• Please wait to eat until Anesthetic wears off. (White fillings may be more sensitive)
• Liquids may be taken right away, but you may find extreme temperatures cause sensitivity please stay in the medium temperatures for comfort for a few days to weeks.
• Ibuprofen or Tylenol products may be helpful for a few days.
• If you notice your teeth do not seem to touch together. Your filling may be high. Please call us for a bite adjustment.
• Remember to avoid hard foods and things like nail biting, etc.

To insure maximum beauty and longevity:

1. Brush with an ULTRA-SOFT TOOTHBRUSH at least 2 times a day. Floss at least once a day, preferably before bedtime.
2. As your natural teeth, the bonded material can pick up stains: try to avoid or keep to a minimum tobacco, coffee, tea, soy sauce, curry, colas, grape juice, blueberries or red wine. Routine dental cleanings will usually remove stains. Do not use baking soda or any abrasive toothpaste.
3. Habits such as opening packages with teeth, biting thread, chewing ice, nail biting should be avoided. Avoid direct biting into ribs, bones, hard candy, nuts or hard bread and rolls. This puts stress on the material and could result in a fracture. Be aware that certain foods such as spare ribs, corn on the cob, carrots and apples can also put added stress on bonded teeth and possibly increase the need for repairs. Most kinds of sandwiches are not a problem.
4. Please wait to eat until Anesthetic wears off liquids may be consumed right away, but you may find Extreme temperatures may cause sensitivity, please stay in the medium temperatures for comfort for a few days to weeks.
5. If a chip or fracture does occur, contact our office to prevent further damage.
6. If you notice your teeth do not seem to comfortably bite together, your fillings may be high, please call our office for a bite adjustment.

Please follow these instructions following the placement of your dental sealants:

• Once sealants are light cured, you may resume normal eating and drinking.
• You should avoid hard candies and chewing ice to prevent fractures of his/ her sealants.
• You should avoid sticky candies that could pull out his/ her sealants.
• Sealants do not prevent all decay.  Flossing is still needed to protect the sides of your teeth.

• Following the preparation for cosmetic veneers, it will take two weeks for the dentist to receive the veneers back from the lab.
• Occasionally temporary dental veneers can be placed until the permanent veneers are back.
• Continue to follow good oral hygiene practices, including brushing and flossing.

Chewing: As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, bones, etc.) because teeth as well as porcelain material can be broken under extreme forces.

Recalls: Checkups are critical. Often, problems that are developing with the veneers can be found at an early stage and repaired easily, while waiting for a longer time may require redoing entire restorations.

The Future: We expect you will receive several years of service from these veneers. However, after watching veneers for many years, we have seen the following situations occur. They may require restoration replacement.

• Extreme force or trauma can break porcelain veneers, just as the same force can break natural teeth. Use care in sports or other potentially traumatic situations. We recommend an athletic mouthguard in these instances. Do not bite extremely hard objects with one tooth. Breakage usually requires remaking the restoration, but occasionally it can be repaired.
• Although it is unlikely, from time to time a contamination can cause laminates to de-bond. This will usually occur within the first week or two of placement. Laminates can be recemented, so carefully place laminate in a secure container.
• After a few years, some veneers may demonstrate slight stains around the edges. Please tell us if this situation occurs. Removal of
• Stain can usually be accomplished.
• The gums (gingival) may recede from the veneers, displaying darker tooth structure. This situation usually takes place over several years and requires veneer replacement.

We have done our best to provide you with the finest quality oral restorations available today. However, as with the fine automobile or watch, only your continuing care and concern can assure optimum service longevity. Replacement of the restorations may be required in several years.

1) You can expect the gum tissue to be sore, possibly red and raw. Gently keep the area clean. Warm salt water rinses will help with relieving the soreness.

Your temporary crown or bridge will be securely placed, with temporary cement.

• Do not chew gum.
• Do not eat sticky foods.
• Do not grind hard things: Like ice, popcorn kernels, etc.
• Be gentle when flossing, taking extra care not to loosen temporary restoration. Slowly pulling the floss out by one end can help avoid putting too much pressure on the temporary.

