Post extraction treatment instruction
A clean and healthy mouth aids healing. The following steps will help prevent bleeding and relieve soreness:
RestRest for a few hours following treatment and avoid strenuous exercise.
RinsingDo not rinse for 24 hours. For several days following treatment rinse your mouth gently after meals and before retiring using a mouthwash made by dissolving 1/2 teaspoon of salt in a glass of warm water. Hold the solution in your mouth for several minutes, discard and repeat 2-3 times.
FoodAvoid hot fluids, alcohol, and hard or chewy foods. Choose cool drinks and soft or minced foods. Avoid sucking at or interfering with the wound.
BleedingShould slight bleeding occur sit upright with head and shoulders raised. Apply pressure using a small pad of gauze or clean linen clamped firmly between the jaws for 10 minutes - repeat if necessary.
PainParacetamol is the medicine of choice to reduce post-operative discomfort.
If excessive bleeding, undue pain or other symptoms occur contact your Dental Surgeon for advice without delay. Please consult your registration card for out of hours emergency contact number. If the problem persists after 9.00pm please go to the closest Accident and Emergency department.
Root Canal Treatment
Root canal therapy or ‘root canal treatment’ is used to alleviate pain and remove infection in preference to extraction. Treatment will often be recommended following an abscess, acute pain or sensitivity and following extensive fracture or trauma.
Treatment aims at removing infection or potentially problematic nerve tissue from the root canal, which is then cleaned, shaped and sealed to prevent further infection.
Root canal therapy is a skilled and time consuming procedure usually performed over several visits. X-rays are required at each stage to allow for accurate diagnosis and treatment and a permanent filling or crown is placed once the tooth is sealed.
A very high percentage of root treatments are entirely successful but a small number do not respond to treatment and require extraction or further treatment. Dead or root treated teeth sometimes darken and do become more brittle but treatments are now available to return these teeth to full strength and life-like appearance.
Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected through decay or injury.
Why is root canal treatment needed?
If the pulp becomes infected, the infection may spread through the root canal system of the tooth.
This may eventually lead to an abscess. If root canal treatment (RCT) is not carried out, the infection will spread and the tooth may need to be taken out. Does it hurt? No. A local anaesthetic is used and it should feel no different to having an ordinary filling done.
The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist. At the first appointment, the infected pulp is removed. Any abscesses, which may be present, can also be drained at this time. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.
In the past, a root filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
Root canal treatment is usually very successful. However, if the infection comes back the treatment can be repeated.
The alternative is to have the tooth out. Once the pulp is destroyed, it can’t heal and it is not recommended to leave an infected tooth in the mouth. Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible.
Yes. However, it is better to restore the tooth with a crown to provide extra support and strength to the tooth.
Root canal treatment is a routine dental procedure, which your dentist will be happy to do for you.
Root-treated teeth should be treated just the same as any other tooth. Remember to clean your teeth at least once a day, preferably with a fluoride toothpaste. Cut down on sugary snacks, and keep them only to mealtimes if possible. See your dentist for regular check-ups.
Care of dentures
- If you have just been given new dentures they are bound to feel strange. Be patient and allow time for you to get used to them; you may have to modify your diet to soft food until you can manage your dentures. It also helps to cut food into very small pieces.
- Speaking may also be altered at first with new dentures but the tongue and lips adapt quickly to make small adjustments needed to restore your voice to normal.
- Remove your dentures at night, unless you have been told not to, and clean using a toothbrush or nail-brush with soapy water or a proprietary denture cleaner. It is very important that for the health of your mouth that the dentures are kept spotlessly clean. Without this the gums, over time, may become red and sore.
- Soak your clean dentures overnight in water or a denture cleaning liquid. Follow manufacturers instructions carefully, and do not use household cleaner like bleach. Do not use soaking agents on metal-based dentures.
- When you leave your dentures out of your mouth, always keep them in a tumbler of cold water to prevent them from drying out and warping.
