Post Operative Instructions

Composite (White) Fillings

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. It can also be used for cosmetic dentistry. If we used a local anesthetic to thoroughly numb the area we treated, the numbness in your lips, teeth and tongue might last for several hours after the procedure. To prevent damage to your tongue and lips, you should avoid any chewing until the numbness has completely worn off.

Things to expect after treatment:

  • Once numbness has worn subsided, you are able to eat and drink normally.
  • For the first few weeks, it is normal to experience some pressure, or sensitivity to hot and cold after your composite is finished. The injection sit may also be sore. Aleve, Ibuprofen or aspirin will work well to alleviate the tenderness.
  • If your gums are swollen or sore, rinsing your mouth with warm salt water can help to alleviate discomfort and swelling. Dissolve a teaspoon of salt in a cup of warm water, then gently swish the water around the tooth and spit.
  • Floss and brush your new filling as you normally would, and maintain consistent hygiene routines.

Notify our office if any of the following occurs:

  • You feel that your bite is not correctly balanced. It feels as if the filling is too high, or you are hitting the filling first when you bite down.
  • You have discomfort or pain that persists from hot or cold temperatures. Both of these symptoms are normal and are caused from not being able to properly feel your bite while being numb.

Warranty Information

The model filling is no more than 50% of the tooth. This leaves half of your tooth to support the filling. Occasionally, we place a filling as a conservative measure, anticipating there is enough natural structure to hold the filling, when in reality it turns out there is not. The tooth then starts to break away because it can no longer support the filling. In this case, we will credit the cost of the filling towards the cost of a new porcelain restoration (CEREC crown). For a period of three years from the date of service, our warranty also covers the replacement of the filling if it fails, at no additional cost. Please be aware that this warranty is null and void if you do not maintain your 6 month- preventive cleaning appointments.

One Visit Crowns

Congratulations! You have just received one of the best things modern dentistry can offer, a porcelain CAD/CAM restoration. A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the tooth structure that cannot be restored with fillings or other types of restorations. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting, beautiful smile.

Grinding/Clenching: Patients who grind/clench their teeth typically have more post-op problems with any given treatment rendered. Expect more post-op sensitivity and tenderness, as well as longer, more difficult recovery period. Properly designed and fitted night guards (NTI) help alleviate these problems. The crown of a tooth is the portion that is covered by enamel. A restorative crown replaces this outer part to protect and strengthen the tooth. This protection becomes necessary when a tooth cracks, has its entire structure weakened by decay, or becomes brittle after a root canal.

Things to expect after treatment:

  • We used a local anesthetic that might last for several hours after the procedure. You should avoid any chewing until the numbness has completely worn off. There are no restrictions on your usual activities. Brush and floss the crown as you do your natural teeth.
  • Sensitivity to foods and liquids is a normal reaction to a new crown, and may last for several weeks, but it should begin to feel better everyday. If the tooth hurts or continues to feel sore each passing day, call us to set up a simple bite adjustment.

Warranty Information

We believe in the quality and craftsmanship of our work so much that we offer a warranty for your crown!

  • 1 year unconditional warranty. Includes all necessary repair, rebond, or replacement.
  • Within the next four years, if your crown needs replacement, the charge will be 50% of the present fee.

It is mandatory to wear a NTI (special night guard) to protect your crown and other natural teeth if indicated due to wear patterns from abnormal wear like clenching or grinding.

Extractions

Things to expect after treatment:

  • The initial healing period usually takes one to two weeks, and you’ll likely experience some swelling for the first forty eight hours.
  • Before the procedure began, you were given an anesthetic to ensure your comfort. This anesthetic typically leaves your lips, teeth and tongue feeling numb after the appointment. For this reason, you should avoid chewing for two hours following surgery, or until the numbness has completely worn off.
  • Discomfort after the extraction is normal. An over-the-counter pain reliever may be sufficient. We can also give you a prescription for a stronger pain reliever if needed.
  • To avoid nausea, do no take pain medication on an empty stomach.
  • You can also decrease pain and swelling by applying an ice pack (twenty minutes on, twenty minutes off)  for the first six hours following the extraction. A frozen bag of peas work great as well!
  • A blood clot will form on the extraction site, and this clot is vital to the healing process. To keep the clot intact, avoid touching the extraction site with your tongue or fingers, do not drink liquids through a straw, and do not spit vigorously.
  • Blowing your nose or sneezing violently can also dislodge the blood clot and impair healing, so if you have an upper respiratory infection or suffer from allergies, be sure to have the appropriate sinus medication on hand.
  • Do not drink alcohol for 48 hours after extraction. Smoking or allowing food particles to pack into the tooth’s socket should be avoided, as both will significantly affect the healing process.
  • Do not rinse your mouth for 12 hours after surgery. 24 hours following the procedure, you can rinse gently with mouthwash or a warm salt water solution. (Dissolve one teaspoon of salt with one cup of warm water. Gently swish the solution around the affected area, and spit carefully.) You should do this two to three times each day for the week following the extraction.