2) If the temporary comes off, please rinse off food and use temporary cement provided to place it back. You can also use Fixodent to hold temporary restoration in place. If you cannot get it back on or cannot keep it on, please call our office to have temporary crown inserted back in as soon as possible.

• Do not chew on hard or sticky foods for 40 hours (Two Days) from the time of cementation. The cement must mature for about 40 hours to have optimum strength.
• Your new crown may feel tight or as if it is pushing against the teeth next to it for several hours. This discomfort will go away within a day or two.
• Sensitivity, especially to cold is common after a crown is cemented. Usually the deeper the cavity, the more sensitive the tooth will be. It may take some time for the sensitivity to go away. Infrequently, sensitivity can linger for up to six weeks.
• The finished restoration may be contoured slightly different and have a different texture than the original tooth. Your tongue usually magnifies this small difference, but you will become accustomed to this in a few days.
• Please follow prescribed oral hygiene instructions:
  • 45 degree angle brushing twice a day and flossing once a day to avoid getting a cavity or gum disease around your new crown.
  • Flossing is especially important in preserving the health of your crown or bridge.

• Scaling & Root Planing therapy includes the removal of tartar and bacterial plaque from the root surfaces below the gum line. This procedure helps reduce inflammation, infection and the depth of periodontal pockets, allowing more effective flossing and brushing.
• When anesthesia 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 easy to bite or burn your tongue or lip while numb. It is recommended that you take some ibuprofen (Motrin or Advil, 1-2 tablets every 4-6 hours as needed) before the anesthetic completely wears off.  This will help with any swelling or pain at the injection sites where you’re anesthetic was administered.
• It is not unusual for the teeth to be more sensitive to hot or cold temperatures, and/or sweets.  This occurs as the gum tissue heals and shrinks in size.  Brushing two to three times daily with sensitivity toothpaste or using fluoride rinses may help alleviate this over time.  If sensitivity continues or is severe, professional application of a desensitizing agent may be required.
• For a few days, a soft diet is recommended, chewing on the opposite side.
• Consistent and thorough daily oral hygiene is essential to the proper healing of your gum tissues.  Brushing, flossing and rinsing with recommended products are critical. Use Periactive Rinse, or warm salt water rinse 3 to 5 times a day.
• If a localized antibiotic (Arestin) was placed, please follow all additional instructions given to you at your appointment.
• In most cases, only one half of the mouth is treated at a visit.  Please remember to keep all appointments to complete the treatment on the opposite side, and all follow-up appointments thereafter.

Congratulations! You’ve just experienced a revolutionary tooth whitening procedure. The next 48 hours are important in enhancing and maximizing your whitening results for a lasting, bright and healthy smile.

FOR THE NEXT 48 HOURS, DARK STAINING SUBSTANCES SHOULD BE AVOIDED, SUCH AS:

• Coffee and/ or tea
• Berry pie
• Tobacco products
• Red Wine
• Red Sauces
• Mustard or Ketchup
• Cola
• Soy Sauce

After Bleaching Procedure:

• Use MI Paste Plus with Fluoride for sensitivity. Use pea size amount and rub on teeth and gum. Leave on teeth for 3 minutes then expectorate residue. Don’t rinse for 30 minutes.

ADDITIONAL WAYS TO MAINTAIN YOUR SPARKLING SMILE:

Home Bleaching Instructions:

• For home bleaching with the trays, wait about 2 days or if sensitive, wait until sensitivity goes away.
• Place a very thin dot of gel across your bleaching trays. If it gets in contact with the gums, wipe away immediately with a cotton tip (Q-tips) or tissue.

Post operative care is most important for healing and recovery after tooth extraction.

Follow these Instructions carefully:

• Swelling, bleeding, stiffness and some discomfort are normal and should not cause alarm.
• If medication has been prescribed, Please take as directed (Take medication with food).
• After we place gauze over the extraction, bite down with gentle pressure for 30 to 40 minutes. (If heavy bleeding continues, but down on a moistened tea bag for 30 to 45 minutes. Repeat for a long as necessary)
• Apply ice to your face for first couple of hours 15 minutes on /15 minutes off.
• Over the next 48 hours, prop your head up higher than usual when you sleep.
• If Antibiotics were prescribed take until completed.
• DO NOT:
  • Do NOT Smoke
  • Do NOT spit out
  • Do NOT use straws
  • Do NOT engage in activities requiring heavy exertion.

