Temporary Crowns or Bridges (Fixed Prosthesis)

You have just received a temporary crown. This temporary crown is meant only to serve your needs while a permanent crown is being made for you. Color: The color of the plastic temporary crown does not resemble the final (permanent) crown in any way. Shape and Size: Temporary crowns are custom-made for each patient, but they will not, in any way, resemble the final crown, which is being made especially for you. Tooth Sensitivity: Your temporary crown will help protect the sensitivity of the prepared tooth. However, it does not fit your mouth like the permanent crown will, so you may notice sensitivity to heat, cold, or sweets—sensations you should not feel when your specially-made crown is in place.

Here are some other things you need to know about your temporary crown:

  1. The temporary cement requires about 30 minutes (one half-hour) to set. Please do not chew during that period of time.
  2. Certain foods will stick to the temporary crown. Please refrain from chewing gum, candies, or foods that might stick to the crown or even pull it out.
  3. Temporary crowns are not strong and they may occasionally break or come off. If this should happen to you, please contact our office immediately, bring your crown with you and we will replace it. If you unable to contact us, simply go to a pharmacy and get some Fixodent. Replace the temporary crown on your tooth using the Fixodent to hold it in place until you can contact us.
  4. Please do not leave the temporary crown out of your mouth. Without the temporary crown, your teeth may move and then the permanent crown may not fit!
  5. Do not brush or floss too vigorously around your temporary crown. Remember that it is important to keep the area clean-but use caution.
  6. It is imperative that you return to our office at the appointed time for your permanent crown. Failure to do so may result in the need to re-prepare the tooth and re-make the crown at your cost.

 

Gum Surgery/ Crown Lengthening

It is important to take care of your surgery site. Please follow these instructions:

  1. Bite on gauze for 30 minutes (one half-hour) to stop any bleeding. If bleeding continues, place another gauze and continue to apply pressure.
  2. For at least 24 hours do not:
    • smoke
    • drink through a straw
    • drink alcohol, carbonated beverages (“pop”), or hot liquids
    • blow your nose
    • spit excessively

Any of these things may cause the blood clot over the surgery site to dislodge from the “socket,” causing a “dry socket” and resulting in unnecessary pain. (Should this happen, call this office to see the doctor as soon as possible)

  1. Do maintain a soft diet for the remainder of the day—things like warm soup, ice cream, milk shakes (remember no straws), etc.
  2. If your pain, discomfort, or bleeding continues or worsens, call the office for a re-examination.
  3. If you were given medications, take them according to the instructions. If you have pain medications at home, you may take them according to the instructions.
  4. Tomorrow morning, start rinsing gently with warm salt water (1/4 teaspoon of salt to 1 cup of water) every four (4) hours for two (2) days.
  5. If any problems or questions do arise, please feel free to call the office (410-775-7878).

 

Your New Dentures

  1. Sore spots may occur under new dentures. Do not cut or grind on the dentures—we will adjust them for you. If the soreness remains more than one day, return to our office with the dentures in your mouth so we can find the sore spot and adjust the denture for you.
  2. Don’t overwork your dentures, they are artificial. If you had a wooden leg you wouldn’t expect to run a mile in four minutes, so take it easy. Learn slowly to use your new teeth. No one can teach you how to wear your dentures. It will take time for you to learn the best technique to chew.
  3. Talking and eating will be difficult at first. Your mouth will seem full of water (saliva) and your tongue will feel boxed-in. Don’t try to eat a juicy steak, fresh apples, corn on the cob, or similar foods, for the first few weeks. Gradually change from soft foods to harder varieties, but avoid sticky foods.
  4. Keep your dentures clean to prevent staining and bad breath. Brush them at least twice a day (in your hand). Use a soft bristle brush with plain soap and water. Do not use toothpaste or baking soda as it has abrasives which can scratch the denture, making it prone to bacterial accumulation and odors. Leave the dentures out of your mouth at night, soaking in a water and mouthwash solution. Soak at least twice weekly in an effervescent cleanser such as Polident to prevent stains from accumulating on your dentures.
  5. Use of Adhesives: The most rapid bone loss occurs within the first several months following tooth extractions. Thereafter, your bone and gums will steadily decrease as you age. Factors such as drastic changes in weight can also affect the way your dentures fit. We recommend using a Zinc-free denture adhesive to better retain dentures for short term use only, as long term use can damage the soft tissue of your mouth. When your dentures become loose you may need to have your dentures relined or perhaps remade. If you still do not have the tight fit that you desire, you may consider dental implants to help retain your dentures. Ask your dentist if you are a candidate for this procedure which can drastically enhance your ability to function in a more natural manner. If you should break, chip or crack your denture, return to our office with all the pieces of the denture. We are usually able to repair your denture.
  6. Oral Cancer Screenings: You should return for a check-up at least once a year for your dentist to evaluate and clean build-up from your dentures (dentures get tartar build-up too!). This visit is very important to check your oral tissues for any abnormalities such as oral cancer.

