- Make sure you arrive on time as it is very important that we start on time with your treatment.
- Please make sure you take all medicines as you normally do so, unless instructed otherwise.
- Please make sure you have something small to eat prior to your dental treatment.
Teeth Cleaning (Prophylaxis)
A dental prophylaxis is a cleaning treatment performed to thoroughly clean the teeth and gums. Prophylaxis is an important dental treatment for stopping the progression of gingivitis and periodontal disease.
Prophylaxis is an effective procedure in keeping the oral cavity in proper health and halting the progression of gum disease.The benefits include:
- Plaque removal. Tartar (also referred to as calculus) and plaque buildup, both above and below the gum line, can result in serious periodontal problems. Unfortunately, even with a proper home brushing and flossing routine, it can be impossible to remove all debris, bacteria and deposits from gum pockets. The experienced eye of a dentist or hygienist using specialized dental equipment is necessary to catch potentially damaging buildup.
- A healthier looking smile. Stained and yellowed teeth can dramatically decrease the esthetics of a smile. Prophylaxis is an effective treatment in ridding the teeth of these unsightly stains.
- Fresher breath. Bad breath (or halitosis) is generally indicative of advancing periodontal disease. A combination of rotting food particles (possibly below the gum line) and potential gangrene stemming from gum infection, results in bad breath. The routine removal of plaque, calculus and bacteria at our facility can noticeably improve halitosis and reduce infection.
Once we have restored your teeth with tooth-colored materials, these restorations will serve you well for several years. The resin (plastic) material used contains small "filler" particles of glass-like material for strength and wear resistance. They contain the finest and most up-to-date materials available today. However, you should be aware of the following information about your new restorations:
- As with natural teeth, avoid chewing excessively hard foods on the filled teeth (hard candy, ice, raw carrots, etc.) because the resin material can break under extreme forces. Composite fillings set up hard right away. There is no waiting time to eat. Children should be observed until the anesthetic wears off. Due tothe strange feeling of the anesthetic, many children will chew the inside of their lips, cheeks, or tongue which can cause serious damage.
- Sensitivity to hot and cold is not uncommon for a few weeks following a dental restoration. Usually, the deeper the cavity, the more sensitive the tooth will be. As discussed before in rare cases of severe, persistent sensitivity a root canal treatment might be needed. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.
- The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site.
- The finished restoration may be contoured slightly different and have a different texture than the original tooth. Your tongue usually magnifies this small difference, but you will become accustomed to this in a few days. Also, patients who clench or grind their teeth typically have longer more difficult healing period. Properly designed bite guard might be needed to alleviate these problems.
When a tooth has a cavity the Dentist removes the decay and fills the hole with a filling material, the tooth supports the filling. The ideal filling is no more than 50% of the tooth. This leaves half the tooth to support the filling. When you get a cavity that takes up 600/0or more of the tooth, a crown is indicated. A crown covers the entire tooth and holds the tooth together. Sometimes we place a filling thinking there is enough tooth to hold the filling when actually there is not. The tooth then starts to break away because it can no longer support the filling. In this case, if it happens with in a year, we will credit the cost of the filling towards the cost of a crown.
Crowns, Onlays, Veneers and Bridges
Temporaries are not strong. They may break or come off occasionally. If so, slip it back on the tooth with some FixodentTM (Denture Adhesive) and call us for an appointment, please be careful until you come to us so as not to swallow it. If you don't feel comfortable, don't put the temporary back in with Fixodent, just bring it to us in a zip lock bag. We will re-cement the temporary ASAP. Please do not leave the temporary out of your mouth because the teeth will move and the final restoration will not fit. Please floss as directed.
- The size, shape, and color of the temporary do not resemble the final restoration.• Temporary restorations may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure or sweets is not uncommon. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment.Permanent. Crowns, onlays, veneers and bridges• After the final cementation of your restoration, it may take a few days to get used to the new crown or bridge. Hot and cold sensitivity is possible for a few weeks and occasionally lasts for several months. Usually the deeper the cavity, the longer the sensitivity. In rare cases of severe persistent sensitivity a root canal treatment might be needed. As with the temporary, if the bite doesn't feel balanced please call US.• Do not chew hard or sticky foods on the restoration for 24 hours from the time they were cemented. The cement must set up during this time to have optimum strength.