• No smoking for 48 hours
• No flossing or use of any interdental aid for THREE days
• No waterpik during periodontal therapy for THREE days
• Rinse mouth 2 times a day with warm salt water for three days.
• Do not brush that evening; start next morning, but be gentle.

Use MI Paste Plus 3 to 5 times a day.

Brush with Fluoridex Toothpaste.

IMPORTANT! Just because a laser treats periodontal disease, it doesn’t mean that patients will get perfect result every time. Results can vary from patient to patient. Here are some altering factors to optimum results:

• Systemic conditions
• Autoimmune disorders
• Medications • Smoking
• Home Care/Compliance
• Hormones
• Genetics

The placement of dental implants usually does not create a great deal of pain. In order to assure the best possible results, certain instructions should be followed after surgery.

• FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

 

• MEDICATION: You may take over the counter Tylenol or Advil every 4 to 6 hours. If prescribed another regimen, please follow the instructions. If antibiotics are prescribed, please take as directed until they are completed. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.

 

• SWELLING: Swelling is a normal occurrence after surgery and will not reach its maximum until 2-3 days after surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied 10 minutes on and 10 minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

 

• DIET:  Eat SOFT foods. Avoid extremely spicy or hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first days intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) It is best to avoid foods like rice, nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical areas. Over the next several days you may gradually progress to solid foods. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor. Avoid alcohol for 48 hours.

 

• ORAL HYGIENE: Starting the day after surgery, you may begin brushing, staying away from the surgical site with your toothbrush. You may also rinse your mouth gently with warm salt water (1 teaspoon salt to 6oz warm water). Return to rinsing with Periactive rinse on the second day after surgery.

 

• DENTURES, PARTIALS, FLIPPERS, ETC.: Appliances should be left out for at least 1 week following surgery, unless modified by your dentist. Adjustment to your denture of Flipper can be made at your post operative appointment.

 

• HEALING: Normal healing after placement of dental implants should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office.

 

• NO SMOKING: Smoking can be a large rick factor in post operative inflammation or infection, which could lead to the loss of your implant.

If you have any questions or concerns, please don’t hesitate to contact our office immediately.

Healing, following oral surgery, is usually fast and uncomplicated if you follow the directions below:

• BLEEDING: bite on the gauze sponges for 30 minutes. Replace them with moistened gauze sponges for another 30 minutes if fresh, red blood is present. If bleeding continues after the time, bite on a moistened Lipton “tea” bag for 30 minutes. If you are still bleeding after this, please contact our office.
• DO NOT drink or eat hot foods today, as you may dissolve or loosen the healing Blood Clot. Eat cool, soft, nutritious food today.
• DO NOT use a straw or Suck on the wound site for the next few days. You may disturb the blood clot, causing bleeding, slow healing, and /or bone pain often called a “dry socket”.
• DO NOT eat hard foods for a few days in the part of your mouth that received the surgery. You could disturb the healing.
• SUTURES: Were placed. You need an appointment in about 7 to 10 days for a follow up appointment.
• PAIN: Take Advil or Tylenol for discomfort. If the pain is more than these drugs can control, Please call our office for a prescription. If you have been given a prescription, please get the prescription filled.
• ANTIBIOTIC: Please take the medication until completed.

These are suggestions and not requirements. Avoiding activities that will re-injure or further damage the joints, muscles, or ligaments should be considered.

