Tips and Instructions

General Guidelines for all procedures:

Feel free to call our office anytime if you have a post-operative problem.

If you have had local anesthetic (“Novocain”) the injection site will often be sore or feel swollen for a few days, but this will resolve on its own. If it persists, please make an appointment to let the Doctor examine it.

Until full feeling has returned, do not eat anything, or drink anything but cold water, as you could bite or burn your cheek, lip or tongue without knowing it.

Most fillings or new restorations on teeth need a few hours to set and don’t reach full hardness for 24 hours, so be gentle the first day. Chew on the other side. Never chew on ice.

Many procedures will have residual soreness for the first 48 hours, so don’t be worried unless the pain is severe. Usually, 600 mg (3 tablets of 200 mg each) of over-the-counter Ibuprofen medication (for example, Advil), or 2 Tylenol tablets every 6-8 hours will take care of the soreness.

After that, the most common problem is that the bite is off, and needs to be adjusted by the Doctor. Sensitivity to cold or to biting is a common indicator of this. Remember, you may have been numb, and perhaps fatigued from being open, when the bite was checked at the time of treatment. PLEASE DO NOT WAIT TOO LONG TO MAKE AN APPOINTMENT TO ADJUST THE BITE. IT OFTEN MAKES SYMPTOMS WORSE IF YOU LET IT GO.

Carefully follow all guidelines provided by the doctor and their staff and most importantly practice good oral hygiene. Additional instructions following various types of treatment are listed below. Please click on the below topics for detailed instructions. If you are experiencing a serious or life-threatening emergency, please call 911 or visit the nearest emergency room.


 Post-Operative Instructions Following

Denture or Partial Delivery

You may have discomfort for a few days after receiving your final dentures or partials.  Dentures and partials will often need several adjustments in order to fit comfortably.  To help adjust to your dentures you can practice reading aloud for a little while each day.  At night you should remove your dentures and clean them. They should be stored in a clean container filled with denture cleaning solution.  Dentures should be removed for at least 6 hours a day to give your mouth and gums time to rest.  Food particles can become trapped under dentures causing inflammation or sore spots.  Brush the roof of your mouth, your tongue and lightly brush your gums after removing your dentures.

Ongoing care for your restoration includes brushing your teeth and surrounding tissues after every meal and snack, and flossing at least once a day before bedtime unless you have full dentures, in which case brushing them is very important.  Rinsing your mouth with water or mouthwash will also help to remove any additional particles that may have been missed during brushing and flossing.

You should visit our office at least once a year to have your dentures or partial adjusted and checked by the doctor.  Wearing ill-fitting dentures or partials without proper care and adjustment can cause severe bone loss and very serious oral disease.  Please call our office at the first signs of any symptoms or if you are experiencing ongoing pain or discomfort.


Post-Operative Instructions Following:

Scaling and Root Planing

Scaling and root planing therapy includes removing tartar and bacterial plaque from the root surface below the gum line.  This helps reduce inflammation and infection and improves the depth of periodontal pockets, therefore allowing more efficient flossing and brushing.

For the first 24 hours you may experience some cold and heat sensitivity.  Do not eat, drink, chew or consume hot foods or beverages until the numbness has worn off following anesthetic. Avoid vigorous physical exercise and foods and are extremely hot or spicy for the first 24 hours and do not consume alcoholic beverages or smoke for at least 48 hours.  Some bleeding following a deep cleaning is normal, but if you experience excessive bleeding please call our office.

You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by your doctor as needed.  A warm salt water rinse, approximately one teaspoon in an eight ounce glass of water, three times a day can be helpful. Brush and floss gently following a deep cleaning, resume normal brushing and flossing when the soreness is gone.

Follow any other instructions provided by our office on your visit.  Please take all medications as prescribed.

Oral or Periodontal Surgery

Immediately following surgery, keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops.  A certain amount of bleeding is to be expected following a surgical procedure.  Placing the gauze pad over the area and biting firmly may control excessive bleeding.  Slight bleeding, oozing, or redness in the saliva is not uncommon.  Repeat as necessary within a one-hour period following surgery.

If you have been prescribed pain medication besides aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication.  Do not take more than 800mg every 4-6 hours.  Medication should not be taken on an empty stomach.  If you have been placed on antibiotics, take the medicine as directed.  Antibiotics may be prescribed to help prevent infection.

Swelling around the face, eyes and surgical site is not uncommon.  This swelling may not appear until the day following the surgery and may become more noticeable two to three days following surgery.  You can help to minimize the swelling by applying a cold compress on the face near the extraction site alternating on for 20 minutes then off for 20 minutes.  After 36 hours the ice will have no further impact on swelling.  After this period, the application of moist heat to the sides of the face can help reduce swelling.

For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke.  Avoid hot and spicy foods, carbonated and alcoholic beverages.  During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.  Restrict your activities on the day of your surgery, avoid excessive work or play and resume normal activity the following day as tolerated.

After the first day, gently rinse with a warm salt water rinse, approximately one-half teaspoon of salt in an eight ounce glass of water, three times a day.

If any sutures were required, they may need to be removed by the Doctor 7-10 days after the procedure.  If they loosen on their own prior to this, please call the office.

Children should be supervised after having an extraction to make sure they do not bite or their tongue or lips as it can cause serious injury to their soft tissue.

Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

Root Canal Therapy

Thank you for selecting us for your root canal therapy. Please follow the guidelines below and contact us with any questions.

Some discomfort following the root canal is normal for 2 to 4 days after the treatment. The injection site will be tender, and in some cases the tooth and surrounding tissue may be sore for a few weeks following the treatment. Please try to avoid eating on the tooth for at least 48 hours. It will also be sensitive to pressure from your tongue or fingers. The outer layer of the tooth is still alive, even though the interior nerve is removed.

Most often you will need to take any ibuprofen type of medication such as Motrin or Advil, 3 200 mg tablets (600mg), or 2 Tylenol, every 6-8 hours for discomfort and alleviation of swelling, particularly in the first 48 hours. Do not exceed the guidelines printed on the label for any medication. If you are unable to achieve adequate pain control, please call our office.

If any prescriptions were given, please have them filled promptly. It is important to take any antibiotics exactly as prescribed. Take any prescribed pain medication at your discretion. It is for your comfort, and first try the Ibuprofen or Tylenol and allow 20 minutes for relief before adding the prescription medication.

You may find using an ice pack to the affected area helpful. Please do not apply ice directly to the skin, have a cloth between the ice and skin at all times. You may apply the ice for up to 20 minutes on and 20 minutes off for the next 6-8 hours as needed.

Once you begin to eat and drink, avoid chewing or biting on the area worked on until your permanent restoration is in place. The temporary in place is a soft composite that is vulnerable to fracturing (cracking) with hard substances such as peanuts, pretzels, hard candy, ice cubes, etc. A root canal tooth is fragile, so be very careful until the final restoration is placed that will protect the tooth.

Normal brushing and flossing are okay, unless otherwise specified by the Doctor.

While flare-ups are rare, they occur in about 5% of the cases and cause significant pain. They occur with teeth that are extremely irritated and/or infected or with teeth that have a history of prior treatment. These sometimes occur randomly, even on patients that have had root canals done in the past without problems. If you have a flare-up you may experience moderate to severe pain, swelling, throbbing or general discomfort; please contact our office.

The Family Dentist

Richard A. Epstein, DMD, FAGD

Emergency 24/7 Care – (203) 222-1227

Dr. Epstein's office is located adjacent to his home and he has an easily adaptable schedule to respond to dental emergencies.
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