- Proper brushing, flossing, and regular 6-month (minimal) cleanings are required to help you retain your final restoration. The only area that a crowned tooth can decay is at the edge of the crown at the gum line. Often, small problems that develop around the restorations can be found at an early stage and corrected easily, but waiting for a longer time may require redoing the entire restoration.
- The gums may recede from the veneers, displaying discolored tooth structure underneath. This situation usually takes place after many years and requires veneer replacement.
Important Information on Crowns
Gold and Porcelain, composite, Crowns are the same for practically all cases except that porcelain ,composite can chip and gold crowns can come off . Approximately 1 out of every 100 porcelain crowns chip and need replacement. This should be taken into consideration when choosing between a porcelain and gold crown. Althoughrare, this mostly happens in cases where patients have severe clenching /grinding or other harmful habits, or have extremely heavy bite and might have to be redone with gold.
Sore Spots: Usually, your mouth will have a few &ldquol;sore spots&rdquol; after wearing the denture for 24 hours. These areas can be relieved with very little effort during your next appointment.
The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surfaces of your teeth after the dentures have settled into place.
Cleaning the Dentures and your Mouth
Your denture can be cleaned easily by using a denture brush and mild toothpaste. Periodic denture soaks are also very useful (ex: Polident). We recommend leaving your denture out of your mouth at night and soaking in water.
Brush your gums with a regular toothbrush once per day to toughen and clean them. Use special care to clean parts of the denture that contact any natural teeth. Both the partial and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting.
We have done our best to provide you with well-fitted, functional, and esthetic dentures. We feel confident that after a few weeks of becoming adjusted to the new dentures, you will have years of satisfaction from them. Over time, your jawbone and gums shrink when there are teeth missing. When this occurs, your dentures will feel loose and may require relining. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and very serious oral disease. Please call our office if these symptoms occur.
For complete denture wearers: Please understand that even though you have no natural teeth left, it's very important that you keep your routine exam and recall appointments.
Proper care for your retainer will ensure you get the most of it. Please read our tips about proper retainer care:
- Wear Your Retainer Properly - When you wear your retainer as directed by the dentist you are sure to have a successful orthodontic outcome. We urge our patients to follow our guidelines on how often and how long they should wear their retainers. The benefits to doing so are to ensure your teeth stay as beautiful as they are now after treatment. Also, the better you care for your teeth, you will make less visits to the dentist; which means less time and less expense.
- Do Not Consume Beverages or Food While Wearing - Eating food or drinking beverages while wearing the retainer can either harm the device, your teeth, or cause bad breath. Food and beverages will get caught under the device and can cause rapid tooth decay. Chewing food while wearing the retainers can also put undue stress on the materials and potentially break them.
- Clean Your Retainer Thoroughly - Throughly cleaning your retainer, in the proper manner, is important so bacteria and calculus do not accumulate and cause tooth decay and other health issues. Depending on the type of retainer you receive, we will give you instruct you on the best cleaning solution and tools you can use to keep your retainer in good working condition.
- Keep Track of Your Retainer - Do not lose it! Keep your retainer in the case we give to you when you receive the etainer. When you are out at restaurants or other places and need to take out your retainer, be sure to put it in your case and put the case in your pocket. Cases and retainers tend to get left behind when they are set on a table, chair, napkin, or other place. At home, when you take your retainer out, be sure to put it in the same place every time, so you can easily find it again.
After Oral Surgery
The following conditions may occur and are considered normal:
- Bleeding: A certain amount of bleeding is to be expected following surgery. Bleeding is controlled by applying pressure to the surgical area using small rolled gauze for 90 minutes. Gauze pads will be given to you. Change these every hour for the next 3-4 hrs immediately following your oral surgery. As bleeding lessens, you may go longer intervals between changes. Take two gauze pads double twice and place over extraction site and bite gently.
