Dental Patient Info
Post Operative Instructions
- Extraction
- Fillings
- Crown and Bridges
- Root Canal Treatment
- Teeth Cleaning ~ Deep Cleaning
- Braces
- Gum Surgery
- Implant Surgery
- Denture Delivery
- Apicoectomy (Root Canal Surgery)
- Bone Graft Surgery
Basic Maintenance
- How to Brush Your Teeth
- How to Floss Your Teeth
- Electric Brush vs. Manual Brush
- Bad Breath
- Dental Health and Your Diet
- Fluoride & Dental Decay Prevention
Extraction
1 Pressure should be placed on the gauze pad that has been placed on the extraction site for one hour. If the bleeding continues new gauze should be placed and pressed on for another 45 minutes.
2 If you are supervising children who have had extraction done, make sure they don t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).
3 Avoid eating or drinking anything hot on the day of your extraction. Also, do not rinse your mouth, do not use a straw for drinking. Do not spit and do not drink carbonated beverages. Do not brush on the day of the surgery; you can resume your brushing and flossing the day after, gently.
4 You may experience some pain, bruising around your lips and/or some swelling, especially after extraction of impacted wisdom teeth. Ice bag application and medication prescribed for you will help to minimize your discomfort.
5 Please take all the medication you have received based on the instructions given to you.
6 During the first 2-3 days after the surgery a diet of soft food and liquids is recommended (soup, yogurt, milk shake and juice).
7 For more complex Surgical Procedures including Impacted Wisdom Tooth Extraction, Implant Surgical Procedures, etc; you will receive an ice wrap which should be worn for the rest of the day and until you go to bed on the day of surgery only (10 minutes on and 5 minutes off). Individual instructions for various surgical treatments will have some unique directions which will be supplied to you at the time of your treatment.
8 Call our office if you experience excessive bleeding, severe pain or swelling or if you have any questions or concerns. In case of serious emergencies call 911.
Fillings
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1 Do not eat on your new filling for one hour and until your numbness is gone.
2 If you are supervising children who had fillings done, make sure they don t bite on their numb lips or tongue (it can cause serious injury to their soft tissue).
3 Do not bite hard or chew on fillings for 24 hours.
4 You may experience cold and heat sensitivity and some soreness on your gum, this usually subsides in few days.
5 Call our office if you experience pain or discomfort for more than a few days after the fillings, or if you have any questions.
Crown and Bridges
1 Crown and bridges usually take 2 or 3 appointments to complete. On the first appointment the tooth/teeth are prepared and impressions are taken and a temporary crown is placed on your tooth/teeth.
2 You may experience sensitivity, gum soreness and slight discomfort on the tooth / teeth, it should subside after the placement of permanent crown.
3 Whenever anesthesia is used, avoid chewing on your teeth until the numbness has worn off.
4 Temporary crown is usually made of plastic based material or soft metal. It could break if too much pressure is placed on it. The crown also may come off; if it does, save the crown and call our office. The temporary crown is placed to protect the tooth and prevent other teeth to move. If it comes off it should be replaced. To avoid losing your temporary, avoid chewing on sticky and hard food (chewing gum, ice). Try to chew on the opposite side of the treatment as much as possible.
5 After the permanent restoration is placed you may feel slight pressure for a few days. Also, the bite may feel different for a day or two. But if the bite feels uneven or you feel discomfort on chewing on the tooth after 2-3 days call our office. Delaying the necessary adjustments may damage the tooth permanently.
6 Continue your normal brushing but be careful while flossing around the temporaries (remove the floss gently from the side).
7 Call our office if you are in pain or if you have any questions.
Root Canal Treatment
1 You may experience moderate pain and sensitivity to pressure on your tooth. Also, you may feel gum soreness for few days after your treatment. The healing process may take several days but the pain and discomfort should subside gradually.
2 Take any medication that was prescribed for you according to instructions.
3 Usually a temporary filling has been placed on your tooth, do not bite on the tooth for one hour and while you are numb. Also, until the permanent restoration is placed, be very gentle with the tooth. Try to chew with the opposite side.
4 Continue your brushing and flossing.
5 Follow up with the placement of your permanent restoration as you have been advised. Any unnecessary delay on placement of final restoration may damage the tooth permanently.
