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After Crown and Bridge Appointments

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 so we can re-cement it. It is very important for the 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 (a tsp. Of salt in a cup of warm water, rinse- swish-spit) to reduce pain and swelling. Use medication 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 your 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 at 760-568-9371.

After 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 our office so we can schedule an adjustment appointment.

It is normal to experience some hot and cold sensitivity. The teeth require some time to heal after removal of tooth structure and will be sensitive in the interim. Your gums may also be sore for a few days. Warm salt water rinses (a teaspoon of salt in a cup of warm water) three times a day will reduce pain and swelling. A mild pain medication (one tablet of Tylenol or Ibuprofen (Motrin) every 3-4 hours) should ease any residual discomfort.

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 salivation. This is because your brain is responding to the new size and shape of your teeth. This should subside to normal in about a week.

Daily brushing and flossing are a must for your new dental work. Daily plaque removal is critical for the long-term success of your new teeth, as are regular cleaning appointments.
Any food that can crack, chip or damage a natural tooth can do the same to your new teeth. Avoid hard foods and substances (such as beer nuts, peanut brittle, ice, fingernails, or pencils) and sticky candies. Smoking will stain your new teeth. Minimize or avoid foods that stain such as coffee, red wine, tea and berries.

If you engage in sports let us know so we can make a custom mouthguard. If you grind your teeth at night, wear the night guard we have provided for you. Adjusting to the look and feel of your new smile will take time. If you have any problems or concerns, please call our office at 760-568-9371.

Post-op Instructions - Tooth Extraction

DO NOT DISTURB THE AREA: For the next few days, and especially the first 24 hours, it is very important to allow your body to form a good clot and start the natural healing process. Swishing, sucking through a straw, and smoking can all dislodge the clot. Keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils). Be sure to chew on the opposite side for 24 hours.

BLEEDING: When you leave the office, you might be biting on a gauze pad to control bleeding. Keep slight pressure on this gauze for at least 30 minutes. Don't change it during this time; it needs to remain undisturbed while a clot forms in the extraction socket. After 30 minutes you may remove it. You may bite on another gauze or a tea bag for another 30 minutes if you feel it is still bleeding. Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

SMOKING: Smoking should be stopped following surgery. Healing and success of the surgery will be substantially reduced by the cigarette smoke chemicals in your body. Also the suction created when inhaling cigarettes can dislodge the clot. Smokers are at greater risk of developing a painful Dry Socket.

PAIN: Some discomfort is normal after surgery. To minimize pain, Take two Tylenol, Nuprin, Advil, or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don't exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes the extraction causes residual numbness or tingling for six weeks or longer.

BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.

RINSING: Avoid all rinsing or swishing for 24 hours after extraction. Rinsing can disturb the formation of a healing blood clot which is essential to proper healing. This could cause bleeding and risk of dry socket. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water). Avoid commercial mouthrinses.

DIET: Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

ACTIVITY: After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

FOLLOW-UP APPOINTMENTS: You may need to return to the office to have sutures removed, or just for a brief follow-up healing check.

Please call your dentist if you have:

  • uncontrollable pain
  • excessive or severe bleeding
  • marked fever
  • excessive warm swelling occurring a few days after the procedure
  • reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected. If you have any problems or concerns, please call our office at 310-970-0433.

After Composite Fillings (white fillings)

When an anesthetic has been used, your lips and tongue may be numb for several hours after the appointment. Avoid any 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. Ibuprofen (Motrin), Tylenol or aspirin (one tablet every 3-4 hours as needed for pain) work well to alleviate the tenderness. If pressure sensitivity persists beyond a few days or if the sensitivity to hot or cold increases, contact our office.
You may chew with your composite fillings as soon as the anesthetic completely wears off, since they are fully set when you leave the office.
If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office at 760-568-9371.

INSTRUCTIONS FOR DEEP SCALE PATIENTS

To minimize the discomfort and aid proper healing following your deep cleaning, we suggest the following:

1. After the procedure, take aspirin, Tylenol (acetaminophen), or Advil (ibuprofen) before the anesthetic wears off. Continue to take one tablet every four hours for the next two days.
2. Rinse with a warm salt-water solution (mix 1⁄2 teaspoon salt in 8 oz. warm water) two or three times an hour for the next day or two.
3. Use a soft toothbrush at least two times a day. Be gentle and clean thoroughly. Slight bleeding may occur while brushing as the tissues begin to heal.
4. Avoid strong spicy seasonings, and hard “chippy” for the next few days.
5. As the tissues heal, some sensitivity to cold may occur. Use a desensitizing toothpaste (such as Sensodyne or Denquil), or fluoride gel (such as Prevident or Gel-Kam) frequently (at least 4 times/day) for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.
6. Faithfully use any other oral hygiene aids that have been recommended (floss, Perio-Aid, rubber tip, Sonicare, Proxabrush, Gel-Kam fluoride, Peridex mouthrinse, etc).
7. Refrain from smoking for 24 hours or longer. Tobacco interferes with healing.
8. If you have any questions or concerns, please call our office at 310-970-0433.

Arestin Periodontal Treatment

What is it? Arestin is a bioresorbable gel containing minocycline (a tetracycline derivative) microspheres. It has been FDA approved for treatment of gum disease after a deep cleaning procedure known as scaling and root planing.

How does it work on gum disease?

When placed in a periodontal pocket, Arestin maintains a high-level of antibiotic right at the gum disease site without exposing the rest of the body to antibiotics. This allows treatment using one-hundredth the usual pill-form dose. It directly fights the gum disease infection for 14 days.

How do I get the best results from my treatment with Arestin?

  • Avoid touching the 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 the treated teeth.
  • Avoid foods for 1 week that could hurt your gums.
  • Don’t chew gum or eat sticky foods.
  • After 10 days, resume cleaning between the treated teeth on a daily basis.

Remember, you must do your part. If you don’t brush at least 2 times per day and floss every day, then any dental treatment of your gum disease will not work effectively.