- If your dentures are uncomfortable or give you pain, then see your dentist. Do not attempt to adjust the dentures yourself.
- Some discomfort may be felt at first. If actual pain is experienced then remove the dentures, contact your dentist, but replace the denture for as long as possible prior to attending your appointment and for a minimum of three hours before you visit the dentist. This will assist the dentist in identifying the problem.
- Your dentures may last you several years; although they may need modifying during this time as your gums will continue to change shape. However, your mouth and dentures should be examined every 12 months to ensure your mouth is healthy and your dentures are satisfactory.
You have been prescribed a course of antibiotics by your dentist. It is important to follow the instructions below carefully in order to obtain the maximum benefit.
- Do start the course as soon as possible
- Do complete the whole course even if your symptoms improve
- Do take regularly, and follow any additional instructions regarding food and alcohol etc
- Do take painkillers if required in addition to the antibiotics
- Do contact us if you have any concerns
- Don’t continue with the antibiotics if they make you feel ill or cause a rash – contact the surgery for immediate advice or go to your local A&E Dept
- Don’t expect antibiotics to work immediately. There is often a delay of 48 hours before your symptoms noticeably improve
- Don’t consume alcohol if instructed to refrain
Oral Contraceptives (The Pill)
Some antibiotics can reduce the effectiveness of oral contraceptives. Female patients taking oral contraceptives are advised to use an additional form of contraception whilst taking antibiotics, and for 7 days afterwards. If the packet runs out before these 7 days, seek your Doctor’s opinion as it may be advised to start a new packet early.
You have been provided with ‘immediate’ dentures. You should follow carefully any instructions given relating to care of the extraction site and more long term general care of dentures in addition to the specific instructions below.
- Do wear denture all the time for the first few days, including night-time.
- Do expect soreness for several days. Take pain relief such as Nurofen or Paracetamol regularly if required.
- Do remove regularly (at least three times a day) and scrub your dentures; and clean any remaining teeth thoroughly.
- Do expect your dentures to get loose quite rapidly – healing gums shrink and remodel particularly in the first six months.
- Do return to your dentist once dentures are loose to have them relined or remade – there will be a charge for this treatment.
- Don’t expect immediate dentures to last for years. Your gums will change and ill-fitting dentures often cause considerable damage.
- Don’t leave dentures out particularly in the first few days. Swelling might well mean that you are unable to reinsert for some time!
- Don’t carry on if the dentures are cutting or causing ulceration. Please telephone the practice for a denture ease.
The words lichen planus mean lacy white patches. Lichen planus can occur in the mouth, on the skin and in some cases on the nails, in the hair and on the scalp. Women may also get it in the vagina.
This leaflet deals with lichen planus in the mouth. It may appear just as lacy white patches or as ulcers or even red and bleeding gums. It lasts for many years before gradually disappearing; in some cases it may last for life. From time to time it will feel sore and may be made worse by spicy, acidic or highly flavoured foods. Hard foods, such as toast, may scratch the affected parts.
We do not know its precise cause. We do know that it is not an infection and so you cannot pass it on to anyone.
If your mouth is sore you will be given some remedies by the hospital doctor and more of these can be obtained from your own doctor or dentist.
‘Adcortyl in Orabase’ is a steroid that you apply to the sore area. It is important that you use a wet finger or a wet cotton-wool bud to put the cream to the sore area. If possible, dry the area with a piece of gauze. It is probably most effective to use this cream last thing at night. It can be used up to four times a day. It will leave a gritty feel in your mouth.
‘Corlan Pellets’ are small, bitter tasting steroids which you suck very slowly. These can be used four times a day until the soreness eases and should be left near painful patches.
‘Becotide Spray’ is occasionally used for those areas of the mouth where it is difficult to apply any of the other remedies. The spray is normally given to patients with asthma and therefore it is larger than necessary for the mouth. Use 2-3 puffs of the inhaler on the area that is sore. DO NOT breathe in at the time of puffing, hold your breath as you do not want the spray to go down into the lungs. It can be used up to four times a day.
