Consents & Post-Op
Instructions

You will be numb for 1–2 hours after leaving the office. Please be careful not to bite your cheek, lips, or tongue. Avoid very hot foods and beverages until the numbness has fully worn off.

• Composite resin filling: The material has been light-cured to bond to your natural tooth structure. You may eat as soon as you like, but please avoid chewing ice or hard candy, as these can fracture even healthy teeth.
• Glass ionomer filling: This material cures chemically over the next 24 hours. Avoid eating on the treated side for the first 24 hours. After that, resume normal eating — but always avoid chewing ice or hard candy.

Tenderness & sensitivity

Some tenderness and sensitivity at and around the treated tooth is normal and should not last more than a few days. Over-the-counter Advil, Ibuprofen, or Tylenol taken as directed on the bottle is recommended for the first 48 hours. If tenderness does not improve, one of the following may explain it:

• The filling material may expand and contract slightly with hot and cold temperatures — this usually subsides on its own.
• If the filling covers more than half of the tooth, biting will never feel exactly the same as a healthy tooth. Chew tough foods on the opposite side. A custom crown may be the better long-term solution.
• If the cavity was very close to the nerve, the nerve may be inflamed and root canal therapy may be needed to relieve the pain and prevent infection. Please call our office if you experience this.

Crown recommendation

Teeth with large fillings may eventually need a custom-made porcelain crown to best support and protect the remaining tooth structure. Please ask our team for fees and insurance estimates if this applies to you.

Following Tooth Preparation

• Sensitivity and tenderness of the tooth and surrounding gums is common for the first day or two after a tooth has been prepared for a restoration. If the tenderness or sensitivity lasts longer than this, please contact our office.
• If anesthesia is used, avoid chewing, biting, and eating until the numbness wears off.
• The final restoration may be placed the same day that the tooth is prepared or may be placed during a separate appointment.

For Temporary Restorations

• Eat softer foods, and avoid foods that are particularly crunchy, chewy, or hard.
• Carefully clean around the restoration, brushing and flossing daily. Be gentle when flossing, taking extra care not to loosen the temporary restoration. Slowly pulling the floss out by one end can help avoid putting too much pressure on the temporary.
• If the temporary restoration becomes loose or breaks, please call us immediately.

After Final Restoration Placement

• Avoid chewing on hard, crunchy, or sticky foods for 24 hours in order to give time for the cement to fully bond.
• Mild sensitivity to hot or cold foods is not unusual and should dissipate after a few weeks. If sensitivity lasts more than six weeks, please let the office know.

Ongoing Care

• Proper care of your restoration includes brushing your teeth after every meal and snack, and flossing at least once a day before bedtime.
• Rinsing your mouth with water or mouthwash will also help to remove any additional particles that may have been missed during brushing and flossing.
• Please call our office if you are in pain or have any questions regarding your treatment.

First 24 to 48 hours

• Mild to moderate soreness in the treated area is normal. The tissue around the tooth needs time to heal.
• Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) as directed for pain management. Do not exceed recommended dosages.
• Eat soft foods and chew on the opposite side.
• Avoid biting down hard on the treated tooth until a permanent crown is placed. A root canal-treated tooth is more brittle and can fracture without crown protection.

After the first few days

• Soreness should decrease noticeably by day 3. Complete resolution may take up to 2 weeks.
• If you were prescribed antibiotics, take the full course even if you feel better.
• Resume normal brushing and flossing. Keeping the area clean supports healing.

Important reminders

• A crown is almost always recommended after a root canal on a back tooth. Schedule this appointment as soon as possible.
• The treated tooth should feel normal once fully restored. Contact us if you experience increasing pain, swelling, or a return of symptoms after initial improvement.
• Avoid very hot foods that may cause discomfort while the area is still sensitive.

First hour after extraction

• Bite firmly on the gauze pad placed over the extraction site. Keep pressure on it for 45 to 60 minutes.
• If bleeding continues, replace with fresh gauze and bite for another 30 minutes. Light oozing for up to 24 hours is normal.
• Do not spit, rinse, use a straw, or smoke for at least 24 hours. These actions can dislodge the blood clot.
• Avoid touching the extraction site with your tongue or fingers.

First 24 to 48 hours

• Apply ice to the outside of your face in 20-minute intervals (20 on, 20 off) to minimize swelling.
• Take pain medication as directed. Ibuprofen is preferred for its anti-inflammatory effect.
• Eat soft foods: yogurt, eggs, mashed potatoes, soup (not hot), applesauce. Avoid crunchy, hard, or sharp foods.
• Sleep with your head slightly elevated to reduce swelling.

