Here you’ll find all the information and guides to help you prepare for your clinic visit and post operative procedures. If you have any questions, please contact our office.
Crowns and Bridges
Crowns and bridges usually take two or three appointments to complete. In the first visit, the teeth are prepared and molds of the mouth are taken. Temporary crowns or bridges are placed to protect the teeth while the custom restoration is being made. Since the teeth will be anesthetized, the tongue, lips and roof of the mouth may be numb. Please refrain from eating and drinking hot beverages until the numbness is completely worn off. Occasionally a temporary crown may come off. Call us if this happens and bring the temporary crown with you so we can re-cement it. It is very important for the temporary to stay in place, as it will prevent other teeth from moving and compromising the fit of your final restoration. To keep your temporaries in place, avoid eating sticky foods (gum), hard foods, and if possible, chew on the opposite side of your mouth. It is important to brush normally, but floss carefully and don’t pull up on the floss which may dislodge the temporary crown but pull the floss out from the side of the temporary crown. It is normal to experience some temperature and pressure sensitivity after each appointment. The sensitivity should subside a few weeks after the placement of the final restoration. Mild pain medications may also be used as directed by our office. If your bite feels uneven, if you have persistent pain, or if you have any other questions or concerns, please call our office (704) 364-3717.
New dentures always require a period of adjustment. First-time denture patients may require several weeks to get used to their new appliance. Speech may be altered, and may require adaptation of the tongue and lips. For the first few days, you should wear your dentures for as long as possible, and chew soft food in small bites. Remember, dentures do not have the same chewing efficiency as natural teeth and may affect your taste of food. If your bite feels uneven after several days, we can adjust the way your teeth contact at follow-up visits. It is not unusual for sore spots to develop in isolated areas of the mouth. These areas can be relieved easily at follow-up appointments. If a severe sore spot develops which prevents wearing the denture and an appointment is made for adjustment, please wear the denture for 24 hours prior to the appointment. This will greatly aid in locating the exact location of the area, and make adjustments significantly easier and more predictable. Proper cleaning of your denture is important to prevent stains and bacteria from accumulating on your appliance. Since cleaning procedures differ for various types of appliances, please follow the directions given to you at your insertion appointment. Do not wear your complete or partial dentures to bed. It is important to allow your gum tissues and jaw bones to rest in order to prevent further tissue irritation, infection, and future bone shrinkage. Over time, or with weight loss or gain, the supporting gum tissues and bone may change shape and size. Periodic relines of your dentures may be necessary to ensure a retentive fit. Denture teeth may wear or chip over time. For this reason, an annual check of your tissues and dentures is recommended.
Do not wear your complete or partial dentures until your doctor gives you permission to do so. If a temporary tooth was/is to placed on your implant today, it is critical that you do not bite on this tooth until your doctor allows. Occasionally, the cover screw or healing abutment may loosen or fall out. This should not affect the stability of your implant. It is important, however, to call us as soon as possible so we can replace it for you.
It is absolutely essential that all follow-up appointments be kept. Routine follow-up appointments allow us to identify potential problems that could complicate your recovery. Pain Some degree of discomfort and pain arises as the numbness subsides. We recommend that you start taking a non-steroidal anti-inflammatory once you arrive home. Advil/Ibuprofen/Motrin/Aleve are such medications and should be taken as directed on the bottle (usually 400 mg every 4-6 hours). If you are unable to take anti-inflammatory medications, take Tylenol or acetaminophen as directed on the bottle (usually 650 mg -1000 mg every 6 hours). If the pain is not relieved, then you may take the prescribed pain medication as directed.
All pain medications have the ability to cause severe nausea and vomiting, so try to have some food in your stomach before you take them. Do not wait for the pain to become unbearable before using some form of pain medication, as then it will be more difficult to control. Moderate to severe pain usually does not last longer than 24-72 hours, sometimes peaking on the 3rd postoperative day. Relief should begin on the 4th post-operative day.
Expect minor bleeding or OOZING from the operative site. This bleeding may continue throughout the first day. Keep firm pressure on the surgical site by biting on a gauze sponge for 30 minutes at a time until bleeding subsides. Once the oozing has slowed down, try to avoid placing gauze or any other irritant near the surgical site as this will only lead to further bleeding and discomfort. Biting on a moist tea bag wrapped in gauze may help control persistent oozing.