 

Home Use of Fluoride in Trays

Because of your high need to prevent or control dental decay (caries), or to reduce tooth sensitivity, it is recommended that you use specially custom-fitted trays containing fluoride each day. These trays will prevent new decay almost totally and will slow down currently present decay, as well as desensitize sensitive tooth root surfaces. You must be consistent in carrying out the following procedure daily just before going to bed:

  1. Cleaning Methods:
    ___A. Brush and floss your teeth well.
    ___B. Use the described special cleaning methods we recommended:
    ________________________________________________________
    ________________________________________________________
  2. Place about six drops of Fluoride into each tray, spacing the drops equally. This is a medication requiring a prescription. If you run out, please tell us so that we can give you a new prescription.
  3. Place the tray(s) into your mouth, seating them completely.
  4. Expectorate (spit out) the excess fluoride.
  5. Let the trays and fluoride remain in your mouth for five (5) minutes.
  6. Remove the trays, wash them out with water and place them upside down in a convenient place to let them drain out and dry before the next use.
  7. After fluoride use:
    ___A. If you are living in an area that has fluoride in the drinking water, rinse your mouth with water, expectorate, and go to bed without eating.
    ___B. If you are living in an area that does not have fluoride in the drinking water, you do not need to wash the excess fluoride out of your mouth. Expectorate the excess and go to bed without eating anything.
  8. You should continue this therapy for _____________________

 

Care Following Extractions

  1. Proper Care of Blood Clot: For three (3) hours, maintain moderate pressure by biting on the gauze sponge that has been placed over the surgical area. If needed, replace gauze with another as provided. A moistened Black Tea bag (which contains Tannic acid, a natural clotting aid) can be used like gauze if you are having difficulty controlling bleeding.
  2. Do Not Rinse or use a mouthwash for at least 24 hours, but brush carefully. After 24 hours, rinse gently with warm salt water, using a concentration of 1/4 teaspoon of table salt in 8 ounces of warm water, two to three (2-3) times daily. The use of commercial mouthwashes during the healing period is not encouraged.
  3. Pain: Following dental surgery, you will most likely experience mild soreness in the area of the extractions for a few days. Most often, an anti-inflammatory pain medicine such as Ibuprofen will be sufficient to alleviate the pain. Some patients that are taking medication for heart conditions should not take Ibuprofen or other NSAID type pain medications. Please follow your physician’s recommendations if they have told you to avoid any of these drugs. If you have been prescribed an antibiotic be sure to completely finish the tablets, even if you are feeling better. If pain persists or becomes severe, call us at the office. Your comfort is important to us.
  4. Toothbrush: Use it carefully but thoroughly. A clean mouth heals faster.
  5. Eating, Drinking and Smoking: Avoid alcoholic beverages and smoking until healing is well established. Adequate food and fluid intake following surgery is important. Do not consume liquids through a straw. If your regular diet is too difficult, you may supplement it with liquids. Should you find yourself unable to chew solid foods of any kind, call us.
  6. Avoid All Excessive Activity: Do not do things that will raise your blood pressure. Go home, lie down and rest. Do not disturb (pick at) the surgical area.
  7. Sutures: If sutures were used in your treatment, be sure to return for their removal on the appointment date given unless you were instructed that the dentist placed resorbable sutures. If this is the case, the sutures will be broken down by your body in 7-14 days. Try not to play with your sutures!