Days 3 through 7

• Begin gentle warm saltwater rinses (1/2 teaspoon of salt in 8 oz of warm water) 4 to 5 times daily, starting 24 hours after extraction. This keeps the site clean without disturbing the clot.
• Swelling typically peaks at 48 hours and then begins to improve.
• Resume brushing all other teeth normally. Avoid the extraction site for the first 3 days.

Warning signs to watch for

• Dry socket: Severe throbbing pain that starts 3 to 5 days after extraction and radiates to your ear. Call us immediately if this occurs.
• Increasing rather than decreasing pain after 48 hours.
• Swelling, redness, or discharge that worsens after day 3.
• Fever above 101 degrees Fahrenheit.

Swelling & discomfort

Slight swelling of the treated area is not unusual. Chapped lips or bruising of the lip and cheek area may occur.

• Apply a reusable ice bag or frozen vegetable bag wrapped in a soft towel to the treated area — 20 minutes on, 20 minutes off — for the first 24–48 hours to reduce swelling.
• Keep your head elevated above your heart to minimize swelling. Most swelling peaks in the morning and can last up to 3 days. Avoid lying on the treated side.
• Report any major swelling to our office immediately.

You may experience tooth sensitivity, especially to cold, following the procedure. Sensitivity typically decreases within several weeks as long as the area is kept free of plaque. If sensitivity is extreme, contact our office for recommendations.

Bleeding

Minor bleeding — such as a pinkish tinge to saliva — may occur during the first 48 hours. Avoid very hot foods and do not rinse your mouth on the day of treatment, as these prolong bleeding. If bleeding increases or continues past 48 hours, call our office promptly.

Diet

Eat as tolerated once numbness has fully worn off. Avoid sticky, hard (ice cubes, nuts, popcorn, chips), brittle, spicy, or acidic foods. Soft options like soups, pasta, scrambled eggs, mashed potatoes, and macaroni and cheese are best. Stay hydrated and maintain adequate nutrition.

Smoking

Smoking is not advised for 7–14 days following treatment, as it significantly delays healing.

Home care

Brush twice daily and floss daily. Rinse with chlorhexidine (Peridex) twice daily after brushing and flossing — measure the dose using the cup provided, swish for at least 30 seconds, then spit. Do not rinse with water after.

Your 3-month periodontal maintenance (cleaning) appointment is essential to your periodontal health and will help prevent the need for repeat scaling and root planing. If you have not yet scheduled this appointment, please call our office right away.

Day of surgery

• Rest for the remainder of the day. Do not drive or operate machinery if you received sedation.
• Keep your head elevated, including while sleeping. Use an extra pillow.
• Bite on gauze as instructed. Change it every 30 to 45 minutes as needed until bleeding slows.
• Do not rinse, spit, or use a straw for 24 hours.
• Apply ice packs to your face for the first 24 hours, 20 minutes on and 20 minutes off.

Nutrition

• Stick to soft, cool or lukewarm foods for the first 48 hours: smoothies (no straw), protein shakes, yogurt, pudding, mashed potatoes.
• Stay hydrated. Avoid alcohol, carbonated beverages, and hot liquids for the first 24 hours.
• Gradually introduce soft solid foods on day 3 as tolerated.

Medications

• Take prescribed antibiotics for the full course to prevent infection.
• Use prescribed or over-the-counter pain medication as directed. Ibuprofen + acetaminophen together (staggered) provides better pain control than either alone — ask us about dosing.
• If you received IV sedation, do not take any additional sedatives or drink alcohol for 24 hours.

Activity and healing

• No strenuous exercise, heavy lifting, or bending over for 3 to 5 days.
• Swelling peaks at 48 to 72 hours. After that it should progressively improve.
• Stitches, if placed, typically dissolve on their own in 7 to 10 days.
• Warm saltwater rinses starting 24 hours after surgery, 4 to 5 times daily.

The consent information below summarizes what was reviewed and signed during your consultation. Post-operative instructions follow.

Patient Consent — What You Agreed To

You authorized the surgical placement of dental implants. Dental implants are metal anchors placed into the jawbone beneath the gum line, with small posts attached so artificial teeth or dentures can be fastened in place.

Most patients require two surgical procedures: first, drilling small holes into the jawbone and placing anchors (a temporary denture may be worn while the bone heals); second, uncovering the implants and attaching the posts. Bone grafting or guided tissue regeneration may also have been performed.

You were informed of potential risks including: postoperative pain and swelling, bleeding, infection, nerve injury causing temporary or permanent numbness of the chin/lips/gums, jaw fracture, bone loss, sinus cavity penetration, mechanical failure, or implant failure. These risks are uncommon but exist.

