After Crown and Bridge Appointments

Crown and Bridge

Crowns and bridges usually take two or three appointments to complete. On the first appointment the teeth are prepared. Temporary crowns or bridges are placed to protect the teeth while the custom restoration is being made. 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.

On rare occasions temporary crowns come off. Call us if this happens, and keep the temporary crowns come off. Call us if this happens, and keep the temporary so we can re-cement it. It is very important for proper fit of your final restoration that temporaries stay in place.

It’s normal to experience some hot, cold and pressure sensitivity after each appointment. Your gums may be sore for several days. Rinse three times a day with warm salt water to reduce pain and swelling. Use medication only as directed.

To help keep your temporary in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of you mouth. It’s important to continue to brush normally, but floss very carefully and remove the floss from the side to prevent removal of the temporary crown.

If your bite feels uneven, if you have persistent pain, or you have any other questions or concerns, please call our office.

Close

Arestin Patient Questions and Post Treatment Instructions

WHAT IS ARESTIN? Arestintm (minocycline hcl 1mg) microspheres is indicated as an adjunctive therapy to scaling and root planing (srp) procedures for reduction of pocket depth in patients with adult periodontitis.

Arestin™ (minocycline hcl 1mg) microspheres is a new treatment for chronic periodontitis, an infection of the gums, that can lead to tooth loss and may be linked to other serious diseases such as cardiovascular disease, osteoporosis and diabetes. Arestin uses new microsphere technology to easily and effectively kill the germs that cause periodontal disease. arestin is the antibiotic and is administered locally, directly into the infected pockets between your teeth. A dentist or dental hygienist can administer arestin after scaling and root planing, a common procedure used to treat periodontal disease. When used together with scaling and root planing, arestin significantly reduces the depth of infected pockets and helps prevent disease progression. A combined therapy of arestin plus scaling and root planing is more effective at fighting periodontal disease than scaling and root planing alone. Arestin was shown to be particularly even effective in the more difficult to treat patients such as smokers or people who have cardiovascular disease.

Arestin was studied in more than 920 patients with adult periodontitis at 22 universities and dental schools across the country. These large clinical trials allowed for the collection of extensive data establishing the safety and efficacy of arestin. Minimal side effects were reported and those that were reported were similar to placebo. In these trials arestin did not alter taste buds, stain teeth or cause stomach upset.

How does arestin work? Arestin™ (minocycline hcl 1mg) microspheres provides dentists and hygienists with a new way to treat periodontal disease. Arestin uses microsphere technology that delivers minocycline, a potent antibiotic that kills the bacteria that cause periodontal disease. Minocycline is placed painlessly under the gum, directly to the infected site.

If you could see them, these microspheres would look like tiny beads of many different sizes. However, they are smaller than a grain of sand and look like a yellow powder to the naked eye. Administered as a powder, the microspheres become moist from various fluids beneath the gums, they stick to the infected sites around your teeth. The moisture causes the release of the antibiotic minocycline, which can then access the bacteria in the intricate sites around your teeth, including the sites that are difficult to reach with other methods of treatment. The different sizes of the microspheres enable the medication to be continually released and fight the infection for at least 21 days. This helps control periodontitis for at least 12 months when used with srp.

Arestin is administered quickly and easily. Application is comfortable and no anesthesia is needed. Arestin does not require bandages and won't leak or fall out or leave anything to be removed by your dentist.

Post op following treatment for periodontal disease using a combination of arestin™ and scaling and root planning (srp), you should continue to take care of your gums and mouth by practicing good oral hygiene, brushing three times a day and flossing regularly. After treatment, patients should avoid eating hard, crunchy, or sticky foods for one week. You can resume your normal oral hygiene routine 12 hours after treatment. To maximize the results of your treatment, speak to your dentist and follow these recommendations.

