Before Endodontic Treament

Root Canal Treatment

This procedure will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. Should a problem arise after your treatment, call our office immediately.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.

Please eat a full breakfast or lunch as applicable.

If you have been advised by your physician or dentist to use antibiotic premedication because of a medical condition, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment.

If you have any questions, please call our office at 416-781-5251

After Endodontic Treatment

General Instructions After Each Visit

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation treatment and the previous condition of your tooth. This tenderness is normal and is no cause for alarm. Do not check tooth on either side until your endodontic therapy is completed and your tooth is covered with a protective restoration provided by your restorative dentist. You may continue your regular dental hygiene regimen.

If your medical history allows, discomfort may be alleviated by taking Ibuprofen (Motrin or Advil 600mg. which is equivalent to 3 over the counter tablets, every 6 hours), Aspirin, or Acetaminophen (Tylenol) as directed. These should be taken with food. Alcohol intake is not advised while taking any of these medications. Should you experience discomfort that can not be controlled by the above listed medications, or should swelling develop, please contact our office immediately. Our office telephone is answered day and night. If you need to call after hours, please have your pharmacy phone number available.

Home Care Instructions

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and/or the previous condition of your tooth. This tenderness is normal and is no cause for alarm. Do not chew food on the affected side until the anesthetic has worn off. Also, do not chew hard substances on that side until your tooth is covered with a protective restoration provided by your restorative dentist. You may continue your regular dental hygiene regimen. Discomfort may be alleviated by taking over-the-counter medications as directed.

NOTE: Alcohol intake is not advised while taking any of these medications. Should you experience discomfort that cannot be controlled with over-the-counter medications, or should swelling develop, please contact our office immediately.

After Completion of Endodontic Treatment

Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface of the tooth is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. Please telephone your restorative dentist for an appointment. A complete report of treatment will be forwarded to your restorative dentist. Included in your treatment is a follow-up examination to evaluate the progress of healing. This appointment will require only a few minutes and no additional fee will be charged for the first check-up visit. Usually this follow up appt. is 6 months after completion of the root canal.

Your tooth is more prone to fracture immediately after endodontic treatment. You should chew on the other side until your restorative dentist has placed a core build-up and a protective restoration, usually a crown. If your tooth’s strength is seriously compromised, your restorative dentist or even your endodontist may place a post and core build-up inside the tooth. Your restorative dentist will determine the appropriate restoration to best protect your tooth.

Are There Any Potential Problems After Treatment?06

• Lower teeth and nerve injury. There is a slight possibility that nerve injury can occur during root canal surgery to the lower posterior teeth. Your endodontist is trained to assess this possibility prior to treatment and will advise you accordingly. For lower posterior teeth, the root tips may be near a nerve that supplies feeling to the lip, chin and gums. Your endodontist is trained to perform your surgery in such a way as to minimize the chances of damaging this nerve.  Although the incidence is rare, this nerve can become irritated during the process of surgery. In these cases, when the local anesthesia wears off, you may experience tingling, altered sensation or in rare cases a complete lack of feeling in the affected tissues. Should this occur, it is usually temporary and will resolve over a period of days, weeks or months. In rare case will these changes can be permanent and/or painful.
• Upper teeth and sinus communication. The upper teeth are situated near your sinuses, and root canal surgery can result in a communication between your mouth and the adjacent sinus. Should this complication occur, it will usually heal spontaneously. We will give you special instructions if this is apparent at the time of surgery. We prefer that you don’t blow your nose for two to three days after surgery. If you have to sneeze, you should sneeze with an open mouth into a tissue. You should not create any pressure in the sinus area. If you sense a complication after surgery, please contact us immediately.

• Post-operative infections. Post-operative infections occasionally occur. This usually requires just an office visit and examination. Many times placing you on an antibiotic for one week will take care of the infection Occasionally, other follow-up procedures will be needed.

Post Surgical Instructions

What to expect after surgery:

1. Slight oozing or bleeding is normal for 24 hrs
2. Although severe pain seldom occurs, some discomfort will usually be present.
3. There may be some swelling and discoloration for one week. This is a normal part of the healing process.
4. There may be some temporary loss of feeling in the surgical site.
5. The treated tooth may feel loose for a brief time following the procedure.

Home care instructions following Endodontic Surgery:

1. Rest. Avoid strenuous activity for at least 48 hours.
2. Take and complete any medications as prescribed.
3. Do not lift or pull lip to examine surgical area. This may disrupt stitches which may increase irritation.
4. Place ice pack on surgical area 20 minutes on and 20 minutes off for approximately 6 hours. This will minimize swelling and discoloration. Do not use ice after the first day.
5. Remove any gauze pack placed upon arriving home. If the bleeding continues after the first hour, remove the old gauze and place a new piece over the wound. Apply firm pressure for an additional 30-60 minutes. For excessive bleeding, you may place a wet tea bag (Lipton Black Tea) over the area for 45 minutes. Tea contains an ingredient that helps promote blood clotting. Assume a semi-upright bed position, using 2 pillows. Spitting and rinsing causes bleeding. Avoid this if at all possible.
6. During the first 48 hours use foods that will not require vigorous chewing. Eat soft foods on the opposite side of surgical area and avoid hot foods and foods that will cause you to stretch your mouth for at least 1 week.
7. Do not brush, floss, or rinse mouth for 24 hours.
   1. After 24 hours, meticulous oral hygiene should be continued in all other areas of the mouth, but avoid brushing and flossing in the area of surgery during the first week.
   2. After 24 hours, begin rinsing with salt water (1 tsp. salt with 1 glass of warm water) after meals and as often as practical to help remove debris, prevent a sour taste and make your mouth feel more comfortable. An anti-bacterial mouth rinse, Peridex(Chlorhexidine) may have been prescribed & this rinse should be used in addition to salt water use. The instructions are to soak for 30 seconds and then expectorate gently (spit). Do not swallow. This is done 2 times daily, after breakfast & before bedtime. Avoid drinking or rinsing for 30 minutes after using Peridex.
8. Avoid straws and spitting for at least 48 hours.
9. Do not smoke for 1 week after surgery. Smoking delays healing.
10. Return to this office for suture removal as directed.

If you have any of following symptoms following surgery:

• Fever
• Your bleeding has not stopped or decreased after 24 hours
• Severe pain
• Any questions or concerns

Please do not hesitate to call our office at 416 781 5251 or Dr. George Sas (C) 416 781 0304 or Dr. Geoffrey Sas (C) 416 454 2992. or Dr. Dana by email at r.dana@alum.utoronto.ca