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	Dental Care Instructions Amalgam or Resin/Composite (tooth colored fillings) Crowns and Bridges Deciduous Extractions (Baby teeth) Extractions Invisalign Aligners - wear and use Invisalign Aligners - care and maintenance Root Canal Therapy Scaling and Root Planing Sealants Amalgam or Resin/Composite (tooth colored fillings) After an amalgam filling you need to wait 24 hours before eating/chewing on the side the fillings were placed. For composite fillings there is no need to wait 24 hours. Sometimes after an amalgam or composite filling is placed you may experience hot/cold sensitivity or pain when biting/chewing. This may indicate the filling is “high” and may need to be adjusted. Please call the office and the dentist will be able to adjust your bite. Crowns and Bridges: You have just had a crown preparation on one or more teeth. Avoid chewing food until local anesthetics have worn off, as you could accidentally bite your lip, cheek or tongue. You have left the office with one or more temporary crowns. Do only light to moderate chewing on the temporary and avoid gum, ice, nuts, and hard or gooey foods. These could loosen or remove the temporary crown. If the temporary crown should come off, please contact the office as soon as possible. Please do routine brushing (1-2 times a day) around the temporary, brushing gums to avoid plaque and stimulate healing. Avoid flossing around the temporary until the permanent crown is on, unless instructed to do so by the dentist. If flossing is necessary to remove food caught around the temporary, gently pull the floss down, to remove the debris and pull the floss out around the gum line of the tooth. For the first day or two, do warm salt-water rinses (1 cup warm, not hot water, mixed with 1/2 to 1 tsp. salt). This helps to relieve any discomfort following the crown preparation and impressioning procedure and stimulates healing. Do this 2-3 times a day. Over the counter Advil 400-600 mg. 3x daily is recommended to keep the tooth comfortable or 2 tablets of Aleve 2x daily. You may experience hot/cold sensitivity depending on your sensitivity level and depths of crown preparation, old filling, decay, etc. This may soon subside or could continue for several weeks or months. If you begin experiencing pain (greater than 30 minutes) or spontaneous pain (not associated with temperature or chewing) please call the office as soon as possible for necessary medication for relief of discomfort or treatment. Deciduous Extractions (Baby teeth) Postoperative care is important after extractions and recovery may be delayed if this is neglected. Some swelling, stiffness and discomfort are to be expected. If this is excessive, please call or return for care. Avoid chewing food until local anesthetics have worn off, you could accidentally bite your lip, cheek or tongue. Bleeding: 1. Keep gauze pack in place 15-20 minutes with constant firm pressure. 2. Keep head elevated and rest quietly. 3. Do not suck or spit excessively. If bleeding persists, repeat the above. 4. Some oozing and discoloration of saliva is normal. Pain: Take appropriate dose of children’s Tylenol or children’s Advil for discomfort. Diet: Liquids, soft or regular foods (as desired). Do not skip meals. Evening of Extraction: Brush teeth. Use warm rinse (1/2 tsp. salt in glass of warm water) 2-3 times per day. Continue tablets for pain if necessary. Call with any concerns. Extractions BLEEDING AND BLOOD CLOTS: There may be some bleeding when you get home today. Gauze packs may have been placed that are used to apply pressure to the socket or wound. Keep the original packs in place for 1 hour or until they become saturated. To place new packs, fold the gauze into a small square and place the pack directly over the socket. Then bite firmly on the gauze pack. Place more than one pack if needed. Keep the packs in as long as possible (1-2 hours). Frequent packing changes may disturb the established clot, causing its loss. A clot forms within 60 minutes and organizes to form a strong matrix within several hours. All gauze packs should be removed before sensation returns to the surgery site. A slight amount of blood may seep at the extraction site until a clot forms, causing your saliva to be pink for a few days. This is normal. However, if heavy bleeding continues, please call. (Remember though, a lot of saliva and a little blood can look like a lot of bleeding). Bleeding stops quicker if you lie down with your head raised. There are some activities that you should avoid to help protect the blood