Noa Dental | Your Best Valencia Dentist

HOME CARE INSTRUCTION AFTER - TEETH CLEANING/ FLUORIDE

FLUORIDE TREATMENT: Avoid eating/drinking for the first 30 minutes. Avoid drinking hot drinks within the first 4 hours after the treatment
MILD SENSITIVITY COLD: Use a desensitizing toothpaste or fluoride gel (e.g., MI Paste, Prevident, Clinpro or Enamelon) at least 4 times per day for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.
JAW PAIN: First, apply ice packs/cold compress to both the muscles and joints for 5 minutes and then follow with hot compress for 15 minutes to the same areas. This can be repeated several times throughout the day.

HOME CARE INSTRUCTION AFTER - DEEP CLEANING/ ANTIBACTERIAL MOUTHWASH/ ARESTIN

EATING: Wait till the anesthesia wears off. Be cautious to avoid accidentally chewing on your tongue, lips, cheeks from “numbness”. Avoid any hard chippy foods such as tortilla chips, potato chips, popcorn or seeds for the next several days
SMOKING: Please avoid smoking for 24-48 hours as it can delay the healing of the tissue.
MILD SENSITIVITY TO COLD: Use a desensitizing toothpaste or fluoride gel (e.g., MI Paste, Prevident, Clinpro or Enamelon) at least 4 times per day for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be
GUM DISCOMFORT: Following the procedure, your gum may feel tender. The injection site may also feel sore. Rinsing your mouth 2-3 times per day with ½ teaspoon of warm salt water can help to alleviate discomfort. Taking Tylenol or Advil works well to alleviate the tenderness
JAW PAIN: First, apply ice packs/cold compress to both the muscles and joints for 5 minutes and then follow with hot compress for 15 minutes to the same areas. This can be repeated several times throughout the day.
ANTIBIOTICS: If antibiotics have been prescribed,, please take with food as directed
ANTIBACTERIAL MOUTHWASH (CHLORHEXIDINE RINSE): Rinse your mouth 2 times a day for 2 weeks. Swish for 30 seconds and spit out. Your teeth may be temporarily stained as the medication may linger
ARESTIN: If you are treated with Arestin today:
- Avoid touching the treated areas
- Wait 12 hours after your treatment before brushing teeth
- Wait 10 days before using floss, toothpicks, or other devices designed to clean between the treated teeth
- Avoid food that could hurt your gums for 1 week
- Don’t chew gum or eat sticky food
- After 10 days, resume cleaning between the treated teeth on a daily basis
PERSISTENT DISCOMFORT/SWELLING/ PAIN: contact the office at 661-857-7662 for further instructions

HOME CARE INSTRUCTION AFTER - FILLINGS

EATING: Wait till the anesthesia wears off. Be cautious to avoid accidentally chewing on your tongue, lips, cheeks from “numbness”
HIGH/TALL BITE, OFF-BALANCED BITE: Please give us a call at 661-857-7662 for adjustments as needed
SENSITIVITY TO HOT AND COLD: This is normal following the procedure. The symptoms will lessen within a few days but in some cases it may take a few weeks. As long as the sensitivity continues to decrease, there is no need for concern
GUM DISCOMFORT: Following the procedure, your gum may feel tender. The injection site may also feel sore. Rinsing your mouth 2-3 times per day with ½ teaspoon of warm salt water can help to alleviate discomfort. Taking Tylenol or Advil works well to alleviate the tenderness
JAW PAIN: First, apply ice packs/cold compress to both the muscles and joints for 5 minutes and then follow with hot compress for 15 minutes to the same areas. This can be repeated several times throughout the day
ANTIBIOTICS:If antibiotics have been prescribed,, please take with food as directed
PERSISTENT/ SEVERE SENSITIVITY TO HOT/COLD/THROBBING PAIN: Deeper cavity can lead to severe/throbbing pain inside the tooth. Please give us a call at 661-857-7662 for a further evaluation.

