Instructions for Patients after Surgery or Extractions

Avoid physical exertion and rinsing mouth as much as possible for 24 hours as this tends to prolong bleeding. Slight bleeding for the first 24 hours is normal and can be ignored (since blood is mixing with saliva it looks as if there is more blood than there actually is). If bleeding is excessive, place a folded gauze pad over the area and bite gently upon it for 30 or more minutes. Be sure to take any prescribed medications as directed on the bottle. If no pain medication has been prescribed, the patient may take Advil (same as Motrin or Ibuprofen). Tylenol is ok, but not as effective for the pain. Avoid aspirin as it may prolong bleeding. Starting the day after surgery or extraction rinse your mouth several times a day with 1 tsp. salt in a glass of warm water. It is particularly important to do this after eating. Continue to rinse with warm salt water until your gums look closed (no more hole) where the tooth was extracted. Call the office if any problems or questions arise.

Root Canal Post-Treatment Instructions

Although the procedure is minimally invasive, a root canal is a surgical procedure and some post procedure discomfort is not uncommon. You may experience a dull ache in the treated tooth immediately after the root canal.

The tooth that was treated may also be sensitive to biting/chewing pressure. This is normal and will subside with time, usually after a week or so. We would like you to avoid chewing on that side for 5-7 days, especially hard or sticky foods.

During the procedure the inner most portion of the tooth is hollowed out and predisposed to breaking. Most teeth that have had a root canal will require a crown afterwards. It is recommended to have the crown placed within 2-6 weeks after your root canal.

Clinical Recommendation:

In general, for patients with prosthetic joint implants, prophylactic antibiotics are NOT recommended prior to dental procedures to prevent prosthetic joint infection.

For patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.* To assess a patient’s medical status, a complete health history is always recommended when making final decisions regarding the need for antibiotic prophylaxis.

Clinical Reasoning for the Recommendation:

  • There is evidence that dental procedures are not associated with prosthetic joint implant infections.
  • There is evidence that antibiotics provided before oral care do not prevent prosthetic join implant infections.
  • There are potential harms of antibiotics including risk for anaphylaxis, antibiotic resistance, and opportunistic infections like Clostridium difficile.
  • The benefits of antibiotic prophylaxis may not exceed the harms for most patients.
  • The individual patient’s circumstances and preferences should be considered when deciding whether to prescribe prophylactic antibiotics prior to dental procedures.

Article courtesy of ADA Center for Evidence-Based Dentistry™
*In cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and when reasonable write the prescription.