How do I get the best results from my treatment with arestin?
To achieve the best results, follow the instructions given by your dental professional. You'll also find these important guidelines useful:

• Avoid touching treated areas.
• Wait 12 hours after your treatment before brushing teeth.
• Wait 10 days before using floss, toothpicks, or other devices designed to clean between teeth.
• Avoid foods for 1 week that could hurt your gums.

Gum disease can recur and needs to be checked regularly. Be sure to return for your follow-up appointments.

Arestin indication, supply, and administration
Arestin indications and use
Arestin is indicated as an adjunct to scaling and root planing procedures for reduction of pocket depth in patients with adult periodontitis. Arestin may be used as part of a periodontal maintenance program which includes good oralhygiene, and scaling and root planing.

How supplied
Arestin™ (minocycline hydrochloride) microspheres, 1 mg is supplied in unit.
Doses of 12 cartridges in one tray (ndc number) packaged with desiccant in a Heat-sealed foil laminated resealable pouch. There are 2 pouches in each box. Each Unit-dose cartridge contains the product identifier “op-1.”

Close

Caring for Your Appliance

There are several things you can do to make your appliance last longer. Before and after each use, rinse it with cold water or with a mouth rinse. You can clean it with toothpaste and a toothbrush.

• The appliance can occasionally be cleaned in cool, soapy water and rinsed thoroughly.
• Place the appliance in a firm, perforated container during storage or while transporting it. This permits air circulation and helps prevent damage.
• To minimize distortion, avoid high temperatures, such as hot water, hot surfaces or direct sunlight.
• Like any other sports gear, a mouthguard will wear out, making it less effective. If the appliance becomes loose, it can irritate the teeth and oral tissues. These conditions also diminish the amount of protection the appliances provides when are wearing it. Occasionally, check the appliance’s condition and replace it as necessary.

Our goal is to help preserve your smile for a lifetime.

Close

Cerec Post Treatment Instructions

Congratulations! You have just received the finest dental restoration advanced technology dentistry has to offer. Your Cerec ceramic restoration has replaced a portion of the tooth that has been damaged over time. With proper care it should provide years and years of service, as though your tooth were virtually re-enameled.

Sensitivity: Mild to moderate sensitivity to hot or cold food or drink is expected following placement of any bonded dental restoration. Typically, this sensitivity gradually diminishes over a period of few weeks. A very small percentage of bonded ceramic restorations display sensitivity that persists for longer periods of time. If this continues for more than six weeks, please inform us-it could be a sign that your tooth has nerve damage and may require further treatment to alleviate the problem.

Chewing: Avoid chewing hard foods for 24 hours in order to allow the bonding to achieve its maximum strength.

Your Bite: It is not unusual for your bite to be off-balance after a ceramic restoration is placed. We adjust the bite immediately after placing it, however the numb feeling often does not allow for proper refinement of the bite at the time of service. Please contact our office to schedule for a swift adjustment if needed.

Hygiene Visits: Make sure you keep your periodic hygiene visits. Often, small problems that can develop around the restorations can be corrected, if found early. The most often cited reason for failure of any dental restoration is failure to return for your professional cleanings.

Preventative Procedures:
a. Brush and floss after eating and before bedtime.
b. Rinse vigorously for at least 30 seconds daily with a recommended fluoride rinse product such as fluorigard or ACT rinse. The best time is just prior to bed.
c. Use a fluoride toothpaste.
You have one of the finest dental restorations possible in dentistry today. Continued care and routine dental check-ups will ensure years of fine service.

Thank You

Close

Cosmetic Reconstruction

Remember that it will take time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed it takes several days for the “brain” to recognize the new position of your teeth or their thickness as normal. If you continue to detect any high spots or problems with your bite, call us so we can schedule an adjustment appointment.

It’s normal to experience some hot, cold and pressure sensitivity. Removing tooth structure and placement of new materials may result in a period of adjustment. Your gums may also be sore for several days. Rinse three times a day with warm salt water to reduce pain or swelling.

