Creative Smile Designs-Logo
Edward J. Lynch, DDS, PC
Family, implant and cosmetic smiles created!
Located in Rapid City, SD  605-343-5925

Patient Instructions

dental services

View Our Instructions Before Your Visit

At Creative Smile Designs, we know that you may have plenty of questions about pre and postoperative instructions, along with what you need to do if a hospital dental surgery has been scheduled. 

Pre-Treatment Instructions

  • Sedation: Read through "Oral Sedation Pre-Operative Instructions" to learn more
  • Dental implants
  • Bone grafting
  • Sinus surgery
  • Hospital dentistry: Read through "Hospital Surgery Information Sheet" to learn more

Oral Sedation Pre-Operative Instructions

  • Take regular medications unless specified by physician or dentist
  • Do Not eat or drink for 8 hours prior to the dental appointment (Diabetic patients need to check with dentist for special instructions)
  • Patient must be driven to the office by a responsible companion
  • No sedative medications for 24 hours prior (sleeping medications or medications that make you drowsy) unless prescribed by dentist
  • No smoking or drinking alcohol for 8 hours prior to the dental appointment
  • Do not wear contact lenses
  • Sedative medications must be taken according to Dentist’s instructions

Hospital Surgery Information Sheet

The following information will be helpful if you are planning on a hospital dental surgery. All of the items listed are requirements that are established by the hospital prior to admittance for surgery. Others listed are standards our office follows to assure that your surgery will be performed with the utmost of safety and a minimum of concern on your behalf.
  • Our surgeries are done at the Rapid City Regional Hospital Surgery Center (in the main hospital). The hospital is located at 353 Fairmont Boulevard. Check-in at the hospital is done by going through the large front revolving doors, to the information desk. Receptionists there will get your name, and direct you to the admissions department where they will need your insurance information, to sign or receive the consent forms, and provide you with a hospital wrist nametag. They will then direct you to the surgery center area.
  • We always try for a 7:15 AM start time for our surgeries. The hospital requires that you be at the hospital by 6:00 AM so that they have time to prepare you for the surgery. Part of this preparation may be an IV solution, or medication depending on your individual circumstances, and health history.
  • No food or drink is allowed (for the patient) after 12:00 AM (midnight) the night before you are to have surgery. The anesthesiologists determine whether you will be able to have your surgery; and may cancel the surgery if you have had any food or water to drink. Some patients are on regular medications, please check with us as to whether you are to discontinue your medications the morning of surgery, or proceed as usual.
  • The hospital requires that you have a history and physical performed prior to admittance. A physician must perform this history and physical. Our staff may be able to assist you in obtaining your physical. All physicals must be done no more than two days (48 hours) prior to the surgery.
  • Patients from out of town may need to spend the night before, and the night of the surgery in Rapid City. This will assure that you will be able to reach Dr. Lynch or the hospital in case of emergency. We also need to be able to monitor patients who may have complicated health histories, etc. The day after the surgery, we may need to see you in the office for a brief 15-minute appointment before leaving town. All out of town patients need to let our office and the hospital know where you will be staying, so that we can contact you. Our office can supply you with a list of motels in the area, if necessary.
  • Many of our hospital surgeries are on patients who are physically or mentally handicapped and uncooperative in an office setting. Because of this, it is not possible, in many instances, to know exactly what needs to be done for the patient. We will attempt to do all of the patient’s dentistry during the surgery, which means we will not be able to tell you in advance how long the surgery will take. We try to notify the family members as soon as we have completed our exam and x-rays what the length of the surgery will be. If waiting family members must leave the waiting area, please notify the volunteer at the reception desk as to your destination and phone number.
  • Both the hospital and anesthesia care team require signed consent forms for the surgery. In many instances the patient, parent or legal guardian will sign these forms. No work can be performed without these consents. In the event the patient is unable to sign their own consents and the parent or legal guardian cannot be present, the forms enclosed in this packet can be signed, notarized, and returned to us one week prior to surgery.
  • The hospital requires that you have a relative / friend to bring you home following your surgery. Because of the anesthesia you will be too groggy to drive or operate machinery. Further instructions regarding home care will be given to the patient depending upon procedures performed.
  • Whenever possible, we will advise you of the charges for our office in advance. For those patients with insurance, we will need to do a predetermination of benefits. Some procedures may not be covered by insurance or Medicaid (title 19), and are the responsibility of the patient, parent, or legal guardian. Our office charges the same fees for work performed in the hospital, as in the office, except for a $105.00 operating room set-up fee and a $132.00 hospital visit fee. This set-up fee is for equipment required for dental surgery, which is not, provided by the hospital, and the additional time necessary for our staff to coordinate the OR case. The hospital visit fee may or may not be covered by your insurance (it is covered by Medicaid). Patients on Medicaid will have to pay for the OR set-up fee ($105.00) since it is not a Medicaid benefit. Payment arrangements must be made with our office staff prior to the surgery. If you have questions regarding your dental insurance please contact our business coordinator.
  • A separate statement is sent from the hospital, and anesthesia for their charges. Any questions regarding the hospital charges can be directed to the hospital-billing department or anesthesia department.
  • Setting up a hospital dental surgery requires coordination with the hospital, anesthesiologist, our staff, and physician. Cancellation of the surgery at the last minute affects many people. In an emergency, if a cancellation becomes necessary, please contact our office as soon as possible.
  • Special individual requirements may be needed.
  • To contact our office after hours, please call the office phone number and leave a message and phone number on our voice mail. This will activate Dr. Lynch’s pager, and he will return your call as soon as possible.

