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Post Operative Instructions

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Please select the procedure you received to see a summary of post-op instructions. Call us if you have any questions:


1- Pressure should be placed on the gauze pad that has been put over the extraction site for one hour. If the bleeding continues new gauze should be placed and pressure applied for another 45 minutes.

2- If you are supervising children who have had an extraction done, make sure they don't bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

3- Avoid eating or drinking anything hot on the day of your extraction. Also, do not rinse your mouth and do not use a straw for drinking. Do not spit and do not drink carbonated beverages. Do not brush on the day of the surgery; you can gently resume your brushing and flossing the day after.

4- You may experience some pain, bruising around your lips, and/or some swelling, especially after extraction of impacted wisdom teeth. Ice bag application and medication prescribed for you will help to minimize your discomfort.

5- Please take all the medication you have received based on the provided instructions.

6- During the first 2-3 days after surgery a diet of soft food and liquids is recommended (soup, yogurt, milkshakes and juice).

7- For more complex surgical procedures, including Impacted Wisdom Tooth Extraction, Implant Surgical Procedures, etc: You will receive an ice wrap which should be worn for the rest of the day until you go to bed on the day of surgery (10 minutes on and 5 minutes off). Instructions for various surgical treatments will have some unique directions, which will be supplied to you at the time of your treatment.

8- Call our office if you experience excessive bleeding, severe pain or swelling, or if you have any questions or concerns. In case of serious emergencies call 911.


1- Do not eat on your new filling for one hour and until your numbness is gone.

2- If you are supervising children who had fillings done, make sure they don't bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

3- Do not bite hard or chew on silver amalgam fillings for 24 hours.

4- You may experience cold and heat sensitivity and some gum soreness; this usually subsides within a few days.

5- Call our office if you experience pain or discomfort for more than a few days after the fillings, or if you have any questions.

Crowns and Bridges (also Inlays and Onlays):

1- Crowns and bridges usually take 2 or 3 appointments to complete. On the first appointment, the tooth/teeth are prepared, impressions are taken, and a temporary crown is placed on your tooth/teeth.

2- You may experience sensitivity, gum soreness, and slight discomfort on the tooth/teeth; it should subside after the placement of the permanent crown(s).

3- Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.

4- A temporary crown is usually made of plastic-based material or soft metal. It can break if too much pressure is placed on it. The crown may also come off; if it does, save the crown and call our office. The temporary crown is placed to protect the tooth and prevent other teeth from moving. If it comes off it should be replaced as soon as possible. To avoid losing your temporary, do not chew on sticky or hard food (chewing gum, ice). Try to chew on the opposite side of the temporary as much as possible.

5- Continue your normal brushing but be careful while flossing around the temporaries (remove the floss gently from the side). If it is difficult to get the floss between the temporary and surrounding teeth, refrain from flossing until you receive your permanent crown.

6- After the permanent restoration is placed you may feel slight pressure for a few days. Also, the bite may feel different for a day or two. But if after 2-3 days the bite still feels uneven or if you feel discomfort when chewing on the tooth, call our office. Delaying the necessary adjustments may damage the tooth permanently.

7- Call our office if you are in pain or if you have any questions.

Root Canal Treatment:

1- You may experience moderate pain and sensitivity to pressure on your tooth. Also, you may feel gum soreness for few days after your treatment. The healing process may take several days but the pain and discomfort should subside gradually.

2- Take any medication that was prescribed for you according to instructions.

3- Usually a temporary filling has been placed on your tooth; do not bite on the tooth for one hour and while you are numb. Also, until the permanent restoration is placed, be very gentle with the tooth. Try to chew with the opposite side.

4- Continue your brushing and flossing.

5- Follow up with the placement of your permanent restoration as you have been advised. Any unnecessary delay in placement of final restoration may damage the tooth permanently.

6- Call our office if you are in severe pain or experience swelling, or if you have any questions.

Teeth Cleaning (Deep Cleaning):

1- You may experience some cold and heat sensitivity (especially after deep cleaning).

2- If you have received anesthesia do not eat anything until the numbness has worn off.

3- Continue your regular brushing and flossing.

4- Some bleeding for a day or two after cleaning is normal, but if you
experience any excessive bleeding call our office.