Things to expect after treatment:

  • Keep your head elevated with pillows to control bleeding. Relax as much as possible. We will give you a supply of gauze sponges to place over the bleeding area.
  • If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
  • Once the numbness has worn off, you should eat. Nourishment is an important part of the healing process. Limit your diet to soft foods like yogurt, soft soups, ice cream, or soft-cooked eggs for the first forty-eight hours, and drink at least eight large glasses of water or fruit juice each day.
  • Change the gauze as necessary and use them until the bleeding stop completely. You can bite carefully, but firmly on a moist tea bag for twenty minutes. Use tea bags if bleeding persists…YES, tea bags! They have a natural coagulant.

Notify our office if any of the following occurs:

  • Heavy bleeding develops. This may be suspected if the gauze sponges are still being heavily saturated with blood after two hours. Oozing is normal, heavy bleeding is not.
  • Any bleeding from the socket occurs after 18 hours.
  • Severe nagging or “gnawing” pain is present at the extraction site after 24 hours.
  • Elevation of temperature over 101 F develops.
  • Dry socket may occur after any dental extraction. It usually comes on 48 hours after surgery, even if the area felt normal before. We may be able to place a soothing medicine to relieve symptoms, however relief is seldom found. It could last for 10-14 days.

Temporary Restoration

You have just received a temporary restoration that will serve you for a short period of time while your final restoration is being made. This will protect the tooth and holds the tooth in position so the final restoration will fit properly. Temporaries are not strong, they are meant to function as they sound “temporary”. It is very important if you have temporaries to rinse them twice a day for one minute with 50% hydrogen peroxide and 50% water. This will aid in maintaining a clean and healthy temporary, and insure that the final restoration will fit properly.

Things to expect after treatment:

  • Temporaries may break or come off occasionally. If so, you may slip it back on the tooth will something like denture adhesive or even toothpaste, or call if you need an appointment. Please do not leave the temporary out of your mouth because the teeth can shift and the final custom made restoration may not fit properly.
  • Please clean around your temporary as instructed, and keep your gums healthy by brushing and flossing gently around the temporary.
  • The size, shape, and color of the temporary may not resemble the final restoration. Futhermore, it may fade or change shades, especially when exposed to things like coffee, soda, red wines, etc. Candy and gum will very likely remove any given temporary, so please refrain from using them while your custom restoration is being made.
  • Temporary restorations may leak saliva or food onto the tooth if left in place longer than recommended, even with proper care.
  • Sensitivity to hot, cold, pressure or sweets is not uncommon.

Notify our office if any of the following occurs:

  • You feel that your bite is not correctly balanced. It feels as if the filling is too high, or you are hitting the filling first when you bite down.
  • The temporary breaks or falls out and you are unable to secure it.

Please call the office to schedule an appointment at no charge for a simple adjustment.

Root Canal Therapy

Teeth, just as any other part of your body, can become infected. The infection usually is caused by (1) a deep cavity, or (2) traumatic injury to the tooth.

A root canal treatment will save your tooth and avoid the harmful effects of tooth loss. Root canal therapy is usually done in two appointments. The abscessed area at the root canal (under the gum) will start to heal slowly and may require several months for complete healing. We will want to check the healing process by comparing x-rays taken at a later date with the original x-rays.

Things to expect after treatment:

  • Once numbness has worn off, you are able to eat and drink normally.
  • The healing process may take a few days and any minor discomfort will subside gradually. It most ofter feels bruised. You may experience moderate sensitivity to pressure. Your tissue near the treated tooth may feel sore for a few days after treatment.
  • Take any medications that we have prescribed for you according to instructions.
  • Floss and brush your new filling as you normally would.

