If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate form of birth control method. Contact your birth control prescriber for more information on length of time needed for alternate form of birth control.

ACTIVITY:
After leaving the office, relax for the remainder of the day. Avoid strenuous activity for several days. For GRAFT placement, avoid trauma to area, especially vigorous face washing or resting of the telephone on your chin. Do not replace dressing (bandage) if dislodged.

1. SWELLING:
Some swelling is normal, and an ice pack held on the cheek or lip over the surgical site for intermittent periods (10-20 minutes on and 10-20 minutes off) during the first 24 -48 hours may help reduce swelling and will relieve some discomfort. For any residual swelling after the first 48 hours, heat is encouraged (hot water bottle, heating pad, etc.) to increase circulation and promote healing. If swelling becomes progressively more severe after 2-3 days, please let us know.

2. BLEEDING:
There should be minimal bleeding after the surgery is completed. There may be a pink discoloration of your saliva for several hours; frank bleeding (bright red) is not to be expected. Should bleeding occur, place a moistened tea bag (no herbal tea) over the area and hold it against the bleeding site. It may take several minutes before the bleeding stops. If there is no change in the amount of bleeding, call the office immediately.

3. SUTURES:
Dissolvable sutures (stitches) are placed to hold the gingival tissues on the proper position for ideal healing. Your doctor will want you to return so that he can observe sufficient healing of the surgical area. Do not disturb the sutures with your tongue, toothbrush, or any other manner since displacement will impair healing.

4. DIET:
It is necessary to maintain a relatively normal diet throughout the course of healing. For the first few days, soft food, cool or room temperature, may be eaten. Chewing should be done predominantly on the site opposite the surgical site. It may be necessary to stick to liquids for the first day, if chewing is uncomfortable. High protein foods and liquids are desirable for 3-4 days post surgery.

5. ORAL HYGIENE:
It is important to maintain a normal level of oral hygiene in the non-surgical areas by brushing and flossing. The assistant will have instructed you on the care of the surgical areas.

6. MEDICATION:
Take medications as instructed. Generally, medications should not be taken on an empty stomach. IMPORTANT: Never drive or operate equipment while taking narcotics. If antibiotics are prescribed, take them as directed until ALL are gone as long as there are no adverse reactions or discomfort (itching, redness, etc.).

7. SMOKING:
Please do not smoke during post surgical period, as wound healing will be delayed.

If you have any questions. please give the office a call at 469-351-6010.

What to expect while wearing braces

• Your teeth and lips will be sore for about 1-2 weeks (everyone is different)
• If you have BITE GUARDS placed on your teeth (most patients) you will only be able to bite on the bite guards. Your other teeth won’t touch until about 2-4 months into treatment.
• You will get used to eating with the BITE GUARDS! Hang in there!
• Use wax and Ibuprofen (or other pain meds) to help aid with discomfort
• Wax can be used in any area that is bothering you (wires or braces)

If one of the braces (brackets) come off

• We want the braces to stay on your teeth, but if one pops off your tooth it will sometimes come out of your mouth or it sometimes stays on the wire.
• If the dislodged brace (bracket) isn’t hurting you, just try to hang on to it until you come in for your next adjustment.
• You are responsible for keeping the braces on your teeth!

Avoid the following foods

• Anything that is harder than a PRETZEL
• Crusts, nuts, bagels, chicken wings, popcorn kernels, raw vegetables, whole fruit, candy taffy, corn on the cob, ice and ANY OTHER FOOD THAT WILL POP A BRACKET OFF

Brush and floss your teeth

• Brush like crazy! Rotadent has a special attachment that is ideal for you.
• Keep all plaque off your teeth so that it doesn’t harden up and turn into tartar
• Use your fingernails to check if all soft plaque and debris has been removed.
• Teeth move slower when plaque and tartar are in the way!
• Your adjustments will be easier if you teeth are clean! Flossing can be difficult but it is do-able. Thoroughly floss at least twice per week.

