Home Care Instructions

WHITENING INSTRUCTIONS

1. 1. Brush and floss your teeth with your regular toothpaste. The plaque and food in there do not need to be whitened.
   2. Ensure that your custom made whitening trays are clean and free of debris, then apply your whitening gel to the facial surface (the surface people can see if you’re smiling & not the biting surface) of the tray, just one small dot for each tooth; about the size of the head of a pin. LESS IS MORE!
   3. Insert the trays into your mouth and leave them in for 30-40 minutes, during this time do not eat, drink or smoke.
   4. If you have excess gel oozing from the trays then you have used too much product and need to wipe away the excess with a damp cloth OR Q-tip. You do not want any of the gel to touch the gums.
   5. Once you have completed between 30 minutes with the trays in your mouth you can remove them and wash them under cold water with a toothbrush to remove any remaining gel and rinse your mouth out with water to remove any remaining gel in your mouth.

1. When the whitening trays are not in your mouth please keep them in the plastic container we have provided you with as they can get lost very easily as they are clear.
2. If you experience moderate sensitivity from the whitening please do not whiten again until it goes away. Sensitivity toothpaste can help.
3. You will be performing this process for between 5 to 14 nights depending on the results that you are expecting. It is recommended to only whiten about every third day.
4. Please avoid drinking tea, coffee, red wine, and smoking during the whitening process.

Side Effects:

If the gums come into contact with the gel, you may experience a burning or tingling feeling. If left on the gums, they can even turn white. Even though this is temporary, it is uncomfortable and is not where we wanted things to turn white. Therefore, the first instance you have that sensation on your gums, take the trays out and use a Q-tip to wipe the excess off – both off your gums and the excess in the tray. Remember, LESS IS MORE (it is better to do 6 whitening sessions rather than 3 or 4 with more gel). This gel will not “spot” whiten your teeth.

Cold sensitivity may also occur. If so, it is also temporary. Within a few days, it will lessen and eventually go away. Simply don’t whiten as often (once every other week instead of every third day). If extreme, you can contact our office for a desensitizing gel to put in the trays to make it more comfortable.

Lastly, keep the trays in a safe place (no dogs allowed). A refill of whitening can be purchased in our office. Usually, most people only need one refill per year. Refrigerate the unused portion. Shelf life is typically less than 2 years

Enjoy your new white teeth!

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 at Precision Dental of Post Falls Phone Number 208-773-5505 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 let us know. We always welcome your questions.

After Crown and Bridge Appointments

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 at Precision Dental of Post Falls Phone Number 208-773-5505 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 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 at Precision Dental of Post Falls Phone Number 208-773-5505.

After Tooth Extraction

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 at Precision Dental of Post Falls Phone Number208-Precision Dental of Post Falls Phone Number 208-773-5505 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 Precision Dental of Post Falls Precision Dental of Post Falls Phone Number 208-773-5505.

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 at Precision Dental of Post Falls Phone Number 208-773-5505.

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 Precision Dental of Post Falls Phone Number 208-773-5505.

Fluoride Tray Instructions

Because of your need to prevent or control dental decay (caries) or to reduce tooth sensitivity, our office has recommended the use of custom-fit tray(s) to apply fluoride to your teeth daily. From well-documented research and from our own observations over many years, we know that use of these trays and fluoride will prevent new decay almost totally and will slow down currently present decay. Additionally, regular use will desensitize sensitive root surfaces. However, you must be consistent in carrying out the following described procedures daily, just before going to bed. At bedtime, floss teeth by sliding the floss up and down each side of each tooth. Brush teeth thoroughly with a soft toothbrush and regular toothpaste. Note: It is very important to remove all food and plaque from between teeth before using fluoride. Food and plaque can prevent the fluoride from reaching the surface of the tooth.

Place a thin ribbon of the fluoride gel into each upper and lower fluoride tray so that each tooth space has some fluoride. The fluoride can be spread into a thin film that coats the inside of the trays, by using a cotton-tipped applicator or toothbrush.

Seat the trays on the upper and lower teeth and let them remain in place for 10 minutes. Only a small amount of fluoride should come out of the base of the trays when they are placed, otherwise, there may be too much fluoride in the trays.

After 10 minutes, remove the trays and thoroughly expectorate (spit out) the residual fluoride. Very Important – do not rinse your mouth, drink or eat for at least 1 hour after fluoride use.