HOME CARE INSTRUCTION AFTER - CROWN / TEMPORARY CROWN

EATING: Wait till the anesthesia wears off. Be cautious to avoid accidentally chewing on your tongue, lips, cheeks from “numbness”
HIGH/TALL BITE, OFF-BALANCED BITE: Please give us a call at 661-857-7662 for adjustments as needed
SENSITIVITY TO HOT AND COLD: This is normal following the procedure. The symptoms will lessen within a few days but in some cases it may take a few weeks. As long as the sensitivity continues to decrease, there is no need for concern
GUM DISCOMFORT: Following the procedure, your gum may feel tender. The injection site may also feel sore. Rinsing your mouth 2-3 times per day with ½ teaspoon of warm salt water can help to alleviate discomfort. Taking Tylenol or Advil works well to alleviate the tenderness
PAIN MEDS: Take an anti-inflammatory pain reliever if needed (e.g., Ibuprofen – Advil).
JAW PAIN: First, apply ice packs/cold compress to both the muscles and joints for 5 minutes and then follow with hot compress for 15 minutes to the same areas. This can be repeated several times throughout the day
ANTIBIOTICS:If antibiotics have been prescribed,, please take with food as directed
TEMPORARY CROWN LOOSENED, CAME OFF: Please give us a call at 661-857-7662 to get it re-cemented. If it happens over the weekend, check your local pharmacies (e.g., Walgreens, Rite-aid) or grocery stores (e.g., Ralphs) for an Over-the-Counter cement. When re-cementing:
- Practice placing the temporary crown on the tooth with the right orientation
- Clean your tooth and also clean inside the temporary crown then dry temporary crown before putting it on
- Place temporary material (e.g., cement) inside the temporary crown and place it on your tooth, bite on a rolled tissue paper (directly placed on the crown) for 5-10 mins until the material sets
- Also using toothpaste as temporary cement may work as a temporary solution until you can be seen by a dentist
PERSISTENT/ SEVERE SENSITIVITY TO HOT/COLD/THROBBING PAIN: Please give us a call at 661-857-7662 for a further evaluation.

HOME CARE INSTRUCTION AFTER - ROOT CANAL

EATING: Please do not chew or attempt to eat on the side of your mouth that has been worked on while this area is still numb. Whenever possible, try to chew on the opposite side from the treated tooth until you have a crown placed. Until such time, your tooth will be still weak and could fracture. Please avoid crunchy or hard food which could cause the tooth (that hasn't been crowned) to fracture.
PAIN MEDS: It is recommended that you take something for pain-relief within one hour of leaving our office. It is best to get the medication into your blood stream before the anesthesia begins to subside. Ibuprofen (e.g., Advil, Motrin) is very effective. Two to four tablets may be taken up to four times a day for the next 3–4 days (if needed) to help control the sensitivity in this area. If you have a medical condition or gastrointestinal disorder which precludes ibuprofen, take acetaminophen (e.g., Tylenol) as a substitut, although it does not contain anti-inflammatory properties. Aspirin and aspirin-containing products are NOT advisable, as they tend to increase bleeding at the treated area
DISCOMFORTS: If you are experiencing discomfort, you can put an ice pack over the treated area for 30 minutes when you first get home to minimize swelling
GUM DISCOMFORT: Following the procedure, your gum may feel tender. The injection site may also feel sore. Rinsing your mouth 2-3 times per day with ½ teaspoon of warm salt water can help to alleviate discomfort. Taking Tylenol or Advil works well to alleviate the tenderness.
SMOKING: Please avoid smoking for 24-48 hours as it can delay the healing of the tissue
EXERCISE: Avoid strenuous exercise for 24 hours
FOLLOW-UP VISIT: A putty-like material is placed in your tooth at the completion of your root canal treatment. If left in too long, it can allow bacteria to enter your treated tooth requiring further treatment. It is recommended that you return to the clinic no later than 3–4 weeks after having the root canal treatment to have your tooth prepared for a crown and build-up. Delay in obtaining your final restoration (i.e., a crown unless otherwise discussed) may result in fracture and/or possible loss of the tooth
PERSISTENT/ SEVERE SENSITIVITY TO HOT/COLD/THROBBING PAIN: Please give us a call at 661-857-7662 for a further evaluation