You may be given a mouthwash (Bioral) to use four times a day. The packet is dissolved in a quarter of a cup of warm water. It should be kept in the mouth for 2-3 minutes and then spat out. It may leave a burning sensation after use.
Your mouth needs to be looked at regularly until all the patches have gone. This will be done either by your dentist or doctor at an Oral Medicine Clinic. It is important that you return for your review appointments or earlier if your mouth is causing you discomfort.
Tooth whitening information and Consent Form
The amount of whitening varies from patient to patient and cannot be predicted or guaranteed but in general:
- Yellow or brown teeth, extrinsic stains and darkened monochromatic teeth are easier to whiten.
- Grey or bluish teeth and striated or splotchy teeth are more difficult to whiten.
- The whitening system is a procedure designed to whiten teeth that are being maintained with proper oral hygiene.
- Tooth Whitening is a gradual process, which you are in control of so if you want natural looking teeth but of a lighter colour rather then unnatural white teeth, you can stop the procedure when you think you have achieved the result you want.
Candidates for Treatment
Generally, just about anyone who wants their teeth whiter, however:
- People with significant periodontal disease are not candidates.
- People with fillings that may be breaking down, with cavities in their teeth, or with chipped or worn teeth may be better treated by restorative procedures first.
- Do not use whitening treatment if you are pregnant. There have been no adverse reactions, but long-term clinical effects are unknown.
- Heavy smokers should discontinue the use of tobacco before whitening.
- Peroxide solution has been available for many years as an antiseptic for the mouth and is widely used for its effect on teeth whitening. There is new research indicating the safety for use on the soft tissues of the mouth (i.e. gums, cheeks, tongue, throat); the long-term effects are as yet unknown. Although the extent of the risk is unknown, acceptance of treatment means acceptance of risk.
- Sensitivity of teeth is a common side effect. If you experience any sensitivity you should stop whitening for a few days, then resume the treatment. If the teeth become ultra sensitive you can place desensitising toothpaste or gel into the trays for an hour a day, which will usually stop the sensitivity; please contact your dentist if this is the case.
- Temporary inflammation and/or white spots on your gums can be caused by the whitening.
- If you have fillings that are breaking down, decay in your teeth, erosions of the teeth or exposed root surfaces due to periodontal disease, the peroxide may have direct access to the vital tissues of the teeth. Such access of the peroxide may cause tooth sensitivity. Such conditions need correction prior to the whitening procedure.
- The whitening procedure can be very effective at whitening teeth but will not change the colour of fillings or crowns already in your teeth/mouth. For aesthetic reasons such fillings may need changing after whitening procedures.
- Avoid the use of tobacco, tea, coffee, red wine and teeth staining foods such as tomato paste and dark green vegetables during the whitening procedure.
- Never place household or commercial bleaches in your mouth.
- Keep your recall appointments with your dentist.
- when the treatment is completed, please keep the trays so that they can be used for a booster/maintenance treatment. It may be necessary to do a top-up treatment in 18-24 months depending on the amount of staining.
- There are no guarantees as to the degree of whitening your teeth.
- The amount of whitening varies with the individual.
- Pure white or snow white teeth are not shades consistent in natural teeth and can only be achieved by other restorative procedures.
Information for Patients About Jaw Joint Malfunction
What causes the problem?
The majority of jaw joint problems are mechanical in origin and result from excessive use, for example, chewing very hard foods (tough meats, toffees, chewing gum), opening the mouth too wide (yawning, singing, shouting), and various tension habits associated with stress, such as tooth clenching and grinding.