5- Call our office if you are in pain or if you have any questions.

Placement of Braces:

1- You may experience some pressure and discomfort on your teeth.

2- Be gentle with braces and avoid chewing hard and/or sticky food.

3- Brushing and flossing around braces is sometimes challenging and time consuming, but very important.

4- Call our office if you have any questions.

Gum Surgery:

1- You may experience some pain, swelling, and bleeding after the surgery.

2- Take all medication that was prescribed for you according to instructions.

3- Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.

4- Keep your next appointment on time for removal of sutures and follow up

5- DO NOT raise your lips with your fingers to inspect the treated area.

6- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

7- There is often a temporary loss of feeling in the operated area and the tooth may feel loose.

8- Do not smoke, spit, or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

9- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.

Implant Surgery:

1- You may experience some discomfort and bleeding the day of the surgery.

2- Take all medication that was prescribed for you according to instructions.

3- Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.

4- Keep your next appointment on time for removal of sutures and follow up checks.

5- DO NOT raise your lips with your fingers to inspect the treated area.

6- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

7- There is often a temporary loss of feeling in the operated area and the
tooth may feel loose.

8- Do not smoke, spit, or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

9- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.

Denture Delivery:

1- You will experience some discomfort with any new denture for a few days. All new dentures need several adjustments to completely and comfortably fit your mouth.

2- You should take the dentures out every night and keep them in a clean container filled with water or denture cleaning solution. Your gums need to rest and be without the dentures every day for a period of time.

3- Clean dentures thoroughly with a brush and water before putting them back in your mouth.

4- It may be difficult to talk normally with the new dentures for a few days. One way to practice is to read a book or newspaper out loud for a period of time everyday. Your tongue and muscles will get used to the new dentures and you will talk normally very soon.

5- Call our office if you are experiencing pain, discomfort, or if you have any questions.

Apicoectomy (Root Canal Surgery):

1- Swelling, minor pain and/or skin discoloration may be experienced following the surgical procedure. This will be temporary.

2- In order to keep the swelling to a minimum, use an ice pack for the first few hours after surgery (on for 10 minutes and off for 5 minutes).

3- The day after the surgery, use lukewarm water rinses for the treated area following each meal. This should continue for the first 3 days following the surgical procedure.

4- Eat only soft foods. Avoid hard and chewy foods.

5- Get plenty of rest and insure normal intake of food, especially liquids such as fruit juices, soup, and milk. Use a vitamin supplement if desired. Try not to sleep on the operated area for 2-3 days.

6- DO NOT raise your lips with your fingers to inspect the treated area.

7- DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.

8- There is often a temporary loss of feeling in the operated area and the tooth may feel loose.

9- Take all medication that was prescribed for you according to instructions.

10- Should any difficulties occur, do not hesitate to call our office anytime. In case of serious emergencies call 911.

Bone Graft Surgery

You have just had surgery completed for the reduction of periodontal pocketing and/or for replacement of bone in an area where pathology existed, or in conjunction with endosseous dental implant surgical placement with or without platelet addition to the bone graft. You will be advised of the particular procedure and pertinent directions relative to your treatment modality. Whether you were put to sleep for this procedure or were only given local anesthesia, the post-operative instructions remain the same.

You will have several sutures (stitches) placed at the surgical site. These sutures may or may not be resorbable. If you have been told that you received external silk sutures, they have to be removed by us. The sutures will cause a pulling of your tissue over the bone grafting site. Since the bone graft site will have approximately 15 % more bone fill than what was naturally there, it is imperative that you do not pull up your lips or cheeks to show or examine the area. The undue pressure will cause the sutures to widen away from the surgical site, expose bone, create more pain, and delay healing dramatically. This delay can lead to the need for the area to be sutured again when you are seen for your 1 week post-surgical evaluation. The sutures will remain in place for 2 to 3 weeks depending on the size of the graft, the severity of the pathology, and the condition of the tissue being sutured.

Your doctor will tell you what time period to expect, but keep in mind that this is not etched in stone and the doctor may extend the time before your sutures are removed to assure adequate healing and to avoid surgical regression.