Post-Operative Instructions — Day of Surgery

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment visible through the gum tissue — do not disturb it.

Bleeding: Some bleeding or redness in the saliva is normal for 24 hours. Control excessive bleeding by biting firmly on a gauze pad directly over the wound for 30 minutes. Call us if bleeding does not slow.

Swelling: Apply an ice bag or towel filled with ice to the cheek over the surgery area continuously for the first 36 hours to minimize swelling.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Eat soft food and liquids on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain

Begin taking pain medication as soon as the local anesthetic starts wearing off.

• Moderate pain: 1–2 Regular or Extra Strength Tylenol every 3–4 hours.
• Or: Ibuprofen (Advil/Motrin) 200 mg — take 2–3 tablets every 3–4 hours as needed.
• Severe pain: take the prescribed medication as directed.
• Do not take any medication you are allergic to or have been told to avoid.

Antibiotics

If prescribed, take antibiotics exactly as directed for the full course to prevent infection.

Oral Hygiene

• Night of surgery: use prescribed Peridex Oral Rinse before bed.
• Day after surgery: use Peridex twice daily — after breakfast and before bed. Rinse for at least 30 seconds, then spit.
• Warm saltwater rinses (1 teaspoon salt in a cup of warm water) at least 4–5 times daily, especially after meals.
• You may brush your teeth and the healing abutments. Be gentle around the surgical area.

Activity

Keep physical activity to a minimum immediately after surgery. If you exercise and notice throbbing or bleeding, stop and rest. You may be taking in fewer calories than normal, which can further limit your stamina.

Dentures / Prosthetics

Do not wear partial dentures, flippers, or full dentures immediately after implant surgery unless Dr. Ardekani or Dr. Khan specifically instructed you to do so.

Call us at (202) 750-8718 if you experience heavy bleeding, severe pain not controlled by medication, or any signs of infection.

The consent information below summarizes what was reviewed and signed during your consultation. Post-operative instructions follow.

About the Sinus Lift Procedure

The roots of upper back teeth typically extend close to the sinus floor. When teeth are missing, the sinus enlarges and bone depth decreases — often too much to support a dental implant. A sinus lift grafts bone to the floor of the sinus, restoring depth and allowing a full-length implant to be placed.

A closed (crestal) approach is used for smaller lifts: the graft is done through the implant site itself. You may feel a tapping pressure during this. A lateral (open) approach creates a small window in the side of the sinus for better visibility on larger grafts — this typically causes some bruising and swelling on the side of the face.

Potential Risks

• Post-surgical infection, bleeding, swelling, and pain
• Facial discoloration
• Temporary or permanent numbness of the lip, teeth, or gum
• Jaw joint injuries or muscle spasms
• Allergic reactions to anesthetics

Your Responsibilities After Surgery

• Follow all self-care instructions and take all prescribed medications.
• Limit or eliminate smoking and alcohol — both impair bone healing.
• Do not wear removable dentures over the surgical site unless cleared by Dr. Khan.
• Attend all scheduled follow-up appointments so healing can be monitored.
• Contact us immediately if you experience increased pain, fever, swelling that worsens after 72 hours, or any unusual nasal symptoms.

No guarantee can be made that the graft will produce enough bone for implant placement. Individual results vary. Please ask us any questions — we are here to support your healing.

The consent information below summarizes what was reviewed and signed during your consultation. Post-operative instructions follow.

About the Pinhole Surgical Technique (PST)

You were diagnosed with significant gum recession. The PST procedure was recommended to treat this. Using a small pinhole (or several pinholes) made in the vestibule under the lip, specially designed instruments gently loosen and reposition gum tissue over the exposed root surfaces. Resorbable collagen is placed in the pinholes to secure the tissues and build gum width.

Expected benefits: Widened zone of attached gum tissue, reduced likelihood of further recession, improved appearance of the gum line, and reduced root sensitivity or root decay.

Risks include: Bleeding, bruising, swelling, infection, temporary or permanent tooth sensitivity, temporary or permanent numbness of lips/chin/gums, and allergic reactions. The amount of root coverage achieved depends on the severity of recession, blood supply, bone health, smoking, alcohol use, grinding habits, and compliance with post-operative instructions.

Post-Operative Instructions — First 6 Weeks

Your healing outcome depends on how carefully you follow these instructions for the full 6-week period.