Post-Treatment Instructions

Silver fillings: You should not eat anything for at least two hours or until the numbness is completely gone, whichever is longest. It takes two hours for a silver filling to set up hard enough that it will not easily break. Also, we don't want you to bite your tongue or lip while it is still numb, even if it is slightly tingly you should not bite your tongue or lip.

All new fillings or larger fillings will have some sensitivity to temperature, especially cold. At first even tap water will be somewhat sensitive. After a while it will take colder, and colder things to make the fillings sensitive. The sensitivity will last anywhere from a few days to a few months depending on the size of the filling.

If the bite is high on the filling when the numbness wears off let us know right away so that we can adjust the filling. If the filling is hitting hard it may cause a sore tooth, broken tooth, or broken filling, none of which you want. Call us so we can set up a time to adjust the bite.

Tooth colored fillings: Your filling is as hard as it will get. You should not eat anything until the numbness is completely gone. We don't want you to bite your tongue or lip while it is still numb, even if it is slightly tingly you should not bite your tongue or lip.

All new fillings will have some sensitivity to temperature, especially cold. At first even tap water will be somewhat sensitive. After a while it will take colder, and colder things to make the fillings sensitive. The sensitivity will last anywhere from a few days to a few months depending on the size of the filling.

If the bite is high on the filling when the numbness wears off let us know right away so that we can adjust the filling. If the filling is hitting hard it may cause a sore tooth, broken tooth, or broken filling, none of which you want. Since these fillings are tooth colored it can be difficult for us to tell where the filling ends and the tooth begins so it is easy to get a high spot on these type of fillings. Call us so we can set up a time to adjust the bite. 

Crowns / Bridges: The temporary crown that we are placing does not fit as tightly as the final crown. You'll notice some sensitivity around the edges, particularly to temperature. If you like citrus fruit or citrus drinks, like grapefruit or orange juice, you may get kind of a funny taste. It would be kind of like brushing your teeth and then drinking orange juice, you get kind of a funny taste. It won't hurt anything it just tastes funny.

If you have a lot of problems, give us a call at 605-343-5925. If we do not answer, leave your name, number, and a message. It sounds like an answering machine, but if you leave a message it will page us to let us know you left a message.

Complete or Partial Dentures: Read through "Complete Denture / Partial Denture Instruction Sheet" to learn more!

Extractions: Read through "Care Following Extractions" to learn more!

Root Canals: Read through "Root Canal Information" to learn more!

Deep Scaling: Read through "Patient Instructions Following Scaling and Root Planning" to learn more!

Fluoride treatment

Dental Implants

Bone Grafting

Sinus Surgery

Sedations: Read through "Oral Sedation Postoperative Instructions" to learn more!

Complete Denture / Partial Denture Instruction Sheet

No matter how small or thin your denture is, it may seem bulky. This sensation usually disappears quickly and requires patience during the learning period. You will experience more saliva during this period than normal. Rinsing your mouth with cold water can reduce this.

Your tongue may feel crowded and tend to push the denture out of your mouth. If the denture moves or becomes dislodged while you are chewing or speaking, you will have to learn to keep it in place with the muscles of your tongue and cheek. Chewing should be done on both sides at the same time. Use your tongue to direct some of the food to each side as you chew.

While you are becoming accustomed to your new dentures, you should select soft foods. Take small bites and chew slowly. After a few days, when you can eat more comfortably, try more course foods until you are eating normally again. Avoid sticky or hard foods until you become more experienced. Front teeth on dentures are primarily for appearance. You cannot incise (bite) foods with your front teeth like with your natural teeth. Chewing food with front teeth will tend to dislodge your denture. Chewy food should be twisted off using the back teeth. Apples should be cut into small pieces; corn should be removed from the cob.