You also may have a periodontal pack placed over the surgical site. The pack is pink in color and impregnated with antibiotic, which will protect the surgical site from infection and any washout of the particulate bone utilized to restore your jaw. The pack should be left in place for as long as possible. If a pack is placed the doctor will remove the packing at your 1 week follow up and decide if the packing should be replaced or kept off. Usually the packing is kept on for 7 to 10 days at a minimum. You must return to the office if your pack falls off before you are seen for your 1 week follow up.

Your maintenance during healing has to be completed carefully. You can brush in every area except where the periodontal pack is placed. It is imperative that you use NO ASTRINGENTS such as mouth wash or antiseptic solutions during the healing period of your bone graft. Listerine, Viadent, or any other potentially caustic agent can RUIN your bone grafting procedure if contaminated, and require a replacement bone graft. The doctor and our staff will reiterate this to you at, during, and after your bone graft surgical procedure. After the first stages of healing are satisfactory, we will provide you with normal saline and instruct you on how to use it (with or without the addition of salt), as well as irrigation syringes for cleaning the surgical site.

Since bone grows and heals slowly, it requires conditions conducive to a proper environment and blood supply. Thus, it is imperative that immediately after your bone graft you alter your diet, as you would for any oral surgical procedure. This means that you should not eat anything that is too large, too hot, or too sticky. Your food should be tepid or on the cool side. Any food that is too hot will have a deleterious effect on your surgical procedure. Common sense must be used in determining what should be done or avoided. If for some reason you have questions about anything post-surgically, please call the office and we will inform you of the proper action to take.

Smoking after any oral surgical procedure will ALWAYS delay or disrupt normal healing due to a decrease in oxygenation of the tissue that is healing. Smoking should therefore be stopped for the first 7 to 10 days to allow for adequate initial tissue closure. Complete epithilization (closure) and wound healing normally takes a minimum of 21 days from the day the surgery was completed under ideal healing conditions, and with no other underlying systemic causes such as Diabetes Melitus, etc.

Bone grafting is a very predictable surgical procedure when done correctly and when patient cooperation is adhered to. Please try to be reasonable in understanding that this procedure has inherent risks associated with it, as stated in your informed consents. Some of these risks are also pertinent to your post-operative care.

We want nothing more than a perfect outcome with the surgical procedures that you are having done to rehabilitate your bone. This can only be attained with your cooperation. Please feel free to communicate with us at any time to make sure that the procedures you are having are properly maintained. No question is ever perceived by our office as being silly or unreasonable. We would rather have questions answered immediately than risk the chance that the procedure will not go as planned, especially from omissions that are preventable.

As stated above and outlined in your informed consents, please remember that there are some instances when no matter what is done, the outcome is not perfect. There are even infrequent occasions when a surgery may have to be redone; these situations are neither the doctors nor the patients fault.

Thank you

Endodontic Surgery
  1. Some discomfort is normal after treatment. Discomfort can be highest for the next 72 hours and may last for 2 weeks. During this time your symptoms should decrease.
  2. Avoid chewing on the tooth after treatment until you have seen your general dentist for a permanent filling or crown. Chewing on a root canal treatment tooth without permanent restoration may cause the tooth to fracture and may need to be extracted (pulled).
  3. Brush and floss your teeth as usual.
  4. Your tooth may have a temporary filling at the end of treatment that may only last 1 to 4 weeks only. Aggressive chewing on the tooth or eating sticky foods may dislodge the filling which is undesirable. If your filling falls out please contact the dental office as soon as possible.
  5. You must contact your general dentist upon completion of root canal treatment for a final filling/crown. It is strongly recommended that this follow up treatment within 30 days to avoid any leakage of saliva and/or bacteria back into the root canal space. This type of leakage may lead to further treatments on the tooth such as retreatment or endodontic surgery.
  6. Your jaws may be sore for days to weeks after treatment. This may be expected if you have been asked to keep your mouth open for an extended period of time for optimal treatment.
  7. You may be given pain medication and/or antibiotics prescription. It is very important to follow all directions for pain control or infection.
  8. Recommended over the counter pain medication: Advil or Motrin. Follow written label instructions.
  1. You develop a fever
  2. You develop a swelling
  3. You notice a pimple forming on your gums
  4. You have difficulty breathing or swallowing
  5. Pain increases over time and or becomes severe
  6. Any convers or questions

Call you Endodontist’s/Office emergency contact phone number 925-456-7600 (Livermore) or 925-754-1650 (Antioch)
If you are unable to contact your Endodontist, general dentist and/or office and have any of the symptoms listed above go to your nearest emergency room.
If you experience any life threatening problems, call 911 immediately for assistance


Sometimes the after-effects of surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office. Please note that there is no additional charge for your post-operative care in this office!


