After Completion of Endodontic Treatment

FOLLOWING ROOT CANAL THERAPY OR RETREATMENT THERAPY PROCEDURES:

• Unless otherwise directed, please call your referring dentist this week to make arrangements to have the tooth permanently restored.  A permanent restoration must be placed to protect your tooth against fracture and decay.
• The root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration to seal the biting surface of your tooth.  This temporary filling material is soft and may wear away slightly, causing the filling or tooth to feel uneven.  This is normal.  If the entire temporary filling needs to be replaced, please contact our office.
• Your tooth may often be sensitive to chewing for several weeks following root canal therapy, typically being most sensitive on day two or three after treatment.  This is a normal symptom and should decrease with time.  Please avoid chewing on the tooth until the tooth is restored permanently with a permanent filling or crown by your restorative dentist.  This will help the healing process and help prevent the tooth from cracking. Posterior teeth (back teeth) usually require crowns after root canal treatment.  Your restorative dentist will determine the appropriate permanent restoration to best protect your tooth. 
• Please follow the recommended medication guidelines described to you by your endodontist.  Please also refer to home care instructions on our website for more information.
• Place an ice compress on your cheek or jaw near the treated tooth as needed for 15-20 minutes every hour for several days.
• Rarely, fever or swelling will develop.  If that occurs, please call our office.
• You may alleviate any gum tenderness by rinsing with a warm salt water solution (made by mixing 1/2 teaspoon salt with 8 ounces of warm water) several times per day.
• If you have any concerns or questions with the tooth that was treated, please call us.
• If you have an allergic reaction to any medication prescribed and are unable to reach your doctor, please contact the nearest urgent care clinic or hospital.  
• A complete report of treatment will be sent to your restorative dentist.

Following ENDODONTIC SURGICAL PROcEdures 

• ACTIVITIES:  During the first 24 hours after surgery, lie down, elevate your head, and do not do anything more strenuous than watching TV or reading.
• Apply an ice bag or cold compress to the outside of your face over the operated area.  Apply the ice compress for 15-20 minutes every hour.  Continue for up to 48 hours as needed or instructed otherwise.  This will help reduce swelling and inflammation.  You may find that applying a most heat compress to the outside of your face over the operated area is helpful after the first 48 hours.  
• On day 2 after surgery, you may resume normal activities at a reduced pace (No vigorous athletic activities for 48 hours).
• Avoid pulling on the lip or cheek to look at the incision, it may disrupt the sutures.
• MEDICATION:  (There is usually minimal-moderate post-operative pain.  Pain is highest on days 3 or 4).  Take the medication as prescribed or recommended by your endodontist.    
• ORAL HYGIENE:  Brush and floss your other teeth gently.  Please avoid gingival (gum) contact with a soft bristled toothbrush and no flossing for the rest of the week in the surgical site after surgery.  
• Continue with the prescribed mouthwash and rinse with warm salt water (mix 1/2 teaspoon salt with 8 ounces of warm water) 2-3 times a day until the sutures are removed.
• Use a manual toothbrush for the teeth near the surgical site.  However, please avoid the gumline and tooth in area of surgery as directed by your endodontist.
• Use cotton-tipped applicators (soaked with Peridex mouthrinse) to gently wipe and clean area of the surgical site twice per day for 1-2 weeks.
• BLEEDING AND SWELLING:  Bleeding is usually minor.  It may seem worse than it is because blood mixes with saliva.  Minor oozing may continue for several days.
• Minor discoloration of your face/bruising can occur for 5-7 days particularly if you bruise easily.
• Swelling can occur.  It is usually minor and of no concern.  If substantial swelling occurs or you have an elevated temperature after the surgery, please call our office. 
• DIET:  Chew on the other side for one week.  Please avoid the surgery area.  Avoid sharp, crisp, and hard foods (popcorn, potato chips, crisp bacon, etc.).  Avoid hot and spicy foods (pizza, tacos, etc.).
• SMOKING and ALCOHOL:  Avoid smoking until the sutures are removed.  Avoid alcoholic beverages while taking pain medications and antibiotics.
• If you are experiencing a severe reaction to any of the medications we have prescribed and you cannot reach our office, please contact the nearest urgent care clinic or hospital.  

Are There Any Potential Problems After Treatment?

• Lower teeth and nerve injury. There is a very slight possibility that nerve injury can occur during root canal surgery to the lower posterior teeth. Our endodontists are 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.  Our endodontists are 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.  
• 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. 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.

If you have any questions, please call our office at Madison Office Phone Number 608-310-ENDO (3636).