ORAL HYGIENE -Toothbrush

Type: soft bristle or electric

Technique: apply toothpaste with ADA seal, brush gently from the gum line to chewing edges of your teeth in a circular motion

Frequency:  after each meal and snack, and before bedtime

Interdental brush: use with toothpaste for areas where there are large gaps between your teeth or under bridgework

Water pik: fill the tank with water, as warm as you can tolerate, and add 2 tablespoons of cool Listerine. Use the highest setting on the machine but be careful to direct the pulsating water jet at right angles to the long axis of the teeth (irrigate from outside to inside). Irrigate each space between the teeth for 5 seconds.

Floss: floss daily as instructed by our  hygienist

Tongue:  Brush the top of your tongue at least once a day and can use a tongue scraper

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Deep cleaning (root planning)

·         Discomfort:  It is common for your gums to experience discomfort which can very considerable. You may also develop tooth sensitivity where the root surfaces were thoroughly scaled.

·         Diet: Refrain from eating hot, spicy or crunch foods for a few days to allow for normal tissue healing

·         Home care: Meticulous home care is paramount. Please follow home care instructions

·         Rinses:  rinse with warm salt water 3-4 times per day for 1-2 weeks (1 tsp. of Salt in 8ox warm water)

·         Medication:  Please takes medication as prescribed.

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Post - Care Instructions Following Tooth Extraction

·         Anesthetic:  Allow at least 2 hours for numbing to wear off.  Avoid chewing during numb period to prevent injury to your tongue, lips or cheeks.

·         Bleeding:  Bite on gauze with pressure for 1-2 hours. Repeat with new gauze for 3O min if bleeding continues.  Please note oozing of blood is normal and can persist until next day. Biting on a teabag can be used to aid in clotting the wound.

·         Icepack:  Wrap icepack in cloth and apply to your face where the surgery was performed for 24-48 hours.  A 20 minute interval (pack on and off) is suitable.

·         Rinsing:  For first 24 hours do not rinse; After this time, gently rinse with warm salt water 4-5x per day for 5 days. (1/2 tsp. salt mixed with 8 0z warm water). Do not spit vigorously

·         Drinking:  Do not drink any alcoholic or carbonated beverages for first 24 hours. Do not use straws to drink with to avoid clot disruption.

·         Smoking: Do not smoke cigarettes, for a minimal of 48 hours to for normal healing of the clot

·         Diet: It is advisable to have a liquid diet for 3 days to avoid contamination of the site.  If food becomes lodged in the socket, use the provided irrigate syringe with salt water to clean out the socket. Also avoid spicy and excessive hot foods or liquids during healing. 

·         Brushing:  avoid brushing for the first 24 hours; use a wet cloth to clean teeth.  After this time, brush gently and avoid the surgical site.

·         Activity: It is recommended for a minimal of 2 days bed rest, particularly if taking a prescribed pain medication

·         Sinus:  To aid in healing, try to avoid blowing your nose or sneezing violently; use sinus medication if suffering from current allergy.

·         Sutures:  In some case, it was necessary to suture the surgical site to keep the tissue together.  A subsequent appointment, usually one week post extraction, your sutures will be removed.  Sutures can cause an infection if they are not timely removed.

·         Medication:  Please take medication as prescribed.  Immediately call office and discontinue medication if develop a reaction to medicine (such as skin rash, itching, vomiting, etc.)

·         Pain and Swelling: post-op discomfort and swelling are normal after tooth extraction.  Follow directions as above for rapid healing response. 

·         Urgent Care: If you develop excessive bleeding, pain, swelling, fever, difficulty in swallowing or breathing, please contact our office immediately.  If unable to contact, seek medical evaluation at your nearest ER hospital. 

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Post op Bleaching Instructions

·         Use of the product: Dispense whitening gel from syringe to fill approximately to 1/3 of depth of the whitening tray.  Insert tray on your teeth to be whitened with gentle pressure; excess material is expectorated.

·         Duration:  Use product after lunch to before dinner and during sleep for 1-2 week period

·         After eating: Brush teeth, re-apply gel as directed

·         Diet:  Avoid coffee, tea, dark colored sodas, drinks with citrus content, and staining types of foods during whitening therapy.

·         Smoking:  Avoid tobacco during whitening process

·         Sensitivity:  Post op sensitivity of the teeth is considered normal for at least a few days and is reversible.  Discontinue product if teeth become too sensitive, wait until teeth resume to normal sensation, and repeat use of the product.  Use Sensodyne toothpaste or a Fluoride mouthwash (Act) to help with sensitivity. 