For head and neck radiation patients, begin using fluoride in the custom trays no longer than one week after radiotherapy is completed. Repeat daily for the rest of your life!! Remember that tooth decay can occur in a matter of weeks if the fluoride is not used properly.

Care for Fluoride Carriers (Trays)

1. Rinse and dry the trays thoroughly after each use. Clean them by brushing them with a toothbrush and toothpaste.
2. Occasionally, the trays can be disinfected in a solution of sodium hypochlorite (Clorox) and water. Use one teaspoon of Clorox in about one-half cup of water. Soak them for about 15 minutes.
3. If the trays become covered with hard water deposits, soak them in white vinegar overnight and brush them the next morning.
4. Do not boil the trays or leave them in a hot car as they may warp or melt.

WARNINGS:

Keep fluoride gel out of reach of children. Do NOT smoke, drink or eat while using fluoride trays. Do NOT use if pregnant or nursing.
After deep cleaning – Scaling and root planing.

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 discomfort from the procedure. If you have persistent discomfort or swelling, please contact our office.

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 2-3 times daily with sensitivity toothpaste or using fluoride rinses may help alleviate this over time. Remember to spit and NOT rinse with water when using these. If sensitivity continues or is severe, professional application of a desensitizing agent may be required.

For a few days, a soft diet is recommended. Keep up with highly nutritious foods and make sure you are getting plenty of Vitamin C. It is best to avoid nuts, seeds, popcorn and chips (things that can get stuck between your teeth and gums that are trying to heal) for the first two weeks.

Brushing, flossing and rinsing with recommended products are critical. Use Listerine, or if prescribed, Peridex (Chlorhexidine).
You may also find during the initial healing phase slight bleeding of your gums. It can be helpful to rinse with warm salt water 2-3 times per day to help with healing. As healing continues, you can expect to notice less redness, less bleeding, and less swelling of your gum tissues. Your teeth may feel smoother and your mouth will taste and feel better. Your gum health must be maintained with proper homecare, as instructed, and regular professional care.

Avoid smoking as this will delay and compromise healing.

Because of your periodontal condition, we strongly recommend that you return for your periodontal maintenance appointments at 3-month intervals. It only takes 90 days for the bacteria to reach critical numbers again and we want to keep your mouth in a healthy, stable condition.

After dental implants

The placement of dental implants usually does not create a great deal of pain. General postoperative instructions apply with the exception of rinsing.

DO NOT rinse with warm salt water for the first few days. Dr. Michael has given you a prescription rinse containing chlorhexidine, an antibacterial medicine to assist in the healing and keep the site healthy.

Make sure that you get rid of any toothpaste residue prior to rinsing and DO NOT eat or drink for 30 minutes after. This will maximize the potency of the medication.

Generally speaking following implant surgery the sutures placed will be resorbable and not need removing. It is normal for them to become loose within the first few days.

As the numbness subsides, some degree of discomfort and pain may arise. At the first sign of this take the prescribed medications. As an alternative, you may take 2-4, 200mg ibuprofen (Advil) tablets. If you cannot take ibuprofen, Tylenol is fine. If pain persists, return to the prescribed pain medication. It is best to take it with food in your stomach to minimize nausea. Please do not drink alcoholic beverages while taking prescription medication. Most pains diminished after day 3 following surgery.

Swelling related to the surgical procedure may occur following certain types of procedures. An ice pack should be placed on the side of your face for 20 minutes then taken off for 10 minutes and repeated. Remember, ibuprofen is also an anti-inflammatory that can decrease swelling.

Do not disturb the area of surgery! Allowing the tissues to rest undisturbed assists the healing process. Avoid vigorous chewing, excessive spitting, or aggressive rinsing. If you use a Water Pik or Air Flosser, avoid doing so during the healing phase as it can delay healing or introduce infection.

Expect minor bleeding or oozing. If bleeding persists, continue pressure with a fresh gauze sponge for an additional 30 minutes to 1 hour. Bite on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site by promoting clotting. Please call our office if bleeding cannot be controlled by the above methods.

Limit physical activity during the first 24-48 hours after surgery. Over-exertion may lead to postoperative bleeding and discomfort. When you lie down, keep your head elevated on a pillow. You may wish to place a towel on your pillowcase to avoid staining from any blood-tainted saliva.