HOME CARE INSTRUCTION AFTER - DENTURE

BREAKING IN PERIOD: New dentures require a break-in period before they become comfortable. It is normal to feel awkward at first with your new dentures. This break-in period varies with each patient depending on their ability, determination, and perseverance to learn how to use their new denture
LOOSENESS: If you had teeth removed just prior to placing your denture, the denture may begin to feel a bit loose. This is due to the gum shrinkage that occurs as the gums heal. Complete healing of the gums and the bone will take between three to six months. During this period, your dentures will loosen and a temporary liner can be placed to keep it relatively snug. A temporary liner will need to be placed several times throughout the healing period to keep the denture secure. Denture adhesives can also help to keep your denture in place. Once the healing process is complete, a permanent liner will be placed to allow for a better fit
SORE SPOTS: Soreness from uneven pressure on the gums can develop at any time and is not unusual. If any sore spots develop, please call our office to set up an appointment for an adjustment. Sore spots are best corrected if the dentures are worn at least 3-6 hours before your adjustment appointment to allow for precise detection of the area
EATING: Start with soft food that are easy to chew. Take small bites and chew slowly. Be sure to evenly distribute food on both sides of your mouth. Cutting up foods that require a lot of chewing or biting with the front teeth can make it much easier. Eating with dentures has a bit of a learning curve, but eventually you will be able to advance your diet to incorporate different foods.
SPEAKING: Learning to talk with your new dentures in place also requires patience. Try reading out loud whenever you can to make this process go faster.
DAILY CLEANING: It is important to rinse a full/partial denture under warm water after eating to remove food debris. Avoid hot or boiling water as it can cause the denture to warp. Dentures should be brushed daily with a soft toothbrush or denture brush using warm water, mild soap, or cleaning paste. While not wearing your denture, be sure to soak in water. Cleaning tablets can be used while soaking the denture to help remove slight stains. After soaking your denture, be sure to rinse it with warm water before putting it back into mouth; mouthwash can also be used after rinsing to give you a fresh taste and feeling.
CARING FOR MOUTH AND GUM TISSUE: Anytime you are not wearing your denture, be sure to soak in water or denture solution, otherwise the acrylic will dry out overtime and cause the denture not to fit as well. It is important to take your denture out at night to allow your tissues to breath. This helps to avoid irritation and infection of the gum tissue. While your full/partial denture is out of your mouth, take use a damp washcloth or a very soft toothbrush with warm water to clean the tissues inside of your mouth. Rinsing daily with lukewarm saltwater can also help keep your gums clean.
DENTURE MAINTAINING PRODUCTS (local pharmacies, ralphs, walgreens, CVS etc):
- DENTURE CLEANER: Polident tablets, Efferdent tablets, etc.
- DENTURE ADHESIVE: Fixodent, poligrip, cushion grip, Effer grip, etc.

HOME CARE INSTRUCTION AFTER - PLACEMENT OF AN IMMEDIATE DENTURE FOLLOWED BY EXTRACTIONS ON THE SAME DAY

FIRST 24 - 48 HOURS: Do not take the denture out until the following morning after your extractions. Oozing of blood around the denture is normal and is not a cause for concern. Your immediate denture not only replaces your missing teeth, but it is acting to protect the surgical site, and control swelling and bleeding. The denture needs to be in place to be effective. First morning after the procedure, wash your hands first and carefully remove the denture using both hands. Stand over the sink counter. Rinse the denture carefully under cold water. Then scrub both the inside and outside with the denture brush using only cold water. Do not use soap, denture cleaners, or toothpaste. Carefully put the denture on the counter and gently rinse your mouth using a teaspoon of salt in 8 oz. of very warm water. Do not expectorate forcefully. Put the denture back in your mouth. Go ahead and clean any remaining natural teeth as you normally would at this time. Repeat the above procedure for the next two mornings
FOURTH DAY AFTER THE EXTRACTION: you should take the denture out at bedtime. Rinse and scrub it as described above. Rinse your mouth again with the warm salt water. Put the denture in a denture cup/container and cover it with clean, cold water. Leave it there while you sleep. After rinsing it again, put it back in your mouth in the morning. Continue with the warm salt water rinses for at least 7-10 days. (Do not use denture cleaning tablets or adhesive until instructed)
APPOINTMENT WITH YOUR DENTIST: If you don’t have an appointment with your dentist within a week from the extraction, please call at 661-857-7662 to set up an appointment
PAIN/ MEDICATIONS: Take all medications as prescribed and as directed by your surgeon and your physician on your regular medications. Ibuprofen (e.g., Advil, Motrin) is very effective. Two to four tablets may be taken up to four times a day for the next 3–4 days (if needed) to help control the sensitivity in this area. If you have a medical condition or gastrointestinal disorder which precludes ibuprofen, acetaminophen (e.g., Tylenol) can be taken as a substitute although it does not contain anti-inflammatory properties. Aspirin and aspirin-containing products are NOT advisable as they tend to increase bleeding from the area that was treated. You may also alternate ibuprofen and acetaminophen as instructed
SWELLING: Swelling is common after oral surgery for up to one week with the maximum amount of swelling usually present 2-3 days after the surgery. The swelling will slowly resolve over 4-7 days. Apply an ice bag to the outside of the face for 15-20 minutes, and then leave off for 15-20 minutes. Repeat for 24 hours, and then discontinue using the ice. This will reduce discomfort, bleeding and swelling
EATING/ ACTIVITIES: After extractions, do not spit, rinse, smoke or suck on a straw. Avoid hot or carbonated beverages. All of these things can dislodge blood clots that are necessary for healing. Soft food that don’t require chewing for the first few days are recommended (e.g., soups, yogurt, pasta, eggs, potatoes, bananas, smoothies). Avoid hard or crunchy food. Drink plenty of water, but do not go on a liquid diet. Avoid strenuous activity for the first 24-48 hours. You may resume normal physical activity as tolerated 2-3 days after your surgery.
SORE SPOT, UNEVEN BITE: Please give us a call at 661-857-7662 for a simple adjustment of the denture.

