Post Operative Homecare
by Shannon Pace Brinker CDA, CDD
After tooth preparation is done, provisional restorations are placed to protect and seal the tooth structure. Provisional restorations also support and manage gum tissue while the final restorations are being fabricated. Explain fully to patients the importance of complying with home-care instructions is key to a successful outcome. When talking to patients about postoperative home care, you should give them a take-home sheet with the instructions. Patients may be tired and exhausted after treatment. Most patients forget or only hear 50% of what we say at the chair. Take-home instructions provide patients the opportunity to go over the information and then call you if they have any questions.
In our practice we designed a take-home kit to present to patients following their procedures. I never realized until after my temporaries were placed, what the patient was not only feeling but also tasting. When we experience our own dental treatment, we develop more compassion for patient comfort. The day my teeth were prepared, I not only had full mouth reconstruction, but also synthetic bone placement, gingival contouring, and surgical crown lengthening. I had not taken anything before treatment, and my body metabolizes anesthetic quickly. By the time I left the office, my anesthetic was gone and I was in severe pain. All I could think about was getting something in my system for the pain. As I was driving home, I stopped off at a little diner and purchased coffee. I then took my ibuprofen. Immediately I felt better. The warmth from the coffee soothed my tissues. This was when I understood what the patient was feeling and made it a goal to educate assistants on the importance of proper home-care instructions.
Take-Home Kits
Items to include in patient take-home care kits:
- 10 (800 mg) ibuprofen
- Battery-powered toothbrush
- Sensitivity formula toothpaste
- Tissue gel
- Battery-powered flosser
- Irrigator
- Alcohol-free mouthrinse
- Mug with drink packets
- Pocket-pack breath freshners
- Desensitizing paste
- Lip balm
- Temporary night guard, if necessary
Author’s Note: To achieve results similar to mine, I recommend using the following products, which I include in my patient take-home kits. Crest Spinbrush Pro (Church & Dwight Co), Crest Sensitivity Protection (The Procter & Gamble Co), Oxyfresh Super Relief Gel (Oxyfresh Worldwide, Inc), Power Flosser and Irrigator (Water Pik, Inc), Zinc Mouth Rinse or Lemon Power Rinse (Oxyfresh Worldwide, Inc), apple cider drink packets, Listerine Pocket Pak (Pfizer), Prospec MI Paste (GC America, Inc), mug and bag (Smart Practice).
The first step toward compliance is to be firm with your instructions. The second step is to look them in the eye when explaining what to expect. I go through each instruction to make sure that patients understand the importance of proper home care. I highlight that improper care can lead to gingival bleeding, and if bleeding is present, we may not be able to cement the final restoration at their next appointment. Go over the instructions after treatment and demonstrate how each item in the kit is properly used. I have found that the more time spent communicating the instructions, the easier it is to deliver the final restorations.
Take-Home Instruction Sheet
We recommend the following steps to minimize any discomfort you may endure:
- Take ibuprofen or acetaminophen as needed for the first 24 hours. We have enclosed ten, 800-mg tablets of ibuprofen, which can be taken every 6 hours.
- Brush at least twice a day. Before brushing, hold the battery-powered toothbrush under warm running water. Apply sensitivity formula toothpaste. If laser contouring was performed on your gums, you may see a thin white line where the temporaries and the gums meet, after the first couple of days. It may look as if you have some bread stuck there. Do not brush that off. This line is the body healing itself. Apply the tissue gel 4 times daily, including after brushing at bedtime.
- The temporaries are splinted together for strength, although they appear to be individual teeth. It is important to keep them clean. Use the battery-powered flosser or irrigator to remove any food or plaque. Do not floss this area in the usual manner.
- Use the alcohol-free mouthrinse twice daily, preferably after breakfast and before bed. Rinse for a full 30 seconds. That may seem like a long time, but it is necessary for healing of the tissue. Do not eat or drink for 30 minutes after rinsing.
- Drink something warm. Tea, coffee, cocoa, or apple cider will help soothe any areas that are tender as well as help you relax after your dental appointment. Some packets are provided in your take-home care kit.
- These temporaries may develop an odor from the absorption of fluids and can become stained. We have provided some pocketpack breath fresheners to help control the odor caused by bacteria.
- Your temporaries are made of acrylic. Acrylic shrinks and contracts. You may hear popping sounds while drinking hot or cold beverages. This is normal. While drinking something hot, your temporaries may feel loose. While drinking something cold, they may feel tight. Drinking room temperature fluids is recommended.
- Avoid foods that are hard or sticky, as they may break or pull off your temporaries. Also avoid biting into foods, especially hard and crunchy foods. Cut your food and chew on your back teeth. Soft foods are recommended, such as baked chicken, fish, pasta, mashed potatoes, cooked vegetables, eggs, oatmeal, grits, and yogurt.
- Avoid any foods that are highly acidic, such as barbecue sauce, ketchup, orange juice, grapefruit juice, and hot sauce. Acidic foods may burn or irritate the gum tissue.
- Desensitizing paste is provided for any tooth sensitivity.
- Lips can sometimes get chapped and sore from stretching during the procedure. Lip balm is provided for comfort.
- If you should loosen or break your temporaries, do not panic. Call the office and bring the loose piece to your appointment. Do not throw the piece away. The temporaries usually can be repaired or recemented.
- The dentist may prescribe a nightguard to help protect your temporaries during the night. Be careful not to pull hard when removing the nightguard so as to not pull off or break the temporaries.
- I will be calling to check on you tonight, but if you have any other questions, don’t hesitate to call our office.