In most cases, there will be minimal bleeding since the wound is often closed with sutures. If used, the sutures are usually the dissolving type which will fall out on their own 5–10 days after surgery. Some bleeding and oozing may be expected during the first 24 hours. Please keep firm biting pressure on the gauze pack over the surgery site for about one hour. Remove the gauze and then check the site for bleeding. If significant bleeding continues, a new gauze pack should be placed and firm pressure should be applied for one hour. Repeat as necessary. A tea bag can be used if your gauze supply runs low. Avoid vigorous chewing, spitting, or rinsing your mouth or sucking through a straw for 24 hours. Allowing the tissues to rest undisturbed assists the healing process. Avoid continually pulling at your lip to check the operative site.


Depending on the procedure, you may or may not experience swelling. Swelling may be at a maximum about 2 or 3 days after surgery. Keeping your head elevated (in a recliner or on several pillows) will reduce swelling. Ice packs applied continuously are helpful for the first day or so.

Oral Hygiene

The day following your procedure, it is recommended that you begin rinsing your mouth with warm saltwater rinses (1 teaspoon of salt in a glass of warm water). Continue rinsing with the saltwater mixture approximately 3 or 4 times a day over the next few days following your surgery. Brush your teeth and gums as normal except be gentle in area where procedure was performed. Do not use a Waterpik® or like device or hydrogen peroxide rinses for at least 2 weeks following surgery. If so prescribed by your doctor, a chlorhexidine rinse may be used twice daily instead of salt water.


The day of your surgery, start with nourishing liquids and soft/colder foods, such as ice cream, pudding, yogurt, etc. Avoid extremely hot foods, foods with sharp edges (chips, pretzels, etc.), and do not chew immediately over the surgery area. Avoid straws for the first 24 hours. Gradually return to your normal diet as tolerated.

Limit physical activity during the first 24–48 hours after surgery. Overexertion may lead to post-operative bleeding and discomfort. When you lie down, keep your head elevated on a pillow. You may wish to place a towel on your pillowcase to avoid staining from any blood-tainted saliva.

It is advisable that you refrain from smoking for at least 3 days after the surgery, as this increases the risk of infection and may delay healing.

Initially, you may have some discomfort. Tylenol® or a non-steroidal anti-inflammatory (ibuprofen, Advil®, Motrin®, or Aleve®) may be used for pain. The pain will gradually diminish. If medication was prescribed, use it according to the directions as needed. Make sure you get some type of food or a drink in your stomach before taking your prescription pain medication, as otherwise, it can make you feel nauseated.

Dental Prosthesis
As was discussed at your pre-operative consultation, partial dentures, flippers, or full dentures should not be used after surgery unless otherwise advised by your doctor. These may need to be adjusted at or after your first post-operative return visit.

Post-Op Visits
It is important to return for your post-op visit, generally scheduled 2-4 weeks after treatment. Contact Mary, David or Dr. Reyes if you have questions or problems before that time.

Night Guard

Please follow these instructions for care and use of your new Night Guard.

  1. Clean daily with soap and water (Do NOT use a toothbrush to clean it).  Do not soak in mouthwash or other chemicals.
  2. Do not place your night guard in direct sunlight.
  3. Rinse your night guard before and after use and store with some water.
  4. Keep your night guard out of reach from pets and children.
  5. Never wear an appliance while eating.  Doing so may be painful and possibly traumatic to the opposing teeth.
  6. Avoid sleeping on your stomach. Sleeping on your stomach forces your head to be turned to the side, which may cause significant muscular strain.
  7. Discontinue all gum chewing if you have existing jaw pain.
  8. Nightguard use should be discontinued and adjusted by your doctor:
    1. If your night guard is uncomfortable, too tight or binding, too loose (can be removed with your tongue), or damaged.
    2. If when wearing the night guard, your back teeth or canine teeth can somehow touch each other in various jaw positions.
    3. If your night guard is causing additional muscle or jaw soreness after continued use.
  9. Only wearing your night guard nightly will ensure that it protects your teeth from damage, unless directed otherwise by your dentist.