HOME CARE INSTRUCTION AFTER IN-OFFICE ZOOM

FOOD AND DRINKS TO AVOID: For the next 48 hours, avoid Berries, ketchup, red sauces, tobacco products, coffee, mustard, soy sauce, cola, red wine, tea. Do not use any colored toothpastes or gels for the first 48 hours. In addition, do not use any colored mouthwash or home fluoride treatment. If your daily homecare involves the use of PerioRx or any Chlorohexidine, please wait 1 week before continuing the usage of these producs
POST OPERATIVE SENSITIVITY: Some patients experience sensitivity such as “zingers” or thermal sensitivity 12 to 24 hours after the Zoom! whitening. Place the Relief ACP gel on the problem area.
- Once you receive your customize take home trays, you can place the gel in the trays and seat them over the teeth for 30 minutes
- Remove the tray and spit out the excess gel
- Do not eat, drink or rinse for 30 minutes
- This will help calm the teeth down during sensitive episodes. You are also welcome to take any type of over the counter pain relievers such as Advil, Motrin or Extra-strength Tylenol. Brushing your teeth with Sensodyne or Fluoride Daily Defense Sensitivity Relief toothpaste helps as well.
GUM IRRITATION AFTER THE WHITENING (WHITE SPOTS): The healing process begins immediately after a soft tissue burn. Rinsing with warm salt water will promote this process. If a burning sensation occurs, a small drop of Vitamin-E oil can be massaged into the tissue until the irritation subsides. Depending on the severity of the gum irritation site, it may be a good idea to discontinue whitening applications until tissue heals. In most cases, tissue burns rarely reoccur as long as the tissue is allowed to heal completely.
WHITENING TOUCH-UPS: If your teeth are not too sensitive, try bleaching a few more times with the take home products during the first three to five days after your office visit to maximize your results and attain the whitest shade possible. Store any remaining whitening gel in a cool dry place or refrigerator for later use.

HOME CARE INSTRUCTION AFTER OCCLUSAL GUARD

CLEANING
- Upon removal, the appliance may be cleaned with a soft toothbrush and toothpaste. Or antibacterial hand soap.
- Use care not to brush too abrasively on the soft inner lining. DO NOT use an abrasive tooth brush (e.g., Denture tooth brush)
- NEVER soak your appliance in mouthwash, or alcohol based rinses
- NEVER soak your appliance in bleach or harsh chemicals
- NEVER boil your appliance as it can distort
- Your appliance can be soaked in a denture cleaner for a maximum of 20 mins, 1 time a week
STORE
- Keep appliance away from animals as, they may chew the appliance
- Store your night guard in a dry case when not in use
FIT/BITE
- If fitting / biting feels uneven, please give us a call at 661-857-7662 for a simple adjustment
REPLACEMENT
- Over time, the appliance can be discolored due to age
- Guards should be brought in at your annual exam to make sure it is providing adequate protection
- Be aware that eventual replacement of your appliance will be necessary depending on the severity of grinding as well as regular wear and tear. You can expect your appliance to last anywhere from 3-5 years with normal use

