:: Procedures

::  Crown, Veneer or Bridge Preparation

::  Crown, Veneer or Bridge Delivery

::  Sedative Filling

::  Root Canal Treatment

::  Scaling & Root Planing

::  Mini-implant

::  Filling Restoration

::  Extractions

CROWN, VENEER or BRIDGE PREPARATION

Your gums may be sore today. Warm salt-water rinses will help. Anbesol will temporarily numb your gum if you need it. If you feel that your gums are not healing, we have a gel that can be applied to help you heal. It is not an anesthetic, but it will speed the healing process if needed.

Wait until the numbness wears off before you eat. It is okay to have liquids now. Chew on the other side when you do eat. Do not eat sticky foods that can pull the temporary crown off (i.e. gum, taffy, gummy bears, etc.). If your bite is off, please call and make an appointment to adjust it. It will cause pain in the tooth if you try to ignore it.

When you brush your teeth, run your toothbrush under hot water first to soften the bristles. The temporary crown should be kept clean, so brush gingerly with a soft brush. Do not floss the temporary crown. It may come off. If the temporary crown comes off at night or over the weekend, you can re-cement it with a denture adhesive like Polygrip. Some pharmacies have temporary dental cement behind the counter and will provide that if you ask for it. If you can't get either of these, Vaseline will also work. If it comes off during the day, call us and we will make you an appointment to re-cement it. Do not leave it off because the teeth will shift and the new crown will be difficult to fit or you may damage the prepared tooth.

If you have any questions please call us. If you have an emergency after hours, call the office, 214-361-6088. The machine will say "if this is an emergency, press 1". Do so, then leave a message with your name, phone number and the nature of your problem. The doctors will be paged.

CROWN, VENEER, or BRIDGE DELIVERY

Temporary Cement

We placed your new prosthetic with temporary cement today. This will enable you to observe the function before we put it on permanently. If food gets packed around it when you eat, let us know. If there is too much space when you floss we need to know. Or if you can't floss because it's too tight tell us. The tooth may be sensitive at first. This is normal. It should settle down in a day or two. If not, we may need to leave the crown on with temporary cement until it does. We would not want to permanently cement a crown on a tooth that is hurting, only to find that later on, that tooth requires a root canal. Once you've worn the crown for two or three weeks, and don't have any pain, we can cement it permanently. Today, you will need to wait an hour to eat, and chew on the other side. It is okay to drink liquids now. Tomorrow, you can chew on either side and floss. If the crown should come off, it is imperative that it be put back on immediately. If the crown is left off, that space will close and the crown will no longer fit. If it comes off during the day, call us and we'll re-cement it for you. If it happens at night, on the weekend, or while you are out of town, you can put denture adhesive in it and re-cement it yourself. Then call as us as soon as possible.

Permanent Cement

If we cemented your crown with permanent cement today, you will need to wait one hour to eat. Chew on the other side today. You can drink liquids now. You can start flossing tonight.

SEDATIVE FILLING

If we had to do a sedative filling, that means that your decay is extremely deep and has eroded the enamel and dentin structure very close to the nerve chamber. We place this medicated filling in hopes that the tooth will settle down and not need a root canal. Over time, the tooth will slowly get less sensitive or more painful. This is a conservative approach in order to prevent a root canal if at all possible. Typically, we give it three months to work. Do not eat until the numbness wears off. It is okay to have liquids now.

If you should notice any swelling in the gum area of the tooth, please call the office immediately. You may need medication. If you need us at night or over the weekend, do not hesitate to call. Call the office, 214-361-6088. The machine will say "If this is an emergency, press 1". Do so, then leave a message with your name, phone number, and the nature of the problem. The doctor will be paged.

ROOT CANAL TREATMENT

After a root canal, you may experience some soreness. The gum around the tooth may be irritated from the isolation barrier used to keep the area sterile, the tissue may be sore from the injection, and the muscle may be sore from staying open. The tooth itself usually has little if any soreness. You should be well enough to return to work if you wish. Do not eat until the numbness wears off. It is okay to have liquids now.

If swelling should occur after the root canal, please call the office. You may need to see the doctor or receive a medication. If you are calling after hours, the answering machine will tell you to press 1 if this is an emergency. Do so, then leave a message with your name, telephone number, and the nature of the problem. The answering service will page the doctors.

Once you receive a root canal the tooth will become brittle. It is important to put a crown on this tooth in the near future in order to protect it. The crown is a two-visit process. The first visit lasts approximately an hour and a half. The tooth is prepared, an impression is taken, and a temporary crown is made. You will wear that temporary two or three weeks. When you return for the permanent crown, that visit will take approximately thirty minutes.

SCALING and ROOT PLANING

Following scaling and root planing, you can expect to notice less redness, less bleeding and less swelling of your gum tissue. Your mouth will taste better and feel better. Your gum health can then be maintained with proper homecare and regular professional care.

Discomfort

Discomfort or pain should not be acute and should subside in a few hours, definitely within a few days. Discomfort immediately after treatment is usually associated with slight throbbing or aching and occasionally may be uncomfortable. This discomfort usually subsides in about four hours.

Tooth Sensitivity

Teeth may be sensitive to temperature changes and/or sweets. The sensitivity to temperature may be noticeable the first several days and usually diminishes quickly. Application of a desensitizing fluoride may be recommended.

