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1. Your temporary is glued on with temporary cement. It is designed to come off easily when your final restoration is ready for placement, but it may come off before then. Chew carefully in the area of the crown, and avoid sticky foods such as caramel or taffy. If your temporary does come off, give us a call and we can recement it at the office. If you are going out of town during the period you have the temporary, let us know. If you find yourself with the temporary off and you can not get back to this office, you may reglue it yourself with DenTemp or "oil of cloves", available at most pharmacies. Just use a drop of the liquid to soften the glue already in the temporary and replace the temporary back on the tooth, making sure it is properly lined up before biting hard on the plastic. Denture adhesive is an alternative if DenTemp is unavailable.

2. Your gums may feel slightly sore for the remainder of the day after the crown is prepared, but they should not be inflamed or painful. If you have a problem, call the office.

3. It is generally two weeks before your final restoration is finished at the lab, although there are occasional delays. Please call the office before you come in for your delivery appointment if we do not call you to confirm, to make sure your case is back from the lab.

4. Crowns are placed on teeth with huge fillings or fractures. There is always the possibility that a tooth that has no apparent pathology may in fact be dying and may require a root canal in the future. The same things that cause a tooth to need a crown are the same types of things that cause stress to the nerve of a tooth and cause it to die. If a nerve does in fact die, a root canal can be performed through the crown and in most cases, the crown can be satisfactorily repaired with bonded resin.

5. A crown is a long lasting dental restoration, providing you take care of your teeth. A crown's life is generally fifteen - twenty-five years. The chief cause of failure before then is not usually due to the failure of the crown, but instead because decay at the crown-tooth margin takes hold and eats out underneath the crown.

6. You must come in for regular three to six month dental examinations to provide proper after care for your crown. Be sure to floss daily, and use a fluoride rinse or gel to help protect your teeth if they appear very susceptible to decay.

1. Bleeding: Some bleeding is to be expected the first 24 hours. Bite firmly on a gauze pad until bleeding stops, usually about two hours. If persistent bleeding occurs, continue biting on gauze pad or a wet tea bag for one-half hour. If bleeding is severe, call the office.

2. Diet: For remainder of day, eat only soft, cool foods. No hot liquids.

3. No Smoking or Alcohol: For the remainder of today no smoking or alcoholic beverages. These substances can cause excessive bleeding or a secondary bone infection known as dry socket.

4. Rinsing: Do not try to rinse out your mouth or spit forcefully for remainder of day. Beginning tomorrow, rinse mouth after meals with a solution of 1/4 teaspoon salt in 8 ounces (1 cup) water. Continue for two days.

5. Pain: Take medications as prescribed. Ibuprofen, (Advil or Nuprin) may be all you need for pain. You may double the labeled dosage of ibuprofen if necessary. If pain persists fill the prescription given at time of surgery or call for a prescription medication. If an antibiotic was prescribed, take as directed until it is all used up.

6. Bony Edges: Small bone fragments some times work up through the gum during the healing process. This is not part of the tooth and is a normal occurrence. It this causes any problems, call the office.

7. Pain in Ear: If severe pain develops that shoots up in the ear call the office as soon as possible. This can be a symptom of a postoperative infection and may need additional treatment.

If unusual symptoms develop please call the office. If a rash or itching develops while taking an antibiotic stop taking medication and call the office immediately!

1. Avoid eating until all numbness wears off to avoid injury to your tongue or soft tissue.

2. Composite fillings (tooth colored) are hardened at the office with a curing light, so there is no special care needed for them after leaving the office. For amalgam (silver) fillings, you should eat carefully in the filling area the remainder of the day while the material hardens.

3. We try to adjust your occlusion (bite) while you are here at the office, but occasionally because of the numbness you can't feel a slight high spot. If your tooth feels funny when you bite down, call us for a quick adjustment appointment. Do not think that this will get better. If you fail to have this adjusted, you could bruise your periodontal ligament. A small high spot can also cause hot and cold sensitivity.

4. When decay is close to the nerve, there is always a possibility that the tooth could abscess after the filling is placed, even though there are no signs of infection at the time. We will try to tell you in advance if it we think you could require a root canal in the future. However, variations in tooth anatomy (such as tiny extensions of the pulp that are imperceptible) may make it impossible to determine if there are going to be any pulpal problems in the future.

5. If you have sensitivity after the filling is placed, give us a call. Some sensitivity may be expected if the filling was deep, but the problem could also indicate a problem with the seal or margin. With composite fillings, a drop of saliva between the tooth and filling can prevent the filling from sealing. This happens rarely, but we need to check this out if you are experiencing sensitivity.

1. Discomfort: Your gums may become "achy" and a couple of Tylenol or ibuprofen will eliminate much of the discomfort. Cold sensitivity is often a problem after scaling and can be reduced by using a toothpaste for sensitive teeth or by obtaining a fluoride prescription from the dentist.

2. Care of Your Mouth: Rinse your mouth 2-3 times per day with warm salt water. (One teaspoon salt in 8oz water.) Start home care as instructed immediately. In the beginning you may have to be gentle with your cleaning.

3. Eating: Your next meal should be soft. Avoid any hard "chippy" foods for the next 3-4 days.

4. Swelling: Very seldom does swelling or jaw stiffness occur. However if it does, place warm moist towels to the face in the area of stiffness and give us a call if the swelling increases or if you notice a gum boil on the side of your tooth.

