• Fillings
• Crowns and Bridges
• Root Canal Treatment
• Extractions
• Bone Grafting
• Deep Cleaning
• Dentures
• Veneers
• Tooth Whitening

Fillings

Following your filling appointment if an anesthetic has been used, your lips, tongue and cheek may be numb for several hours after the appointment. Avoid chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue or lip while you are numb. It is normal to experience some hot, cold & pressure sensitivity after your appointment. Injection sites may also be sore. Over the counter Ibuprofen (Motrin) or Tylenol (one tablet every 4 hours as needed for pain) work well to alleviate the tenderness. Once the numbness is completely worn off, if you feel that the filled teeth come in contact prior to the rest of the teeth contact our office for an adjustment. You may chew with your composite (tooth colored) fillings as soon as the anesthetic completely wears off, since they are fully set when you leave the office. If you chose the silver fillings do not eat on that side for the next eight hours since silver fillings take longer to achieve their complete set strength.

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Crowns and Bridges

Crowns and Bridges are usually completed in two appointments. Following anesthesia the teeth are prepared for a permanent bridge/crown and an impression is taken. This impression is very important. Your dentist may have to take more than one impression. It dictates the precision of your permanent bridge or crown. Then a temporary bridge/ crown are placed on the teeth for protection. The size, shape, and color of the temporary do not resemble the final restoration. A temporary bridge/crown is easily removed; therefore care must be taken not to dislodge it before your permanent bridge/crown is placed. Do not chew sticky foods such as caramel or chewing gum. When flossing, pull the floss out the side; do not pop it through the contact with the tooth next to it. You will not be able to floss between the teeth of your temporary bridge. If your temporary bridge /crown comes off, you can place some Fixodent (available at any pharmacy) inside it and put it back on, then call our office during normal business hours and we will re-cement it Do not leave your temporary off, even if you have no discomfort. If you feel the bite is not correctly balanced, please call for an appointment for a simple adjustment. Without a temporary bridge to hold your teeth in place, your teeth can move causing your new bridge not to fit. If that occurs, you would have to purchase another bridge. Your gums may be sore. Warm salt water rinses will speed healing. You may have sensitivity to hot or cold. This is common and normal since the temporary is not an accurate fit of the prepared teeth. If you feel like you are biting first or harder on your temporary or permanent bridge, call us for an adjustment or you will develop a sore tooth. Be sure to brush and floss your new bridge. With a bridge, you will need special floss threaded or other aids to reach and clean all areas properly. If you have any questions or concerns, please do not hesitate to call our office. Your comfort is our priority!

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Root Canal Treatment

Root canal therapy often takes two or more appointments to complete depending on the severity of infection. At the start of treatment your dentist may isolate the tooth with a rubber dam to prevent salivary contamination of the canal system and protect you from the irrigants used during the procedure. A temporary filling or crown is placed to protect the tooth between appointments. After each appointment when anesthetic has been used, your lips, teeth and tongue may be numb for several hours after the appointment. Avoid any chewing until the numbness has completely worn off. If the tooth was asymptomatic to start with there are usually no flare –ups between appointments. But if you came in with a severe toothache or a swelling it will take time to heal and expect to have flare-ups between appointments. Between appointments it is common for a small portion of your temporary filling to wear away or break off. You may even have a bad taste. If the entire filling falls out, or if a temporary crown comes off, call us so that it can be replaced. It's normal to experience some discomfort for several days after a root canal appointment, especially when chewing. To control discomfort, take pain medication as recommended. To further reduce pain and swelling rinse three times a day with warm salt water. If antibiotics are prescribed, continue to take them as prescribed, even if all symptoms and signs of infection are gone. Since the tooth is very fragile following treatment avoid eating sticky and hard foods. Avoid chewing on that side until the permanent crown is placed. The permanent crown will protect the tooth from breaking in future.

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Extractions

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. You may have to do this several times. If bleeding still persists, biting on a moist tea bag wrapped in gauze may help control the oozing from the surgical site. Tea has an ingredient that promotes blood clotting. After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Does not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site. Failure to comply with the above instructions will result in dislodgement of the clot and severe throbbing pain at the extraction site, since the bone is now exposed to the oral environment. After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours. Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable. It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean. After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

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Bone Grafting

In addition to the above instructions, it is important to remember a few additional points if you have received a graft within the socket site after we removed your tooth. The bone graft is made up of many fine particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by the presence of these small granules. It is completely normal for some granules to become dislodged from the graft site, but there are some things you can do to minimize the amount of granules which become dislodged: Do not rinse vigorously or spit for the first 3 to 5 days. Do not apply pressure with your tongue or fingers to the grafted area. The material is movable during the initial phases of healing and it is best to leave the area undisturbed as much as possible. Do not lift or pull your lip back to look at the sutures. This pulling or stretching can damage the wound, tear sutures and decrease the success of the graft. These sutures may or may not be resorbable. If you have been told that you have received external silk sutures they have to be removed by us. Sometimes your dentist may even place a barrier for the graft which may or may not be resorbable and may have to be removed. On the first day it is best to let the area settled and allows the blood clot to stabilize the graft material. Therefore, do not even rinse your mouth the first day. After the first day you may begin gentle rinsing with warm salt water, but avoid rinsing vigorously and avoid forced spitting.

