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Total Care
Please click on one of the following items:
Amalgam (silver) filling
Composite (white) filling
Extractions
Complicated Extractions
Crown build-up
Crown
Fixed Bridges
Root Canal
Tooth Whitening
Important Information:
Amalgam (Silver) Fillings
General Information
A dental filling is any material that restores the normal shape and function of a tooth which has a portion missing due to decay or fracture. The most common filling material used in dentistry is silver amalgam. It has been used for more than 100 years and has the longest history of safety and success of all dental filling materials. Amalgam is commonly used in the back teeth for simple and complex fillings. It is made from metals which are mixed in a puttylike consistency and forced into a specially shaped hole drilled into the tooth. A properly placed amalgam filling will last for years provided it is maintained with good oral hygiene and regular professional cleanings.
Limitations
Amalgam is best used in small cavities. When more than one-half of the tooth is missing or when one of the cusps (points) of the tooth is missing, a crown (cap) should be considered instead of amalgam. Crowns are stronger and will withstand greater chewing forces than will amalgam.
Notify Your Dentist If You Notice Any Of The Following:
- Floss tears or catches in the area where the new filling was placed.
- The tooth with the new filling seems to touch first before your other teeth come together.
- The tooth becomes sore after you chew your food.
- The tooth aches and over the counter pain medications like Tylenol or Advil will not relieve the ache.
Instructions For After Your Appointment And For The Long Term:
- If you received a local anesthetic, do not attempt to chew or drink anything until the numbness wears off. While numb, it is very easy to bite or burn your tongue, cheek or lip without knowing you are doing it.
- If you received a local anesthetic, you may have some soreness in the area of the injection. This soreness will subside over a few days. Warm saltwater rinses will sooth the area.
- No biting pressure should be used on the side of the mouth where the filling was placed. After 24 hours, you can resume normal biting pressure.
- Extra care should be taken to brush and clean the filling because decay is more likely to occur at the junction of the tooth and the filling.
- Amalgam transfers heat and cold to the nerve much faster than the natural tooth material so you may notice the tooth with the new filling is sensitive to heat and/or cold. This temperature sensitivity should decrease over the next few weeks. Avoid extremely hot or cold foods and liquids during this period.
- Occasionally teeth that have been filled will ache for the first few days after the new filling is placed. Over the counter pain medications will normally relieve any discomfort you experience while the tooth is returning to normal. Unless you have restrictions on their use, those medications that have anti-inflammatory properties (Advil and aspirin are the most common) usually give the best results. However, if the nerve was unhealthy or significantly damaged prior to this treatment, the ache may not subside and may even get worse as time passes. This means that the nerve is dying and the tooth will require further treatment. Contact your dentist if the ache or sensitivity does not improve or gets worse.
- Amalgam fillings are not unbreakable. Avoid chewing ice, hard candy, etc. Also avoid habits like chewing fingernails, pens, etc. If an amalgam filling breaks more than once, a crown should be considered as a stronger replacement.
Important Information:
Composite (White) Fillings
General Information
A dental filling is any material that restores the normal shape and function of a tooth which has a portion missing due to decay or fracture. Most front teeth and some back teeth are filled with tooth-colored material known as composite. It is made o f plastic, quartz, and other fillers that give it strength and shine. A properly placed composite filling will last for years provided it is maintained with good oral hygiene and regular professional cleanings.
Limitations
Composite is best used in small cavities. When it is used to fill back teeth in place of the more common silver amalgam fillings, it is less durable. When more than one-half of the tooth is missing, when some or all of the biting edge of a front tooth is missing, or when one of the cusps (points) of a back tooth is missing, a crown (cap) should be considered instead of composite. Crowns are stronger and will withstand greater chewing forces than will composite. Experience has also shown that a small percentage of people will experience some hypersensitivity to this material---especially when it is used to fill back teeth. In these rare instances, removal of the composite filling and replacement with a different material may be necessary and additional costs may result.
Notify Your Dentist If You Notice Any Of The Following:
- Floss tears or catches in the area where the new filling was placed.
- The tooth with the new filling seems to touch first before your other teeth come together.
- The tooth becomes sore after you chew your food.