·         Storage: The whitening tray can be retained for life.  Store gel in refrigerator to increase shelf life of the product.

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Post-care White Fillings

·     Sensitivity:   Thermal sensitivity to cold or hot may occur for a few days to weeks after placement of filling.  If sensitivity does not improve or becomes more severe with time, please call the office to re-evaluate the tooth.  Unfortunately, a root canal may be necessary to alleviate symptoms of post-op nerve pathology.

·     Gums:  Post-op discomfort of the gums is normal, where the gum may have been manipulated to restore your new filling.  Excellent home care is encouraged and a rinse with warm salt water is also recommended.

·     Bite: If you notice after the numbness wears off, you are biting on the filling first, please call our office for a bite adjustment.

·     When to eat: Your filling will set immediately, hence it is not necessary to wait to eat.

·     Longevity:  The life span of filling is variable. The larger the filling is, the greater the risk of fracture and hence the tooth may require a crown.  Foods that are brittle, like nuts, increase the likelihood of fracture.  Foods or drinks that stain, for example, tea also tend to discolor white fillings quicker. Smoking: Avoid tobacco products as these increase the likelihood of staining your new filling.

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Post-care Instructions on Dentures and Partials

·         Discomfort: It is normal after wearing your new appliance to develop sore areas of the tissue.  Call for appointment to adjust and relieve the pressure spots.

·         Use:  Wear your appliance as often as possible. It will take time and patience to become comfortable with your new appliance.  Gently place your appliance to seat in place; Do not use force to avoid distortion or breakage of the appliance. It is recommended not to sleep with your appliance; sleeping with your appliance can lead to underlying tissue complications.

·         Follow up appointments: If your appliance causes tissue soreness or becomes loose or unstable (rocks) call our office for an evaluation.  The appliance may require an adjustment, relined, or remade.  An ill-fitting appliance can damage your underlying tissues.

·         Home Care: All appliances should be brushed with a denture brush or toothbrush after eating and before placing away for storage during sleep. The teeth and/or tissues which retain and support the appliance

·         Storage:  When appliance not in use, store your appliance in water or a commercially available storage solution.  Before sleeping, remove your appliance, clean and soak it in water or cleaning solution overnight.

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Post-0p Care After Crown Preparation and Temporary Crown

·         Sensitivity:   Thermal sensitivity to cold or hot, particularly if the tooth has had no history of root canal treatment, is not uncommon.  This discomfort may occur for a few days to weeks after the doctor has prepared your tooth for a crown.  If sensitivity does not improve or becomes more severe with time, please call the office to re-evaluate the tooth.  Unfortunately, a root canal may be necessary to alleviate symptoms of post-op nerve pathology.

·         Gums:  Post-op discomfort of the gums is normal, where the gum may have been manipulated to prepare your tooth for a crown.  Excellent home care is encouraged and rinses with warm salt water are also recommended.

·         Bite: If you notice after the numbness wears off, you are biting on the temporary crown first, please call our office for a bite adjustment.

·         Diet:   Your temporary crown is made out of plastic material.  For this reason, please refrain from eating foods that are brittle, like nuts, would increase the likelihood of fracture.  Also avoid foods or drinks that stain, for example, tea to prevent the temporary crown from discoloring.  Please do not chew on ice as this may cause fracture.

·         Smoking:  increases the likelihood of staining your temporary crown

·         Temporary crown: Functions to protect the underlying tooth or foundation and preserve the space to prevent tooth movement. If your temporary comes off, fill the temporary crown with toothpaste and place it back on your tooth. If you are unable to seat temporary correctly or it fractures, please call our office to seat or remake your temporary.  It is very important the temporary is on your tooth to prevent shifting of teeth, which may prevent proper seating of the laboratory crown.

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Root Canal Therapy

·         Discomfort:   After the numbness wears off, you may experience discomfort, which can be considerable. Take you pain medication, if prescribed.  Post op discomfort can occur for a week.  If persist or worsens, please call our office to evaluate.  There is small percentage of patients that require root canals to be retreated.

·         Medication:  Take your medication as prescribed. 

·         Bite:   A temporary filling is placed in the tooth.  If you notice you are biting first on the temporary filling or the tooth, please call our office for an adjustment.