Get plenty of fluids. Clear beverages, water, tea, broth, soups or juices are all suitable. Avoid anything too hot while you are still numb or bleeding. Avoid using a straw for the first few days. Soft, cool foods are the most easily tolerated. A nutritious diet is most important to your comfort and healing. Supplements such as Ensure, Carnation Instant Breakfast, and/or yogurt provide excellent added nutrition.

Do NOT eat any popcorn, poppy seeds, sesame seed or seeded fruits as these can get lodged in the surgical site and cause an infection.

Take any medications we have prescribed on schedule. Yogurt with active cultures or acidophilus should be taken while on antibiotics to prevent diarrhea. It is important to take any antibiotics to completion. If you are taking antibiotics with birth control, you should be aware that birth control may become ineffective. Therefore take appropriate precautions.

Take any regularly scheduled medication (for diabetes, high blood pressure, etc..) on your regular schedule unless advised to do otherwise.

Avoid smoking completely! It will delay healing and interfere with regeneration.

On day 3 following surgery, you may swish with ½ teaspoon of salt in 8-12 oz warm water. Repeat 3 times per day until any soreness subsides.

If you experience swelling, soreness or stiffness in the jaw muscles, applying a warm moist towel to the area can provide relief.
Bruising on the skin is not uncommon to see for the first few days following surgery.

If you need to contact Dr. Michael after hours, his cell number is (208) 818-8228. Please leave him a message detailing what you are experiencing and he will call you back ASAP.

Your endodontic, or root canal, therapy will usually maintain your tooth and relieve the pain you may have been experiencing. Please avoid biting on the tooth for the next few days. It is not unusual for the tooth to be tender after a root canal, and healing occurs more quickly if you do not chew on it immediately. Also, avoid biting your lip, cheek, and tongue while anesthetized (numb) since this may cause damage to them.

If your tooth was in pain prior to starting the treatment, it will take up to a week or more for the tooth to get back to normal. Give the therapy a chance to work.

If your tooth was not in pain prior to beginning treatment your tooth may be quite sore for a few days after the appointment. This will be alleviated with time; it may take as much as a week or more.

Should you have pain that you cannot tolerate, abnormal swelling, biting high on the tooth worked on, or fever, please call our office.
Will I need pain medication?

OTC pain medications should be started and maintained the first 3 days following your procedure if experiencing any discomfort. Please refer to our Pain Management Sheet.

Do I need antibiotics?
In most cases, antibiotics are not required after endodontic therapy. You will be given a prescription for antibiotics if we feel it will be necessary.

FLARE-UPS

Although about 95% of root canals cause very little to no discomfort after the treatment is completed, there are about 5% of cases that can cause significant pain. These are commonly referred to as “flare-ups.” They mostly occur on badly infected teeth, teeth that are extremely irritated, or teeth that have a history of prior treatment. Sometimes, however, they occur randomly, even on patients that have had several root canals done previously without any problems.

If you have a flare-up you may experience moderate to severe pain, swelling (can get as large as a golf ball), bruising, throbbing, and general discomfort, which usually begins a few hours after treatment and may last 2 to 3 days.

Please contact our office if you experience any of these symptoms and we will do everything we possibly can to get you some relief.

After bone grafting procedure

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.

Take two Tylenol, Advil, or a similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off.

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.

Eat soft foods for the first 2 – 4 days. Maintain a good, balanced diet. Drink plenty of water. Do not drink through a straw. Avoid alcohol for 48 hours.

Brush all of your teeth after each meal. Avoid the operated area for the first day. Take care to avoid pulling the sutures.

Do not rinse vigorously; do not use a Waterpik®.

A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water) held in your mouth for 2 to 3 minutes every hour may make your mouth more comfortable. Avoid any other mouthwashes during the healing phase.

Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. The socket is overpacked to allow for the loss of a small number of particles. It is normal to have some of them come out of the graft site and into your mouth. There are some things that can be done to minimize the number of particles that become dislodged.

Do not avoid cleaning the area.

Do not apply pressure with your tongue or fingers to the grafted area because the material is movable during the initial healing.

Avoid chewing hard foods on the graft sites. Chewing forces during the healing phase can decrease the body’s ability to heal around the graft.

Do not lift or pull the lip to look at the sutures; this can actually cause damage to the wound site and tear the sutures. Avoid poking the site with your tongue.

It is highly recommended to discontinue smoking for a minimum of one week after your procedure.

If a CollaPlug was placed during your procedure it will come out several days later as the sutures begin to heal and dissolve. This is normal and to be expected.

Please call us 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