Notify our office if any of the following occurs:

  • Swelling in the gum around the tooth being treated develops.
  • Temperature about 101 F develops.
  • The tooth feels as if it’s “coming out of the socket.”
  • The tooth becomes loose.
  • Pain develops which cannot be controlled by simple remedies such as Aspirin, Tylenol, or Ibuprofen.

Please call the office if you have concerns not mentioned above.

Implant

Congratulations! You have just completed the first step of your implant treatment. In just three to four months, we will have you back in our office to complete your implant with your new CEREC crown. Your implant requires a clean environment. Proper care of your mouth will aid in the healing process and reduce the possibility of complications.

Things to expect after treatment:

  • Following the initial procedure, you may find it advisable to take it easy for a day or two.
  • Before the procedure began, you were given an anesthetic to ensure your comfort. This anesthetic typically leaves your lips, teeth and tongue feeling numb after the appointment. For this reason, you should avoid chewing for two hours following surgery, or until the numbness has completely worn off.
  • Discomfort after surgery is normal. An over-the-counter pain reliever may be sufficient. We can also give you a prescription for a stronger pain reliever if needed.
  • You can decrease pain and swelling by applying an ice pack (twenty minutes on, twenty minutes off) for the first six hours following the extraction. A frozen bag of peas work great as well!
  • Avoid touching the implant with your tongue or fingers, and do not drink liquids through a straw or spit vigorously.
  • Avoid smoking for 2 weeks. Smoking significantly affects the healing process.
  • Rinsing is very helpful in keeping your mouth clean. Warm salt water rinses should be started the day after surgery. (Dissolve one teaspoon of salt with one cup of warm water. Gently swish the solution around the affected area, and spit carefully). Rinse gently several times a day and continue to do so for 10-14 days.
  • There is usually a minimal amount of bleeding following implant surgery. We suggest that you bite on the gauze packing in your mouth for at least 20-30 minutes. If you notice bleeding from the area after the first 30 minutes, place another gauze pad over the area. Some oozing may occur for a day or two after the surgery.
  • Do no attempt to floss, brush or water-pick in the area of surgery for the first two weeks.
  • Diet is very important during healing period. Eat soft, nutritious foods. Avoid hard or crunchy foods.

Notify our office if any of the following occurs:

  • Swelling, redness or discomfort in the area of the implant.

Dentures and Partials

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile. There are two types of dentures – complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills in the spaces created by missing teeth, but it prevents other teeth from shifting. Dentures are very durable appliances and will last many years, but may have to be re-made, repaired, or readjusted due to normal wear.

Things to expect after treatment:

  • Sore Spots: Usually your mouth will have a few “sore spots” after wearing the denture/partial for 24 hours. These areas can be relieved with very little effort in the office. Just call if you feel a sore spot.
  • Chewing: The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surface of your teeth after the dentures/partials have settled into place.

We have done our best to provide you with well-fitted, functional, and esthetic dentures/partials. We feel confident that after a few weeks of becoming adjusted to the new dentures/partials, 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/partials will feel loose and may require relining. Wearing ill-fitting dentures/paritals for too long, after they have settled into place, can cause severe bone loss and very serious oral disease.

Please call our office should your partial/denture feel loose due to the above reasons.

Frenectomy

A frenum is a fold of tissue or muscle connecting the lips, cheek or tongue to the jawbone. Frenectomy is a term that refers to the removal of one of these folds of tissue. Sometimes a frenum can be attached too tight on the gums or extend between teeth, this can become a significant problem if tension from lip movement pulls the gums away from the teeth. In addition, this can lead to diastemata (space between teeth); which prevents teeth from coming in to their correct position, and eventually causing gum recession. It is also conducive to plaque accumulation and inhibits proper brushing of the teeth.

Things to expect after treatment:

  • Do not eat or drink anything sharp, spicy, or hard for the next 48 hours.
  • Do NOT pull on lip.
  • No physical contact that can result in a jar to the mouth.
  • The area may become white or grey.
  • Healing can take up to one week.
  • Rinsing with salt water helps keep the area clean and facilitates healing.

Cold popsicles can feel really good too!

Gingivectomy

A healthy and harmonious gum-line is essential for a beautiful smile, as the gums are the frame around the teeth. A gingivectomy is a dental procedure that raises and sculpts the
gum-line. This procedure may involve reshaping the tissue to create the appearance of longer and symmetrical teeth, thereby making the smile more aesthetically pleasing. It can also be done to remove excess tissue for optimal placement of a crown. A gingivectomy is typically done to reduce excessively “gummy” smiles or to balance out an asymmetrical gum-line.