6 Call our office if you are in severe pain or experience swelling or if you have any questions.
Cleaning ~ Periodontal Cleaning
1 You may experience some cold and heat sensitivity (especially after deep cleaning).
2 If you have received anesthesia do not eat anything until the numbness has worn off.
3 Continue your regular brushing and flossing.
4 Some bleeding for a day or two after cleaning is normal, but if you experience any excessive bleeding call our office.
5 Call our office if you are in pain or if you have any questions.
Braces
1 You may experience some pressure and discomfort on your teeth.
2 Be gentle with braces and avoid chewing hard and/or sticky food.
3 Brushing and flossing around braces are sometimes challenging but very important.
4 Call our office if you have any questions.
Gum Surgery
1 You may experience some pain, swelling and bleeding after the surgery.
2 Take all the prescribed medications based on given instruction.
3 Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.
4
Keep your next appointment on time for removal of sutures and follow up checks.
5 DO NOT raise your lips with your fingers to inspect the treated area.
6 DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.
7 There is often a temporary loss of feeling in the operated area and the tooth may feel loose.
8 Do not smoke, spit or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).
9 Should any difficulties occur, do not hesitate to call our office anytime. In case of an extreme urgency call 911.
Implant Surgery
1 You may experience some discomfort and bleeding the day of the surgery.
2 Take all the prescribed medications based on given instructions.
3 Apply an ice bag on your face over the surgical site on the day of surgery for 10 minutes on and 5 minutes off.
4 Keep your next appointment on time for removal of sutures and follow up checks.
5 DO NOT raise your lips with your fingers to inspect the treated area.
6 DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.
7 There is often a temporary loss of feeling in the operated area and the tooth may feel loose.
8 Do not smoke, spit or use a straw on the day of the surgery (avoid smoking for a few days after the surgery).
9 Should any difficulties occur, do not hesitate to call our office anytime. In case of an extreme urgency call 911.
Denture Delivery
1 You will experience some discomfort with any new denture for a few days. All new dentures need several adjustments to completely and comfortably fit your mouth.
2 You should take the dentures out every night and keep them in a clean container containing water or denture cleaning solution. Your gum needs rest and to be without the dentures every day for a period of time.
3 Clean dentures thoroughly with brush and water before putting them back in your mouth.
4 It may be difficult to talk normally with the new denture for a few days. A way to practice is to read a book or newspaper out loud for a period of time everyday. Your tongue and muscles will get used to the new denture and you will talk normally very soon.
5 Call our office if you are experiencing pain, discomfort or if you have any questions.
Apicoectomy / Root Canal Surgery
1 Swelling, minor pain and / or skin discoloration may be experienced following the surgical procedure. This will be temporary.
2 In order to keep the swelling to a minimum, use an ice pack for the first few hours (on for 10 minutes and off for 5 minutes).
3 The dayafter the surgery use lukewarm water rinses for the treated area following each meal. This should continue for the first 3 days following the surgical procedure.
4 Eat only soft foods. Avoid hard and chewy foods.
5 Get plenty of rest and insure normal intake of food, especially liquids such as fruit juices, soup, and milk. Use a vitamin supplement if desired. Try not to sleep on the operated area for 2-3 days.
6 DO NOT raise your lips with your fingers to inspect the treated area.
7 DO NOT brush teeth near the surgical site. Brush teeth in the rest of your mouth.
8 There is often a temporary loss of feeling in the operated area and the tooth may feel loose.
9 Take medications according to the instructions.
10 Should any difficulties occur, do not hesitate to call our office anytime. In case of an extreme urgency call 911.
Bone Graft Surgery
You have just had surgery completed for the reduction of periodontal pocketing and/or for replacement of bone in an area where pathology existed; or in conjunction with endosseous dental implant surgical placement with or without platelet addition to the bone graft. You will be advised of the particular procedure and pertinent directions relative to your treatment modality. Whether you were put to sleep for this procedure or were only given local anesthesia, the post operative directions remain the same.
You will have several sutures (stitches) placed at the surgical site. 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. The sutures will cause a pulling of your tissue over the bone grafting site. Since the bone graft site will have approximately 15 % more bone fill than what was naturally there, it is imperative that you do not pull up your lips or cheeks to show or examine the area. The undue pressure will cause the sutures to widen away from the surgical site, expose bone, create more pain, and delay healing dramatically. This delay can lead to the need for the area to be sutured again when you are seen for your 1 week post surgical evaluation. The sutures will remain in place for between 14 and 21 days depending on the size of the graft, the severity of the pathology, and the condition of the tissue being sutured.