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. It can also be used for cosmetic dentistry. If we used a local anesthetic to thoroughly numb the area we treated, the numbness in your lips, teeth and tongue might last for several hours after the procedure. To prevent damage to your tongue and lips, you should avoid any chewing until the numbness has completely worn off.

Things to expect after treatment:

• Once numbness has worn subsided, you are able to eat and drink normally.
• For the first few weeks, it is normal to experience some pressure, or sensitivity to hot and cold after your composite is finished. The injection sit may also be sore. Aleve, Ibuprofen or aspirin will work well to alleviate the tenderness.
• If your gums are swollen or sore, rinsing your mouth with warm salt water can help to alleviate discomfort and swelling. Dissolve a teaspoon of salt in a cup of warm water, then gently swish the water around the tooth and spit.
• Floss and brush your new filling as you normally would, and maintain consistent hygiene routines.

Notify our office if any of the following occurs:

• You feel that your bite is not correctly balanced. It feels as if the filling is too high, or you are hitting the filling first when you bite down.
• You have discomfort or pain that persists from hot or cold temperatures. Both of these symptoms are normal and are caused from not being able to properly feel your bite while being numb.

Warranty Information

The model filling is no more than 50% of the tooth. This leaves half of your tooth to support the filling. Occasionally, we place a filling as a conservative measure, anticipating there is enough natural structure to hold the filling, when in reality it turns out there is not. The tooth then starts to break away because it can no longer support the filling. In this case, we will credit the cost of the filling towards the cost of a new crown. For a period of 2 years from the date of service, our warranty also covers the replacement of the filling if it fails, at no additional cost. Please be aware that this warranty is null and void if you do not maintain your 6 month- preventive cleaning appointments.

A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the tooth structure that cannot be restored with fillings or other types of restorations. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting, beautiful smile.

Grinding/Clenching: Patients who grind/clench their teeth typically have more post-op problems with any given treatment rendered. Expect more post-op sensitivity and tenderness, as well as longer, more difficult recovery period. Properly designed and fitted night guards (NTI) help alleviate these problems. The crown of a tooth is the portion that is covered by enamel. A restorative crown replaces this outer part to protect and strengthen the tooth. This protection becomes necessary when a tooth cracks, has its entire structure weakened by decay, or becomes brittle after a root canal.

Things to expect after treatment:

• We used a local anesthetic that might last for several hours after the procedure. You should avoid any chewing until the numbness has completely worn off. There are no restrictions on your usual activities. Brush and floss the crown as you do your natural teeth.
• Sensitivity to foods and liquids is a normal reaction to a new crown, and may last for several weeks, but it should begin to feel better everyday. If the tooth hurts or continues to feel sore each passing day, call us to set up a simple bite adjustment.

Warranty Information
We believe in the quality and craftsmanship of our work so much that we offer a warranty for your crown!

• 1 year unconditional warranty. Includes all necessary repair, rebond, or replacement.
• Within the next four years, if your crown needs replacement, the charge will be 50% of the present fee.

It is mandatory to wear a NTI (special night guard) to protect your crown and other natural teeth if indicated due to wear patterns from abnormal wear like clenching or grinding.

After the surgery you will want to rest in an elevated position If you have been sedated, you will have a driver and someone to stay with you for the remainder of the day. Dr. Ellis may have prescribed pain medication for you. Please take this medication as directed.You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery and you will want to change it as needed every 30 - 45 minutes. If bleeding continues for more than 1 hour, you can slightly wet a black tea bag and place it at the extraction site. If bleeding continues longer than expected, please call us at our office 469-351-6010 or visit the nearest urgent care or emergency room. If you are unsure, please do not hesitate to contact the office.

When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same applies for smoking. If you have prolonged pain, bleeding, irritation, or don't feel that the extraction site is healing properly call 469-351-6010 for a follow up appointment.

Proper care of the mouth following most dental procedure can reduce complications and speed the healing of the surgical area.

Protection of blood clot: Maintain gentle pressure by biting on the gauze sponge that has been placed over the surgical area, or by biting on a tea bag which has been gently moistened and wrapped in a piece of gauze. Keep steady firm pressure for one two hours. Repeat as often as needed.

