Instructions Following Nonsurgical Endodontic Treatment

Pain and Discomfort Management:

It is normal to experience some discomfort following a root canal, particularly during the first few days after treatment. The level of discomfort varies depending on the complexity of the procedure and the condition of the tooth.

• Pain Relief: Over-the-counter pain medications are typically sufficient to manage mild to moderate discomfort.
  • Moderate pain: 400 mg ibuprofen (Advil®, Motrin®) and 325–500 mg acetaminophen (Tylenol®) taken together.
  • Severe pain: 600 mg ibuprofen and 650–1,000 mg acetaminophen taken together.
  • If your discomfort becomes more intense or does not improve after a few days, please contact our office.
• Swelling: Mild swelling around the treated area is common. Applying a cold compress to the outside of your cheek for 15–20 minutes at a time during the first 24 hours can help reduce swelling and discomfort.

Managing Numbness:

Local anesthesia is used during your procedure, and numbness may last for several hours afterward.

• Avoid chewing or biting your cheek, tongue, or lip until the numbness has completely worn off to prevent accidental injury.

Temporary Filling Care:

• The temporary filling is placed to protect the tooth until it can be restored with a permanent restoration by your general dentist.
• Because the material is soft, it may feel uneven or as though it has changed shape. It is unlikely that the filling has completely fallen out, even if it feels that way.
• If you are unsure whether the filling is intact, keep the area as clean as possible and contact your general dentist to have the tooth restored promptly.
• Ideally, the tooth should receive a permanent restoration within one month of the root canal to prevent contamination of the treated canals.

Temporary Post-Treatment Sensitivity:

It is common to experience mild to moderate tenderness around the treated tooth, especially when chewing or touching the area. This sensitivity is part of the normal healing process and should gradually improve over a few days. If pain becomes severe or worsens after several days, please contact our office.

What to Expect in the Days Following Treatment:

Most patients begin to feel better within a few days, with discomfort steadily improving. Some tenderness may persist for up to a week, particularly when chewing. If symptoms persist beyond two weeks or worsen at any point, please reach out to us.

When to Contact Our Office:

Please contact us if you experience any of the following:

• Severe pain not relieved by over-the-counter medications
• Persistent or worsening swelling
• Fever or signs of infection
• Any unusual or concerning changes in symptoms

FOR THE REMAINDER OF THE DAY:

• Do not spit.
• Use a tissue to wipe your mouth as needed or swallow your saliva.
• Do not use a drinking straw.
• Drink straight from the cup.
• Do not smoke
• Keep fingers and tongue away from the surgical area. (Note: Spitting, the use of a straw, smoking, and/or poking can dislodge the blood clot that is forming and will cause bleeding from the area. Also, smoking can increase the chances of an infection.)
• Come back in 3-7 days to remove the sutures.

BLEEDING:

Some minor bleeding is expected after an Apicoectomy. It will usually subside quickly and stop within an hour or two after surgery. A little oozing is normal and may persist for several days.

SWELLING:

Most patients will experience some swelling after surgery in the mouth. It may be mild or severe and varies from patient to patient. The swelling will get bigger for the first 24 to 48 hours before it starts to go away. It may last for several days to one week.

• Use an ice pack on the cheek or face next to the surgical site. Keep it on for 20 minutes, then off for 20 minutes, and repeat until you go to sleep. Start the process again the next day.
• Sleep with your head slightly elevated (above the heart). This will keep swelling down.
• On the third day, change to moist heat instead of ice packs. This will bring the swelling down quicker.

EATING:

You may eat soft foods as soon as the anesthetic wears off. Try not to chew directly on the surgical site. Avoid crunchy foods that break apart, like seeds or nuts for the first several days. These foods can get stuck underneath the soft tissue. Generally, the incision sites will close within a couple of days, and then it is safe to resume a regular diet.

BRUSHING:

You may brush your teeth, avoiding the surgical area both tonight and tomorrow morning. Be gentle and do not spit or rinse forcefully. Start brushing the surgical area after sutures are removed.

RINSING:

You may start rinsing gently with warm salt water for 20 seconds in the morning and evening starting tomorrow. Do not use alcohol-containing mouth rinses for a few days.

BRUISING:

You may experience bruising following this procedure. The bruising may travel to other sites outside of the area where the procedure was performed. This is not unusual and can take some time to fade.

MEDICATIONS:

1. Antibiotics are not always indicated. If they were prescribed to you, continue until the bottle is empty. Do not quit halfway.
2. Pain Medications: We generally recommend ibuprofen (Advil or Motrin) and acetaminophen (Tylenol). Ibuprofen also has anti-inflammatory properties, and so 600mg of ibuprofen every 6 hours is recommended for at least the day of the surgery. If pain is minor on subsequent days, the dosage may be reduced to 400mg every 4 hours as needed. If pain is more severe, two acetaminophen tablets (325mg each or 500mg each) may be taken with 600mg of ibuprofen at the same time, every 6 hours as needed. These drugs are metabolized in different organs and are perfectly safe to take together.

CONTACT:

If you believe there are any complications, please reach out to us: 631-998-9899.