clot. Avoid smoking, spitting or sucking through a straw for 3-5 days. These activities create suction in the mouth, which could destroy the clot and delay healing. You should take it easy the day of surgery. Try to avoid any excessive bending or heavy lifting. SWELLING After a tooth is removed, you may notice some swelling. If so, for the first 24 hours, apply cold packs on the side of your face where your tooth was removed. Put it on for 10 minutes and then off for 10 minutes. Make sure you don’t keep it on for too long, as you may freeze the side of your face and not know it because the area is already numb. After 48 hours if you still notice any swelling or stiffness in the jaw, apply warm packs near the extraction site. RINSING YOUR MOUTH: Unless otherwise directed, do not rinse your mouth the day of surgery. The day following surgery, rinse gently using warm salt water (half a teaspoon of salt dissolved in an 8oz. glass of warm water). Rinse after eating to keep food particles out of the incision or tooth socket. Do not rinse vigorously or the clot may be disturbed. Avoid using a commercial mouthwash for a week. DIET: After surgery, proper nutrition is very important to assure proper healing. Begin by drinking clear liquids after the bleeding is controlled and the packs have been removed. Once these are well tolerated, begin eating soft foods such as soup, eggs, ice cream, cooked cereal, noodles, yogurt, etc. In 4-5 days begin eating solid foods and try to return to a normal diet. ORAL HYGIENE: It is important to continue to brush and floss as normal, but it is also important to be careful near the extraction site for the next few days. The tongue should be brushed, which will help eliminate the bad breath and unpleasant taste that is common after an extraction. A clean mouth heals faster. SUTURES: If they are used, do NOT fail to return for the suture removal at the appointed date given. PROBLEMS: Call us if you have any one of the following: • Heavy bleeding after 2 hours. • Any bleeding from the socket after 18 hours. • Severe pain not controlled by medications. • A severe or gnawing pain after 48 hours (which might mean you lost the blood clot and now there is an infection in the socket). • A temperature over 101 F. ANESTHETICS: The length of time you experience numbness varies depending upon the type of anesthetic, how much was given, and your blood circulation through the area. While you are numb be careful not to bite your tongue, lip, or cheek. MEDICATIONS: TAKE ALL MEDICATIONS THAT ARE PRESCRIBED! DRY SOCKET: A dry socket can occur if a blood clot is lost prematurely. The symptoms of a dry socket are increasing pain 3-5 days after the surgery, at a time when the pain should be decreasing. Returning to the office easily treats dry sockets. Dry sockets can be avoided by: Following the above diet instructions. A soft diet is very important in preserving the clot. Avoid smoking, using a straw, spitting, and vigorous activity for 3-5 days after the surgery. Invisalign Aligners - wear and use Here are some tips to help ensure proper use and to avoid damaging your aligners. Always Remember to. . . 1. Wash your hands thoroughly with soap and water before handling your aligners. 2. Handle only ONE aligner at a time. Aligner Insertion 1. Make sure you have the proper aligner - the upper for the top teeth and the lower for your bottom teeth. 2. To help avoid confusion each aligner is engraved with your unique case number, a "U" for upper or an "L" for lower, followed by the stage number. 3. You may insert either the upper or the lower aligner first. When inserting each aligner, gently push the aligners over your front teeth, then, apply equal pressure, using your fingertips, to the tops of your left and right molars (back teeth) until the aligner snaps into place. 4. DO NOT BITE your aligners into position. This may damage them. Note: If you experience sharp pain or significant discomfort, discontinue use of the aligners and contact your doctor. Aligner Removal 1. Using your fingers, start on one side at the molars (back teeth), and slowly work your way around to the other side. 2. To help prevent damage, avoid unnecessary removal. 3. DO NOT use any sharp object to remove your aligners. 4. Immediately rinse aligner with water, shake off excess water, and store your aligners in the protective case provided with your starter kit. *Note:* Use care in removing your aligners, particularly if multiple attachments are being used. Do not use excessive force to bend or twist an aligner to get it off. Consult with your doctor if your aligners are difficult to remove. Invisalign Aligners - care and maintenance 1. Clean your aligners prior to each insertion. Use the Invisalign Cleaning System (recommended) or a soft bristle toothbrush using water or a small amount of toothpaste. 