- The tooth aches and over the counter pain medications like Tylenol or Advil will not relieve the ache.
Instructions For After Your Appointment And For The Long Term:
- If you received a local anesthetic, do not attempt to chew or drink anything until the numbness wears off. While numb, it is very easy to bite or burn your tongue, cheek or lip without knowing you are doing it.
- If you received a local anesthetic, you may have some soreness in the area of the injection. This soreness will subside over a few days. Warm salt water rinses will sooth the area.
- Extra care should be taken to brush and clean the filling because decay is more likely to occur at the junction of the tooth and the filling.
- You may notice the tooth with the new filling is sensitive to heat and/or cold. This temperature sensitivity should decrease over the next few weeks. Avoid extremely hot or cold foods and liquids during this period.
- Occasionally teeth that have been filled will ache for the first few days after the new filling is placed. Over the counter pain medications will normally relieve any discomfort you experience while the tooth is returning to normal. Unless you have restrictions on their use, those medications that have anti-inflammatory properties (Advil and aspirin are the most common) usually give the best results. However, if the nerve was unhealthy or significantly damaged prior to this treatment, the ache may not subside and may even get worse as time passes. This means that the nerve is dying and the tooth will require further treatment. Contact your dentist if the ache or sensitivity does not improve or gets worse.
- Composite fillings are not unbreakable. Avoid chewing ice, hard candy, etc. Also avoid habits like chewing on fingernails, pens, etc. If a composite filling breaks more than once, a crown should be considered as a stronger replacement.
- Composite fillings are more susceptible to stains. Avoid coffee, tea, and other staining foods if you want to keep them looking good. Smoking will also discolor them.
Post Treatment Instructions
for Extractions
The following are general instructions for care following tooth extraction. Please rely on the specific instructions given by your doctor.
- Bleeding: Some bleeding is expected following an extraction. Place gauze over the socket and apply firm pressure by closing the teeth together. This pressure can also be applied by applying pressure on the gauze with your fingers. Allow the gauze to remain in place undisturbed for 20 minutes. Remove the gauze pack. If there is a small amount of blood on the gauze there is no need to replace it. Reinsert the gauze only if it is saturated in bright red blood. Repeat if necessary. Avoid using a straw, forcibly spitting, and anything else that creates suction or pressure in your mouth. If bleeding continues, bite on a moistened tea bag for 30 minutes. If bleeding remains excessive, call the office.
- Activity: Remain quiet and keep your head elevated until retiring. Avoid any strenuous physical activity for at least 24 hours.
- Pain: Some pain is normal following a tooth extraction. Take prescription or over the counter pain medications as prescribed by your doctor. Do not take any over the counter pain medications that contain aspirin as the aspirin will cause bleeding to continue. If you were prescribed narcotic prescription pain medication, do not drive a car or operate dangerous machinery while taking these medications. Do not take these medications on an empty stomach unless the directions specifically state to do so. Call the office if pain seems excessive and is not reasonably controlled by the medications.
- Swelling and bruising: For a single extraction, apply an ice bag or chopped ice wrapped in a towel to the area for 10 minutes and then off 10 minutes for 4 hours. For multiple or wisdom tooth extractions, continue for 24 hours. Do not be alarmed by bruising or discoloration of the face after extractions. It is normal.
- Diet: A liquid or soft diet is advisable for at least the first 24 hours following extractions. Avoid hard, crunchy foods such as peanuts, potato chips, etc. for several days and until you can chew them comfortably. Also avoid foods that have kernels and seeds like popcorn and sunflower seeds. These seeds or particles may become lodged in the extraction site. Avoid using a straw for one week. It is very important that you do eat or drink something nutritional every 3 to 4 hours following the extraction. Your body needs the nutrition to help it heal and maintain blood sugar levels, and taking medications on an empty stomach may lead to nausea and increased side effects.
- Mouth Rinse: Do not rinse your mouth for the first 24 hours following extractions. After 24 hours, a warm saltwater rinse made by dissolving a teaspoon of table salt in a tall glass of warm water can be used to sooth the extraction area and aid healing. Do not use commercial mouthwashes (Listerine, Scope, etc.). They contain alcohol and interfere with healing. When using rinses, do not spit forcibly to remove them from your mouth. Lean over the sink and let them flow out.