Don’t be concerned if your speech is affected for the first few days. You’ll quickly adapt and be speaking normally. You may notice increased salivary flow. Your brain may respond to the new size and shape of your teeth by increased salivary flow. This should subside to normal within a week or so.

Daily plaque removal is critical for the long-term success of your dental work. Maintain a regular oral hygiene routine. Daily brushing and flossing is a must. Regular cleaning appointments in our office are also critically important. We’ll use the appropriate cleaning abrasives and techniques for specific cosmetic work.

It’s important to change habits to protect your new teeth. Any food that could chip, crack, or damage your teeth can do the same to your new cosmetic restorations. Avoid sticky candies, any unusually hard foods or substances (such as peanut brittle, fingernails, pencils or ice). Avoid or minimize your use of foods that stain, such as tea, coffee, red wine and berries. Smoking will quickly yellow your teeth.

Let us know if you grind your teeth at night or engage in sports so we can make a custom mouth guard for you. Adjusting to the look and feel of your new smile will take time. If you have any problems or concerns, we always welcome your questions.

Close

Crown and Bridge

Crowns and/or bridges usually take two or three appointments to complete. On the first appointment the teeth are prepared. Provisional crowns or bridges are placed to protect the teeth while the custom restoration is being made. 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.

On rare occasions provisional crowns come off. Call us if this happens and keep the temporary crown so we can re-cement it. It is very important for proper fit of your final restoration that your provisional stays in place.

It’s normal to experience some hot, cold and pressure sensitivity after each appointment. Your gums may be sore for several days. Rinse three times a day with warm salt water to reduce pain and swelling. Use medication only as directed.

To help keep your provisional in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of you mouth. It’s important to continue to brush normally, but floss very carefully and remove the floss from the side to prevent removal of the provisional crown.

If your bite feels uneven, if you have persistent pain, or you have any other questions or concerns, please call our office.

Close

Day White Take Home Whitening Instructions

How to Use Your Whitening Trays

1. Floss and brush your teeth. Next, remove the plastic cap from the syringe and replace with the mixing nozzle.
2. Place a small drop of gel inside the front portion of each tooth compartment of your tray. To guide you, refer to the “gel-drop” shown on the inside cover of your whitening kit. Each syringe has 12 marked treatment doses. Use one line on the syringe for each tray.
3. Once the gel is dispensed into your trays, place the blue tip cap on the mixing nozzle from the syringe, and replace it with the original plastic cap.
4. Place the tray with the gel in your mouth. Be careful not to push the gel out of the tray, but be sure that the tray is completely seated over your teeth. You may see the gel bubbling within your trays while wearing them. This bubbling is part of the whitening process.
5. Remove the excess gel (outside the trays) with your finger or a dry toothbrush. If you notice any whitening of your gums, this is temporary and should last only 5-10 minutes. These are signs that you are using too much gel. Use a little less next time.
6. Wear your trays for 30 minutes, twice a day. Wait at least one hour between applications.
7. After whitening, remove the trays and rinse and brush excess gel from your teeth and gums. Rinse trays with cold water. Use a toothbrush or cotton swab to remove any residual gel from the trays. Place the trays in the storage case, and keep them in a cool, dry place.

• If you must interrupt treatment for any reason, please repeat steps 1-7.
• If you have any questions, or if more than mild tooth sensitivity develops, stop the treatment and give us a call.

Close

Dentures

New dentures may feel awkward or uncomfortable for the first few weeks. They may feel loose, while the muscles of your cheeks and tongue learn to hold them in place. Salivary flow temporarily increases. Minor irritation or soreness is not unusual. These inconveniences often diminish as your mouth becomes accustomed to the new dentures.

Eating with dentures takes a little practice. Start with soft foods, cut into small portions. Chewing slowly and using both sides of your mouth at the same time will prevent the dentures from moving out of place. Other types of foods can be gradually added until you resume your normal diet.

Speaking with your new dentures will require some practice. Reading out loud and repeating difficult words will help.

