Patient Instructions

Before Endodontic Treatment

This procedure will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. A doctor is available for consultation at all times, should a problem arise after your treatment.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.
Please eat a full breakfast or lunch as applicable.

If you have been advised by your physician or dentist to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment.

If you can take ibuprofen (Advil) or naproxen sodium (Aleve), it does help reduce inflammation when taken pre-operatively. We recommend 2 tablets of either medication 2-4 hours before endodontic therapy.

If you have any questions, please call our office at 817-381-4146.

After Endodontic Treatment

Endodontic treatment has now been completed and the root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. Please telephone your restorative dentist for an appointment. A complete report of treatment will be sent to your restorative dentist.

Your tooth is more prone to fracture immediately after endodontic treatment. You should chew on the other side until your restorative dentist has placed a core build-up and a protective restoration, usually a crown. If your tooth’s strength is seriously compromised, your endodontist or restorative dentist may place a post and core build-up inside the tooth. Your restorative dentist and endodontist will determine the appropriate restoration to best protect your tooth.

Are There Any Potential Problems After Treatment?

Upper Teeth and Sinus Communication
The upper teeth are situated near your sinuses, and root canal surgery can result in a communication between your mouth and the adjacent sinus. Should this complication occur, it will usually heal spontaneously. We will give you special instructions if this is apparent at the time of surgery. We prefer that you don’t blow your nose for two to three days after surgery. If you have to sneeze, you should sneeze with an open mouth into a tissue. You should not create any pressure in the sinus area. If you sense a complication after surgery, please contact us.

Post-operative Infections
Post-operative infections occasionally occur. In most cases, placing you on an antibiotic & steroid for one week will take care of the infection or discomfort. Occasionally, other follow-up procedures will be needed.

If you have any questions, please call our office at 817-381-4146.

Post Operation Apicoectomy

Please follow these instructions as closely as possible. They are designed to help you heal quickly, and comfortably, with minimal side effects. If you experience any complications, please call our office.

FOR THE REMAINDER OF THE DAY:

1. Do not spit. Use a tissue to wipe your mouth or swallow your saliva.

2. Do not use a drinking straw. Drink straight from the cup.

3. Do not smoke.

4. Keep fingers and tongue away from surgical area. Sitting, the use of a straw, smoking, and poking can dislodge the blood clot that is forming, and will cause bleeding from the area. Also, smoking can increase the chances of an infection.

FOR BLEEDING:

Some minor bleeding is expected after an apicoectomy. It will usually subside quickly, and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours.

1. Keep gauze on the surgical site for 30 to 45 minutes, and replace it with a new piece of gauze if you are still bleeding. It is important to make sure the gauze is directly on the surgical site. Firm pressure for another hour should stop the bleeding.

2. If you find that this is not working after your third attempt, use a moistened tea bag instead of the gauze.

3. If all else fails, call the office.

FOR SWELLING:

Most patients will experience some swelling after surgery in the mouth. It may be mild or severe. The swelling will get bigger from the first 24 to 48 hours. It may last for several days or one week.

1. Use an ice pack on the cheek or face next to the surgical site. Keep on for 15 to 20 minutes, then off for 10 minutes and repeat until you go to sleep. Start again the next day.

2. Sleep with your head elevated slightly, above the heart. This will help keep the swelling down.

3. One the third day, change to moist heat instead of ice packs. This will bring swelling down quicker.

EATING:

You may eat soft foods as soon as the anesthetic wears off. You may resume a regular diet as soon as you feel up to it. Please stay nourished and well hydrated. You will heal faster.

BRUSHING:

You may brush your teeth, avoiding the surgical area, either tonight or tomorrow morning. Be gentle, and do not spit or rinse forcefully. Start brushing the surgical area on the second day, and be very gentle on the stitches.

RINSING:

You may start rinsing today, gently, with some warm salt water every few hours. Do not use alcohol containing mouth rinses for a few days.