HOME CARE INSTRUCTION AFTER ORTHODONTIC RETAINER

REMOVABLE RETAINERS
- Removable retainers MUST be worn all the time. The only time the retainer is to be removed is when you clean your teeth and the retainer and when you eat. You must brush your retainer gently with a soft toothbrush and toothpaste. Do not place in the dishwasher or place under hot water. This will ruin the retainer requiring replacement. You will be instructed as to when you can limit your retainer wear
- If you are having trouble with your retainer, call the office. Do not stop wearing unless directed to do so
- If the retainer breaks or if you have any troubles or questions, please do not hesitate to call the office.
- When eating or brushing, place the retainer in the hard case that was provided. Do NOT wrap the retainer in a napkin to avoid accidental disposal requiring a replacement.
SPLINTED RETAINERS
- Proper oral hygiene is required with a splinted retainer as well as removable retainers. You may brush your splinted teeth the same way you brush your non-splinted teeth. Make sure to floss your teeth at least once per day. You have received instruction on how to use floss threaders to make flossing around your splint quick and easy.
- If you have been given a removable retainer in addition to your splinted retainer please wear as directed.
- Check your splint daily for any loose bonds. If you notice a loose bond wear your removable retainer (if one was given) and call the office.

HOME THERAPIES FOR TMJ SUFFERERS

Apply heat over tender muscles and apply cold over tender joints. You may choose to cool with ice packs first over both the muscles and joints for 5 minutes and then follow with heat for 15 minutes. This can be repeated several times throughout the day
Avoid overuse of jaw activities and behavior that fatigue the jaw muscles. This is critical to achieve healing. Overuse activities include gum chewing, nail & cuticle biting, biting on pens, pencils, straws, ice, plastic items, eyeglass frames; the list goes on
Avoid clenching your teeth during the daytime
Avoid cradling your phone between your shoulder and neck and try to reduce the amount of time you are texting. Your head in a forward posture for lengths of time can wreak havoc on your neck and jaw muscles
Apply pain-soothing gels over the jaw, neck muscles, and jaw joints. These may include BenGay, Aspercreme, Biofreeze, but many other preparations are available in the local pharmacy. (Note: some of these products contain menthol, arnica, aspirin, and other anti-inflammatory ingredients so make sure you are not allergic or sensitive to these products.)
Muscle massage techniques can be used over the temporalis muscle and masseter muscle (which is the big muscle that bulges when you clench your teeth). These muscles can be rubbed and massaged as you would for a sore calf or thigh muscle, applying enough force to be uncomfortable but not too much that may induce pain. This can be done for 2-3 minutes 3-4 times a day and the best place to do it is in the shower. There are a number of YouTube videos you can watch to help guide your technique
Avoid hard, large, tough, and/or chewy food. I don’t recommend a mushy diet but rather a thoughtful diet. If you experience pain during or after a meal, you probably ate the wrong food
Minimize caffeine intake (even chocolate) and nicotine use
Abstain from drinking alcohol close to bedtime hours as it leads to restless sleep
Hydrate with a good amount of water throughout the entire day
Try your best to get 7-8 hours of restful sleep every night
Avoid electronic stimulation prior to going to bed. Your cell phone, laptop, and other various devices can all negatively affect your sleep cycle
Exercise at least a few times throughout the course of the week to build endorphins and reduce daily stress. Endorphins are our bodies’ natural painkillers
Practice diaphragmatic breathing or even meditate during the day to slow the number of breaths you take per minute.