If active bleeding should recur at any time, carefully rinse your mouth with cold water and apply a fresh gauze sponge to the bleeding site. Firm pressure for 15-30 minutes usually controls the problem. Should active bleeding persist, please call the office and a member of our surgical team will return your call promptly. The Surgical Site The first stages of healing are aided by allowing tissues to rest. Avoid vigorous chewing, excessive spitting, or rinsing for the first 24 hours as initial healing may be delayed, active bleeding restarted, or infection introduced. Try to avoid smoking completely, as it tends to slow the healing process and may also contribute to infection & prolonged discomfort. Do not worry about the stitches if they start to come out. The sutures usually dissolve in 5-7 days and typically do not require removal.
Swelling usually develops during the first 12-24 hours following surgery, often peaking on the 3rd post-operative day.
Swelling can be minimized by placing an ice pack on the affected side at 30 minute intervals during the first 48 hours after surgery. Any swelling, soreness, or stiffness in the jaw muscles can be relieved by applying a warm moist towel to the affected side of the face several times a day. Moist heat should be used after the first 48 hours.
Limit activity during the first 24-48 hours after surgery. Excessive exertion may lead to postoperative bleeding and discomfort. When you lie down, keep your head elevated at least 45 degrees on a pillow. Do not drive an automobile for 24 hours following surgery if you have had general anesthesia or if you are taking prescription pain medication. Diet FLUID INTAKE IS VERY IMPORTANT. You can advance to soft foods and other fluids as tolerated. Please avoid hot liquids until the numbness has worn off, and the bleeding has stopped. FOOD SELECTION is largely a matter of your choice. Soft, cool foods that require little or no chewing are most easily tolerated.
Start cleaning your mouth 24 hours after surgery by using warm salt water rinses (1/4 teaspoon table salt with a small cup of water). Repeat 3 times daily for one week. BRUSH your teeth starting on the first postoperative day being careful not to irritate the surgical site. Your Medications Take any regularly scheduled medication on your regular schedule unless advised to do otherwise. Patients taking blood-thinners (ie. Coumadin) should restart those medications after surgery unless there is any sign of continued bleeding.
Removable Partial Dentures
After completion of your denture or partial it will be inserted by your dentist. Adjustments will be made to the borders to reduce pressure and make it comfortable and the bite will be checked to make sure that you are closing correctly. The impression of your mouth is made in a static or non functioning position so that when you chew and talk problems may arise that could not be foreseen and for that reason you will be scheduled for a follow up appointment within one week. If your denture was an immediate denture, placed immediately after your remaining teeth or some of your teeth were extracted, please do not remove the appliance for 24 hours. It helps to stop the bleeding. As with the other removable appliances, call the office if you have any irritations or cannot function properly. Remember that you now have a large foreign object in your mouth and no matter how well it fits you must give yourself time to adjust to its presence.
Full Mouth 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 mouth guard. 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 let us know. We always welcome your questions.
After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times. After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site. After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours. Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable. It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean. After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately at (704) 364-3717.
After Composite 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 and 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, please let us know. 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 (704) 364-3717.
Whether you have completed Brite Smile or you are in the midst or completed at-home bleaching there are certain criteria that you should be aware of. Hopefully your expectations have been met. Teeth have surface stain and internal stain. Surface stain is easy to remove and the removal of the internal stain depends on such factors as the type of stain, the depth of the stain. The technique of bleaching uses a peroxide based liquid. This formulation dehydrates the teeth while it removes both intrinsic and extrinsic stains. When teeth are dehydrated they are more porous and more sensitive. For this reason, after bleaching do not eat anything that can stain a white tee shirt. For in-office bleaching that usually means for 24 hours (but 48 hours is better). With at-home bleaching, if you remove the product and return to sleep for at least 6 hours your teeth will probably be rehydrated enough to prevent staining. If you can, even with the take home product, refrain from having red wine, dark gravies, colas, dark coffee and tea during the entire process. This will enhance the results. Some sensitivity may occur during or after the procedure. We have gels that can be used after the procedure to reduce the sensitivity that may result. The sensitivity will decrease and disappear with time. Remember that the shade of whiteness that you have upon completion of bleaching will change over the next 2 weeks due to rehydration of the tooth along with some covering of the enamel by a natural normal protective covering. With the trays you can do additional bleaching for a few days every 3-4 months to re-whiten your teeth. You dentist will discuss with you how long you should use the take home product.