How to Care for Your Dentures
Like natural teeth, dentures must be properly cared for if they are to last. Daily brushing will remove food deposits and plaque, and will help prevent the artificial teeth from becoming stained. While it is best to use a brush made specifically for cleaning dentures, a toothbrush with soft bristles can also be used. Avoid hard bristle brushes that can damage dentures.

Don’t let your dentures dry out or they may lose their shape. When you’re not wearing them, place them in a denture cleanser soaking solution or in plain water.

It is important to continue having regular dental checkups so that a dentist can examine oral tissues for signs of disease or cancer. As you age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your dentures.

Close

IRM- Sedative Filling Material

Temporary fillings are different from permanent amalgam or composite fillings because they are "sedative" fillings. This means that they tend to soothe an inflamed nerve in a tooth, and may make the difference between the tooth needing root therapy or simply filling the tooth later on, after the nerve has calmed down. Sometimes a temporary filling is the best course to relieve pain.

Temporary fillings are made of two major components: Oil of clove (eugenol), which has been used for centuries to relieve toothaches, and Zinc Oxide which is the ingredient that makes Desitin diaper rash ointment white. Zinc oxide is an excellent disinfectant. The oil and oxide mix together to make a stiff paste that eventually hardens into a waterproof substance which soothes the nerve of the tooth and kills germs while protecting the cavity like a hard band aid.

Of course, our primary concern is making certain that a final restoration is fabricated. Although IRM is durable and protective, it is by no means a permanent solution. Please call to schedule an appointment to complete your treatment.

Close

Nite White Take Home Whitening Instructions

How to Use Your Whitening Trays

1. Floss and brush your teeth. Next, remove the plastic cap from the syringe and replace with the mixing nozzle.
2. Place a small drop of gel inside the front portion of each tooth compartment of your tray. Each syringe has 8 marked calibrated treatment doses. Use one line on the syringe for each tray.
3. Once the gel is dispensed into your trays, place the blue tip cap on the mixing nozzle from the syringe, and replace it with the original plastic cap.
4. Place the tray with the gel in your mouth.
5. Remove the excess gel with your finger or a dry toothbrush. When inserting the tray, be careful not to push the gel out of the tray, but be sure that the tray is completely seated in your mouth.
6. After whitening, remove and rinse the trays with cold water. If necessary, use a toothbrush to remove any resisdual gel. Place the trays in the storage case, and keep them in a cool, dry place. Rinse and brush excess gel from teeth.

• Wear the trays all night long while you sleep. Minimum wear-time is 4 hours, although longer wear-time is beneficial.
• If you must interrupt treatment for any reason, please repeat steps 1-6.
• If you have any questions, or if more than mild tooth sensitivity develops, stop the treatment and give us a call.

Partial Dentures

Inserting and removing a new removable partial denture takes some practice. It may feel awkward for the first few weeks especially if you are used to an old appliance. However, your mouth should eventually become accustomed to wearing it. It should fit into place with relative ease. Never force it into position by biting down. For the first few days your new partial may feel slightly uncomfortable. After a few weeks, you won’t even realize you are wearing a partial denture. Removing and inserting the denture will take a little practice.

The primary reasons for removing your denture are to clean it and to sleep. Just like you brush your natural teeth, it is necessary to clean your dentures using a special brush designed for this purpose. Unlike a toothbrush, this type of brush has bristles arranged to fit the shape of the metal framework. You can also use a regular, soft-bristled toothbrush. Avoid using a hard-bristled brush, which can cause damage.

First, clean your removable partial denture by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Gently brush all the surfaces to avoid damaging the plastic or bending the attachments.

Daily brushing and cleaning between your natural teeth help prevent tooth decay and gum disease that may lead to tooth loss. Pay special attention to cleaning teeth that are under the denture’s metal clasps. Plaque that is trapped under the clasps can increase the risk of tooth decay. Having your remaining natural teeth cleaned and examined is vital for maintaining a healthy smile.