INFORMATION FOR DRY MOUTH (XEROSTOMIA) SUFFERERS

Causes of Dry Mouth:
- Certain prescription drugs
- Certain OTC medications
- Tobacco
- Mouth breathing
- Anxiety
- Depression
- Alcohol
- Caffeine
- Spicy or salty foods
- Breathing unusually dry, cold, dusty, or dirty air
- Stress
- Vitamin deficiencies
- Not drinking enough water
- Radiation and chemotherapy
- Arthritis
- Diabetes
- Menopause
- Sjogren's Syndrome
- Lupus
- Parkinson’s disease

What drugs and medications can cause dry mouth?
- High blood pressure medicines
- Antidepressants
- Tranquilizers
- Antihistamines
- Anti-Parkinson agents
- Antipsychotics
- Decongestants
- Narcotic pain relievers
- Chemotherapy
- Antidiarrheals
- Bronchodilators

What problems might develop because of dry mouth?
- Rapid development of tooth decay
- Sore tissues
- Worsening periodontal disease
- Sore spots and ulcers under dentures
- Difficulty wearing dentures
- Mouth sores in non-denture wearers
- Breath doesn’t feel as fresh
- Difficulty chewing and swallowing normal foods
- Difficulty tasting normal foods
- Difficulty speaking
- Burning sensation in the mouth
- Dry or painful tongue

How can I avoid destruction from rapid tooth decay?
- Avoid hidden sugars, such as cough drops, lemon drops, hard candy, breath mints, chewing gum, soda pop, etc. People with dry mouths can get literally dozens of cavities in a matter of a few months.
- Use a prescription fluoride preparation. These get more fluoride to the teeth than regular fluoride toothpaste. They are available as a mouth-rinse, brush-on gel, or a gel applied in a custom-made mouth tray. Ask your dentist for prescriptions, or construction of a custom fluoride tray. MI Paste, Enamelon, Prevident and Gel-Kam are examples.
- Maintain superior oral hygiene habits: brush at least twice a day for two minutes per brushing, floss every day, and have your teeth cleaned/checked twice a year.

What will help relieve my dry mouth?
- Increase water intake throughout the day, and take frequent small sips
- Add moisture to the air with a humidifier
- Protect lips with a balm
- In cold weather, keep mouth and nose covered with a scarf when outdoors
- Don’t use tobacco or alcohol
- Avoid strong toothpastes
- Avoid mouthwashes containing alcohol
- Use only toothpastes and mouthwashes that don’t contain sodium laurel sulfate
- Avoid spicy and salty foods, and products containing cinnamon, peppermint, or wintergreen
- Take a daily multi-vitamin
- Use oral products that contains Xylitol
- Be sure your doctors and pharmacist are aware of all the medications you are taking
- Ask your doctor if your medications can be adjusted or changed
- Use a saliva substitute or mouth moisturizers
- Use sugarless hard candies to stimulate saliva flow

What products are available?
- Mouthwashes: Oasis, BetaCell Oral Rinse, Biotene Mouthwash, TheraBrite Oral Rinse, Tom’s of Maine Natural Mouthwash, Oral Moistening
- Sprays: Moi-Stir Mouth Moistener spray (carboxymethylcellulose), Mouth Kote mouth spray, Salivart Oral Moisturizer spray (carboxymethylcellulose), Stoppers 4 Dry Mouth Spray (glycerin), Thayers Dry Mouth Spray (glycerin)
- Toothpastes, Biotene Dry Mouth Toothpaste, Rembrandt Toothpaste for Canker Sore Sufferers, TheraBreath Oxygenating Toothpaste, Tom’s of Maine Natural Anticavity & Dry Mouth Toothpaste Gums, Mints, Biotene Dry Mouth Gum, XyliChew mints
- Gels: Orajel Dry Mouth Moisturizing Gel, Oral Balance Mouth Moisturizing Gel by Biotene, Saliva Substitute by Roxane, Spry Dry Mouth Tooth Gel
- Other: Biotene Dry Mouth Denture Grip, Moi-Stir Oral Swabsticks (carboxymethylcellulose), Salagen Tablets, 5mg (pilocarpine HCl); by prescription only

PAIN MEDICATION INSTRUCTION - ALTERNATING ACETAMINOPHEN (e.g., TYLENOL) AND IBUPROFEN (e.g., ADVIL)

The best way to alternate acetaminophen (e.g., Tylenol) and ibuprofen (e.g., Advil) is to take them 2 to 4 hours apart. For example, if you get up at 6.00am, you can take a dose of ibuprofen, then at 8.00am, you can take a dose of acetaminophen. You can continue this regimen throughout the day, making sure you don’t exceed the recommended maximum dose for each drug. An alternating dosing schedule of 3 hours for an adult may look like this:
- 6am Ibuprofen 400mg
- 9am Tylenol 1000mg
- 12pm Ibuprofen 400mg
- 3pm Tylenol 1000mg
- 6pm Ibuprofen 400mg
- 9pm Tylenol 1000mg