As a result, the ligaments holding the joint together become stretched and the disc of cartilage within it becomes displaced. This produces a click or grating feeling when the jaw is moved and if the damage becomes worse then the pain occurs in the joint (often interpreted as earache). Associated cramp or spasms of the jaw muscles may occur producing a dull ache or a sharp, stabbing pain on the side of the head, cheek and along the bottom of the jaw (and stiffness which prevents wide opening of the mouth). This is commonly worse at the end of the day when the muscles are tired or in the morning if there is a tooth grinding habit during the night.
How to help the problem:
The majority of jaw joint malfunctions get better with sustained rest. With time the ligaments become stronger again and the cartilage repositions. The following guidelines will help:
|Opening the mouth too wide||Slice all food thinly|
|Biting into apples||Do not bite into large pieces of food|
|Biting into large rolls||Chew slowly and avoid clicking noises if possible|
|Chewing gum/toffee||Take longer over eating – smaller mouthfuls|
|Chewing tough meats||8 hours sleep; 8 hours work; 8hours rest!|
|Chewing raw vegetables||Eat a soft diet|
|Shouting and singing|
|Open mouth yawning|
|Stress and over-work|
|Trying to achieve unrealistic goals|
Any tooth clenching or grinding habit must be identified and eliminated. Many people clench and grind their teeth as a response to stress, and may not even be aware of it. This may be due to concentrating on a particular task, keeping to unrealistic timetables and generally trying to do too much. This is similar to what is described as tension headaches but affecting the muscles of the face rather than the neck and the back of the head.
Use this simple exercise at least twice a day and it will help your jaw work in its most comfortable position. Choose a time when you are generally comfortable and relaxed.
- curl your tongue backwards so that the tip touches the roof of your mouth towards the back (this holds your jaw backwards)
- place your hand under your chin and press the bottom jaw onto it
- keep your teeth JUST APART
- keep your lips RESTING TOGETHER
- keep this pressure up for ONE MINUTE
- Stop pressing
- Relax your tongue by swallowing
- Rest teeth together for ONE MINUTE
Ten minutes at the beginning and end of each day is best. Your discomfort should start to feel better after 1-2 weeks.
Equality and diversity policy
Our vision is for Watercress House Dental to be a successful, caring and welcoming place for patients to receive dental care and advice. We want to create a supportive and inclusive environment where our staff can reach their full potential and care is provided in partnership with patients, without prejudice and discrimination. We are committed to a culture where respect and understanding is fostered and the diversity of people's backgrounds and circumstances will be positively valued.
This Policy will help us to achieve this vision.
The rights of our patients and our staff with regards to discrimination are protected by anti-discrimination legislation including:
- The Equality Act 2010
- Part-time Workers (Prevention of Less Favourable Treatment) Regulations 2000
- Employment Rights Act 1996
By adopting this Policy, we accept our responsibility to ensure that discrimination does not take place and that everyone is treated fairly and equally.
The aim of this Policy is to achieve equality of care experience by removing any potential discrimination in the way that people are cared for and treated by the Practice, including:
- People with disabilities
- People of different sexual orientations
- Trans-gendered and transsexual people
- People of different races
- People on the grounds of their sex
- People of faith and of no faith
- People in relation to their age
- People in relation to their social class or medical condition
- People who work part-time
- People who are married or in a civil partnership
- Women who are pregnant, have recently given birth or are breastfeeding
Putting this policy into practice
We aim to develop and support equality and diversity measures by:
- Providing patient information in a variety of languages, if required
- Having translation services available for patients who need this
- Providing services that are accessible to patients with disabilities
- Ensuring that care of individuals is planned with their specific needs at the centre
- Tackling oral health inequalities through positive promotion and care
- Involving patient groups and individuals in the design of our service
- Responding positively to the diverse needs and experiences of our patients and the community even when those needs are challenging to deal with
- Ensuring that we join up with services involved with the care of patients with particular medical and social care needs.
Comments and concerns
If you believe you have been treated in any way contrary to this Policy or you have any comments on how we can ensure that it works better, please contact Marcello Tulone at the practice. We will investigate your concerns and take appropriate action.