Periodontics and Oral Surgery

Bleeding: It is normal to have some oozing of blood, but not profuse bleeding, from the surgical area for 24 to 48 hours after surgery. To stop excessive bleeding apply WET gauze to the area with direct uninterrupted pressure for a minimum of 10 minutes.
Swelling: The surgical area may experience substantial swelling following surgery. IMPORTANT: To minimize swelling place an ice pack (or a bag of frozen peas) on the surgical site alternating on and off every 15 minutes for the first 24 hours, especially the first 4 hours.
Mouth care: Do not rinse, spit, swish, smoke, drink through a straw, or suck on anything for the first 24 hours after surgery. After the first 24 hours rinse your mouth with the mouthwash prescribed to you 2 times a day.
When to brush after the first 24 hours:
1st week- Do not brush or floss the surgical area. Of course, brush and floss all the non-surgical areas.
2nd week: See Below

  1. Tissue graft patients: Continue same as first week.
  2. Bone graft and Membrane patients: see section on Guided tissue regeneration.
  3. Osseous surgery patients: start brush and flossing the surgical area. *Note: If it is too tender or if you are hesitant to do a good job of brushing & flossing the surgical area you must continue to use the Chlorhexidine rinse.

Pain control: Take the pain medication prescribed on time to control your pain more easily. If your pain is controlled by ibuprofen you do not have to take your narcotic prescription.
DO NOT ingest alcohol (or any other recreational drugs) while taking pain medication; this could be deadly. DO NOT drive or operate heavy machinery while taking narcotic pain medication.

*Instructions for Medrol Dose Pack* 

Day One: Take 6 pills immediately at the same time
Day Two: Take 5 pills at the same time
Day Three: Take 4 pills at the same time
Day Four: Take 3 pills at same time
Day Five: Take 2 pills at same time
Day Six: Take 1 pill
Diet: Your comfort is your best guide as to what to eat. However, do not eat popcorn, nuts, chips, and hard or sticky foods.
Activity: Tissue graft patients do not exercise 5 days following your surgery. All other patients do not exercise for 48 hours following surgery (increased pain and swelling). Do not smoke for 24 hours following surgery (inhibits healing).
Antibiotics: Antibiotics can render birth control ineffective. They can also put you at risk of yeast infection or upset stomach. You could take probiotics with your antibiotics to minimize this. If you get diarrhea from your antibiotics, discontinue and call us right away. You must take you’re antibi
Guided Tissue Regeneration patients: If you have had guided tissue regeneration you must use the Chlorhexidine rinse for 6 weeks following surgery and not brush or floss the specific tooth that has received GTR.
Osseous surgery patients: If you are having osseous surgery, the goal is to reduce your pockets; therefore, you will notice larger spaces between your teeth/ & longer teeth. This is actually a desired effect as the areas are now accessible for you to clean. In addition, some patients notice sensitivity to temperatures, especially to cold. In non- smokers this is often a temporary change. Fluoride gels such as Gel Kam help. In addition, the cleaner you keep your teeth the less sensitive they will be.
There is much variation in people’s reaction to this type of surgery and the medications prescribed. We are committed to giving you the best care & keeping you as comfortable as possible. Therefore, if you have any questions not addressed here, please call us.

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We are proud to provide our patients with the best in dental technology, treatment options and patient comfort. It is our pleasure to address all your questions and concerns.

Smile Line Antioch:
3220 Lone Tree Way, Ste. 102 
Antioch, CA 94509
Mon - Thu: 8:00 AM - 5:00 PM
Friday: Appointment Only
Smile Line East Ave, Livermore:
2545 East Ave Suite A, 
Livermore, CA 94550
Mon - Fri: 8:00 AM -5:00 PM
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