·         Diet: Avoid chewing on brittle food or ice that would increase the likelihood of fracturing your tooth.  Take very good care of your tooth to avoid it from fracturing - see complete treatment.

·         Complete Treatment: To complete the treatment on the root canal treated tooth. It is usually necessary to replace the temporary filling with a foundation (also known as a crown build-up) and crown Unfortunately, it is possible to fracture the tooth or re-infect the tooth if treatment is not complete and hence may lead to potential loss of the tooth. Call for appointment as soon as possible.

·         Adverse Complications: If you develop severe swelling, fever, severe pain, difficulty in swallowing or breathing, immediately contact our office or visit your nearest ER hospital for an evaluation

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Post-op instructions for Periodontal (gum) Surgery

·         Anesthetic:  Allow at least 2 hours for numbing to wear off.  Avoid chewing during numb period to prevent injury to your tongue, lips or cheeks.

·         Bleeding:  Bite on gauze with pressure for 1-2 hours. Repeat with new gauze for 3O min if bleeding continues.  Please note oozing of blood is normal and can persist until next day. Biting on a teabag can be used to aid in clotting the wound.

·         Icepack:  Wrap icepack in cloth and apply to your face where the surgery was performed for 24-48 hours.  A 20 minute interval (pack on and off) is suitable.

·         Sensitivity: Post-op discomfort including thermal sensitivity of teeth where surgery was performed is expected for a few days up to few months with improvement over time. After the site heals, use of Fluoride mouthwashes or Sensodyne toothpaste can be used to aid in diminished sensitivity.

·         Perio Packing: packing is sometimes placed to protect the surgical site.  It is okay if the packing comes off before your next appointment.

·         Rinsing:  For first 24 hours do not rinse; After this time, gently rinse with warm salt water 4-5x per day for 5 days. (1/2 tsp. salt mixed with 8 0z warm water). Do not spit vigorously

·         Drinking:  Do not drink any alcoholic or carbonated beverages for first 24 hours. Do not use straws to drink with to avoid clot disruption.

·         Smoking: Do not smoke cigarettes, for a minimal of 48 hours to for normal healing of the clot.  It is recommend to quit smoking: Periodontal disease has been associated with smoking; patients who smoke have an increased of gum disease as well increased failure with therapy to treat gum disease.

·         Diet: It is advisable to have a liquid diet for 3 days to avoid contamination of the site.  Use the provided irrigating syringe with salt water to clean out between the teeth. Also avoid spicy and excessive hot foods or liquids during healing. 

·         Homecare:  avoid brushing for the first 24 hours; use a wet cloth to clean teeth.  After this time, brush gently and avoid the surgical site.  Maintain meticulous home care by avoiding contamination of the site with food and irrigating the surgical area with the provided irrigation syringe is recommended.  Salt water or mixed peroxide, water (50/50) with 1 tsp. of baking soda can be used to fill your syringe.  After 3 days of healing, the prescribed peridex rinse can be use to keep the surgical site clean.

·         Activity: It is recommended for a minimal of 2 days bed rest, particularly if taking a prescribed pain medication

·         Sutures:  Sutures have been placed to keep the tissue together.  A subsequent appointment, usually one week post surgery, your sutures will be removed.  Sutures can cause an infection if they are not timely removed.

·         Medication:  Please take medication as prescribed.  Immediately call office and discontinue medication if develop a reaction to medicine (such as skin rash, itching, vomiting, etc.)

·         Healing:  Complete healing of the surgical site varies between 6-8 weeks.  The healed site is re-evaluated by the doctor at this time frame and proposed dental restoration(s) can be completed

·         Pain and Swelling: post-op discomfort and swelling are normal after surgery.  Follow directions as above for rapid healing response. 

Urgent Care: If you develop excessive bleeding, pain, swelling, fever, difficulty in swallowing or breathing, please contact our office immediately.  If unable to contact, seek medical evaluation at your nearest ER hospital.

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Post-op instructions for Implant Surgery

·         Anesthetic:  Allow at least 2 hours for numbing to wear off.  Avoid chewing during numb period to prevent injury to your tongue, lips or cheeks.

·         Bleeding:  Bite on gauze with pressure for 1-2 hours. Repeat with new gauze for 3O min if bleeding continues.  Please note oozing of blood is normal and can persist until next day. Biting on a teabag can be used to aid in clotting the wound. Keep you head elevated while resting or sleeping to reduce bleeding and swelling.