2. Rinse each aligner thoroughly with water after each cleaning. 3.. DO NOT use denture cleaners to clean aligner or soak them in mouthwash. These products can damage the surface of the aligner, causing it to become dull and more visible. Proper Oral Hygiene 1. Remove your aligners for eating and drinking, except when drinking water (only). 2. Brush and floss your teeth after each meal or snack prior to re-inserting your aligners. If you have any questions regarding your hygiene techniques, consult your doctor. 3. Regular dental checkups and cleaning are recommended for the continued health of your teeth and gums. Storing your Invisalign Aligners Two aligner cases are included in your starter kit. We recommend that you store your Invisalign aligners in a case when not in your mouth. This will help protect them from loss and damage. Designate your blue aligner case for your "current stage." Store the aligners you are currently using (e.g., stage #1) in this case. When it is time to switch up to the next stage (e.g., stage #2), transfer the previous aligners (e.g., stage #1) to the red case. Always keep the most recently used aligners in this case. If your current aligner is lost or broken, your doctor may recommend that you temporarily go back one stage and use the aligners in the red case while a replacement is being made. *Note:* Keep past aligners in a clean plastic bag or as insturcted by your doctor. Keep out of reach of children and pets. Root Canal Therapy Avoid chewing foods until local anesthetics have worn off; you could accidentally bite your lip, cheek or tongue. You have just had endodontic or root canal therapy performed on one or more of your teeth. Eat a soft diet and avoid chewing on this side for the next 24 hours. It is common to feel sensitivity or achiness in this area for the next several days. Swelling sometimes will follow endodontic therapy. It is important that you finish your antibiotic medication, if this was previously prescribed. Take 400-600 mg. Advil/Aleve at bedtime the day of the root canal regardless of how the tooth feels that evening. After that, continue with anti-inflammatories every 6 hours as needed for discomfort. If discomfort does not diminish, or if you have any questions or concerns please call. We will address your concerns as soon as possible to keep you well informed about your dental health. Scaling and Root Planing* Rinse your mouth two to three times a day with warm salt water. (One teaspoon salt/8oz. of warm water). Your gums may feel achy. Take pain medication, but avoid aspirin products, unless you doctor has prescribed aspirin—don't stop doing anything your doctor has told you to do. Sensitivity to cold may occur. Use toothpaste for sensitive teeth containing fluoride. Avoid tartar control, peroxide (whitening) and baking soda pastes, they can add to tooth sensitivity. Use ACT fluoride rinse or Sensodyne toothpaste if teeth are sensitive to cold. Sensodyne is very harsh so apply gently, possibly even with your fingertip, to the area and don't rinse off. Your next meals should be soft. Avoid popcorn, peanuts, chips of any kind, raw vegetables, crispy crusts or any type of seeds. These can float up under the tissue and interfere with healing. Follow this for the next three days. Swelling or jaw stiffness occur very rarely. However, if this does happen, place cold, moist towels to the face in the affected area to reduce swelling. Please do not smoke following scaling and root planing procedures. Tobacco smoke is an irritant to healing. The nicotine and chemicals also constrict the blood vessels, making the healing time longer and more difficult. Refrain from smoking for 24 hours or longer. Sealants We have recommended sealants for your child. A sealant is a plastic material applied to the chewing surfaces of the back teeth. A sealant acts as a barrier, protecting enamel from cavities. At your child’s sealant appointment, we will be checking for decay that is not detectable by x-rays or instruments. If decay is noted on a tooth that is to be sealed, a sealant cannot be placed on this tooth and your child will need to be scheduled for a filling at a future date. PHONE NUMBERS: Clinic: 320-485-3881 Dr. James Neff: 320-485-2388 home Dr. Jessica Linn: 952-470-5419 home Pager Number: 651-637-6435 (Key in your phone number after the tone)