Postoperative Instructions

Office Policy

The overwhelming majority patients are completely comfortable following root canal therapy.  In cases where patients present with a toothache resulting from inflammation inside the pulp of the tooth, significant relief is experienced immediately following the procedure.

Most patients present for endodontic therapy because they have a tooth that hurts.  Most of the time, the teeth go back to feeling 100% normal within a few days.  Occasionally a tooth may take a month or very occasionally a few months to get there.

Occasionally, significant postoperative discomfort will occur.  It is difficult to predict when it will occur, because it depends on the patient’s individual immune response and the virulence of the specific bacterial ecology in and around the infected tooth.  When postoperative discomfort occurs, it does not effect the successful outcome of treatment.  The discomfort arises from temporary inflammation outside of the tooth as your body proceeds to remove infection from outside of the tooth.  This type of discomfort can normally be managed with pain medication and is resolved in a few days.

Postoperative Instructions for Root Canal Therapy:

Unless you have been instructed otherwise, the general postoperative instructions for pain management are as follows:

1. Take 600 mg. of Ibuprofen every 6 hours. 

This includes setting your alarm to wake up at night to stay on schedule with the medication.  It is not as effective if doses are missed.

Take the Ibuprofen for at least three days, even if you do not feel like you are experiencing pain.

2. If the Ibuprofen is inadequate on its own, add the Vicodin ES to it; don’t stop taking the Ibuprofen.

Take one Vicodin ES three hours after the Ibuprofen, then take the Vicodin ES every six hours.

Ex) You will take 600mg Ibuprofen, then one Vicodin ES three hours later, then 600mg Ibuprofen three hours after that, then one Vicodin ES three hours after that, etc.

Do not take the Vicodin more frequently than every six hours, as this will put you over the daily limit for acetaminophen. Instead, call our office, and we will prescribe you a different medication. You may increase the Ibuprofen to every four hours if necessary.

You may discontinue the Vicodin as discomfort decreases.

After three days, you may discontinue the Ibuprofen as discomfort decreases.

If you were prescribed antibiotics (usually Amoxicillin or Clindamycin), be sure to finish the full course, even if you are not experiencing discomfort.

Discontinue the medication immediately and give our office a call if you experience any adverse reactions to the medication.

Postoperative instructions for Periradicular Surgery:

Follow the medication regimen as described above.

Applying an ice pack (20 minutes on and 20 minutes off) for eight hours can help to reduce normal postoperative swelling.

Avoid pulling on your lip or cheek to look at the area because this can pull the incision apart and cause sutures to come out.

Maintain proper nutrition with a soft diet until you return for your suture removal visit.

Avoid smoking and strenuous exercise for one week.

Do not brush your teeth at all for the first 24 hours.  Do not brush the teeth around the area of the surgery until after the sutures have been removed.

Gently rinse with the prescribed Peridex rinse twice a day, for one week.

Postoperative instructions for tooth extraction:

Follow the medication regimen as described above.

Bleeding from the extraction site is expected.  The initial goal after the extraction is to establish a blood clot to stop the bleeding.

Keep biting on the gauze that was placed until you get home.  Replace the gauze as needed.

Once the blood clot is established, it is important not to lose it.  Avoid picking at the area, do not brush or rinse for the first 24 hours.  After 24 hours you may carefully brush and gently rinse (do not forcefully spit).  Avoid exercise for 24 hours.  Avoid creating negative pressure such as drinking through a straw or smoking for the first week.

Applying an ice pack (20 minutes on and 20 minutes off) for eight hours can help to reduce normal postoperative swelling.

If you have any questions or concerns, you can reach Dr. Boehne at any time.  You may call his cell phone number, which can be found on the back of the card that was given to you following your appointment.