A positive attitude will help you become accustomed to your dentures. The quickest way to become confident and comfortable is to wear your dentures routinely. All dentures should be removed at night. This will allow your gums to rest. Always keep your dentures in water when they are out of your mouth, otherwise they will dry out and not fit, as they should. 

(If this is your first denture / partial denture) I would recommend that you find a good book, magazine, or something to read. Find a corner where no one will think you're going crazy and read aloud to yourself. This will give you an opportunity to get used to talking with the new denture / partial denture while you are alone.

If your dentures or partials cause a sore spot, please call our office for an appointment. Usually you can be seen within a short time. You should never adjust or repair any denture yourself. Bending clasps on partial dentures or relining a denture by yourself can cause serious damage. It can damage teeth or destroy bone.  

When inserting dentures or cleaning them, always do so over water. The water will cushion them if you accidentally drop them. To set a denture, apply gentle, even pressure. Do not force them. Do not try to set a denture or partial by merely biting down. This can cause damage to the gums or bend a clasp on the partial denture.

To clean your partials or dentures, use a regular or denture toothbrush (Do not use a denture brush on natural teeth). You can use just about any cleaning material you want. You can use toothpaste, denture cleaner, hand soap, etc. Do not use bleach, as it will tarnish the metal on your partials and lighten (wash out) the pink plastic on the dentures.

Denture cleansers like Efferdent can be used. They do not need to be used daily, but using them once or twice a week will keep them clean. These type of “bubbly” cleaners can get into small pores that a toothbrush cannot.

If you have any problems or questions, give us a call at 605-343-5925.

Care Following Extractions

Bleeding
Some bleeding is normal following an extraction. You will be given some gauze, which you will have to bit. We do not want you to remove it for 45 minutes. If the bleeding persists, place 2 folded gauze pads firmly over the extraction site and bite down or hold it in place with pressure for 40-45 minutes. Do not disturb the gauze. Repeat the procedure if necessary. This will allow a good blood clot to form which will protect the bone and aid in healing. 

You will get a little bit of oozing of blood for a couple of days, that is okay. A little blood mixed with lots of saliva will taste like a lot of blood. If you see blood coming out of the extraction site like it was a new cut than you should use more gauze.

Do Not…
Smoke, spit, suck on a straw, or drink any carbonated beverages for 24 hours! Any of these activities can cause the blood clot to be rinsed out, which can contribute to a dry socket. These are treatable, but very uncomfortable.

Do Not Rinse Mouth for 24 Hours!
After 24 hours, gently rinse your mouth several times a day, especially after meals. Use a ¼ teaspoon of salt (if not on a low salt diet) in a glass of warm water. Continue for 3-4 days.

Swelling
An ice pack applied to the affected area will help reduce swelling and discomfort. Use the ice in intervals of 20 minutes (keep ice pack on for 20 minutes and take off for the next 20 minutes) for several hours immediately following the extraction. Ice is only useful for the first 24 hours.

Food
A light diet is recommended. Do not attempt to go without eating. Do not take medication on an empty stomach, you may become nauseous. Avoid crunchy foods such as popcorn, nuts, chips, etc., which may fall into the extraction site.

Bony Edges
It is not unusual after an extraction to feel a small bone chip around the extraction area. There are nothing to worry about it as the chips will usually work themselves out.

Medication
You will have some soreness for the next couple days. We recommend you take some Tylenol, Advil, Motrin, Nuprin, or some other non-aspirin type of medication for the next day and half to two days. Don't wait until things start to hurt. Take medication before it starts to hurt and it will take less medicine to make you feel better.  

For mild or average pain, we recommend you use a combination of Tylenol (Acetaminophen) and Advil (Ibuprofen) every 6 – 8 hours. If medication is prescribed, take as directed. If antibiotic coverage is necessary, take the full amount of medication even though symptoms may disappear.

In Case of any Unusual Symptoms, Contact Our Office for Instructions
If you have problems please call our office phone number. If we do not answer, leave your name, phone number, and a message. It may sound like an answering machine, but if you leave a message, it will page us to let us know you left a message.

Root Canal Information

You have decided to save your tooth and have a root canal. We feel this is a wise decision, for nothing is as good as your own teeth. This information sheet is provided so you will know what will be done and what to expect.

Depending on which tooth is being worked on, there may be several “canals” where the nerve and blood supply are normally found. Root canals are done because the nerve is dead or dying, which happens due to decay, broken tooth, tooth knocked out, or some other trauma. The pain you may be feeling is due to infection, pressure and swelling in and around the tooth.

