between visits. Avoid eating hard, sticky or chewy foods in this area. If this filling comes off in between visits, please call our office to schedule a time to replace the temporary filling.
  • Be gentle on the tooth while eating until the final restoration is placed. It is common to feel discomfort for several day after the procedure. Ibuprofen and acetaminophen taken as directed may help alleviate symptoms.

Please call the office if you experience any unusual or lingering symptoms.