Video Post Operative Instructions available by clicking this link if you prefer to watch / hear the instructions.https://youtu.be/CMHaC0Ul7yU

 

THE PROBLEM 

When teeth are cracked, broken, heavily decayed, and/or at high risk for breaking, they often should be restored with a crown or “cap” that covers the tooth while addressing these issues. A dental bridge is made from two or more crowns that are fused together with a replacement tooth that fills the space created from missing or extracted teeth. Crowns and bridges are often made out of ceramic materials, but they can also sometimes be made with gold and other metals. During the preparation for a crown the defective structure of a tooth will be removed to make room for the crown materials. Then an accurate (digital) mold will be taken and sent to the dental laboratory to fabricate the permanent crown. A separate appointment is then required to permanently cement the permanent crown.

THE SOLUTION
FIRST APPOINTMENT

Upon completion of the first appointment, you will receive a temporary crown that is placed and temporarily cemented to the prepared tooth. When anesthesia has been used, your lips, teeth, and tongue may be numb for several hours after the appointment. We recommend that you avoid eating or chewing until the numbness has completely worn off because it is very easy to bite your tongue, lip and/or cheek. If you can’t wait to eat, then use the side of your mouth that isn’t numb to chew. Temporary crowns are made out of a material that has a consistency that is similar to plastic. Your saliva can also wash away the temporary cement with time. As a result, it is normal to experience some cold and hot sensitivity when teeth are covered with temporary crowns.  Brush gently around temporary crowns. When you floss around a temporary crown, pull the floss out from the side to remove the floss from the area rather than up or down. Removing floss with a rapid up or down motion may dislodge the temporary crown. If your temporary crown comes off your tooth or breaks contact our office ASAP to get it re-cemented or re-fabricated. If your temporary crown comes off the tooth and you cannot come to the office soon, you may try to clean the temporary cement from the inside the crown, then apply vaseline or an over the counter dental cement to try to place it back on the tooth. If you do this, keep in mind that these over the counter materials are not as strong as the temporary cement materials we use in our office. Similarly, your crown might not fit the same if you try to re-cement it yourself which can increase the risk of temporary crown breakage. If your tooth remains uncovered by the temporary crown for an extended period of time, cementing your permanent crown might require numbing and will likely become more difficult and time consuming.


SECOND APPOINTMENT

At the appointment for the cementation of your permanent crown, we will likely have to slightly adjust the crown to bite comfortably against the opposing tooth. After your permanent crown has been permanently cemented, it may feel tight or as if it is pushing against the teeth next to it for several hours. This discomfort will typically go away within a few days. The newness of the crown material and the texture might make it feel slightly different in your mouth at first, especially because your tongue can usually detect and magnify any small difference. You will become accustomed to how it feels within several days. Temperature sensitivity can still be associated with the tooth after the crown has been permanently cemented for several weeks because a chemical reaction occurs between the permanent cement and crown. However, the temperature sensitivity associated with the permanent crown tends to be less severe than that of the temporary crown because the permanent ceramic crown and cement provide a better insulated seal on the tooth than the temporary crown does. If your tooth had a deep cavity before the crown was started, you have a greater chance of experiencing more noticeable and prolonged sensitivity after initiation and completion of your crown. If your sensitivity increases or you have chewing discomfort after your crown has been cemented,  a bite adjustment may be needed. If sensitivity persists or worsens, even after a bite adjustment is completed, there is a possibility that your tooth will need additional dentistry, like a root canal, to keep the tooth in your mouth and resolve symptoms.

Please resume following our standard recommendations of brushing your teeth twice a day and flossing once a day after your crown or bridge has been permanently cemented. There is still a natural tooth under crowns. Meaning that poor oral hygiene and/or diet can cause the tooth to get a new cavity, which will require further dental treatment.


DEALING WITH POST OP DISCOMFORT 

Discomfort around the injection site and the gums near the tooth/teeth worked on is common following the initiation of a crown or bridge procedure. This swelling and/or discomfort tends to peak about 72 hrs after a completion of the procedure and tends to diminish after that with passing of time. Current research shows that the best way to treat post-operative discomfort and swelling following this dental procedure is to take 2 tablets of 200mg ibuprofen (commonly known as Advil) and 1 tablet of 500mg acetaminophen (commonly known as Tylenol) by mouth every 4 hours as needed. It is important to only take these three pills together as needed by mouth every four hours. It is equally important to not take a higher dosage of these pills or to take them more frequently than every four hours. Only take ibuprofen and/or acetaminophen if you know your medical history does NOT contraindicate you from taking these medications. If you have any doubt about whether or not you are able to take these medications, you should contact your physician to see if you are able to do so. If you are unable to take ibuprofen and/or acetaminophen, take what you would typically take to relieve a headache to treat your post-operative pain or consult with your physician and/or dentist about alternatives. It is best to start taking any pain medications while you are still numb, as pain responds better to proactive treatment than reactive treatment. Please continue with any other medications as prescribed, unless instructed otherwise by your physician or dentist.

You can also use a warm salt water rinse up to 4 times a day to help provide relief to sore gums. Do this by mixing one teaspoon of salt in a glass of warm water. 

Your jaw may be sore from holding open during the procedure. If you need a supplement to the recommended acetaminophen and ibuprofen, you can apply ice to the area for the first 72 hrs following the procedure. Apply ice packs for 15 minute increments. After the ice has been in the area for 15 minutes, give the treated area a 15 minute break before reapplying ice to the area for another 15 minutes. Repeat this process as needed. Do not apply the ice pack directly to your skin. Use of something like a paper towel to prevent skin irritation works well.