An opening is made in the biting surface of your tooth. The dead nerve(s) and debris are removed from the canal(s) using small files. Progressively larger files are used to clean and shape the canal(s) for the “gutta percha” filling. Gutta percha is a soft pink rubbery material that is placed in the canal using cement; after all necessary filing is completed.

Root canals generally take 1-2 appointments. In most cases there will be some discomfort or pressure for 24 –48 hours following your appointment. In most cases an over-the-counter pain medication is enough to keep you comfortable (Tylenol, Advil, Nuprin, Aspirin, or any equivalent). Start taking the pain medication immediately, don’t wait until the tooth starts to bother you or it will take more medication to get things to settle down. Prescription pain medications, and / or antibiotics (to cure any infection) may or may not be given to you depending on your situation.

After a root canal is finished a permanent restoration must be placed. Often, because of the size of the cavity that caused the nerve to die a “build-up” must be done. Buildups are generally held to the tooth by “pins” or “posts.” I call pins and posts “dental rebar” as most people understand that rebar helps hold concrete together and reinforce it, just like the pins and posts do for the tooth and filling material. The buildup material may be silver, tooth colored or gray plastic material. Buildups give the tooth more “bulk” so that it is almost normal size.

A crown must be done to hold the remaining tooth structure and filling material together and protect the tooth, minimizing the chance that the tooth will break or split when chewing forces are placed on the tooth.

In the vast majority of cases (85-95%) root canals are successful. To make sure the area is healing, we may take an x-ray at six months and one year after the root canal is finished.  

Please feel free to contact our office if you have any problems or questions that are not covered on this sheet.

Patient Instructions Following Scaling and Root Planing

Following scaling and root planning, you can expect to notice less redness, less bleeding and less swelling of your gum tissue. Your mouth will taste better and feel better. Your gum health can then be maintained with proper homecare and regular professional care.

Discomfort 
Discomfort or pain should not be acute and should subside in a few hours, definitely within a few days. Discomfort immediately after treatment is usually associated with slight throbbing or aching and occasionally may be uncomfortable. This discomfort usually subsides in about four hours.

Tooth Sensitivity 
Teeth may be sensitive to temperature changes and / or sweets. The sensitivity to temperature may be noticeable the first several days and usually diminishes quickly. Application of a desensitizing fluoride may be recommended.

Bleeding 
Some slight bleeding may occur during the next several brushings, but the bleeding should steadily decrease.

Appearance
As the gums heal they may change their shape around the teeth. This is normal as they tighten.


Instructions to Minimize Symptoms

Diet / Eating
If extensive root planning was performed, chewing hard foods, such as meat or raw vegetables may be uncomfortable; this should last no longer than a few days. A diet of a softer consistency would be advised until chewing becomes more comfortable. You can determine the consistency, according to your comfort.

Discomfort / Sensitivity
If a local anesthetic was used, avoid chewing foods until feeling returns to avoid injury to the tongue or cheeks. Acetaminophen or a non-aspirin analgesic (pain medication) should be taken as a recommended to reduce discomfort. If tooth sensitivity persists, use a desensitizing toothpaste containing potassium nitrate (Sensodyne, Denquel, or more “sensitive” toothpastes). If the sensitivity is severe and prolonged, professional application of a desensitizing agent may be required.

Oral Hygiene
If gum tissues are tender, brush your teeth gently but thoroughly; this may take a little more time than normal. By the third to fourth day, normal oral hygiene techniques may be resumed. Mouth rinsing is recommended with either of the following solutions: an antimicrobial rinse or a warm salt-water rinse. Use of either of these rinses should be limited to one to two consecutive weeks.

Special Instructions
If symptoms are severe or persistent, please call our office immediately.

Oral Sedation Postoperative Instructions

  • Take all regular or prescribed medications as outlined by physician or dentist
  • No alcohol for 24 hours after surgery
  • No driving for 24 hours after surgery
  • Do not operate machinery, climb stairs, heavy lifting or do any activities that you can hurt yourself for 24 hours after surgery. Sedation can effect coordination and cause drowsiness
  • No important decisions should be made for 24 hours after surgery
  • Must have a responsible adult companion drive patient home and remain with them for 4-6 hours
  • Patient should remain awake for 4-6 hours after surgery (even if they must be “reminded” every 5-10 minutes)
  • Patient should drink plenty of fluids (water is best)
WE WILL ANSWER YOUR DENTAL SURGERY QUESTIONS

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