- Swelling: Some swelling is normal after surgery, and some patients swell more than others. If your doctor expects increased swelling, you will need to place an ice pack adjacent to the surgery site(s) for the next 6-8 hours. Use the ice pack for 20 minutes on and 20 minutes off and so on. Bags of frozen peas work well.
- Medications: Take your pills as instructed. Do not drink alcoholic beverages or take other medications without your doctor’s permission. Take medication on a full stomach or with a full glass of water or juice to lower the chance of nausea. If you become sick and it continues ,notify your doctor.
- Fluids : Drink plenty of fluids such as water and juice for the next few days. Do not use a straw.
- Diet : Eat whatever feels comfortable. Soups and soft foods will be more comfortable for a few days. Diet may consist of soft foods that can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc. Juice is beneficial to drink before taking medication.
- Activity : Remain quiet for 24-48 hours. Avoid running or strenuous activity as this will increase blood pressure and may cause more bleeding from the extraction site.
- Brushing : A clean mouth heals faster; however, don’t brush the immediate area near the surgery site.
- Mouth Rinse : Gently soak your mouth with warm water after each meal to keep the surgery site(s) clean. You may add salt to the water if desired.
- AVOID : Smoking, alcoholic beverages, peroxide, carbonated beverages and commercial mouth rinse for at least 24-48 hours following surgery. Avoid using straws. These things can break down the blood clot and result in a “dry-socket”.
- Sutures : Some sutures are dissolvable and do not need to be removed. Some sutures are not resorbable and will need to be removed. A post op appointment will be scheduled for you one week from today.
- Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a few days.
- You may have a slight earache.
- A sore throat may develop.
- Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
- If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
- There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
- It is not unusual to develop bruising in the area of an extraction.
- The lower lip may have numbness for and extended period of time.
After Dental Implant Surgery
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of the surgery. Apply the ice continuously, as much as possible, for the first 36 hours.
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tables: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Good oral hygiene is essential to good healing. The night of surgery, use to prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.
Keep physical activities to a minimum immediately following surgery. If you considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days. This was discussed in the pre-operative consultation.
Laser Treatment (Gingivectomy)
Do NOT eat anything until the anesthesia wears off, as you might bite your lips, cheek, or tongue and cause damage. You will probably have some discomfort when the anesthesia wears off; take your non-aspirin pain medication(s) as directed, whether it is prescribed or over-the-counter.
- Please take Ibuprofen or Advil 600 mg (equal to 3 tabs of over-the-counter Ibuprofen or Advil) every 4-6 hours for the next 3-5 days.
- Please take it as instructed, whether the area hurts or does not hurt!!!
- Do NOT exceed 2400 mg (12 tabs) in a 24 hour period!!!
- Please take Extra Strength Tylenol 1000 mg (equal to 2 tabs of over-the-counter Extra Strength Tylenol) every 4-6 hours for the next 3-5 days.
- Please take it as instructed whether the area hurts or does not hurt!!!
- Do NOT exceed 4000 mg (8 tabs) in a 24 hour period!!!
- If and when you are taking Vicodin / Tylenol #3 / Ultram / Naprosyn, please only take 1 tab of Extra Strength Tylenol.
- You may have been given a prescription for a stronger pain reliever. This may be filled at any pharmacy if the over-the-counter pain medication does not relieve your discomfort. If Vicodin / Tylenol #3 / Ultram / Naprosyn is too strong, you can cut the pill in half. Please do NOT drive or operate heavy machinery while you are taking Vicodin / Tylenol #3 / Ultram / Naprosyn.
Slight swelling of the operated area is not unusual. Even bruising and chapped lips may occur.
- A reusable ice bag or a frozen vegetable bag, wrapped in a soft towel, may be applied to the area of surgery to help minimize the swelling of your face. Alternating 20 minutes on and 20 minutes off will usually be adequate during the first 24-48 hours after surgery.