- Oral Hygiene: It is important to keep your mouth clean in order to aid healing. Brush and floss as in usual areas of your mouth where there was no treatment. In the area where the tooth was removed, gently brush and floss the teeth in the area near the socket.
- Smoking, alcohol, and recreational drugs: Do not smoke, drink alcohol, or take any recreational drugs for at least one week following an extraction. This can cause serious complications.
- Dry lips: Apply Vaseline or any bland lip ointment 3 times daily.
- Medications: Take all medications as they are prescribed and do not take them on an empty stomach. Taking them on an empty stomach can increase side effects and cause nausea.
- Sutures: Unless specifically told otherwise by your doctor, your sutures will dissolve on their own, and you do not need to return to have them removed. Please do not disturb them. They are placed to control bleeding and to aid in healing.
- Healing: Do not disturb the area of the socket by touching it with fingers, toothpicks, or your tongue. The blood clot which forms over the area is nature's method of healing and should not be disturbed. Disturbing the clot can delay healing and dislodge the clot. This results in a complication called a "dry socket" which means the loss of the blood clot from the socket. Dry sockets normally occur within the first week after the extraction and are characterized by a sudden increase in pain and throbbing. Dry sockets do not normally improve without your doctor's care. If you notice a sudden increase in pain and throbbing, contact the office for an appointment to see your doctor.
- Bony Edges: Small sharp bone fragments may work through the gums during the healing process. These are not roots. Most will come out on their own, but if they annoy you, return to the office for their removal.
- IV Sedation/General Anesthesia: If IV sedation/general anesthesia was administered, do not drive or operate machinery for 24 hours as these medications remain in your system. It is advisable that someone remains with you throughout the day.
- Dentures: If dentures were placed at the time of the surgery, keep the dentures in place until seen by your general dentist.
Multiple and/or Complicated Extractions and
Extractions with General Anesthesia: Post Treatment Instructions
PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY. The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please feel free to call our office any time should you have any questions, or are experiencing any unusual symptoms following your treatment.
* DAY OF SURGERY*
IMMEDIATELY AFTER SURGERY. Patients who received a general anesthetic should return home from the office immediately upon discharge, and lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects vary by individual, and you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours or longer if you feel any residual effect from the anesthetic.
- Do not drive or use appliances or equipment that could be dangerous, such as power tools, stove, burners,
lawnmower, and garbage disposals.
- Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.
- Do not make any important decisions. You may change your mind tomorrow.
- Do not drink any alcoholic beverages. The drugs in your body may cause your reaction to alcohol to be dangerous.
- Diet: If you feel nauseated or sick to your stomach, drink clear liquids like 7-UP, broth, apple juice, ginger ale, tea or cola, or eat jello. If these liquids do not make you sick to your stomach, try eating soft foods like potatoes, rice ,pasta, and cereal.
- Discuss any questions you may have with your surgeon.
ORAL HYGIENE AND CARE. Do not disturb the surgical area today. DO NOT drink with a straw and DO NOT rinse or brush your teeth vigorously or probe the area with the tongue, any objects or your fingers. You may brush your teeth gently, carefully avoiding the surgical site. DO NOT SMOKE for at least 48 hours, since it is detrimental to the healing process.
The day following surgery start rinsing your mouth with a warm salt water rinse (1/2 tsp. salt with 1 cup water) every 2-3 hours. Continue this for several days, then rinse at least 4-5 times a day for the next 2 weeks. You may start normal toothbrushing the day after the surgery or after bleeding is controlled. It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.
BLEEDING. Some bleeding is normal, bite down gently but firmly on the gauze pack that we initially placed over the surgical area, making sure that they remain directly over the surgical area. This is important to allow blood clot formation on the surgical site. The gauze may be repositioned for comfort and may be changed as necessary (every 30 minutes to 1 hour). Bleeding should gradually decrease and blood tinged saliva may be present for 24 hours.