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Deep Cleaning

If you require more than just a regular cleaning your Dentist /Hygienist may prescribe a deep cleaning (Scaling and Root Planing).It is usually done in sections. One half of the mouth is cleaned in one session & you will have to come back for the other half. First the teeth & the gums are anaesthetized then the teeth are cleaned using a combination of ultrasonic & hand instruments. It is normal to experience cold & hot sensitivity after the appointment. Your teeth may even be sensitive to chewing. Your gums will be sore and may bleed. Sometimes your Dentist /Hygienist may advise the placement of an antibiotic ( arestin , perio-chip) in the pocket if it greater than 4mm. In that case, patients should postpone brushing for 12 hours and avoid the use of interproximal cleaning devices(flossing) for 10 days. Also patients should avoid eating hard, crunchy or sticky foods for 1 week. After the completion of treatment it is important to follow good home care which includes regular brushing, flossing, using a mouth rinse (prescription or over the counter). Your Dentist / Hygienist may put you on a 3 -4 month follow up care. Failure to comply with it will return your gum condition back to square one. Regular follow up care will create an environment for the gums and bone to heal and will prevent further destruction. Gum disease is a silent disease and the importance of follow up care cannot be overemphasized.

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Dentures

Immediate or Transitional Dentures These dentures are delivered as soon as the remaining non-restorable teeth are removed. They serve as a bandage to the sockets and help in controlling the bleeding. For the next 24 hours do not remove the dentures from your mouth. Apply firm pressure by biting on a gauze pad for 30-45 minutes following the appointment. You may have to repeat this several times. You may apply cold pack externally to control bleeding and swelling. Your immediate dentures will contain the swelling. Take the prescribed pain medication and antibiotics. Do not rinse your mouth vigorously. Restrict your diet to soft and cold foods. It is normal to see your pillow stained with blood. Do not panic. The following morning gently rinse your mouth. As your sockets heal your dentures will get loose and will need to be adjusted several times. Learning to wear your new dentures (particularly full dentures) is much like learning a new sport. It takes practice and patience. Try not to become discouraged at first. Wear your dentures regularly so your dentist can locate the sore spots when you go in for an adjustment. You may salivate more when you first get your denture. This is normal and usually stops anywhere from within the first few minutes to a few days. It is important that you practice talking. Talk to yourself, read aloud and sing. You should sound normal within a very short time. You will also need to practice eating. Do not plan to eat your first meal in public. Cut your food into small bites, eat easy to chew foods and chew slowly. Some people feel more comfortable wearing adhesives under their dentures (particularly full dentures). You can experiment with over the counter adhesives. It is important to make sure you remove the entire adhesive each day when you clean your dentures. At the end of 3 months your Dentist will reline your denture in house to make them fit tighter. Bone usually takes 365 days to completely heal. At the end of a year your Dentist will send your dentures for a lab reline. It is usually done within a day so be prepared to take a day off. Transitional dentures are only for the period of gum and bone healing and your Dentist may recommend permanent dentures. The removable partial or full denture must be removed at least 8 hours each day, preferably at bedtime. Letting the denture stay in the mouth 24 hours a day will cause you to develop sores and fungus under it. It should also be removed and cleaned after meals. When you take it out at bedtime, clean it with a brush and soak it in water, mouthwash or a denture cleaner. Do not let the denture dry out, as this can cause it to warp. When rinsing and brushing your denture over the sink, it is best to place a wash cloth in the basin with some water to cushion the denture should you drop it. The acrylic will break if dropped. Even if you wear a full denture, it is still important to see your dentist regularly. Your dentures should be checked routinely, along with both the fit and the bite. A poorly fitting denture can cause problems with the underlying tissues and bone loss. You will also be checked for oral cancer and other diseases that can show up in the mouth.

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Veneers

Veneer preparation involves the removal of a small amount of tooth structure. An impression is taken & sent to the lab to fabricate the custom veneers. During this time your Dentist may place temporary veneers on your teeth, Temporary Veneers are made of either acrylic or composite material. They are very fragile and are attached to the underlying tooth structure with temporary cement and can be easily dislodged. If a veneer comes off, call us and we will replace it immediately. If you are in a situation that will not allow you to come in, place the temporary back in place with some Fixodent™ (denture adhesive) till you can come in. The size, shape, and color of the temporary does not resemble the final veneer. Temporary veneers may leak saliva or food onto the tooth. Sensitivity to hot, cold, pressure or sweets is not uncommon. Temporary veneers also stain very easily. Avoid heavy brushing of the temporaries and do not floss between them because you may pull them off. Your permanent porcelain veneers will be as close to the natural teeth as possible. Your Dentist may even send you for custom shading to closely duplicate your adjoining natural teeth. Permanent porcelain veneers are bonded to your teeth using the finest materials. As with natural teeth; avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, raw carrots, etc.) because the porcelain material can break under extreme forces. Proper brushing, flossing, and regular 6-month (minimal) cleanings are essential to the long-term stability and appearance of your veneers. If not your gums may recede reveal the underlying discolored tooth structure requiring replacement of your veneers.

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Tooth Whitening

Pain and sensitivity following teeth whitening is common. You may be sensitive to cold air & fluids; however the pain will fade away within 24-36 hours. It is important not to consume any colorants in the first 24- hours following the procedure. Anything that colors such as red wine, dark colas, coffee, tea, red sauces, soya sauces and smoking must be avoided. Following the whitening procedure an instant lightening is usually seen in most cases. However rebound is not uncommon. On an average during the first month there may be loss of one shade unit, another shade unit during the next 6 months and another shade unit during the subsequent six months. Everyone responds differently, so your rebound effect may be less or greater than the averages stated above. Rebound means that after about two years your teeth may have returned to the color prior to bleaching. Rebound MUST be managed, this is achieved through any combination of: Careful diet control avoiding high colorants, Meticulous oral hygiene, Using a whitening toothpaste Using home bleaching trays, Annual repeat of the in house teeth whitening.

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