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Dental Assisting as a Career • Dental Assisting Training • The Ideal Dental Assistant • Post-Operative Instructions

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These instructions are written for the use of dental assistants. Dental assistants have the responsibility of teaching the patient these points after treatment is rendered. But while dental assistants are primarily responsible for communicating these instructions to the patient, all dental office staff should be familiar with them, since all will be asked questions by patients.

General Post-Operative Procedure

1. Dental assistants should always show the patient the work that has been done. Don’t ask if they want you to show them – just show them. Have the patient reclined, with the operating light on. Make sure they get as clear a view of the work as you can, using a dental mirror and something to point with. Show them every tooth that was worked on, and as you let them see the work, then give the instructions as listed below.

2. Inspect the chart to see if today’s work is entered. If it has, pack up  the chart. If it hasn’t, leave the chart in the room, open, so that the doctor will remember to write in it.

3. The dental assistant should either walk the patient to the business desk to check out, pay, and make their next appointment; or the dental assistant should direct them to the business desk.


Will be tender – tenderness will go away as the body heals this irritated ligament that attaches the tooth to the jaw.

Could be very sore. The tooth could flare up with pain and swelling. If it does, the patient needs to call.

The tooth is weakened until the crown is done, and unless it has a temporary crown on it, they should be careful with it. Minor chipping of the tooth or slight loss of the Cavit is no problem; but, if the tooth has a large hole, biting normally on the tooth before it is fully restored could cause a serious fracture that would jeopardize the life expectancy of the tooth. They need to be especially careful if the tooth is missing both the mesial and distal surfaces, because a fracture down the middle could ruin the tooth.


Familiarize yourself with the instructions in the post-extraction brochure “Tooth Extraction” by the American Dental Association.

The patient needs to sit still for a few minutes immediately after an extraction to be sure a blood clot has formed. Recommended rest times:

                   partially resorbed deciduous tooth                          0-2 min.

                   deciduous tooth with full root                                5-10 min.

                   permanent tooth – simple extraction                  abt. 10 min.

                   flap extraction                                                   abt. 30 min.

                   patient with a lot of bleeding                              abt. 45 min.

After simple extractions, the dental assistant should tell the patient –

1. After leaving the office, be somewhat still, without strenuous activity and without sucking or spitting, for about two hours. If thick bleeding (pink saliva is normal – real, red bleeding with blood clots, etc. isn’t) recurs, use the gauze packs according to the instructions in the post-extraction brochure.

2. For pain, take Tylenol or ibuprofen.

After any kind of flap extraction , the dental assistant should tell the patient –

1. The same instruction as above on bleeding.

2. There will be some swelling. The more extensive the flap and the more extensive the procedure, the more swelling there will be. (Never underestimate the amount of swelling or discomfort the patient can expect.) Use ice packs by the surgical site today and maybe tomorrow, but not past tomorrow. Keeping the head somewhat elevated overnight with something like an extra pillow will also help to keep the swelling down.

3. Gently rinse the mouth after meals tomorrow with warm salt water according to the directions in the pamphlet.

4. There will be pain and it will be hard to open your mouth very far. Generally these patients are given prescription pain medication. Take the pain medication according to the instructions given with the prescription.

5. Brush and floss most of your teeth today. Starting tomorrow, also brush the teeth next to the extraction site, but do it gently.

6. Eat only soft things today. After today, eat what you feel like you can handle—“listen to your body.”



Posterior or Anterior Composites:

Be sure the patient understands the benefits of composite restorations over amalgams.

1. Unlike amalgam, composites are at their full strength at the end of the appointment. They are strong enough to chew on right away, as long as the numbness has worn off (so they don’t inadvertently chew their tongue or something.)

2. With an amalgam, the tooth will always be more sensitive to cold (because metal conducts cold so well). The composite, however, is an excellent insulator, so the only sensitivity we expect is the irritation to the tooth from our having worked on it, which should last only a couple of days. If there is sensitivity that doesn’t get any better after a couple of weeks, or if any sensitivity occurs that seems to get worse, they should call the office.

3. Composites are so hard that they will not mold to the bite after the appointment. If they feel high after the anesthetic wears off, they should call to have the bite adjusted.

4. Point out that with a composite restoration, most of the original strength of the tooth is restored, and the tooth is much less likely to break than with an amalgam.

5. Check the tooth with floss before dismissing the patient. If they have any difficulty flossing, or if floss snags around the filling, or if there are any rough or sharp places, they should call the office and have it smoothed.

