Pre And Post-Operative Care For Filling And Crowns
It is our mission at Rocky Mountain Dental that you do not have pain or sensitivity following the treatment of your teeth. Our heart goes into our work and it is our desire that you do not suffer following treatment. The following advice has helped many of our patients minimize the recovery period to an absolute minimum. It is also our desire that the work we perform in your mouth lasts for a very long time.
Prior to having any fillings or crowns placed it is very important to keep your mouth as clean as possible. Mouth bacteria causes the gums to bleed and directly interferes with the chemical bonding process that is CRITICAL for long term stability of fillings and crowns. The most permanent dentistry is placed on teeth that are perfectly clean and whose gums are not bleeding. Brush and floss as frequently as possible 7-14 days leading up to your appointment. Definitely brush and floss prior to your appointment to provide the best chance at long term success. The ultimate protocol is to have our hygienist clean your teeth 1-2 weeks before starting treatment. This is highly recommended that we clean your teeth prior to working on your teeth if it has been more than 6 months since your last professional cleaning.
Taking pain medication such as Advil (Ibuprofen) or Tylenol (Acetaminophen/Paracetamol) at the start of the appointment will ensure maximum comfort. If anaesthetic was not used, almost every patient would have pain at the end of the procedure. Because we use anaesthetic in every case, nobody feels pain immediately following the procedure. The pain is there but it is being covered up by the numbing effects.
Once the procedure is finished we recommend to continue taking pain medication for a specific time period, based on your specific procedure and Dr. Choubal's judgment. If 400mg of Advil is taken at the start of the appointment we highly recommend taking 500mg Tylenol 4 hours after. Four hours after the Tylenol, take another 400mg Advil; wait another 4 hours and take 500mg Tylenol. Setting an alarm in the middle of the night is not absolutely necessary but certainly helpful in minimizing your recovery. This medication regime is continued for a certain number of days that Dr. Choubal will decide for you.
While you are still feeling numb (even just a little bit) consume only liquids. When the lip, cheek and tongue are numb they feel the same as food to the teeth which is very dangerous. Anything that can be drank is safe, test hot liquids with your finger to avoid inadvertently burning yourself. Along with preventive pain medications we advise eating a very soft diet that does NOT contain hard, crunchy or chewy foods such as nuts, almonds, steak, beef jerky and so forth. The teeth, gums, jaw joints and tissues of your mouth have been traumatized to a degree and everything needs to rest for a few days. The same length of time that you are advised to take medications is the same number of days to eat soft, easy to chew foods.
While you may return to normal function after a week or so, we should note that hard crunchy foods are generally discouraged and should be avoided whenever possible. Even a perfect crown or filling is at the mercy of your jaw muscles. The more continued force that is applied to a tooth that has been filled or crowned, the shorter its lifetime and the sooner will be the need for treating that tooth again. Hard foods can also cause sudden injury to teeth, chronic sensitivity, contribute to gum recession and jaw joint problems. Almonds, nuts, granola, tail mix, large raw carrots are examples of what to avoid, especially if these items are in your backpack during the winter months while you are on the ski hill, hike or backcountry tour.
Maintaining excellent hygiene practices will make your fillings and crowns last longer. Brush and floss everyday and have your teeth cleaned in the interval that has been recommended. While some of this advise will be inconvenient to some it most definitely will add several years to the lifetime of your fillings and crowns.
Preparation For Dental Surgery
The following advice comes with the following intentions:
- To minimize pain, swelling and suffering to an absolute minimum after surgery is performed in the mouth.
- Accelerate healing as much as possible so the patient can return to their normal activities as soon as possible.
Keep your mouth, teeth and gums as clean as possible for 4 weeks prior to surgery. Whenever possible, have a professional cleaning by our hygienist within 60 days of your surgery. Mouth bacteria can build up quickly and is extremely toxic to a surgical site. We have observed many more complications in patients that have more bacteria in the mouth at the time of surgery.