Bleeding

Some slight bleeding may occur during the next several brushings but the bleeding should steadily decrease.

Appearance

As the gums heal they may change their shape around the teeth. This is normal as they tighten.

Instructions to Minimize Symptoms

Diet/Eating

If extensive root planing was performed, chewing hard foods, such as meat or raw vegetables may be uncomfortable; this should last no longer than a few days. A diet of a softer consistency would be advised until chewing becomes more comfortable.

Discomfort/Sensitivity

If a local anesthetic was used avoid chewing foods until feeling returns to avoid injury to the tongue or cheeks. Acetaminophen or a non-aspirin analgesic should be taken as recommended to reduce discomfort. If tooth sensitivity persists, use a desensitizing toothpaste containing potassium nitrate. If the sensitivity is severe and prolonged, professional application of a desensitizing agent may be required.

Oral Hygiene

If gum tissues are tender, brush your teeth gently but thoroughly; this may take a little more time than normal. By the third to fourth day, normal oral hygiene techniques may be resumed. Mouth rinsing is recommended with either of the following solutions: 1) an anti-microbial rinse, 2) a warm salt-water rinse. Use of either of these rinses should be limited to one to two consecutive weeks.

Special Instructions

If symptoms are severe or persistent, please call our office immediately. If it is after hours, the machine will tell you to press "1" for an emergency. Do so, then leave a message with your name, number and nature of your problem. The doctors will be paged.

MINI-IMPLANT

If there are no sutures, you will need to wear the denture for the first 24 hours without removing it. After that, take the denture out and brush it as if it were teeth. Your tissue may be sore for the first few days, but that will go away. It is very important that you keep the denture/partial clean and free from plaque.

You will begin brushing the implants on the second day. You will be given a special brush for the implants. Run it under hot water to soften the bristles, then use on implants in a circular motion. It is very important that they are kept clean and plaque free.

If you have any sore spots, let us know so we can adjust them. These are to be expected.

If you have sutures, after the first 24hours, remove denture/partial and rinse mouth with warm salt water. Clean the denture/partial and replace it. Do not brush implants for the first week. We will do a follow up suture removal in approximately one week. After that, you should be able to brush implants unless otherwise directed.

Sometimes there is some tissue swelling and the denture/partial will not fit on the implants. If this is the case, leave the denture out and make an appointment as soon as possible so we can make the appropriate adjustments.

If you have an emergency, call the office. If it is after hours, the machine will say to press "1" for an emergency. You will then be prompted to leave a message. Be sure and include your name, phone number and the nature of your problem. The doctors will be paged.

FILLING RESTORATION

After you have a filling done, you may be sensitive to hot and cold temperatures. Occasionally it will last as long as two months. You may feel some soreness from the injection site. That will subside rather quickly. If your bite doesn't feel normal, please call us. We will make you an appointment to have it adjusted. If you try to ignore it, it will cause you pain. The filling is as hard as it will get, so it is okay to eat once the numbness wears off. You can have liquids now.

If we had to do a sedative filling, that means that your decay is extremely deep and has eroded the tooth structure close to the nerve chamber. We place this filling in hopes that the tooth will settle down and not need a root canal. Over time, the tooth will slowly get less sensitive or more painful. This is a conservative approach in order to prevent a root canal if at all possible. Typically we give it three months to work. If you should notice any swelling in the gum area of the tooth, please call the office immediately. You may need medication. If you need us at night or over the weekend, please call our office. The machine will tell you to press "1" if this is an emergency. Then you will state your name, the nature of your problem, and the phone number the doctors can call to reach you.

EXTRACTION

Get ice packs on as soon as possible. Use ice packs today to prevent swelling. Switch to moist heat tomorrow if swelling occurs.

You can expect some bleeding tonight. That is normal. What isn't normal, is if you see a pulsating type bleeding from a socket. If so, get a tea bag, wet it with water, place on extraction site, then close and hold constant pressure for five minutes. Do not release pressure to check during that five minutes. Check only after five minutes of consistent pressure. If the bleeding continues, go to the hospital.

Change your gauze every 15 to 20 minutes for 1 to 2 hours. After that, leave it out. Continued use of gauze will cause irritation and bleeding, so once the bleeding has slowed down, discontinue gauze. Do not play with extraction sites with your tongue.

Do not drink through a straw and no vigorous swishing for 3 days. No carbonated beverages. No tobacco products or spitting. These could cause the blood clot to come out of the socket. That is called a dry-socket and is very painful.

When you brush your teeth, run the brush under hot water to soften the bristles, then brush the teeth around the site gently, being careful not to damage surgical site.

You will require a liquid diet tonight and soft diet for a few days.

Medications are different for each patient. If you are prescribed Demerol, you will take it tonight and possibly tomorrow, depending on your pain. Then switch to the Lorcet Plus. Do not take both together. If prescribed, start your Medrol Dospak tonight. The instructions will be on the prescriptions. Most extractions only require the Lorcet Plus.

If you need us at night or on the weekend, call 214-382-4991. The machine will say "If this is an emergency, press 1." Do so, then leave a message with your phone number and symptoms. The doctor will be paged.

If you have any questions, feel free to contact our office. We will be glad to help you!!