Post Operative Instructions

Apicectomy (Root Canal Surgery)
There are some valuables recommendations you can follow after the procedure:

  • Swelling, minor pain and / or skin discoloration may be experienced following the surgical procedure. This will be temporary.
  • In order to keep the swelling to a minimum, use an ice pack for the first few hours (on for 10 minutes and off for 5 minutes).
  • The dayafter the surgery use lukewarm water rinses for the treated area following each meal. This should continue for the first 3 days following the surgical procedure.
  • Eat only soft foods. Avoid hard and chewy foods.
  • Get plenty of rest and insure normal intake of food, especially liquids such as fruit juices, soup, and milk. Use a vitamin supplement if desired. Try not to sleep on the operated area for 2-3 days.
  • DO NOT raise your lips with your fingers to inspect the treated area.
  • DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.
  • There is often a temporary loss of feeling in the operated area and the tooth may feel loose.
    Take always medications according to the instruction given by the dentist.
Bone Graft Surgery
What is Bone Graft Surgery?

It is a surgical produce which replaces the missing bone with material from the patient´s own body and artificials substitutes. This procedure is used specially for replace complex fractures or areas that fail to heal properly. When some of this circunstances are detected, you will be advised of the particular procedure and pertinent directions relative to your treatment modality. Whether you were put to sleep for this procedure or were only given local anesthesia, the post operative directions remain the same.

Bone grafting is a very predictable surgical procedure when done correctly and when patient cooperation is adhered to. Please try to be reasonable in understanding that this procedure has inherent risks associated with it as stated in your informed consents. Some of these risks are also pertinent to your post operative care.

The Procedure

You will have several sutures (stitches) placed at the surgical site. These sutures may or may not be resorbable. If you have been told that you have received external silk sutures they have to be removed by us. The sutures will cause a pulling of your tissue over the bone grafting site. Since the bone graft site will have approximately 15 % more bone fill than what was naturally there, it is imperative that you do not pull up your lips or cheeks to show or examine the area. The undue pressure will cause the sutures to widen away from the surgical site, expose bone, create more pain, and delay healing dramatically. This delay can lead to the need for the area to be sutured again when you are seen for your 1 week post surgical evaluation. The sutures will remain in place for between 14 and 21 days depending on the size of the graft, the severity of the pathology, and the condition of the tissue being sutured.

Your doctor will tell you what time period to expect. Remember though that this is not etched in stone, and that the doctor may extend the time before your sutures are removed to assure adequate healing and to avoid surgical regression.

You also may have a periodontal pack placed over the surgical site. The pack is pink in color, impregnated with antibiotic, and will protect the surgical site form infection and any wash out of the particulate bone utilized to restore your jaw. The pack should be left in place for as long as possible. If a pack is placed the doctor will remove the packing on your 1 week followup and decide if the packing should be replaced or kept off. Usually the packing is kept on for 7 to 10 days minimally. You must return to the office if your pack falls off before you are seen for your 1 week follow up.

A proper maintenance

Your maintenance during healing has to be completed carefully. Follow carefully the instructions given by the dentist and brush in every area where the periodontal pack is not placed. It is imperative that you use NOTHING ASTRINGENT such as mouth wash or antiseptic solutions during the healing period of your bone graft. Listerine, Viadent, and any other potentially caustic agent can RUIN your bone grafting procedure, if contaminated, and require a replacement bone graft. Doctor and our staff will reiterate this with you at, during, and after your bone graft surgical procedure. After the first stages of healing is satisfactory, we will deliver and instruct you on how to use normal saline (with or without the addition of salt), and irrigation syringes for cleaning of the surgical site.

Since bone grows and heals slowly, and requires conditions conducive to a proper environment and blood supply, it is imperative that immediately after your bone graft that you alter your diet, as you would for any Oral Surgical procedure. This means that you should not eat anything that is too large, too hot, or too sticky. Your food should be tepid or on the cool side. Any food too hot will have a deleterious affect on your surgical procedure. Common sense must be used in determining what should be done or not done. If for some reason you have a question about anything post surgically, please call the office and we will inform you of the proper action to take.

Smoking after any Oral Surgical procedure will ALWAYS delay or badly disrupt normal healing due to a decrease in oxygenation of the tissue that is healing. Smoking should therefore be stopped for the first 7 to 10 days to allow for adequate initial tissue closure. Complete epithilization (closure) and wound healing normally takes a minimal of 21 days from the day the surgery was completed under ideal healing conditions and no other underlying systemic causes such as Diabetes Melitus, etc.

We want nothing more than a perfect outcome with the surgical procedures that you are having done to rehabilitate your bone. This can only be attainable with proper cooperation from you. Please always feel free to communicate with us, at any time, to make sure that the procedures that you are having completed are properly maintained. No question is ever perceived by our office as being silly or unreasonable. We would rather have questions answered immediately than to have a chance that the procedure will not go as planned, especially from omissions that are preventable.