STEADY BLEEDING. Bleeding should not be severe. If bleeding persists, this may due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site. Try repositioning the gauze. If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in hot water, squeezed dry and wrapped in a moist gauze) on the area for 20-30 minutes. If bleeding continues, please call our office.
SWELLING OR BRUISING. Swelling is to be expected, and usually reaches its maximum in 48 hours. To minimize swelling, cold packs or ice bag wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied 20 minutes on then removed for 20 minutes during the first 12-24 hours after surgery. If you were prescribed medicine for the control of swelling, be sure to take it as directed. After 24 hours, it is usually best to switch from using the cold pack to applying moist heat or heating pad to the same area, until swelling has receded. Bruising may also occur, but should disappear soon. Tightness of the jaw muscles may cause difficulty in opening the mouth. This should disappear within 7 days. Keep lips moist with cream or vaseline to prevent cracking or chapping.
DIET. It is advisable to restrict the first day's food intake to bland liquid or pureed food. (Yogurt, pudding, etc.) Over the next several days, you may progress to soft foods. Avoid small hard foods like nuts, sunflower seeds or popcorn, which may get lodged in the socket areas. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow you physician's instructions regarding your insulin schedule.
PAIN AND MEDICATIONS. Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication prescribed as directed. The local anesthetic administered with the general anesthetic during your surgery normally has a 3-hour duration, and it may be difficult to control the pain once the anesthetic wears off. We therefore, advise you to take the pain medication immediately after your surgery. If you do not achieve adequate pain relief, you may supplement each pill with an analgesic such as acetaminophen. Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset.
If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
ORTHODONTIC APPLIANCES. If you wear orthodontic appliances, replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.
*INSTRUCTIONS FOR THE FOLLOWING DAYS*
ORAL HYGIENE. Keeping your mouth clean after oral surgery is essential. Keep using warm salt water rinses to rinse your mouth at least 4-5 times a day for the next two weeks. Begin your normal toothbrushing routine as soon as possible after surgery. Soreness and swelling may prevent rigorous brushing of all areas, but make every effort to clean your teeth within your comfort level.
CARE OF SURGICAL AREA. Starting the day following surgery, apply warm compresses to the skin overlying areas of swelling for 20 minutes on and 20 minutes off to help soothe these tender areas. This will also aid in reducing swelling and stiffness.
OTHER POSSIBLE POST-SURGERY EFFECTS
DRY SOCKETS. The blood clot on the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office to report these symptoms.
SKIN DISCOLORATION. This may be expected, and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week for this to completely disappear. Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. The prescribed pain relievers and application of heat on the area will usually correct these symptoms.
NUMBNESS. Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.
It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office.. After office hours, you may call our 24-hour answering service and our doctor will contact you as soon as possible.
Important Information:
Crown Build-ups (restorations under crowns)
General Information
A crown is necessary to restore a tooth when there is not enough remaining tooth structure to surround a filling. Part of the process of doing a crown often involves the removal of any decay and/or existing filling material and the placement of a material that will serve as the foundation for the crown. This material is known as a crown build-up or a restoration under crown. There are several different materials that can be used for this purpose, but many of the most common materials are resins that bond with the natural tooth structure that remains.
Sometimes this crown build-up is done at the same time as the tooth is shaped for the crown. At other times, preparation of the tooth for the crown is postponed, and only the crown build-up is placed. It is allowed to serve as a short-term restoration. Among the reasons your doctor may decide to place the crown build-up and wait are:
- The tooth has deep decay or a deep filling that is near the pulp (nerve) of the tooth. Prior to preparing the tooth for a crown, your doctor wants to stabilize and seal the tooth and allow some time to determine if the pulp will remain healthy or return to a healthy state. If you are experiencing mild sensitivity or discomfort with the tooth this is a common approach. Once the crown build-up is placed and any sensitivity or discomfort subsides, your doctor can proceed with the crown preparation with a better assurance that the pulp is healthy. If your symptoms persist or worsen after placement of the crown build-up, this usually means root canal treatment will be necessary prior to placing a crown. In either case, placement of the crown build-up seals and stabilizes the tooth for the short term.
- You have several teeth with large areas of decay that will need fillings and/or crowns, and your doctor wants to stabilize as many of them as quickly as possible to prevent further deterioration.