Eat 3-4 servings of Oranges and Tomatoes for 4 weeks prior to surgery. Orange juice that is not from concentrate (Tropicana) and Tomato juice (not Clamato) can also be used as a serving. These foods dramatically improve your body's ability to heal itself. We have observed that loading the body with the nutrients from these foods 4 weeks before and 4 weeks after surgery shortens the healing time significantly
Avoid all tobacco products for 4 weeks prior to surgery and one week after surgery. Tobacco products greatly impair your body's ability to heal and is therefore strongly discouraged. Complications such as prolonged pain, dry socket and infection are much more likely in the presence of tobacco.
PRF – Platelet Rich Fibrin is an advanced regenerative treatment that amplifies your body's natural healing properties. Your blood is drawn in vials and placed in a centrifuge, the result is gel-like tissue that forms in the vials. This tissue contains highly concentrated amounts for healing factors, platelets, white blood cells and stem cells. It is stitched into surgical sites and not only provides rapid healing but also minimizes complications. We use this technique in almost every surgical procedure because it is so effective.
If you are going to be sedated do not eat or drink anything 6 hours prior to your appointment. Small amounts of clear liquids are acceptable. Also, do not take any narcotic pain medications or substances that contain alcohol, codeine, percocet, oxycontin, oxycdodone, phentanyl and morphine. Unless permission has been given by Dr. Choubal please do not consume any medications 24 hours prior to sedation. If you are receiving laughing gas (nitrous oxide) you may leave the office unescorted and drive. If you are receiving IV sedation you MUST have a responsible adult take you from our office to your home. If you are receiving IV sedation, do not operate a motor vehicle, power tools or machinery for 24 hours. Do not operate an aircraft for at least 48 hours and do not sign or enter into any legally binding contract for 24 hours.
After surgery it is critical that the surgical site remains stationary/still while it is healing. Movement of the surgical site is associated with improper healing, higher rate of infections and more pain. The following list are normal activities that should be avoided for 7 days following surgery to prevent MOVEMENT of area operated on:
To assist you in avoiding these activities, do not use toothpaste for 7 days following surgery. Toothpaste use inevitably leads to the need for both rinsing and spitting. Milkshakes and liquid drinks are essential when the mouth has been operated on but the sucking action caused by using straws causes lots of movement in surgical sites. Plan to use a spoon or drink by the glass.
You will be biting gently on gauze when you leave our office. Change this gauze every 40-60 minutes until you go to sleep. The gauze can be temporarily removed for consuming liquid foods or cleaning the teeth. If any prolonged bleeding is experienced, soak a few tea bags in cold water and then gently bite on the tea bag as if it were the gauze. Keep the tea bag in for 15-20 minutes, repeat as needed.
Rinsing for salt water is NOT advised. Rinsing and swishing with any liquid is not advised to 7 days following surgery. To keep the surgical site clean you will be given a blunt curved syringe and/or elongated Q-tips and a medicated liquid ointment. Any liquid can be used to gently irrigate/flush the wound clean. You may start using the syringe 48 hours AFTER surgery. You may clean the area with this technique 3-6 times a day. Tap water is most commonly used but you may also use mouthwash or saltwater in the syringe.
Take pain medication before you experience pain. To minimize pain levels, we recommend alternating doses of Advil (Ibuprofen) and Tylenol (Acetaminophen/Paracetamol) every 4 hours. For example, while you are still numb take 400mg Advil and 4 hours later take 500mg Tylenol. 4 hours after the Tylenol take 400mg Advil and repeat this cycle for 5 days regardless of whether you are in pain or not. This strategy is very effective in managing pain and minimizes the need for narcotics that have considerable side effects. We have found that preventing the onset of pain is much more effective and simple that waiting for pain to arrive and then trying to alleviate it with medications. If you are unable to take one or both of these medications, please advise us and we will provide alternatives.
Do not sleep flat in bed for 5 days. When you are flat, blood rushes to the head and will increase swelling and pain levels. Using pillows and blankets, make yourself a ramp so that your upper body can rest at an incline and place you head elevated above heart and feel. This keeps blood pressures in the head lower and prevents pain from waking you up at night.
Dr Choubal can be reached after hours for any reason at 4037602127. Call or text anytime and please leave a message if there is no answer.