Please also remember, as stated above, and as outlined on your informed consents, that there are some occasions that no matter what is done that the outcome is not perfect. There are even infrequent instances when a surgery may have to be redone that are neither the doctors or the patients fault.

Braces Were Placed
The dental braces (also known as orthodontic braces, or simply braces) are devices used in orthodontics to align teeth and their position with regard to a person’s bite. They are often used to correct malocclusions such as underbites, overbites, cross bite or teeth with other flaws of teeth and jaws, whether cosmetic or structural.

Types of Braces:

There are many types and varieties of braces. They ‘d been determined according to teeth situations and of course, cosmetic reasons:

  • Tradicional braces: made by stainless steel, sometimes in combination with nickel titanium, and are the most widely used.
  • Gold-plated braces: employed for patients allergic to nickel (a component of stainless steel), but may also be chosen sometimes because someone simply prefer the look of the gold on the teeth.
  • Lingual braces: fitted behind the teeth, this kind of bracer are not visible with casual interaction.
  • Clear braces: a cosmetic alternative to the tradicional braces. They have elastic ties and with white metal ties are combined to create a more natural look in combination with the color of the teeth.
  • Removable aligners: they’re used to gradually move teeth to their final positions.
  • After the process, you may experience some pressure and discomfort on your teeth. Be gentle with braces and avoid chewing hard and/or sticky food. Brushing and flossing around braces are sometimes challenging but very important.
Crown and bridge (also inlays and Onlays)
About the treatment.

As we told you before, crown and bridges are types of restoration which completely caps or encircles a tooth or dental implant. Specifically speaking of this treatment, the usual action taken by the dentist is to provide the tooth with an intracoronal restoration: a process consisting of a dental material that will exist totally within the confines of the remaining tooth structure.

This kind of treatment usually takes 2 or 3 appointments to complete. On the first appointment the tooth/teeth are prepared and impressions are taken and a temporary crown is placed on your tooth/teeth. It´possible you may experience sensitivity, gum soreness and slight discomfort on the tooth / teeth, it should subside after the placement of permanent crown. Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.

A temporary crown is usually made of plastic based material or soft metal. It could break if too much pressure is placed on it. The crown also may come off; if it does, save the crown and call our office. The temporary crown is placed to protect the tooth and prevent other teeth to move. If it comes off it should be replaced. To avoid losing your temporary, avoid chewing on sticky and hard food (chewing gum, ice). Try to chew on the opposite side of the treatment as much as possible.

After the permanent restoration is placed you may feel slight pressure for a few days. Also, the bite may feel different for a day or two. But if the bite feels uneven or you feel discomfort on chewing on the tooth after 2-3 days call our office. Delaying the necessary adjustments may damage the tooth permanently. After the treatment, continue your normal brushing but be careful while flossing around the temporaries (remove the floss gently from the side).

Denture Delivery
Dentures (also known as dental plates) are devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. This kind of prosthetic devices are removable with different designs depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch.

With any new denture, you will experience some discomfort for a few days. All new dentures need several adjustments to completely and comfortably fit your mouth.

You should take the dentures out every night and keep them in a clean container containing water or denture cleaning solution. Your gum needs rest and to be without the dentures every day for a period of time. It´neccesary to clean dentures thoroughly with brush and water before putting them back in your mouth.

It may be difficult to talk normally with the new denture for a few days. A way to practice is to read a book or newspaper out loud for a period of time everyday. Your tongue and muscles will get used to the new denture and you will talk normally very soon.

Extractions
They are also known as exodontia which consist in the removal of the tooth from the mouth. This procedure is performed for a wide variaty of reasons which includes tooth decay for a regular use or by presence of dental caries, tooth in the fracture line and insuficent space for wisdom teeth.

Extractions are categorized as “simple” or “surgical”.The first class is performed on teeth that are visible in the mouth, usually under local anesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. In this cases, the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the Periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth loose enough to remove.

The Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. They always require an aditional incision elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding bone tissue with a drill or osteotome.

More information and rules to follow after the extraction.

The Pressure should be placed on the gauze pad that has been placed on the extraction site for one hour. If the bleeding continues new gauze should be placed and pressed on for another 45 minutes. If you are supervising children who have had extraction done, make sure they don t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

Avoid eating or drinking anything hot on the day of your extraction. Also, do not rinse your mouth, do not use a straw for drinking. Do not spit and do not drink carbonated beverages. Do not brush on the day of the surgery; you can resume your brushing and flossing the day after, gently.

You may experience some pain, bruising around your lips and/or some swelling, especially after extraction of impacted wisdom teeth. Ice bag application and medication prescribed for you will help to minimize your discomfort. Please take all the medication you have received based on the instructions given to you.

During the first 2-3 days after the surgery a diet of soft food and liquids is recommended (soup, yogurt, milk shake and juice).