Your doctor will tell you what time period to expect. Remember though that this is not etched in stone, and that the doctor may extend the time before your sutures are removed to assure adequate healing and to avoid surgical regression.
You also may have a periodontal pack placed over the surgical site. The pack is pink in color, impregnated with antibiotic, and will protect the surgical site form infection and any wash out of the particulate bone utilized to restore your jaw. The pack should be left in place for as long as possible. If a pack is placed the doctor will remove the packing on your 1 week followup and decide if the packing should be replaced or kept off. Usually the packing is kept on for 7 to 10 days minimally. You must return to the office if your pack falls off before you are seen for your 1 week follow up.
Your maintenance during healing has to be completed carefully. You can brush in every area where the periodontal pack is not placed. It is imperative that you use NOTHING ASTRINGENT such as mouth wash or antiseptic solutions during the healing period of your bone graft. Listerine, Viadent, and any other potentially caustic agent can RUIN your bone grafting procedure, if contaminated, and require a replacement bone graft. Doctor and our staff will reiterate this with you at, during, and after your bone graft surgical procedure. After the first stages of healing is satisfactory, we will deliver and instruct you on how to use normal saline (with or without the addition of salt), and irrigation syringes for cleaning of the surgical site.
Since bone grows and heals slowly, and requires conditions conducive to a proper environment and blood supply, it is imperative that immediately after your bone graft that you alter your diet, as you would for any Oral Surgical procedure. This means that you should not eat anything that is too large, too hot, or too sticky. Your food should be tepid or on the cool side. Any food too hot will have a deleterious affect on your surgical procedure. Common sense must be used in determining what should be done or not done. If for some reason you have a question about anything post surgically, please call the office and we will inform you of the proper action to take.
Smoking after any Oral Surgical procedure will ALWAYS delay or badly disrupt normal healing due to a decrease in oxygenation of the tissue that is healing. Smoking should therefore be stopped for the first 7 to 10 days to allow for adequate initial tissue closure. Complete epithilization (closure) and wound healing normally takes a minimal of 21 days from the day the surgery was completed under ideal healing conditions and no other underlying systemic causes such as Diabetes Melitus, etc.
Bone grafting is a very predictable surgical procedure when done correctly and when patient cooperation is adhered to. Please try to be reasonable in understanding that this procedure has inherent risks associated with it as stated in your informed consents. Some of these risks are also pertinent to your post operative care.
We want nothing more than a perfect outcome with the surgical procedures that you are having done to rehabilitate your bone. This can only be attainable with proper cooperation from you. Please always feel free to communicate with us, at any time, to make sure that the procedures that you are having completed are properly maintained. No question is ever perceived by our office as being silly or unreasonable. We would rather have questions answered immediately than to have a chance that the procedure will not go as planned, especially from omissions that are preventable.
Please also remember, as stated above, and as outlined on your informed consents, that there are some occasions that no matter what is done that the outcome is not perfect. There are even infrequent instances when a surgery may have to be redone that are neither the doctors or the patients fault.
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The first step is to choose a good toothbrush. You always want to use a soft brush with a small head. A soft brush is hard enough to remove plaque and soft enough not to damage your teeth or gum. The next issue is to choose a good toothpaste. In general any toothpaste that contains Fluoride will do the job, unless you have a special need that is determined by your dentist. Two of the best brands of toothpastes are Colgate Total and Crest Multicare.
The first rule of brushing is to start from a specific location and work your way to the opposite side and all the way through the whole mouth so that you end where you started. This way you won’t miss any area. Also usually a pea size of tooth paste is enough. A good brushing should at lease take 2 minutes and ideally around 4 minutes.
There are many different techniques for brushing your teeth but one of the most popular ones is described here:
Hold the brush with a 45 degree angle toward the teeth and the gum. Gently press against the gum so the tips of the bristles go in between the gum and the teeth. Then apply lateral vibration for a few times and roll down the brush to sweep the plaque away from the teeth and the gum. Repeat this motion 6 to 10 times and move on to the next area of 2 to 3 teeth. If your mouth is full of foam, spit out and continue brushing. Your brushing is completed when you have brushed all the surfaces of your teeth and not when your mouth is full!
On chewing surfaces, short strokes will work best to get the plaque out of the grooves and pits. Also when brushing the front teeth from inside, hold your brush vertically to be able to reach the teeth better. As far as frequency of brushing is concerned, ideally you want to brush your teeth after each meal. But if you can’t, brush at least twice a day after breakfast and before going to bed.