This dosing schedule does not exceed the recommended maximum dose of 3000 mg/day for acetaminophen and 1200mg/day for over-the-counter ibuprofen. An alternating dosing schedule of 4 hours for an adult may look like this:
- 6am Ibuprofen 400mg
- 10am Tylenol 1000mg
- 2pm Ibuprofen 400mg
- 6pm Tylenol 1000mg
- 10pm Ibuprofen 400mg
- 2am Tylenol 1000mg

The dosing schedule of every 4 hours allows for a middle-of-the-night dose for those who need round-the-clock pain relief.

This dosing schedule does not exceed the recommended maximum dose of 3000 mg/day for acetaminophen and 1200mg/day for over-the-counter ibuprofen.

PREPARE FOR SURGERY

PREPARING FOR SURGERY – IMPLANT / TEETH EXTRACTION / GUM SURGERY

Refrain Tobacco and Alcohol use: as it may delay or inhibit healing process and increase the risk of complications after surgery
Disclose medications to your surgeon/ dentist: Certain medication can lead to complications on the surgery and/or recovery. Some medical condition may need a clearance by your physician prior to the dental surgery, so it is important that you consult your medical condition/ history with your dentist in advance
Keep your teeth clean: if you are due for the cleaning, please make an appointment to get your teeth cleaned prior to the surgery or practice good oral hygiene at home as the incision area can be infected by the oral bacteria
Antibiotics/ medications: if your doctor prescribed you antibiotics to start prior to the surgery, please start 2 days prior so the surgery day falls on your day 3 of taking the antibiotics. ( probiotic supplement is recommended to be taken along with the antibiotics.)
Tips and arrangements: soft foods, ice pack, prescription, transportation ready prior to the surgery so you can go straight home and comfortably rest right after the surgery