- Keeping your head elevated above your heart will also help. One to two days after surgery, moist heat will help resolve minor swelling. Major swelling should be reported to the doctor at once.
- You may experience some tooth sensitivity after surgery, especially to cold. Sensitivity usually decreases within several weeks after surgery and can be minimized by keeping the area as free of plaque as possible. If the sensitivity is extreme, contact the doctor for recommendations or medications to relieve the discomfort.
We may apply a periodontal dressing to protect the surgical site and keep you comfortable. The dressing will harden in a few hours. In most cases the dressing is left in the mouth for a period of 7-14 days and may be changed once or more by the doctor during this time. If the dressing becomes loose or comes off, please call our office as soon as possible to notify the doctor and receive further instructions. Maintain normal oral hygiene measures in the areas of your mouth not affected by the surgery. In areas where there is dressing, lightly brush only the biting surfaces of the teeth.
- Please chew on the opposite side of your mouth and try to avoid the dressing as much as possible.
- Be sure to keep your post-operative appointment to allow for removal of any dressings or sutures and to assess your healing!!!
Minor bleeding, such as a pinkish tinge to your saliva, may occur during the first 48 hours following surgery. Avoid extremely hot foods for the rest of the day and do NOT rinse out your mouth, as these will often prolong the bleeding. If bleeding continues, apply light pressure to the area with a moistened gauze or moistened tea bag. Keep in place for 20-30 minutes without looking to see if bleeding has stopped. (NO PEEKING!) If bleeding increases or occurs past the initial 48 hours, please call our office as soon as possible to notify the doctor and receive further instructions. Avoid any strenuous physical activity for the next 2-3 days to prevent or minimize severe bleeding.
Eating / Diet:
- Please follow a soft food diet, taking care to avoid the surgical area(s) when chewing. Chew on the opposite side and do NOT bite into food if the procedure was done in the front of the mouth. Avoid sticky, hard (such as ice cubes, nuts, popcorn, chips), brittle, spicy, highly seasoned, or acidic foods in your diet. Foods such as soups, pasta, scrambled eggs, mashed potatoes, macaroni & cheese etc. are best. Be sure to maintain adequate nutrition and drink plenty of fluids.
- Avoid alcohol (even beer and wine) and smoking until after your post-operative appointment. Smoking is not advised during the 7-14 days following surgery.
Maintain normal oral hygiene measures in the areas of your mouth not affected by the surgery. In areas where there is dressing, lightly brush only the biting surfaces of the teeth. After you have eaten or you have snacked, please use lukewarm salt water rinse 4-6X a day; 30 seconds of swooshing with each use. Vigorous rinsing should be avoided!
- Please use Periogard, Peridex, or Chlorhexidine mouth rinse 2X (morning and night) a day; 30 seconds of swooshing with each use.
- Please do NOT play with the surgery area with your fingers or tongue.
- Do NOT pull up or down the lip or cheek to look at the area and do not have someone else look at the area. Just LEAVE IT ALONE!
- Do NOT use a drinking straw, as the suction may dislodge the blood clot.
- Avoid extremely hot foods. Cold foods such as ice cream or shake are OK as long as you use a spoon.
- Try to relax and practice the best oral hygiene possible and your healing should progress well. If you have any questions or concerns, please call the office.
The purpose of splint therapy is to help your lower jaw function more properly. Since the treatment you are to receive is mainly orthopedic in nature, we have fabricated an orthopedic appliance to help reposition your lower jaw. This appliance will help to relax any of your jaw muscles which are in spasm and to reduce any muscle pain. There are many situations that may cause your lower jaw to malfunction including accidental trauma, developmental defects, peculiar oral habits, naturally occurring malocclusion (poor bite), psychological stress, clenching or bruxing of teeth, and other problems.