 

Your New Removable Partial Dentures

We have done our best to provide you with well-fitted, functional, and aesthetically pleasing partial dentures. We feel confident that after a few weeks of adjustments, you will enjoy years of satisfaction and use. In the meantime, the following is important information:

  1. Your First Few Weeks. New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to become accustomed to them. You may have difficulty eating and speaking for a few weeks. This is normal. Be consistent and persistent.
  2. Sore Spots. Your mouth will most likely have a few sore spots about 24 hours after you first put your new partial dentures in. An initial readjustment appointment should be made and another appointment, about seven days later, will usually eliminate any other sore areas. Thereafter, please call us if you need additional adjustment to your prosthesis.
  3. Chewing. The new “bite” or occlusion will not feel comfortable for a period of days. We will adjust the contacting surfaces of your teeth after 24 hours, and again in about one week after the dentures have “settled” into place.
  4. Cleaning the Dentures – and Your Mouth. Your partial dentures can be cleaned easily by using a denture brush and toothpaste. Use special care to clean parts of the partial that contact any natural teeth. Both the partial denture and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting. Use a toothpaste that contains fluoride. Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, then leave them soaking in a water-and-mouthwash solution.
  5. The Future. Your jawbones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This is one of the main disadvantages of dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us at least every six (6) months. We will inform you when relining or rebasing of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and very serious oral disease.

 

Implants

We have just completed the prosthesis for your oral implants. Such implants have been placed successfully for over 25 years. The following information will be interesting and useful for you relative to future expectations for your implants and the prosthesis placed on them.

Acceptance of dental implants by bone and gum tissue has been excellent, however a few implants fail. Additionally, the prosthesis that has been placed over the implants is subject to wear and/or breakage. Any of the following conditions that occur require your immediate attention. Please contact us if any of the following conditions occur:

  1. Feeling of looseness
  2. Peculiar
  3. Clicking or metallic snap while eating
  4. Breaking a piece of the prosthesis
  5. Redness in the gum tissue around the implant
  6. Feeling of the bite being different
  7. Pain

We have done our best to provide to you the highest quality service available. The continuing success of the implant and prosthesis is up to you. Please do the following items checked:

  1. Visit us for examination, scaling, and polishing at least once every six months.
  2. Clean the implant daily, especially before bedtime using:
    ___A. Floss
    ___B. Bridge cleaner
    ___C. Toothbrush
    ___D. Interplak mechanical toothbrush
    ___E. Peridex

Your failure to accomplish thorough cleaning of the implant prosthesis daily will compromise its longevity significantly. We expect years of service from this therapy. We recommend wearing a custom night guard in order to protect the investment you have made in your implant and crown. Almost everyone has experienced some type of parafunctional clenching and grinding movements at night time even if they themselves are not aware of this habit. Implants are engulfed in bone unlike natural teeth that are held into the bone by ligaments. This means that implants are not meant to accept any movement within their socket. Clenching and grinding can produce dangerous forces which can loosen the implant itself or implant components over time. A night guard can prevent this from occurring.

 

Veneers

We have placed porcelain veneers on your teeth. These restorations were placed with the finest materials and techniques available today. You should be aware of the following things about your restoration because, as with a fine automobile or watch, only your continuing care and concern can assure optimum service longevity.

Chewing: As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, bones, etc.) because under extreme forces, the porcelain material can be broken from the teeth. Avoid biting directly into hard foods such as apples or corn on the cob as they may chip the porcelain.