Things to expect after treatment:

  • We used a local anesthetic that might last for several hours after the procedure. You should avoid any chewing until the numbness has completely worn off. There are no restrictions on your usual activities.
  • Do not eat or drink anything sharp, spicy, or hard for the next 48 hours.
  • Healing can take up to one week.
  • Rinsing with salt water helps keep the area clean and facilitates healing.
  • Brush your teeth in the area, but avoid brushing into the gums for 7 days.

Instructions for Sedation

Sedation dentistry refers to the use of sedation during dental treatment. While sedated, you are still conscious, you maintain all of your protective reflexes like swallowing, breathing, coughing, and you can even walk to the bathroom if necessary. However, all your anxieties about dental care are removed. Most people remember very little about their visit except that all their dental work was completed while they were sedated. Drugs are given by taking small pills which create a state of deep relaxation and amnesia. You will be free of anxiety, may lose sense of time, and have little memory of the procedure. This is an excellent commodity for an apprehensive patient for any dental procedure, or a patient undergoing a surgical procedure. During this process, the patient is continually monitored with automatic blood pressure and oxygen saturation levels. The patient cannot drive after this procedure.

Take all medication as prescribed.

  • No stimulants for 12 hours before appointment (i.e. caffeine).
  • You should not eat at all prior to your appointment.
  • If you appointment is in the late afternoon, you may have a light breakfast (i.e. toast and some type of protein). Late afternoon appointments; please do not eat anything three hours before appointment. If you are a diabectic, this may not apply to you.
  • You may take the medication with a glass of water or orange juice, however no grapefruit juice please. Wear something comfortable (i.e. sweatpants and sweatshirt).
  • Please remove any fingernail polish for this appointment, as it interferes with heart rate/oxygen monitoring.

____________________________________________________________________________________________________________

Things to expect after treatment:

  • It is normal to sleep or be sleepy for the rest of the day.
  • For a period of 12 hours, patient may not remember events or conversations.
  • No driving for 12 hours after appointment.
  • No operating hazardous devices.
  • Avoid heavy lifting.
  • Avoid climbing stairs.
  • Important decisions should NOT be made.
  • Drink plenty of fluids as soon as possible.
  • Patient should be attended to at all times –Do not trust him/her alone.
  • Attendee should hold patients arm when walking.

Night Guard/NTI

You have received an acrylic nightguard/NTI. 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. You may also wear it during the day if you find yourself clenching or grinding your teeth. This appliance will help to relax any of your jaw muscles which are in spasm, and to reduce any muscle pain, as well as protect your teeth.

Things to expect after treatment:

  • Your teeth may become tender from being confined to the night guard. The tenderness lasts 1-3 days and will not reoccur.
  • You may notice an increase in saliva due to the extra material in your mouth. It does get better!
  • WEAR IT EVERY NIGHT. To be effective, the night guard/NTI must be worn every night. If it is left out for extended periods, the teeth may move slightly and then the night guard may not fit. Sometimes it has to be remade if the teeth have moved too much.

How to care for your NightGuard/NTI:

  • Brush and floss your teeth before wearing the guard.
  • Clean the guard under running cold water every morning.
  • Keep the guard in the provided case when not in use.
  • Use Efferdent/Polident denture cleaner to soak your guard.
  • Do not use toothpaste or toothbrush to clean your guard.
  • Keep the guard away from hot water/surfaces—Do not boil.
  • Keep away from pets —-They love to chew on the guard material.

Bring your night guard to your maintenance appointments and we will put it through the ultrasonic cleaner.

Sealants

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Things to expect after treatment:

  • Avoid chewing anything hard (i.e. ice, hard candies). They will wear sealants and teeth out fast.
  • Your bite may appear to feel off at first, however, this sensation will go away within a few days.

Remember, sealants alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

Fluoride

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. We generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Things to expect after treatment:

  • Avoid anything acidic (i.e. sodas).
  • Avoid hot drinks and products containing alcohol (i.e. beverages, oral rinses, etc) during treatment period.
  • Avoid brushing and flossing for 8-12 hours. If possible, wait until tomorrow morning to resume normal oral hygiene.
  • Teeth will feel sticky.
  • After application, fluoride may appear white and streaky on the tooth surface. A thorough brushing and flossing will remove any remaining fluoride.

Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.