You have received an acrylic bite splint (occlusal splint). This treatment has been used for many years to keep the teeth from contacting while you sleep and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth. It is essential that you wear your night guard every night and you may also wear it during the day if you find yourself clenching or grinding your teeth, When it's not inyour mouth, make sure your splint is placed in water to avoid warping.
Cleaning the Splint
Food will accumulate under the splint. After brushingand flossing your teeth very thoroughly, brush and rinse the inside and outside of the splint and return it to your mouth. Dental decay can be stimulated if you are not careful about the cleanliness of your mouth and splint. Fluoride containing rinses or gels is useful when placed in your splintonce per day if you have a high dental decay rate. Using a dental soak cleanser (ex: Polident) on a monthly basis will help keep the splint fresh.
Endodontic treatment ca takes 1, 2 or appointments depending on the case. It is possible to experience any day of the following symptoms after any of these appointments:
- Sensitivity to hot and/or cold; Sensitivity to pressure; possible swelling. If you experience swelling, please call our office immediately as additional medication may be required.
- One common occurrence with a newly root—canalled tooth is for the tooth to feel high when you bite your teeth together. If this occurs it will cause your tooth to stay sensitive for a longer period of time. Please call us if your bite feels “high” as this problem is easily rectified with a simple bite adjustment.
- A temporary filling may be used to temporarily seal the tooth between visits.
- Be gentle on the tooth while eating until the final restoration is placed.
- The gum tissue could have been irritated during the procedure and may be sore for a few days together with the anesthetic injection site.. During endodontic treatment, the nerve, blood and nutrient supply to the tooth is removed. This will cause the tooth to become brittle and prone to fracturing which could result in the need to extract the tooth. A full coverage crown is recommended to prevent this from happening.
- Do root canals always work? NO! A root canal is a therapy not a cure. It has a high success rate but almost 4 % of them fail. If your root canal fails within a period of 3 years from the date of service, we will either refund the cost of your root canal or retreat your failed root canal. In addition, if the tooth cannot be saved, the cost of the crown placed in our office will be refunded during that 3 — year period. This warranty is null and void if the patient does not maintain their 6 month continuing care cleaning appointments.
In-Office Whitening or Take Home Kit Whitening
Sensitivity and soreness following whitening is very common. Your teeth may be especially sensitive to cold air and drinks and if any of the whitening agent gets on your gums, it may cause them to be tender. Sensitivity and soreness will gradually subside after a couple of days. If you are more prone to sensitivity, you may choose to use anti-sensitivity toothpaste before, during, and after whitening.
Try to avoid any darkly or reddish colored foods and beverages (red sauces, coffee, red wine, tea) and smoking for a few hours following whitening. This is when your teeth are most susceptible to absorbing new stain. To maintain your shade for as long as possible, avoid colorants (dark food and drinks, tobacco), use a whitening toothpaste, and have regular cleanings. You may need to use home whitening trays a few times a month to maintain your shade.
Tooth-colored fillings will not whiten. If the filling matches your current color, bleaching will result in miss-matched shades with your natural teeth. You may need to have your old fillings replaced to match your newly whitened teeth.
The best way to maintain your white teeth after in-office whitening will be to utilize a take home teeth whitening kit.
Take-home Whitening Kit Instructions
While bleaching or whitening your teeth, normal oral hygiene measures should be followed (flossing and brushing).
Bead the bleaching gel into your custom tray, using caution not to overload the tray. Insert the tray into your mouth over teeth and gently wipe any excess gel from around the edges of your tray, taking extra care not to leave any gel on your gums. Irritated gums usually means you have used too much gel in your tray.
Wear the tray for one hour the first time; you may use the gel up to two hours, twice daily for seven days. I the sensitivity is too uncomfortable, stop and reduce time and/or frequency. Usually sensitivity stops after several days.
Do not rinse your mouth, since this may dilute the bleaching agent. Do not swallow the whitening gel. Never drink, eat, or smoke while wearing your tray. After completing the daily bleaching session, remove the tray and gently clean it with a toothbrush. Rinse it completely, and let dry thoroughly before the next session.