As you age, your mouth naturally changes, which can affect the fit of the base. Your bone and gum ridges can recede or shrink, resulting in a loose fit. The denture clasp also may become loose from normal wear. Anything that affects the precise fit of the removable partial denture can cause irritation. If it needs adjusting or repair please call the office to schedule an appointment. In many instances, we can make the necessary adjustments or repairs, often on the same day. Complicated repairs may take longer.

Close

Porcelain Veneers

Remember that it will take time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed it takes several days for the “brain” to recognize the new position of your teeth or their thickness as normal. If you continue to detect any high spots or problems with your bite, call us so we can schedule an adjustment appointment.

It’s normal to experience some hot, cold and pressure sensitivity. Removing tooth structure and placement of new materials may result in a period of adjustment. Your gums may also be sore for several days. Rinse three times a day with warm salt water to reduce pain or swelling.

Don’t be concerned if your speech is affected for the first few days. You’ll quickly adapt and be speaking normally. You may notice increased salivary flow. Your brain may respond to the new size and shape of your teeth by increased salivary flow. This should subside to normal within a week or so.

Daily plaque removal is critical for the long-term success of you dental work. Maintain a regular oral hygiene routine. Daily brushing and flossing is a must. Regular cleaning appointments in our office are also critically important. We’ll use the appropriate cleaning abrasives and techniques for specific cosmetic work.

It’s important to change habits to protect your new teeth. Any food that could chip, crack, or damage your natural teeth can do the same to your new cosmetic restorations. Avoid sticky candies, any unusually hard foods or substances (such as peanut brittle, fingernails, pencils or ice). Avoid or minimize your use of foods that stain, such as tea, coffee, red wine and berries. Smoking will quickly yellow your teeth.

Let us know if you grind your teeth at night or engage in sports so we can make a custom mouth guard for you. Adjusting to the look and feel of you new smile will take time. If you have any problems or concerns, we always welcome your questions.

Close

Post & Core

A tooth that has had endodontic (root canal) therapy often has minimal remaining tooth structure. Frequently, the cause for the root therapy is a fractured tooth or a tooth that has been filled extensively. The tooth requires internal stabilization so that the forces of chewing are properly directed throughout the tooth. Additionally, after endodontic therapy, a tooth may become more brittle and possibly fracture.

A post and core provides the necessary internal support that directs the forces of chewing throughout the crown of the tooth, through the post and core, and into the surrounding bone structure where it belongs. The lateral (sideways) forces directed on the thin, remaining, weakened tooth structure without the post and core will be too excessive and can lead to tooth breakage. Current dental procedures for the post and core utilize the latest advances in adhesive dentistry. A passive surgical steel post is bonded internally, within the root structure. A crown is often fabricated over this substructure and the tooth functions and looks like a natural tooth. The post and core is a separate procedure/fee from root therapy and the final restoration.

Close

Posterior Composite Restorations

• 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.
• It is normal to experience some hot, cold and pressure sensitivity after your appointment for a few days.
• Your gums may be sore for several days. Rinse three times a day with warm salt water (put a tsp. of salt in a cup of warm water, to reduce pain and swelling).
• You may chew right away since the restoration sets completely during your appointment.
• If your bite feels uneven, if you have persistent discomfort, or if you have any other questions or concerns, please call our office.

How to care for your restorations

• Maintain good dental hygiene through flossing, brushing, and regular recare visits.
• Avoid eating foods that may stress restorations. Ice, hard candy, and sticky foods should be eaten with caution or avoided entirely.
• If you grind your teeth, please let us know. You may need a protective appliance to protect your restorations.
• Keep in mind that, like other sticky foods, chewing gum may cause stress on restorations

Root Therapy

Root Canal therapy often takes two or more appointments to complete. 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.

Between appointments it is common (and not a problem) for a small portion of your temporary filling to wear away or break off. 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 (a tsp. of salt in a cup of warm water, rinse-swish-spit.)