- You have a tooth that has had a root canal and needs a crown. The crown build-up serves as a temporary filling and the foundation for the crown.
- You have active periodontal (gum) disease or other dental conditions that require treatment prior to the placement of any crowns.
- You need a large amount of treatment and express financial or insurance limitations that require you to spread your treatment over a longer period of time. Your doctor may place crown build-ups in some or all of the teeth needing crowns and then complete the crowns as finances or insurance permit. However, crown build-ups are not meant to be long term restorations and will deteriorate within a few months if not covered by a crown. Doing this will only allow you to delay the placement of a needed crown for a few months.
Limitations
As mentioned above crown build-ups are not meant to be final restorations. They deteriorate quickly if not covered by a crown. Follow your dentist's advice regarding the best time to proceed with the crown. Avoid chewing hard foods on teeth with crown build-ups until the crown is placed over them.
Notify Your Dentist If You Notice Any Of The Following:
- The tooth with the new crown build-up seems to touch first before your other teeth come together.
- The tooth becomes sore after you chew your food.
- The tooth aches and over the counter pain medications like Tylenol or Advil will not relieve the ache.
Instructions For After Your Appointment And For The Long Term:
- If you received a local anesthetic, do not attempt to chew or drink anything until the numbness wears off. While numb, it is very easy to bite or burn your tongue, cheek or lip without knowing you are doing it.
- If you received a local anesthetic, you may have some soreness in the area of the injection. This soreness will subside over a few days. Warm salt water rinses will sooth the area.
- Extra care should be taken to brush and clean the build-up because decay is more likely to occur at the junction of the tooth and the build-up.
- You may notice the tooth with the new build-up is sensitive to heat and/or cold. This temperature sensitivity should decrease over the next few weeks. Avoid extremely hot or cold foods and liquids during this period.
- Occasionally teeth that have new build-ups will ache for the first few days after the build-up is placed. Over the counter pain medications will normally relieve any discomfort you experience while the tooth is returning to normal. Unless you have restrictions on their use, those medications that have anti-inflammatory properties (Advil and aspirin are the most common) usually give the best results.
- In some cases, if the nerve was unhealthy or significantly damaged prior to this treatment, the ache may not subside and may even get worse as time passes. This means that the nerve is dying and the tooth will require further treatment. You may experience spontaneous aching (aches without chewing or having anything in you mouth), lingering sensitive to cold and/or heat, and sensitivity to pressure when biting on the tooth. Contact your dentist if you experience any of these symptoms.
- Exposed crown build-ups are fragile. Avoid chewing ice, hard candy, and other hard food on the tooth with the build-up.
Post-Treatment Instructions for Crowns
Your tooth was prepared for a crown today, and a temporary crown was placed to temporarily protect the tooth while the laboratory makes the permanent crown. Please be aware of the following:
- Your temporary crown is made of a resin material and is not as strong as your permanent crown. Avoid hard foods that can fracture the temporary crown.
- Your temporary crown is cemented temporarily with temporary cement so that it can be removed in order to place your permanent crown. Stiff and sticky foods can stick to the temporary crown and pull it off the tooth. Avoid sticky foods like taffy, caramels, chewing gum, etc.
- Teeth are prepared for crowns in the areas near and under the gumline. This can be somewhat irritating to the gums. If your gums are sore, use warm, saltwater rinses every other hours to soothe them.
- Floss and brush the temporary crown as instructed. If instructed to floss, do not pull it back through the contact---pull it out to the side. Brush the temporary crown thoroughly but gently.
- If your tooth aches, use over-the-counter pain medications. Ibuprofen (Advil, Motrin, Nuprin, etc.) generally works well since it has both pain relieving and anti-inflammatory properties. Normally this discomfort will last only a day or two.
- If you experience any of the following, notify your dentist:
- Spontaneous sharp or throbbing pain not relieved by over-the-counter pain medications.
- Sensitivity to biting pressure.
- Sensitivity to heat and/or cold that causes pain for more than 5 seconds. after the source of the heat or cold is removed from the tooth
- Swelling or tenderness of the gums in the area of the root of the tooth.