Preventive Resin Restorations (and Sealants)

1. Be sure patient is aware of the superiority of this conservative filling technique as opposed to the old-style amalgam filling. The preventive resin is a very small filling that only fills the area of decay, and is usually less than ¼ th the size of what an amalgam would have been.

2. For no additional cost, a milky white plastic layer has been placed over the grooves (rather than have amalgam fill all the grooves as we used to do). This may make the tooth feel “high” to the bite. If a patient is under 20 years old, the bite will adjust itself in time, and it is better not to grind away this protective plastic coating in order to adjust the bite. Older patients may require adjusting if the bite later feels high.

Anterior Composite Bonding

1. If bonding develops spots that snag the floss, they should contact the office.

2. It is important to keep the edges of bonding clean by brushing, flossing, and keeping plaque amounts down by avoiding between-meal sugary or starchy snacks.

3. If bonding extends onto the biting edges of front teeth, the patient needs to be aware that these edges are not as strong as their natural teeth. Avoid biting directly on these edges, especially biting on hard objects such as bones, pins, etc.


1. It’s important to keep the tooth and temporary crown clean between appointments by brushing and flossing. If the tissue gets too irritated because the tooth has not been kept clean, it will be hard to keep the bleeding off the tooth when we try to bond or cement the permanent crown.

2. Brush normally. When they floss around a temporary crown, be sure to pull the floss out sideways rather than snapping it out through the contacts as this could risk loosening the temporary.

3. Because of the shape of some teeth, some temporary crowns can be difficult to keep on. While we try to make them so they don’t come off between appointments, we also try to make them so they will come off easily when we want them to. If it does come off before its time, the patient should come in right away to get it put back on. Going two days or more without a temporary crown will probably cause the tooth to move. If it moves enough, the permanent crown may not fit.


1. Crowns are a very durable restoration, and we ordinarily look for at least ten to fifteen years of trouble-free service out of a crown. They should be able to chew without sensitivity with a crown. If there is any chewing sensitivity, they should come in for an adjustment.

2. They need to give the cement one hour to fully harden before chewing, then they can eat what they want.

3. They need to floss around the crown and brush well, as the part of the tooth that is not covered by the crown, especially the margin where the tooth meets the crown, is still susceptible to decay. There is no need to worry about “pulling the crown off” if they floss – our doctor’s crowns are very secure.

4. The tooth could be sensitive to cold for a few weeks. If it is sensitive for longer than that, or if there is any increase in sensitivity over time, they should come in and have the tooth checked.


1. The veneer may make the tooth feel thicker. The veneer, however, is only as thick as a fingernail, except in those places where a tooth was crooked, and extra thickness of porcelain was used to make the tooth look straight. It usually seems thicker right when the veneer is placed because we made the teeth slightly thinner in preparing them.

2. For the most part, the patient can chew normally. However, it would be wise to be careful with activities that stress the teeth, such as chewing ice or metal objects.

3. Patients involved in contact sports, or who clench or grind their teeth at night should wear a protective mouthguard or nightguard to help prevent chipping of the veneers.

4. Brush and floss conscientiously to protect your investment. Special cleaning procedures by the hygienist can help keep the margins of the veneers bright and extend their life. We recommend twice yearly veneer maintenance in addition to the twice yearly regular cleanings.


1. Familiarize yourself with the instructions in the ADA brochure Your New Dentures. Know this information backwards and forward and be able to explain the reasons for all of the instructions.

2. Explain to the patient how to clean the dentures and how to adjust to wearing them. Answer all of the patient’s questions.

3. We assume that the denture will need a couple of adjustments. Be sure the patient is scheduled for the adjustment – don’t just tell them to call in case they need an adjustment. Don’t create the expectation that there may be no sore spots or adjustments required. In preparation for the adjustment appointment, they need to be sure we can see the sore place. Therefore, it’s important for the patient to continue to wear the denture in spite of the sore spot, or we may be unable to help them.


1. Again, be totally familiar with all of the instructions in the brochure, Removable Partial Dentures. Be prepared to explain these items fully to the patient, and be sure you understand all of the reasons for the instructions.

2. Again, if there are sore places, the patient needs to continue to wear the partial so that we can identify those places. They need to be scheduled for the first adjustment – don’t wait till it hurts.

3. The partial will move a little bit during chewing, but there should be no major shifting or rocking during use. The difference between normal movement and major shifting would be that in major shifting, the position of the clasps on the teeth may change. Major shifting requires an office visit for an adjustment.

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