DO these things:

1. Ice the outside of your cheeks as much as possible for the first 48 hours — 10 minutes on, 10 minutes off.
2. Brush your tongue gently.
3. Brush any teeth that were not operated on.
4. You may very slowly and gently brush the lingual (tongue-side) surfaces of the teeth that had surgery.
5. Use the provided rinse by “drool rinsing” only — tilt your head side to side and let the rinse drain out. No gargling, no swishing, no spitting.
6. Eat a healthy diet of soft, easily chewable foods. You may blend any healthy foods into a smoothie.
7. Reduce sugar intake to support healing.
8. Use an extra-soft toothbrush for 6 months after surgery.
9. Return for all post-operative and polishing visits.

DO NOT do these things:

1. Do not do anything that could disturb the surgical sites. Be as gentle as possible for the full 6 weeks.
2. No brushing, flossing, or Waterpik at the surgical sites.
3. Do not brush the biting surfaces of teeth that had surgery.
4. Do not touch the surgical sites with your fingers, tongue, cotton swabs, picks, or any other object.

Call us at (202) 750-8718 with any questions about your healing progress or if you notice anything unusual.

Some pain, bleeding, swelling, and seeping are normal following oral surgery. Please do not try to view the site by pulling on your lip and do not probe the area with your tongue or fingers.

Bleeding and Medications

• Avoid forcefully rinsing or spitting or drinking through a straw. Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding. Some bleeding is normal for the first 24 hours. If bleeding continues, please call our office.
• Please take all medications, including mouth rinses, as prescribed.

Oral Hygiene

• After 24 hours, brushing and oral hygiene procedures should be done as usual in all untreated areas. In the treated areas, please limit your oral hygiene to brushing using a soft manual toothbrush.
• Avoid dental flossing in treated areas during the first week following surgery.
• No undiluted mouthwash, salt water or peroxide rinses should be used during the first week following surgery.

Swelling and Activity

• Swelling and bruising may occur and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the surgical site will help minimize swelling.
• If using an ice pack, do not apply ice directly to your skin. Place a cloth between the ice and your skin at all times. Apply for up to 20 minutes on and at least 20 minutes off. After 36 hours, cold compresses will have no further impact. After this period, the application of moist heat to the sides of the face can help reduce swelling.
• Keep physical activities to a minimum immediately following surgery. Avoid strenuous activity for 2 to 3 days.

Diet

• Drink plenty of fluids. Stay away from spicy or acidic foods. Avoid sharp and crunchy foods like tacos, chips, and nuts.
• Tobacco and alcohol should not be used. Alcohol should not be used in combination with pain medications or antibiotics.

Surgical Bandage

If a surgical bandage was used, it will ideally remain in place for 24 hours. There is no need for you to remove it; it will come off when ready. Once it does, you can begin cleaning the wound gently with a cotton swab dipped in a mouth rinse.

If you have questions about your progress, please call the office. For emergencies overnight or on Sunday, call Dr. Ardekani's cell: (315) 371-7255

Comfort

• Complete rest for the first 6 to 12 hours will ensure early, comfortable, and complete healing.
• Comfort will be maintained by taking two Extra Strength Tylenol every three hours, or Motrin (ibuprofen) 600mg to 800mg every eight hours for the first day. As aspirin is an anti-coagulant, an aspirin substitute is preferred during the early healing period.
• You may be given an additional prescription if needed for comfort. Pain medication should be taken as soon as you feel discomfort. Do not drink alcohol while taking narcotic prescriptions. Do not take any pain medication on an empty stomach or nausea may result.

Swelling

• Apply an ice bag to the outside of your face over the treated area for 15 minutes on and 15 minutes off. Ice is effective for approximately the first 24 hours. A bag filled with crushed ice or frozen peas wrapped in a towel works well. Continue for a minimum of 3 to 4 hours.
• You might be given a prescription to minimize swelling. Take as directed.

Diet

• You may remain on your normal diet. However, avoid hot spicy foods and crunchy foods such as chips or nuts. Foods that are soft and easily chewed are usually kinder to the graft area.
• Do not chew on the graft area and avoid temperature extremes.

Oral Hygiene

• It is very important that the surgical area be left completely alone to assure the best possible result. Brushing and flossing the treated area is to be avoided completely for two weeks. Do not pull or stretch the lip back for inspection.
• Gentle lukewarm water rinses are helpful in the healing process and should be initiated 12 hours after surgery. This should be done 5 to 6 times a day using 1/2 tsp. of salt dissolved in 8oz of warm water. Vigorous rinsing, spitting, probing, or anything that may cause suction should be avoided. This includes smoking.
• If chlorhexidine or Closys rinses have been prescribed, use 1/2 capful for 30 seconds twice daily.