- If your temporary crown comes off, it is extremely important that it be recemented within 24 hours even if there is no discomfort. The temporary crown not only protects the tooth, it also maintains the position of the crowned tooth, the adjacent teeth, and the opposing tooth. If the temporary crown is off and these teeth drift, the permanent crown is unlikely to fit. This will mean re-doing the crown procedure causing additional appointment time and additional cost.
- It is your responsibility to return to the office within 5 weeks to have the permanent crown seated. If you wait longer than 5 weeks, you may need your treatment redone resulting in additional appointment time and additional cost.
Post-Treatment Instructions for Fixed Bridges
Your teeth were prepared for a bridge today, and a temporary bridge was placed to temporarily protect the tooth while the laboratory makes the permanent bridge. Please be aware of the following:
- Your temporary crown is made of a resin material and is not as strong as your permanent crown. Avoid hard foods that can fracture the temporary crown.
- Your temporary crown is cemented temporarily with temporary cement so that it can be removed in order to place your permanent crown. Stiff and sticky foods can stick to the temporary crown and pull it off the tooth. Avoid sticky foods like taffy, caramels, chewing gum, etc.
- Teeth are prepared for crowns in the areas near and under the gumline. This can be somewhat irritating to the gums. If your gums are sore, use warm, saltwater rinses every other hours to soothe them.
- Floss and brush the temporary crown as instructed. If instructed to floss, do not pull it back through the contact---pull it out to the side. Brush the temporary crown thoroughly but gently.
- If your tooth aches, use over-the-counter pain medications. Ibuprofen (Advil, Motrin, Nuprin, etc.) generally works well since it has both pain relieving and anti-inflammatory properties. Normally this discomfort will last only a day or two.
- If you experience any of the following, notify your dentist:
- Spontaneous sharp or throbbing pain not relieved by over-the-counter pain medications.
- Sensitivity to biting pressure.
- Sensitivity to heat and/or cold that causes pain for more than 5 seconds. after the source of the heat or cold is removed from the tooth
- Swelling or tenderness of the gums in the area of the root of the tooth.
- If your temporary bridge comes off, it is extremely important that it be recemented within 24 hours even if there is no discomfort. The temporary crown not only protects the tooth, it also maintains the position of the crowned tooth, the adjacent teeth, and the opposing tooth. If the temporary crown is off and these teeth drift, the permanent crown is unlikely to fit. This will mean re-doing the crown procedure causing additional appointment time and additional cost.
- It is your responsibility to return to the office within 5 weeks to have the permanent crown seated. If you wait longer than 5 weeks, you may need your treatment redone resulting in additional appointment time and additional cost.
Post Treatment Instructions for Endodontic (root canal) Treatment
What to Expect:
- It is not uncommon for the tooth to still be uncomfortable in the first few days following treatment. The area around the tip of the root(s) of the tooth needs time to heal. Your dentist may have given you prescriptions for pain medication and/or antibiotics. Taking theses prescriptions as prescribed will make you more comfortable while healing occurs.
- Your tooth may be sensitive to biting pressure and may feel loose for several days. This is not abnormal and should last only a few days.
- You may feel a depression or rough area (on the top of a back tooth or the back of a front tooth) where the access to the pulp was made. This is a soft, temporary filling material that was placed to temporarily close the opening. The material may wear as you chew on it, but it extends far into the tooth and should not be a concern.
- Occasionally a small "bubble" or "pimple" will appear on the gum a few days after treatment. This represents the release of pressure and bacteria from the infected area around the tip of the root of the tooth. It should disappear within a few days as healing progresses.
- It is normal for it to take a few days for your symptoms to subside. The important factor is that the tooth should gradually feel better by 3 to 4 days following treatment. In general, the longer the pain was present prior to treatment, the longer it will take to subside.
What You Should Do or Not Do
- If you were given prescriptions for antibiotics (Penicillin, Keflex, Erythromycin, Clindamycin, etc.) and/or pain medications (Vicodin, Tylenol #3, Darvocet, Ultracet, Lortab, Motrin, etc.) please fill them immediately and begin taking them as prescribed. You should begin the pain medication as soon as possible and not later than one hour after your appointment in order to allow it to take effect before your anesthetic subsides.