For more complex Surgical Procedures including Impacted Wisdom Tooth Extraction, Implant Surgical Procedures, etc; you will receive an ice wrap which should be worn for the rest of the day and until you go to bed on the day of surgery only (10 minutes on and 5 minutes off). Individual instructions for various surgical treatments will have some unique directions which will be supplied to you at the time of your treatment.

Fillings
As we explained before, a dental filling is a restorative material used to restore the function, integrity and morphology of missing tooth structure. They are divided in direct restorations and indirect restorations. They can also be classified by location and size.

After the procedure, the patient must follow some extra instructions in order to take care of the filling.

The patient should not eat on with the new filling for one hour and until the numbness is gone. Try to be extra careful and don´t bite hard or chew on silver Amalgam fillings for at least 24 hours. It´possible the patient will experience cold and heat sensitivity and some soreness on the gum for a few days.

If the person is supervising children who had fillings done, make sure they don´t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).

Gum Surgery
Also known as periodontal surgery, the gum surgery consists in a procedure to treat the gingiva. There are several types of this kind of process which includes:

1-Crown lengthening: is the removal of gum tissue and/or bone to expose more of the tooth.

2-Gingivectomy: this one reduce gaps or pockets between the teeth and gums that trap food particles.

3-Gingival flap surgery: it is used to temporarily separate the gums from the teeth giving a clear access the roots of the teeth and their supporting bone.

4-Gingivoplasty: commonly used to treat gum tissue malformed due to genetic factors, disease, trauma among other factors.

5-Soft-tissue graft: in this procedure, the issue is taken from the palate or other tissue source and added to an area where the gums have receded. This is considered one of the most delicated dental process.

Thorought the surgery, you may experience some pain, swelling and bleeding for a short period of time.

The patient should take all the prescribed medications based on given instruction by the dentist. Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off. Keep your next appointment on time for removal of sutures and follow up checks. And above all, DO NOT raise your lips with your fingers to inspect the treated area. and DO NOT brush teeth near the surgical site.

There is often a temporary loss of feeling in the operated area and the tooth may feel loose. Do not smoke, spit or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

Implant Surgery
What is Implant Surgery?

It is a procedure that replace damaged or missing teeth with an artificial teeth with an exact look of the real one. Actually, it works like a real one without any difference. How the surgery is performed depends on the type of implant and the condition of the jawbone area. Major classifications are divided into osseointegrated implant and the fibrointegrated implant.

This kind of procedure requires a preparation into the bone using either hand osteotomes or precision drills with highly regulated speed to prevent burning or pressure necrosis of the bone. After a variable amount of time to allow the bone to grow on to the surface of the implant (osseointegration) a tooth or teeth can be placed on the implant.

After the surgery, you may experience some discomfort and bleeding. The patient must take all the prescribed medications based on given instructions. Is important to apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.

No matter what DO NOT raise your lips with your fingers to inspect the treated area and DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth. DO NOT smoke, spit or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).

It is important to consider there is often a temporary loss of feeling in the operated area and the tooth may feel loose.

Root Canal Treatment
  • You may experience moderate pain and sensitivity to pressure on your tooth. Also, you may feel gum soreness for few days after your treatment. The healing process may take several days but the pain and discomfort should subside gradually.
  • Take any medication that was prescribed for you according to instructions.
  • Usually a temporary filling has been placed on your tooth, do not bite on the tooth for one hour and while you are numb. Also, until the permanent restoration is placed, be very gentle with the tooth. Try to chew with the opposite side.
  • Continue your brushing and flossing.
  • Follow up with the placement of your permanent restoration as you have been advised. Any unnecessary delay on placement of final restoration may damage the tooth permanently.
  • Call our office if you are in severe pain or experience swelling or if you have any questions.
Teeth Cleaning (Deep Cleaning)
Is the removal of dental plaque from teeth, to prevent cavities (dental caries), gingivitis, and periodontitis. It is part of the program of oral hygiene. It helps to prevent build-up of plaque bacteria on the teeth. This cleaning procedure (Prophylaxis) done by a dental hygienist is recommended at least once every 12 to 24 months in order to remove tartar (mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult for a patient to reach on his own at home.

During this kind of procedure, you may experience some cold and heat sensitivity (especially after deep cleaning). If you have received anesthesia do not eat anything until the numbness has worn off.

After this, continue your regular brushing and flossing at home. Some bleeding for a day or two after cleaning is normal, but if you experience any excessive bleeding please contact us. We are glad to serve you.

Dental Treatments

Nova Dental combines superior technology and special commitment to become one of the leading Dental Clinics of Costa Rica.
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Dental Implants

The replacement of missing teeth is important to a patient’s oral health and overall well-being.
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Crowns

A crown serves as a cover that protects the damaged tooth, preventing further decay or cracking.
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Porcelain Veneers

A Porcelain Veneer is a thin layer that is placed on a tooth surface in order to protect a vulnerable tooth area.
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