5. Smoking: Smoking has a direct effect on the gum tissue. People who smoke have a higher incidence and greater severity of periodontal disease. Reducing or stopping smoking will improve your gingival health, healing ability and your health in general. Tobacco smoke is an irritant to the healing process and will delay healing.

1. Pain After Treatment: in the majority of cases, you will feel much better after the root canal than you did before. In most cases, there may be some sensitivity; you will feel like you have been "worked on". In a small proportion of cases, particularly if the infection was very severe at time of treatment, it may take a while for the infection to resolve, and there may be pain for a few days. We will prescribe pain relievers when you leave in case pain does develop. Call us if pain after treatment is so severe that pain relievers do not work.

2. Swelling: Call the office if you have any facial swelling. That is a sign that the infection has spread beyond your tooth area and you need to be on an antibiotic. If you are on an antibiotic and swelling increases and you have a fever, you may have a serious infection and need to be seen either by the dentist or an emergency room physician. Do not take chances with infections, if in doubt go to an emergency room!

3. Antibiotics: Depending on your specific needs, we may prescribe an antibiotic. If there is no sign of tissue infection at the time of treatment, and we are simply removing a dead nerve, there is usually no need for antibiotics. We will give you an antibiotic prescription if there is an active infection. Be sure and take all of the medicine prescribed.

4. Follow up Treatment: Root canal therapy is usually completed in one visit. In complicated cases where unusual anatomy or pathology is present, the treatment will take more than one visit. You must have the root canal finished and sealed to prevent reinfection of the root canal space. Many times these reinfections are harder to treat and involve more serious infections than the original problem.

5. Tooth Restoration and Crowns: Root canal therapy cleans out and seals the internal space in the root of your tooth. The access opening leading to this space as well as any remaining decay must be repaired quickly to prevent leakage into the interior of the tooth. Usually a bonded composite restoration is used but occasionally other materials and post buildups are required. Often this "filling" is done the day of the root canal but occasionally a return visit is necessary. Since the tooth is weakened by the decay and access opening to the root canal, most teeth require the strength of a cast crown restoration to protect them from the forces of chewing. If crown restoration is delayed, you run an extreme danger of fracturing the tooth and occasionally catastrophically leaving extraction as the only treatment option.

Use bleach for three to six weeks. Effective treatment requires use of bleach for one to two hours each day. Evaluation appointments are scheduled at one week and then every second week for duration of treatment. The first three evaluation appointments are included in the initial fee. Subsequent visits and additional bleach will be billed as appropriate for your individual case.

Directions
1. Fill tray spaces with a thin ribbon of bleaching solution.

2. Place trays on teeth. Wipe out excess material with tissue or rinse mouth with water to remove excess bleach that has oozed out of the trays. Do not swallow bleach.

3. Remove trays at one hour intervals and rinse tray. Repeat steps 1 & 2.

4. After a maximum treatment of two hours remove trays and thoroughly rinse mouth with water to remove all traces of bleach.

A very small percent of bleaching patients may experience tooth sensitivity to hot and/or cold. If this occurs, discontinue bleaching and contact the office for further instructions. While it is unlikely to occur, if any burning or blistering develops while bleaching, immediately discontinue bleaching and rinse your mouth. You may cover the affected area with toothpaste. Call the office as soon as possible for further instructions.

Bleaching is not effective on all teeth. Some teeth will remain resistant to attempts to bleach. Cosmetic resin bonding, porcelain laminate veneers, or crowning the teeth may be the only way to correct some stains. Some teeth will bleach unevenly. There is no way to consistently predict this occurrence. It is fair to state that if your teeth have uneven coloration to begin with they will bleach unevenly. Bleach is not effective on fillings. Old fillings will not bleach along with your teeth and may appear darker after bleaching of your teeth. You may want to replace them to match the new color of your teeth.

During the bleaching process, try to avoid foods that discolor teeth. We recommend using a straw while bleaching for any beverages that may cause discoloration.

Duration of the lighter shade of your teeth is unknown. Personal anatomy, environment, and habits all have an effect on the longevity of the bleached appearance. The bleaching process can be repeated periodically to maintain the lighter shade.

Do not bleach within three weeks of any fillings you are scheduled to receive. The bleach may interfere with the bonding agents used to glue your fillings in place.

Your occlusal guard is designed for nighttime use. It is officially called a MAPA or Maxillary Anterior Passive Appliance. It is designed to keep your back teeth from touching in your sleep. It acts as a shock absorber to lessen the load on you tempromandibular (jaw) joint. It is not designed for extended daytime wear and doing so could cause your teeth to shift. If you need an extended wear appliance one can be designed for you.

1. Keep the guard either in your mouth or the protective case to prevent damage or loss. Many people wrap appliances in a tissue and someone else unknowingly throws the tissue away not realizing that there is an important appliance inside.

2. Brush the appliance with toothpaste to keep it fresh.

3. Use only warm or cool water to wash the appliance. It is made of thermal plastic and will distort with hot water.

4. To remove the appliance use gentle pressure on the top rim of plastic. Use a gentle rocking motion to dislodge the appliance.