·         Icepack:  Wrap icepack in cloth and apply to your face where the surgery was performed for 24-48 hours.  A 20 minute interval (pack on and off) is suitable.

·         Sensitivity: Post-op discomfort including thermal sensitivity of adjacent teeth where surgery was performed is expected for a few days up to few months with improvement over time. After the site heals, use of Fluoride mouthwashes or Sensodyne toothpaste can be used to aid in diminished sensitivity

·         Rinsing:  For first 24 hours do not rinse; After this time, gently rinse with warm salt water 4-5x per day for 7-10 days. (1/2 tsp. salt mixed with 8 0z warm water). Do not spit vigorously. After 3 days of healing, rinse with the prescribed Peridex mouthwash (1/2 capful of this solution 2-3 times a day for 1 minute and gently spit out - DO NOT SWALLOW

·         Drinking:  Do not drink any alcoholic or carbonated beverages until instructed. Do not use straws to drink with to avoid clot disruption.

·         Smoking: Do not smoke cigarettes, until instructed otherwise to allow for normal healing of the clot.  It is advised if you smoke to quit: there is a higher risk of implant failure associated with smoking.

·         Diet: It is advisable to have a liquid diet for 3 days to avoid contamination of the site.  Use the provided irrigating syringe with salt water to clean out any soft food that may become lodged at the implant surgical site. Also avoid spicy and excessive hot foods or liquids during healing. 

·         Chewing: Do not bite or chew on the implant area until instructed to do so. Any forces applied during healing can lead to implant failure.

·         Homecare:  avoid brushing for the first 24 hours; use a wet cloth to clean teeth.  After this time, brush gently and avoid the surgical site.  Maintain meticulous home care by avoiding contamination of the site with food and irrigating the surgical area with the provided irrigation syringe is recommended.  Salt water or mixed peroxide, water (50/50) with 1 tsp. of baking soda can be used to fill your syringe.  After 3 days of healing, the prescribed peridex rinse can be use to keep the surgical site clean 2-3X/day.

·         Activity: It is recommended for a minimal of 2 days bed rest, particularly if taking a prescribed pain medication

·         Appliances: Do not wear your denture or partial until instructed. Failure to comply can lead to early implant failure.

·         Sutures:  Sutures have been placed to keep the tissue together.  A subsequent appointment, usually one week post surgery, your sutures will be removed.  Sutures can cause an infection if they are not timely removed.

·         Follow-up Appointment: A follow up appointment approximately 7 days from date of surgery is made to remove your sutures. Healing is re-assessed at subsequent follow up appointments prior to completing planned restorative therapy.

·         Medication:  Please take medication as prescribed.  Immediately call office and discontinue medication if develop a reaction to medicine (such as skin rash, itching, vomiting, etc.)

·         Healing:  Complete healing of the implant site varies between 6 weeks to 6 months.  The healed site is re-evaluated by the doctor at the correct time frame and proposed dental restoration(s) can be completed

·         Pain and Swelling: post-op discomfort and swelling are normal after surgery.  Follow directions as above for rapid healing response. 

Urgent Care: If you develop excessive bleeding, pain, swelling, fever, difficulty in swallowing or breathing, please contact our office immediately.  If unable to contact, seek medical evaluation at your nearest ER hospital.

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Post-op instructions for Bone grafting or Sinus Elevation Surgery

·         Anesthetic:  Allow at least 2 hours for numbing to wear off.  Avoid chewing during numb period to prevent injury to your tongue, lips or cheeks.

·         Bleeding:  Bite on gauze with pressure for 1-2 hours. Repeat with new gauze for 3O min if bleeding continues.  Please note oozing of blood is normal and can persist until next day. Biting on a teabag can be used to aid in clotting the wound. Keep you head elevated while resting or sleeping to reduce bleeding and swelling. Nose bleeding is normal for first few days; do not blow your nose until instructed otherwise.

·         Icepack:  Wrap icepack in cloth and apply to your face where the surgery was performed for 24-48 hours.  A 20 minute interval (pack on and off) is suitable.

·         Sensitivity: Post-op discomfort including thermal sensitivity of adjacent teeth where surgery was performed is expected for a few days up to few months with improvement over time. After the site heals, use of Fluoride mouthwashes or Sensodyne toothpaste can be used to aid in diminished sensitivity.