Call us right away if you experience heavy bleeding, fever, or worsening pain. DC Pearls: (202) 750-8718

Immediately after

• Your bite may feel slightly different for a few days as you adjust to the new tooth shape. This is normal.
• Some sensitivity to cold, heat, or pressure is common for 1 to 2 weeks after veneer placement.
• If temporary veneers were placed, treat them as you would a temporary crown: avoid sticky and hard foods.

Long-term care

• Brush gently twice daily with a non-abrasive fluoride toothpaste. Abrasive pastes can scratch the veneer surface.
• Avoid biting nails, chewing on pens, or opening packages with your teeth.
• Do not chew ice or very hard foods. Veneers can chip or fracture under excessive force.
• Wear a night guard if you clench or grind your teeth. Bruxism is the number one cause of veneer damage.
• Avoid staining foods and beverages in the first 48 hours after bonding: coffee, red wine, berries, and tomato sauce.

Maintenance

• Veneers last 10 to 20 years with proper care. Annual dental exams are essential to monitor their integrity.
• Floss daily, sliding along the gum line where the veneer meets the tooth.

Expectations

Significant whitening is achievable in many cases, but there is no definite way to predict how light your teeth will get. Yellow or yellow-brown teeth tend to whiten better and faster than gray or gray-brown teeth. Teeth discolored by antibiotics, root canal therapy, or trauma may require additional treatment. If your teeth are already a very light shade, results may be minimal. Outcomes vary by individual.

Sensitivity

You may experience tooth sensitivity during or after the procedure. If your teeth are normally sensitive, you may experience more significant sensitivity. Tylenol, Ibuprofen, or Advil will usually provide relief. Sensitivity generally resolves within 12–24 hours. If it persists beyond 24 hours, please contact our office.

Gum & soft tissue irritation

Temporary gum or soft tissue irritation can occur if the whitening gel contacts those areas during treatment. This typically resolves within 1–2 hours. If discomfort persists beyond 24 hours, contact our office.

Dental restorations

Tooth-colored fillings, composite veneers, porcelain crowns, and porcelain veneers will not whiten. Visible restorations may need to be replaced after whitening to match your new shade. Please discuss this with Dr. Ardekani before beginning treatment.

Maintaining your results

You may notice a slight shade change within the first 24–48 hours as saliva coating reforms. Ongoing consumption of tobacco, coffee, tea, or red wine will cause gradual regression. We recommend Zoom Dazzling White Plus toothpaste after meals to maintain your results.

First few days with new aligners

• New aligners may feel tight or uncomfortable for the first 1 to 3 days. This pressure means the aligners are working.
• Over-the-counter pain relievers such as ibuprofen can help with initial discomfort.
• Speech may be slightly affected at first. Reading aloud helps you adjust faster.
• Edges of new aligners may feel sharp on the tongue. A small piece of orthodontic wax can protect irritated areas temporarily.

Wearing and caring for your aligners

• Wear aligners 20 to 22 hours per day. Remove only to eat, drink (anything other than plain water), and brush your teeth.
• Never eat or drink hot beverages while wearing aligners. Heat can warp them.
• Rinse aligners with cool water when you remove them. Clean them daily with the prescribed cleaning crystals or a soft toothbrush and mild soap.
• Do not leave aligners in a napkin at restaurants. They are easy to throw away accidentally.
• Store aligners in their case when not in use.

Oral hygiene

• Brush and floss after every meal before reinserting aligners. Trapping food and bacteria against your teeth can accelerate decay.
• Stay on schedule: switch to the next aligner set on the day prescribed, usually every 1 to 2 weeks.
• Attend all scheduled check-in appointments to keep treatment on track.

Nitrous oxide (laughing gas)

• Effects wear off within minutes after the oxygen is administered at the end of your visit.
• Most patients can drive home and return to normal activities immediately.
• Some patients may feel mildly sleepy or lightheaded for a short time. Wait until you feel fully alert before driving.

Oral conscious sedation

• Arrange a responsible adult to drive you home. Do not drive for the rest of the day.
• You will likely feel groggy and drowsy for several hours after your appointment.
• Rest at home for the remainder of the day. Avoid stairs or situations where a fall could occur.
• Do not operate machinery, sign legal documents, or make important decisions for 24 hours.
• Do not drink alcohol or take sleep aids for 24 hours after oral sedation.

Eating after sedation

• If nausea is present, start with clear liquids and light foods like crackers or toast.
• Stay hydrated. Drink water throughout the day.
• Avoid heavy or greasy meals until you feel fully alert and comfortable.