HOMECARE AFTER THE SURGERY

DAY OF THE SURGERY AND AFTER CARE - IMPLANT/ TEETH EXTRACTIONS/ GUM SURGERY

MEDICATIONS/ANTIBIOTICS: If you did not receive your prescriptions before the surgery, fill your prescriptions and take your medications as directed. It is recommended that you take a probiotic supplement when antibiotics have been prescribed. Yogurt with lactobacillus and acidophilus milk may also reduce antibiotic-related diarrhea if you are not lactose intolerant. Please call the office to report an allergic reaction to any prescribed drug. If you develop a rash in response to a prescribed drug, you should stop the medication immediately and take Benedryl or an antihistamine.
FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning
DISCOMFORT: Mild to moderate discomfort is a normal part of the healing process and should be anticipated. Take the prescribed pain medication before the anesthetic begins wearing off, not when the pain peaks. Follow label directions for dosage and frequency information. If you are taking a narcotic medication, do not drive. Many patients will take pain medication the day of the surgery and that night. The next day, you may take the prescription medication if you feel it is necessary or you may take Advil, Aleve or Tylenol Extra Strength. Do not take aspirin for 7 days after surgery as this may cause bleeding in the surgical site. Instead of taking narcotic medication you may take 2 tablets of Advil (Ibuprofen 200mg each tablet) and 2 tablets of Tylenol (regular or extra strength) every 4 to 6 hours. This combination has pain relief equivalent to a narcotic without the adverse side effects of nausea, dizziness and constipation. This recommendation only applies if you do not have an allergy or sensitivity ibuprofen (Advil) and/or acetaminophen (Tylenol).
SWELLING: Swelling is a normal part of the healing process and can be minimized with ice packs applied gently to the outside of your face and jaw for the first 48 hours after surgery. Repeat the pattern of holding the ice pack on the face in the area of surgery off and on for 10 minutes at a time. Do not press hard or rub the area or you risk disturbing the surgical site. The swelling usually peaks in 48 hours and tapers off after that. Ice packs will help to minimize the swelling. If you do not ice the area, you will have swelling that will taper off after about 3-7 days. This swelling may put pressure on the sutures and the surgical site. You will improve your chances of healing with a better result if you minimize swelling by icing the area, reduce facial expressions and minimize talking for the first two days.
BLEEDING: A small amount of bleeding or oozing is normal and usually occurs on the day of surgery and sometimes, the following day. This is not a problem. The site will continue to clot and heal. Keep your head slightly elevated for 24 hours. When you lie down tonight, use two pillows to keep your head slightly raised. For the next 24 hours, do not spit, do not swish vigorously and do not drink through a straw because this may initiate bleeding. For the next 24 hours, do not exercise or do anything that increases your heart rate such as strenuous physical activity because this may raise blood pressure and initiate bleeding in your mouth. However, if the surgical site is continuously bleeding and filling up your mouth, you should place a cold, wet teabag in the area and apply continuous pressure by either biting down or applying even finger pressure for 20-60 minutes as needed. If the dressing is in place, use two fingers to apply even pressure on both sides of the dressing. If bleeding reappears uncontrolled, please call Noa Dental at 661-857-7662.
NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.
CLEANLINESS: Do not use an electric toothbrush anywhere in your mouth until your follow-up visit. A manual toothbrush with a small amount of toothpaste may be used for the rest of your mouth as well as floss. Take care not to stretch your cheeks near the surgical site as this might pull on the sutures. Do not brush anywhere in or near the surgical site(s) until you see your doctor for your follow-up visit. Do not rinse for 3 hours after the procedure. After the initial 3 hour period, you may rinse gently with lukewarm salt water but do not spit forcefully. If you have been given a prescription for antiseptic mouthwash, start using it the morning after the surgery and use it twice a day. You may either hold the mouthwash in your mouth for one minute or saturate a cotton ball and GENTLY dab the area with it for one minute. If you use the cotton ball, dab around the biting surfaces of the teeth and allow the mouthwash to seep down onto the gum tissue. Do not rub. The mouthwash will last longer if you use the cotton ball method and it will stay off your tongue if you do not like the taste. Do not use peroxide, Scope or Listerine.
FOOD: For the first 24 hours, do not eat HOT foods/liquids. Heat may cause an increase in bleeding from the surgical site. Eat a soft diet such as pasta, meatloaf, fish, chicken, cooked vegetables, eggs, smoothies or yogurt. Avoid crunchy foods such as hard breakfast cereal, hard crusted bread, raw vegetables, chips, popcorn or nuts. Chew on the opposite side and cut your food up into small pieces. Eat a balanced diet and maintain adequate fluid intake. Usually you will need to stay on a soft diet for 2-3 weeks but follow the instructions given at the time of surgery.
SUTURES: Do not tug or remove your sutures. Follow your doctor's orders for your post-operative visits. We use both resorbable and non-resorbable sutures. Your doctor needs to see you for your follow-up to evaluate your healing progress and remove sutures if needed.
DRESSING: If a periodontal dressing has been placed, do not disturb it. It may come off either partially or completely before your next appointment. The edges might break off periodically. This is not an emergency and you will not need to have it replaced. Do not pull on the sutures if the dressing is lost. If the dressing is still in place at your follow-up visit, we usually remove it at that time.
REST: Avoid strenuous activity for 1 week and get adequate rest. Absolutely no smoking for at least 48 hours.
SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS AFTER THE SURGERY

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily. You may continue to use prescribed antiseptic mouth rinse 2x a day as instructed. DO NOT use mouth wash such as Listerine, Crest etc. for the first week.
BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery but do not brush, disturb the surgery area. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

AN EMERGENCY IS:
A) Excessive bleeding occurs, is prolonged and is not controlled with a teabag
B) Severe pain occurs, is prolonged and is not controlled with the medication
C) Marked swelling that is accompanied by fever

Emergency only!! Contact Dr. Bassir (Surgeon) @ 310-801-4208 or Leave a voicemail @ 661-857-7662 (Noa Dental Office)
All other questions, please call during office hours at 661-857-7662.

**CALL 911 WHEN ANYTIME YOU THINK YOU MAY NEED IMMEDIATE EMERGENCY CARE**
For Example, call or have someone call 911 if:

YOU PASSED OUT (LOST CONSCIOUSNESS)
YOU HAVE DIFFICULTY BREATHING, SWALLOWING/ THROAT TIGHTNESS
UNCONTROLLABLE FEVER

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