·         Rinsing:  For first 24 hours do not rinse; After this time, gently rinse with warm salt water 4-5x per day for 7-10 days. (1/2 tsp. salt mixed with 8 0z warm water). Do not spit vigorously. After 3 days of healing, rinse with the prescribed Peridex mouthwash (1/2 capful of this solution 2-3 times a day for 1 minute and gently spit out - DO NOT SWALLOW

·         Drinking:  Do not drink any alcoholic or carbonated beverages until instructed. Do not use straws to drink with to avoid clot disruption.

·         Smoking: Do not smoke cigarettes, until instructed otherwise to allow for normal healing of the clot.  It is advised if you smoke to quit: there is a higher risk of Bone graft failure associated with smoking.

·         Diet: It is advisable to have a liquid diet for 3 days to avoid contamination of the site.  Use the provided irrigating syringe with salt water to clean out any soft food that may become lodged at the implant surgical site. Also avoid spicy and excessive hot foods or liquids during healing. 

·         Chewing do not bite or chew on or near the grafted area until instructed to do so. Any forces applied during healing can lead to graft failure.

·         Sinus:  To aid in healing, try to avoid blowing your nose or sneezing violently; use sinus medication if suffering from current allergy.

·         Homecare:  avoid brushing for the first 24 hours; use a wet cloth to clean teeth.  After this time, brush gently and avoid the surgical site.  Maintain meticulous home care by avoiding contamination of the site with food and irrigating the surgical area with the provided irrigation syringe is recommended.  Salt water or mixed peroxide, water (50/50) with 1 tsp. of baking soda can be used to fill your syringe.  After 3 days of healing, the prescribed peridex rinse can be use to keep the surgical site clean 2-3X/day.

·         Activity: It is recommended for a minimal of 2 days bed rest, particularly if taking a prescribed pain medication

·         Appliances: Do not wear your denture or partial until instructed. Failure to comply can lead to early bone graft failure.

·         Sutures:  Sutures have been placed to keep the tissue together.  A subsequent appointment, two weeks post surgery, your sutures will be removed.  Sutures can cause an infection if they are not timely removed.

·         Follow-up Appointment: A follow up appointment, approximately 7 days from date of surgery is made to evaluate healing of the surgical grafted site.  Another appointment is made 2 weeks post surgery to remove your sutures. Healing is re-assessed at subsequent follow up appointments prior to completing planned restorative therapy.

·         Medication:  Please take medication as prescribed.  Immediately call office and discontinue medication if develop a reaction to medicine (such as skin rash, itching, vomiting, etc.)

·         Healing:  Complete healing of the implant site varies between 6 weeks to 6 months.  The healed site is re-evaluated by the doctor at the correct time frame and proposed next phase of dental therapy will be performed based on a satisfactory healed result.

·         Pain and Swelling: post-op discomfort and swelling are normal after surgery.  Follow directions as above for rapid healing response. 

Urgent Care: If you develop excessive bleeding, pain, swelling, fever, difficulty in swallowing or breathing, please contact our office immediately.  If unable to contact, seek medical evaluation at your nearest ER hospital.

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ORAL SEDATION INSTRUCTIONS

You have been given a prescription for Triazolam; Take medication as directed. This is considered an oral sedative to help make your visit during the dental appointment a more relaxed and comfortable experience.

The following below is a list of instructions and recommendations to follow prior to your next appointment.

1.      NO SEDATIVES for 24 hours before or 24 hours after (includes alcohol)

2.      NO STIMULANTS for 12 hours before and 12 hours after (caffeine or nicotine)

3.     USE OF ORAL SEDATIVES IS CONTRAINDICATED IN PREGNANT FEMALES – CAN CAUSE CLEFT LIP

4.      USE OF ORAL SEDATIVES IS CONTRAINDICATED IF YOU HAVE KNOWN ALLERGIC REACTION OR NEGATIVE DRUG INTERACTION THIS MEDICATION.

5.      A responsible person is necessary to bring you to the dental office and take you home after the dental appointment.  It also recommended that this person stay with you until fully recovered from the oral medication.

6.      NO DRIVING for 24 hours

7.      NO OPERATING HAZARDOUS DEVICES (i.e. sharp instruments) for 24 hours

8.      NO HEAVY LIFTING for 24 hours

9.      NO STAIRS until completely recovered

10.  NO IMPORTANT DECISIONS (NO WORK) for 24 hours

11.  No food or water for 8 hours prior to appointment.  (except for medications that are taken by the patient on a daily basis)

12.  No contact lenses should be worn at the appointment

13.  Wear comfortable clothes to the dental appointment

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