How to Floss Your Teeth
The surfaces that are between teeth are not accessible to brush; Therefore, the best way to clean them is with flossing. The frequency of flossing is like brushing and ideally after each meal, though one time a day (before going to bed) is the minimum necessary.
To start, cut a piece of dental floss (approximately 2 feet). Wrap both sides of the floss around your middle fingers. Using your index and thumb move the floss in between all your teeth one by one. When flossing, make sure you are not cutting your gum. The goal is to clean the teeth surfaces and not the gum. In each space in between the teeth, press the floss against each tooth (hug the tooth) and gently move it back and forth and up and down and then move to the opposite surface of the adjacent tooth.
Electric Brush Versus Manual Brushes
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There have been multiple studies comparing the effectiveness of manual brushes as opposed to electric brushes.
Although not all the electric brushes are the same, in conclusion of all these studies it is fair to say that in general electric brushes are more effective in controlling the plaque than manual brushes. Theoretically you could do a very good brushing with a regular hand brush but the movements of an electric brush makes the task easier and more efficient. Also, some electric brushes (Sonicare) have sonic vibration that is difficult to mimic with a hand brush! Other electric brushes like Oral-B and Rotadent have small heads that help you reach hard to reach areas of your mouth. This aspect is more important when you are talking about somebody with orthodontic braces or a history of gum disease.
Bad Breath
There are a few different causes for bad breath. It ranges from stomach problems to diets and teeth problems. Most of the causes can be found in the mouth, they are:
1 Tongue (when bacteria grows in between the papilla)
2 Teeth cavities (especially when food particles get stuck in them)
3 Gum diseases 4- Extraction sites during healing
4 Dentures when not cleaned properly
5 Alcohol and tobacco.
If you or someone you know is concerned about bad breath, the first step is a dental check up. Your dentist will be able to confirm or rule out teeth or mouth as the source of bad breath. When the reason is found, treatment will be explained by your dentist. If the source of the bad breath is your mouth there is little chance that mouth washes or mints can treat the problem. They usually mask the problem for a short period of time. They can even sometimes make the situation worse (mouthwashes that contain alcohol cause dry mouth and that usually makes the bad breath worse).
These are a few other, non-dental reasons that cause bad breath:
1 Sore throat
2 Tonsillitis
3 Some foods
4 Infection of air passages.
Following a good oral hygiene routine and getting regular check ups with your dentist are best ways of preventing bad breath.
Dental Health and Your Diet
Sugar is the main cause of dental decay when there is bacteria present. More important than the amount of sugar you take is the frequency of it.
Probably the worst thing you can do to your teeth is to hold a soda and have a sip every few minutes during a long period of time; the same is true for snacking. It is recommended that if you want to have a snack or a soda or juice it is better to have it after food, as dessert or have it in one sitting. Eating or drinking something sweet over an extended period of time creates a constant supply of sugar for bacteria that cause tooth decay.
It is important to know all the sources of sugar. It is not just everything that is sweet but anything that can turn to sugar like pieces of bread. Cutting down your sugar intake is good for cavity prevention as well as general health.
When you have to have sugar! The best way to prevent cavities is to prevent the sugar from staying next to your teeth. Brushing after eating sugar, rinsing your mouth with Fluoride mouth wash or chewing sugarless gum can help. But nothing has the effect of avoiding sugar!
Is there any kind of food that prevents tooth decay? Well, not really. Some people believed that chewing foods like apple and carrots may have some plaque removal effect, but they still contain some sugar so any advantage of them is not clear. Another group of food that causes significant damage to teeth structure is acidic foods. Things like lime, lemon and grapefruit, if in frequent contact with teeth, can cause serious irreversible damage (erosion) to your teeth.
Fluoride and Decay Prevention
Many years ago scientists started to notice that children who were born and raised in areas with natural fluoride in drinking water had less cavities than children in other areas. Fluoride that is absorbed by your body when teeth were forming (during mother s pregnancy to early childhood) integrates into the structure of enamel and makes it stronger. After teeth eruption fluoride that is inside your toothpaste or mouthwash, or what your dentist places on your teeth still have a positive effect on your teeth. It strengthens the enamel and reduces the chance of tooth decay. If you have children and live in an area that has no Fluoride in its drinking water you should consult your dentist and physician about Fluoride tablets that are available for children.