Post op instructions -Root Canal Treatment/Retreatment

What should I expect after my root canal treatment?  

Your tooth and its surrounding gum tissues may be somewhat tender for several days. This is a result of the infection that brought you into our office as well as the endodontic manipulation during treatment. This is absolutely normal and is part of the healing process. You can expect your tooth to be sore for about 3-5 days. When you touch it, brush it, and chew, it will be tender. Remember: the more your tooth hurt to biting prior to the procedure, the more tender it will be after the procedure.

Every patient is different and there are varying levels of discomfort. Some patients may even have discomfort for longer (i.e. two weeks). As long as it lessens every day, then you are headed in the right direction. Please make sure you continue to brush and floss the area normally.  

How should I manage my discomfort?  

To minimize your discomfort we will give you over the counter pain medication (advil or Tylenol) prior to initiating treatment, in order to stay ahead of any discomfort. It is recommended that you continue to take the medication, if you have PAIN or NO PAIN, around the clock every 6 hours for the next 3 days. A good way to remember this is to take a dose, with food​, at morning, noon, dinner and bedtime. By taking your post operative medications in this manner, you will keep your discomfort to a minimum. If you allow the pain to return because you skipped a dose, it will be harder to get rid of the discomfort. It’s a good idea to keep your pain medication on your nightstand so that you can take a dose at night. If you sleep longer than 6 hours or skip a dose, be aware that your tooth may be more tender in the morning. 

*Please see the chart below for dosage recommendations, based on level of pain.  Start your pain medications at the Mild Pain level and increase as needed.

Just so you know:

Advil and Motrin = Ibuprofen.​  Do not exceed 3200mg/24 hours.  If NSAIDS cannot be used for pain management, the tooth tends to be more sore after treatment and healing tends to take longer.

Tylenol = Acetaminophen.​  Acetaminophen comes in two doses, Regular (325mg) and Extra Strength (500mg).  Do not exceed 3000mg/24 hours. Note: Hydrocodone already contains 325mg Acetaminophen per dose.

Aleve = Naproxen Sodium.​ We suggest taking Ibuprofen instead of Aleve because you can take Ibuprofen more often. If you prefer Aleve, please check the dosage on the bottle. 

If you were given a prescription pain medication like Hydrocodone, the best way to take this is in conjunction with your over-the-counter medication. For the most effective pain management, alternate between the medications every 3 hours (For example: you would take your over the counter medication at noon, 6 pm, midnight, 6 am; while the Hydrocodone you would take at 3 pm, 9 pm, 3 am, 9 am. Your schedule will vary.)

If your pain is still too severe and you are taking both 600mg Ibuprofen and Hydrocodone or Acetaminophen, please call the office for additional information and possibly a different prescription. At this time, we may prescribe you an antibiotic and/or a steroid. 

What if I have swelling after treatment, or if my pain is not going away?

 If you experience any swelling after treatment (for example, your face looks asymmetrical when you look in the mirror), or your pain is not responding to the medication, please call the office and we will prescribe you an antibiotic and/or steroid. Do not be alarmed if this happens as it sometimes can occur after treatment. This is most common in patients who have a “black spot” associated with their tooth in the x-ray. If you have been given an antibiotic, it is important that you complete every pill in your bottle, following the recommended dosage. If swelling occurs while on an antibiotic, we may have to switch your antibiotic. If you have been prescribed an antibiotic and are experiencing significant diarrhea, discontinue the antibiotic immediately and call our office. This side effect can happen with any antibiotic, but is more common with Clindamycin. We also suggest taking a probiotic or eating yogurt when taking any antibiotic and drinking 8 glasses of water a day.

 What if my temporary filling falls out?  

Your tooth has been restored with a temporary filling. It is a soft filling and needs 30 minutes to harden. It is important that your tooth remain sealed between appointments. It is possible for the filling to sink a little as you chew with it. This is ok, but if you feel that you have lost a significant amount of temporary filling, please call our office during normal business hours and we will schedule a convenient time for you to come in to replenish your temporary filling. If this should occur over the weekend, this does not constitute an emergency — please call our office the next business day. 

What should I do after my root canal is completed?  

If endodontic therapy has been initiated on your tooth, it is essential that treatment be completed. If it is not, the tooth will become uncomfortable and may eventually be lost. It is possible that your root canal may take more than one visit if it was too infected or difficult. Once the root canal is done, you will need a final restoration such as a crown, so that the tooth is properly sealed and protected.  At the completion of your root canal, your regular dentist will be sent a full report with your radiographs so he/she knows your treatment with our office is completed. Please make an appointment with your general dentist within 2 weeks for a final restoration on the treated tooth. If your dentist is booked out longer than two weeks, please do not panic, but take their first available appointment. We would like to see you for a follow-up appointment in either 6 months or a year. This is to evaluate the bone supporting the tooth to assure proper healing. There is no fee for this visit and the appointment is typically only 10-15 minutes long.  

What if I need to speak to someone after hours?  

If you should need to speak to someone after hours, call the office at 516-271-3688 ​​and leave a message. Dr. Fleischer will call you back personally.  For the most timely response, call our office during​ normal business hours when possible. Also, if you feel like a prescription is necessary, we do ask that you try to call before 10 pm and after 8 am as these are the hours that the pharmacy is open. Have your pharmacy phone number ready and make sure to spell your name, leave your date of birth, and leave a phone number when using the after-hours service.