Recalls: Visit us for examinations and check-ups at your regular six-month examination periods or during recommended recall visits. Often problems that are developing with the veneers can be found at an early stage and repaired easily, whereas waiting for a longer time may require redoing the entire restoration.

Preventative Procedures: To provide optimum longevity for your restorations, and to prevent future dental decay or supporting tissue breakdown, please use one of the following preventive procedures:
____ Brush with a toothpaste containing fluoride and floss after eating and before bedtime.
____ With a fluoride rinse, swish vigorously for at least 30 seconds – ideally immediately before bedtime.

The Future: We expect that you will receive several years of service from these veneers; however, certain situations occasionally occur that necessitate restoration replacement. Extreme force or trauma can break porcelain veneers just as it can break natural teeth. Use care in sports or other potentially traumatic situations. Do not bite extremely hard objects with a single tooth. Breakage usually requires remaking the restoration, but occasionally it can be repaired.

Call us if you notice any changes or have any questions about your veneers.

 

Crowns or Bridges (Fixed Prosthesis)

You have just had some crowns or fixed bridges cemented onto your teeth. They will replace your missing tooth structure or missing teeth very well, and should give you years of good service – provided you observe the following cautions:

Chewing: Do not eat on crowned teeth for 30 minutes after cementation. Do not chew hard or chewy foods on the restorations for 24 hours from the time they were cemented – to attain optimum strength, the cement must mature for approximately 24 hours.

Sensitivity: Don’t worry about mild sensitivity to hot or cold foods. This sensitivity usually disappears gradually over a few weeks. Infrequently, sensitivity lasts longer than six weeks. Please notify us if this occurs.

Preventative Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please use the following preventive procedures:
___ Brush and floss after eating and before bedtime.
___ Use a fluoride rinse, swish vigorously for at least 30 seconds daily.
___ Use fluoride gel as prescribed by our office.
___ Use, ____________(a Water Pik, an Interplak toothbrush, etc.) as advised by us.

Recalls: The most significant reason for prosthesis failure is inadequate return for examination. Visit us at regular six-month examination periods. Often problems that are developing around the restorations can be found at an early stage and corrected easily. Waiting for a longer time may require redoing the entire restoration.

Problems: Call us immediately if any one of these conditions occurs:

  • A feeling of movement or looseness in the restoration.
  • Sensitivity to sweet foods.
  • A peculiar taste from the restoration site.
  • Breakage of a piece of material from the restoration.
  • Sensitivity to pressure.

We have done our best to provide you with the finest quality restoration available today. Only your continuing care and concern can assure long-term good dental health.

 

Root Canal Therapy

The purpose of the Root Canal Therapy that was performed is to relieve pain caused by a degenerating nerve by removing the nerve and blood vessels within the root of the tooth and thoroughly cleaning and shaping the canal to accept a rubber-like filling material. An interim filling is placed in the access hole on the top of the tooth until a couple weeks after completion of the root canal in which a more permanent filling can be placed.

Chewing: A temporary filling is placed in the tooth between root canal appointments (if 2 are necessary) and following the completion of the root canal as well. It is important to avoid chewing hard foods such as raw vegetables, nuts, popcorn, hard pretzels, candy, etc. on the tooth during this time as the tooth is vulnerable to fracture.

Pain: It is normal to experience a mild soreness following root canal therapy that lasts 3 days on average. While cleaning the root canal bacteria are pushed out of the bottom of the root into the surrounding tissue which can become inflamed while your body fights the infection. Sometimes a small amount of rubber filling material can extend beyond the end of the root, causing a small amount of discomfort to pressure. This will subside as the body resorbs the excess material. If pain is persistent or intense, please contact our office.

What’s Next?: It is highly recommended in most root canal cases that a permanent filling and crown be placed shortly after completion of your root canal in order to protect your tooth from fracturing beyond repair. You should talk with us about what treatment is best to protect your tooth following the root canal.