MEDICATIONS:

If you were given prescriptions for medications, take all medications with a glass of water, and as directed on the bottle. Call us if you experience severe nausea and or diarrhea or cannot swallow your pills.

1. Antibiotics: Continue until the bottle is empty—Do not quit halfway,

2. Pain medicine: Continue as necessary. Remember that narcotics make can make you drowsy, so no driving, operating machinery or alcoholic beverages.

Pre-Operative Instructions for wisdom teeth removal

Intravenous “I.V.” Sedation for Wisdom Teeth Removal

• To reduce the chances of nausea, do not eat or drink anything (including water) for at least six (6) hours prior to your appointment

• If your surgery is in the morning, do not eat or drink anything between bedtime and your scheduled appointment

• If your surgery is in the afternoon, a light breakfast before 7:00 a.m. is encouraged

• Unless specified by Dr. Williams, all medicines taken on a routine basis should be continued without interruption. Please take your normal medications with a minimal amount of water

• A responsible adult, over 18 years of age, should accompany you to the office and remain with you throughout the entire procedure. Following the sedation, this responsible adult should remain with you for the next 24 hours.

• Minors (persons under the age of 18 years) must be accompanied by a parent or legal guardian.

• If receiving intravenous “I.V.” sedation, you should wear clothing that is not restricting to the neck or arms. You should wear loose-fitting tops on which the sleeves can be rolled up to the shoulder.

• Contact lenses must be removed prior to sedation.

• Following the sedation, you should refrain from driving an automobile or from engaging in any activity that requires alertness for the next 24 hours.

Post-Operative Instructions for wisdom teeth removal

Bleeding, Discomfort, & Swelling

Bleeding — controlling bleeding after an extraction or surgery is a matter of applying undisturbed pressure over the bleeding area for an extended period of time (usually about an hour).  This is best accomplished by following the following steps:  carefully place 1-2 pads of 2″x2″ gauze over the bleeding area (it is helpful if you have someone assist you in this process).  Use a flashlight to see the area better.  Use a spoon to help pull back the cheek.  Visualize the area that is the source of the bleeding.  Wipe away the saliva and blood to get a good look at the surgical site.  Place the gauze pads over this area.  Bite down firmly and consistently for at least one hour.  After this time has elapsed gently remove the gauze from the surgical site.  If there is still bleeding, repeat this process until bleeding has stopped.

Problems:  If you notice that there is still bleeding while the gauze is over the area, you may not have the gauze positioned correctly in order to apply adequate pressure.  Re-position the gauze and apply pressure again.  If this does not help, take 1-2 additional gauze pads and add them to the gauze you are currently using to make a thicker pad.  Position this over the area and apply pressure again.  Carefully position so that the gauze is directly over the source of the bleeding.  If you are not able to get the bleeding to stop despite all attempts you should contact Dr. Williams.

Discomfort & Swelling — discomfort & swelling are normal parts of post-operative healing.  The incidence and intensity of each are difficult to predict.  It is, however, normal for both of these symptoms to increase in size or intensity during the second and third post-operative day.  While beginning on the fourth day, they should both begin to resolve.  You can help decrease both of the symptoms by being very gentle to the surgical area.

For mild discomfort, Ibuprofen (600mg) with 2 extra strength Tylenol every 6 hours.  Be cautious with the amount, as the more you take, the more likely it is to cause stomach upset.

Ice Packs:  It is helpful to apply ice packs to the area of the surgery only during the first 8-12 hours.  Never leave the ice packs in place for more than 10-15 minutes at a time.

In rare cases, during the first few hours following the surgery, intense pain may be experienced which isn’t relieved by pain medication.  This is usually a very short-term side effect, present when the local anesthetic is wearing off.  It is best for the patient to be aware of the short-term nature (30 min. to 1.5 hrs.) of this condition.  Pain medication may be increased at this time if the maximum dose has not been taken in the last four (4) hours.

It is normal for swelling to appear and become worse during the first three (3) days following surgery.  However, if you experience an increase in swelling or discomfort after the fourth day, you should contact the office or Dr. Williams.