- Take the full course of the antibiotics (usually 7 or 10 days) even if the tooth begins to feel better before you finish them. In general, it is best not to take both the antibiotic and the pain medication at the same time because this can cause gastrointestinal problems. For the same reason, it is best if you do not take the medications on an empty stomach unless the instructions specifically state to take on an empty stomach. The pharmacist will give you a sheet for each medication that lists precautions and side effects. Please read these sheets. Be particularly careful when taking pain medications, because they can make you drowsy. You should not operate an automobile or other machinery when taking these medications. If your discomfort is minimal, and you do not feel that you need the prescription strength pain medication, over-the-counter pain medications like ibuprofen (Advil, Motrin, Nuprin, etc.) or acetaminophen (Tylenol) may be adequate.
- Eat soft nutritious foods or liquids at regular meal times. You need nutrition to promote healing, maintain blood sugar levels, and make you feel better. Failure to maintain proper nutrition also leads to increased side effects from medications.
- In order decrease discomfort, try to chew on the opposite side from the tooth that was treated and avoid unnecessary chewing (chewing gum, etc.).
- Avoid hard foods that may fracture the tooth or temporary filling.
- Avoid sticky foods (caramels, taffy, etc.) which could dislodge your temporary filling.
- Brush and floss your teeth as normal.
Please contact your doctor if:
- You have significant side effects from your medications that you cannot tolerate (itching, gastrointestinal problems, etc.).
- Your encounter significant post-treatment swelling.
- More than three days after treatment, you are experiencing no improvement in your symptoms.
- Your tooth fractures.
- The temporary filling material is dislodged or feels "high" when biting.
- You body temperature goes above 101 degrees.
- You have any questions.
Very Important
Teeth that have had root canal treatment normally need to have a crown (cap) placed on them as soon as possible after the treatment is completed---unless advised otherwise by your dentist. This prevents the fracture of the already brittle and damaged tooth. The most common cause of the loss of a root canal treated tooth is failure to have a crown placed. Failure to do so makes the tooth much more prone to fracture and/or become re-infected due to deterioration of the root canal seal. The root canal is only the first step. Treatment is not complete until the crown is placed.
TOOTH WHITENING: Information You Should Know
Only natural tooth enamel will whiten. If you have existing white fillings, crowns, bridges, etc., they will not whiten. After you finish the whitening process, these will need to be replaced to match the new shade of your teeth. If you are planning to have any of these done, the whitening program should be completed first.
Some people will experience tooth sensitivity during the whitening process. This can manifest itself as sensitivity to cold, heat, or pressure. Some people also experience an aching feeling. If your symptoms are minor, do not be alarmed. These symptoms usually disappear within a few days following completion of the whitening process. Your dentist can also provide you with a prescription for a fluoride gel that can be used along with the whitening program to minimize these symptoms. Over-the-counter pain relievers will help with the aching feeling. If your tooth sensitivity is significant, discontinue the program and notify your dentist. He will advise you regarding what should be done.
Another side effect that people sometimes notice is gum sensitivity and/or some whitening of the gums in areas where they touch the crowns of the teeth. This also usually subsides within a few days after completion of the program. If you have any extreme tenderness or sores on the gums, discontinue the program and contact your dentist.
Natural teeth will darken slightly as time passes. This occurs regardless of whether they have been whitened. If you want to "touch up" your whitened teeth in a few years, we have kits available for this purpose.
The tooth whitening system that we provide our patients is one that has been available several years and has been tested and approved by the laboratories of the American Dental Association. It is a carbamide peroxide compound. This system works well for most people. However, there are several factors that influence the degree of whitening that each individual can achieve. These factors make it impossible to accurately predict the degree of whitening for each person. For this reason, Cincinnati Dental Services can make no guarantees regarding the results. If you elect to use this whitening process, please be aware that you do so at your own risk and that no refunds will be made should the results fail to meet your expectations.
If you have any other concerns about this whitening process, please discuss them with your dentist before making the decision to proceed.
Cincinnati Dental Services
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