If antibiotics are prescribed, continue to take them as prescribed, even if all symptoms and signs of infection are gone. To protect the tooth and help keep your temporary in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of your mouth. It’s important to continue to brush and floss normally. If your bite feels uneven, if you have persistent swelling or pain, or you have any other questions or concerns, please call our office.

Close

Sealants

Sealants are a clear, acrylic-like material that helps shield decay-causing bacteria from the chewing surfaces of the back teeth. Studies have shown that by sealing teeth it halts the process of the decay.Sealants are an intermediate preventive step that is used to delay or prevent tooth decay on these areas of the back teeth. As teeth develop, deep groves, called fissures, are normally present. Pits occur at the point where grooves cross each other on the tooth surface. Pits and fissures are the most cavity-prone areas.

Sealant application involves cleaning the tooth surface of the tooth and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the enamel surface of the tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed with water. After the site is dried, the sealant material is applied and allowed to harden by using a special curing light. Sealant treatment is painless and takes anywhere from 5 to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.

Sealants are usually applied to newly erupted posterior teeth and are recommended for permanent teeth, and in some cases, for “baby” teeth. Sealants may be recommended for older patients who are especially prone to tooth decay. Since tooth decay may occur rapidly in children, sealants should be applied to a child’s teeth as soon as possible before decay has had a chance to develop.

Post Procedure Instructions

• Sealant material is quite durable, but it is important to maintain regular recare visits to make sure that sealants have not been dislodged and to reapply, if needed.
• Some hard foods, such as candy, ice or sticky foods, may dislodge sealants and should be avoided.
• Following are some great snack alternatives, that combined with sealants and fluoride reduce your chances of tooth day. These foods include peanut butter, popcorn, fresh vegetables (carrot sticks, celery stalks), fresh fruit, yogurt, unsweetened cereal, and sugar free Popsicles.

Close

TMJ Disorders

Temporomandibular joint and muscle disorders, commonly called “TMJ” are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. For the vast majority of people, pain the area of the jaw joint, or muscles, does not signal a serious problem. Studies have also indicated that a “clicking” noise is common in almost 80% of the adult population. This sound is also not diagnostic for a TMJ disorder, unless pain is also noted.

Trauma to the jaw or temporomandibular joint often plays a role in some TMJ disorders. The roles of stress and tooth grinding have been linked to TMJ issues as well.

What are the signs and symptoms?
- Radiating pain in the face jaw, or neck
- Jaw muscle stiffness
- Limited movement or locking of the jaw
- Painful clicking, popping or grating of the jaw joint when opening or closing the mouth
- A change in the way the upper and lower teeth fit together

There are steps you can take that may be helpful in easing symptoms, such as: eating soft foods, applying ice packs, avoiding extreme jaw movements

If you have questions about TMJ, please contact us, and we will discuss how to remedy any discomfort you may be having.

In most cases we will recommend an oral appliance, also called a stabilization splint or bite guard. Studies have shown their effectiveness in providing pain relief.

Close

Tooth Extraction

• It is not unusual to have some tenderness in the area.
• To minimize the potential for swelling, place an ice-pack or cold towel on the outside of the face, 10 minutes on the area, 10 minutes off, for about one hour.
• The gauze dressing may be removed after about 20 minutes.
• A moist tea bag, which contains tannin, may be placed on the area with firm biting pressure if bleeding continues.
• Do not rinse for 24 hours to avoid disturbing the clot.
• After the first 24 hours, rinse with warm salt water, (1/4 teaspoon salt to 8 ounces of water), a few times a day for one week. The more you rinse the better.
• Two to three Advil tablets are advised to minimize any post extraction inflammation and discomfort.
• If antibiotics are prescribed, take as directed until the medication is completed.
• If sutures are used, an appointment in one week will be scheduled to remove them.

Please call the office if there are any questions or concerns.

Close