Instructions

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.

AFTER COMPLETION

Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface may be 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. Included in your treatment is a follow-up examination to evaluate the progress of healing. This appointment will require only a few minutes and no additional fee will be charged for the first check-up visit. 

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 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.

If you have any questions, please call our office at Pomerado Endodontics at  858-250-0108.

Pre-Surgical Instructions

1. This procedure will be performed using local anesthesia
2. There are usually few restrictions after the procedure concerning driving or returning to work.
3. A doctor is available at all times should a problem arise after your treatment.
4. Avoid aspirin or aspirin-based products, including NSAIDs (non-steroidal anti-inflammatory drugs - Motrin/Advil) one week before surgery.
5. Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician.
6. If there is a question, please call our office prior to your appointment.
7. Please eat breakfast or lunch as applicable.
8. If you have been advised, by your physician or dentist to use antibiotic pre-medication, please make sure you are on the appropriate antibiotic on the day your appointment.

Post-Surgical Instructions

1. Avoid strenuous activity for the remainder of the day. Routine, nonstrenuous activity is not harmful, unless otherwise directed. Smoking and alcohol consumption delay the wound healing process and should be avoided or minimized for 3 days following surgery.
2. It is essential that you maintain an adequate diet with proper solid and fluid intake during the first 3 days following surgery.
3. Avoid manipulation of the facial tissues as much as possible. Do not raise the lip or pull back the cheeks to inspect the surgical site as you may dislodge the sutures (stitches).
4. Some oozing of blood from the superficial site is normal during the day and evening of surgery. Slight swelling and facial skin discoloration (bruising) may be experienced. This is temporary and will resolve on its own in a few days.
5. Apply as ice bag with firm pressure to the face directly over the surgical site. You should apply the ice bag alternately 20 minutes on, 20 minutes off, for 6-8 hours following surgery. After 8 hours, the ice bag should not be applied. Frequent moist heat applications to the face are recommended after the third post surgical day. Maximum swelling may occur 48 hours after surgery.
6. Post surgical infection is unusual, but possible. Signs of infection may cause increased pain, increased swelling and tenderness, elevated body temperature, chills, and other flu like symptoms. An objectionable odor and taste may also be experienced. If these conditions exist, please call our office.
7. The superficial site will be tender and sore. For this reason you should follow the analgesic regimen prescribed following surgery.  1 tablet/capsule of 400mg Motrin every 4 hours  OR  1 tablet/capsule of 600mg Motrin every 6 hours  OR 1 tablet/capsule of 800mg Motrin every 8 hours.  Additional prescription medication may be required as well.
8. Careful tooth brushing is desirable and promotes healing. Brush only the teeth and make every effort to avoid the gums. Twenty-four hours after surgery, you may begin rinsing with Peridex if prescribed or a mild saltwater solution of ½ tsp. of table salt and ½ glass of warm water.The sutures (stitches) that have been placed must be removed to ensure proper healing. It is important that you return at the appointed time for suture removal.
9. Recall visits are necessary to monitor the progress of healing.
10. Should any complications arise, please do not hesitate to call. If you feel that your symptoms warrant a physician and you are unable to reach us, go to the closest emergency room immediately.

Are There Any Potential Problems After Surgery?

• Lower teeth and nerve injury. There is a slight possibility that nerve injury can occur during root canal surgery to the lower posterior teeth. Your endodontist is trained to assess this possibility prior to treatment and will advise you accordingly. For lower posterior teeth, the root tips may be near a nerve that supplies feeling to the lip, chin and gums. Your endodontist is trained to design your surgery to minimize the chances of damaging this nerve. Rarely, this nerve can become irritated during the process of surgery. In these cases, when the local anesthesia wears off, you may experience tingling, altered sensation or, in rare cases a complete lack of feeling in the affected tissues. Should this occur, it is usually temporary and will resolve over a period of days, weeks or months. In rare cases, these changes can be permanent and/or painful.

• 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.  Sinus Communication Corrected

• Post-operative infections. Post-operative infections occasionally occur. This usually requires just an office visit and examination. Many times placing you on an antibiotic for one week will take care of the infection. Occasionally, other follow-up procedures will be needed.

Pre-Sedation Instructions

APPOINTMENT CHECKLIST

• You have been given two prescriptions to be filled prior to your endodontic appointment.
• The first prescription is for Valium. You are to take one tablet (5mg total) thirty minutes before bedtime the night prior to appointment. This will help you get a restful night’s sleep.
• The second prescription is for Halcion. You are to take one tablet (0.25mg) 1 hour before your appointment on an empty stomach the morning of your appointment. After arriving at our office you will be monitored and your level of sedation will be evaluated. If necessary, additional medication will be administered.  As was discussed during your consultation, a driver will be needed to take you to and from your appointment. 
• You cannot take these medications if you could be pregnant. 
• Smokers

Nicotine levels in your blood will affect your sedation experience.  If you smoke…
• less than ½ pack a day -  refrain from smoking for 12 hours
• ½ – full pack a day - refrain from smoking for 8 hours
• ½ packs a day - refrain from smoking for 4 hours
• More than 1 ½ packs a day -  Smoke right before coming to the office

• No Alcohol or Narcotic drugs:  We cannot safely sedate you if you have consumed alcohol, narcotics of any type (including Vicodin/Hydrocodone) or any street or recreational drugs.  
• No Grapefruit Juice or Caffeine for 12 hours:

Consuming caffeine will limit your level of sedation (coffee, tea, caffeinated soft drinks, etc).

• Nothing to eat or drink after midnight.
• Wear light-weight comfortable clothing, preferably with short sleeves.
• Wear comfortable shoes and socks.
• Do not operate heavy equipment and/or drive after taking your Valium the night before your appointment.
• It is absolutely essential that your escort drives you to/from your appointment. We will not be able to proceed with your appointment if you drive yourself.
• Your driver will need instructions, so please have him/her speak with the dental team before dropping you off. Your driver is welcome to remain here during your sedation visit.

Post-Sedation Instructions

FOR COMPANION & PATIENT

• Patient cannot drive for 24 hours after taking sedation medication, or operate any hazardous devices or heavy equipment for 24 hours.
• A responsible person should remain with the patient until he/she has fully recovered from the effects of sedation.
• Patient should not go up/down stairs unattended. Let the patient stay on the ground floor until recovered.
• Having nutrition after sedation is important. The patient should begin eating appropriate foods as soon as possible. Avoid anything sticky or excessively chewy until final restoration is completed by their dentist. Avoid hot foods/drinks until numbness wears off.
• Patient needs to drink plenty of fluids as soon as possible. 
• Patient may seem alert when he/she leaves. This may be misleading so do not leave the patient alone.
• Always hold the patient’s arm when walking.
• Call us if you have any questions or difficulties. If you feel that your symptoms warrant a physician and you are unable to reach us, go to the closest emergency room immediately.
• Patient should not carry, sleep next to, or be alone with young children for a period of no less than 24 hours after the last dosage of medication.
• Following most surgical procedures, there may or may not be pain, depending on your threshold for pain. In most cases, a non-narcotic pain regimen will be given consisting of Acetaminophen (Tylenol) and Ibuprofen (Motrin/Advil). These two medications, taken together, will be as effective as a narcotic without any of the side effects associated with narcotics. If a narcotic has been prescribed, follow the directions carefully. If you have any questions about these medications interacting with other medications you are presently taking, please call our office and/or your pharmacist.