1. Avoid sleeping on your jaw. Back sleeping is the best sleeping position to enable your jaw to relax. Sleeping on your stomach is the worst position for you at this time. A small pillow or rolled up towel to
   support the neck curvature and elevation of knees with pillows may be helpful. Avoid placing a hand next to your face.
2. Avoid any hard, tough, or chewy foods. For the next few months, be sure to cut all foods into small, bite sized pieces and try to avoid opening your mouth any wider than the thickness of your thumb. Pizza,
   popcorn, steak, and raw vegetables should be avoided. Avoid chewing gum. A soft diet is highly recommended supplemented with a protein drink.
3. Application of moist heat with a moist heating pad at least twice a day for 20-45 minutes alternating with 5-15 minutes of ice is helpful for swollen or tender muscles of the face and neck followed by gentle
   stretching of these muscles.
4. Avoid protruding your jaws during any nonessential activities. Example: smoking, singing, extended conversation, nail biting and other oral habits that require straining your mouth in unusual positions.
5. Avoid an abnormal posture. Keep your head and shoulders straight. If you must use the telephone a great deal, then use a headset or switch the side on which you hold the phone. If you are holding small children, then try to switch sides frequently when holding the child. Keep your hands from pushing against your face. Do not eat, read, or watch TV while in bed.
6. Avoid opening your mouth more than two fingers wide.
7. Avoid opening wide when yawning. Tilt your head forward and/or put your fist under your chin to keep from opening too wide.
8. Exercise regularly, at least three times per week for a sustained 20 minutes at a fast walking pace or faster. This should be gradually integrated from beginning slowly and then build up to the fast pace at an appropriate rate.
9. Limit your intake of central nervous system stimulants: caffeine, refined sugar, chocolate (you can go online and find these foods to avoid). Eat lots of fresh fruits and vegetables and lots of protein. Your body has to have the materials to rebuild, so if you are unable to eat a balanced diet then you may need vitamin supplementation. You should consider a multivitamin and multimineral. There are multiple brands on the market that fulfill this requirement. You may also consider drinking a protein drink. These can be purchased in any grocery or health food store.
10. Avoid emotional upsets. When under stress make a conscious effort to keep your teeth apart and think “relax”!
11. Lips together and teeth apart: one of the most important steps in breaking the habit of destructive clenching and destructive grinding of your teeth is to become aware of when it occurs and stop doing it. An excellent way to avoid destructive clenching is to learn to keep the lips together and the teeth apart, breath through your nose and make sure your tongue is relaxed in the roof of your mouth. This simple step will not only make it impossible to clench but even more important, it will relax the very muscles that have become tense and taut. It also permits normal positioning of the various components of the temporomandibular joints.

WHY ARE YOU WEARING THIS APPLIANCE?

• To protect your teeth from conscious/unconscious clenching or grinding. These habits can cause your teeth to have excessive wear, sensitivity, fractures, movements, mobility or pain. This places the teeth at risk of fracture, splitting or it can accelerate gum disease or cause damage to the nerves of the teeth.
• To assure how your facial pain or headaches are related to the fit of your teeth and what you do with your teeth.
• To assess how your TMJ joint and pain is related to the fit of your teeth.
• To assess what jaw position is healthiest and the most balanced for you. Where is it most repeatable and to assess the stress on your teeth in all the various jaw movements.
• To find out where your teeth should fit when your jaw joints and muscles are most comfortable and relaxed.
• To further assess if physical therapy or other testing or referrals would be appropriate.
• To discover more of what you do with your teeth before any complex dental work is done that reconstructs your bite.
• To assess how you will adapt to planned changes in your bite that are made with a removable splint.

Your appliance is designed to:

• Provide solid balanced support for your bite. This helps provide jaw joint stability and muscle comfort and relaxation.
• Provide equal and simultaneous pressure when solidly biting on your back teeth. This provides the best stress distribution for your back teeth, with minimal joint and muscle fatigue.
• Provide smooth contacts on your front teeth when you move away from your back teeth. This provides a smooth, non-stressful guidance on your front teeth and reduces lateral stresses on your back teeth.
• Provide a healthy, non-restrictive range of motion for your jaw muscles, which improves comfort and reduces muscle fatigue and spasms.

How to use your appliance:

• You decide how much to wear it. The most common use is nightly while sleeping. The more you wear if, the faster we will discover together all of the various nuances that we are looking for.
• Only wear it if it is quite comfortable. Call if pain or symptoms are made worse.
• Some people will wear it during the day and during drive times or yard work or during various breaks throughout the day.
• A few people wear it almost all day and night, except when chewing.
• Take it in and out from one side, as shown to you. This minimizes the internal wear on the appliance, and it will last longer and stay on tighter with the least adjustment needed.

What to expect from your appliance:

• Most people adapt very quickly, as our appliance is very thin, smooth and highly refined to your mouth.