Post-Operative Instructions

These are the things I tell all of my patients after treatment:

Emergency treatment
“Be certain to take the recommended meds religiously, especially the Aleve as it helps
reduce and heal the cause of the pain, inflammation, as well as reducing the pain. If you
need the Vicoden, be sure to take the Aleve also, as it will help the Vicoden work better
and longer. Be certain to take the full course of antibiotics, if prescribed. Call me if you are
not feeling significantly better than when you came in today, even if you are just concerned
or have further questions about your treatment. Your tooth will not return to a totally
asymptomatic state until we finish the root canal treatment at your next appointment.”
Treatment is finished—see above and add:
“There is a wound at the end of your tooth that must heal now that we have finished
treatment, so it is very normal for your tooth to be sore, reaching a peak within 48 hours
and getting better every day until 30 days has passed, after which it should feel much
like your other teeth in terms of pain to chewing pressure. It is normal for there to be a
different awareness when you chew with this tooth after 30 days, but after 2-3 months it
should be hard to tell where we did the root canal treatment.
“IF YOU HAVE INCREASING PAIN AT 3-4 DAYS POST-OP CALL ME IMMEDIATELY! In that case,
you are one of the unlucky 2-3% of our patients who experience one last infectious flareup
before the wound heals. If this happens a routine antibiotic regiment will resolve the
problem with no decrease in the ultimate outcome. It is rare, so we would be overmedicating
97-98% of our patients if we gave all of them antibiotics after treatment. Finally, be certain
to have the final restoration placed in the tooth within 30 days or our treatment will be
compromised, possibly requiring retreatment.”
Note: The riff about post-op infectious flare-ups (if you are doing your job correctly)
will be told to 48 patients before one of them needs the advice given, but the fear
and distrust that results in these rare cases when the patient wasn’t prepared make
the effort very worthwhile—basically you then look like a smart, prepared doc instead
of an idiot.
Trust me, I had to learn this the hard way—it usually happens to a friend, a lawyer,
or that wealthy patient who is going to bad-mouth you to everyone at the country
club (where all those sick pulps are attached to people who can afford the RCT).