Do not rinse: or use mouthwash for at least 24 hours. After 24 hours, rinse with warm salt water (1/2 teaspoon table salt in 8 oz. of warm water) after every meal. (The use of commercial mouth washed during the healing period is not commended.)

DO NOT DRINK THROUGH A STRAW

Discomfort: Following dental surgery it is normal to experience some discomfort. If medication had been given or prescribed take as instructed.

Toothbrush: Brush your teeth but avoid brushing surgical area.

Eating: Eating adequate food and fluid intake following surgery and/or general extraction is most important. If you find that eating your regular diet is too difficult, you may supplement your diet with liquids such as ensure, instant breakfast, ETC.

Things to avoid:

• Avoid excessive activity.
• Don’t pick at the surgical area.
• Refrain from smoking & alcoholic beverages until healing is well established (no smoking for at least 72 hours, increases chance of dry socket and doesn’t allow healing).

Sutures: If used, do not fail to return for their removal 7-10 days after the surgery.

Control of swelling: Gently apply icepacks to the area for a period of 20 minutes on, 10 minutes off. This procedure should continue for the day of the surgery only.

Allergic reactions: For generalized rash, itching, etc., call the dentist immediately

Do not hesitate to call if any questions arise. In case of an EMERGENCY, call 469-351-6010

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. Although most people receive fluoride from food and water, sometimes it is not enough to prevent decay. Fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. We generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Things to Expect After Treatment

• Avoid anything acidic (i.e. sodas)
• Avoid hot drinks and products containing alcohol (i.e.: beverages, oral rinses, etc.) during treatment period.
• Avoid brushing and flossing for 8- 12 hours. If possible, wait until tomorrow morning to resume normal oral hygiene.
• Teeth will feel sticky.
• After application, fluoride may appear white and streaky on the tooth surface. A thorough brushing and flossing will remove any remaining fluoride.

Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

A frenum is a fold of tissue or muscle connecting the lips, cheek or tongue to the jawbone. Frenectomy is a term that refers to the removal of one of these folds of tissue. Sometimes a frenum can be attached too tight on the gums or extend between teeth, this can become a significant problem if tension from lip movement pulls the gums away from the teeth. In addition, this can lead to a diastema (space between teeth); preventing teeth from coming in their correct position and eventually causing gum recession.

Things to expect after treatment

• Nothing sharp, spicy, or hard to eat or drink for the next 48 hours
• Do NOT pull on lip
• The area may become white or grey.
• It takes about a week to heal.
• Rinsing with salt water helps keep the area clean and facilitates healing.

Cold popsicles can feel really good too!

A healthy and harmonious gum-line is essential for a beautiful smile, as the gums are the frame around the teeth. A gingivectomy is a dental procedure that raises and sculpts the gum-line. This procedure may involve reshaping the tissue to create the appearance of longer and symmetrical teeth, thereby making the smile more aesthetically pleasing. It can also be done to remove excess tissue for optimal placement of a crown. A gingivectomy is typically done to reduce excessively “gummy” smiles or to balance out an asymmetrical gum-line.

Things to Expect After Treatment

• We used a local anesthetic that might last for several hours after the procedure. You should avoid any chewing until the numbness has completely worn off. There are no restrictions on your usual activities
• Nothing sharp, spicy or hard to eat or drink for the next 48 hours.
• Your gums will take about 2 weeks to heal.
• Rinsing with salt water helps keep the area clean and facilitates healing.

BLEEDING: Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

SMOKING: Smoking should be stopped following surgery. Healing and success of the implant will be substantially reduced by the cigarette smoke chemicals in your body.

PAIN: Some discomfort is normal after surgery. To minimize pain, take two Tylenol, Nuprin, Advil, or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don’t exceed the dose on the label. Taking with food or milk will help reduce an upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food, and taking the pill with a large glass of water.

SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, and then remove for 15 minutes. Continue this for the first day.

NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the numb area. Sometimes, the implant procedure causes residual numbness or tingling for six weeks or longer.

BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery for 3 days.

RINSING: Avoid all rinsing or swishing for 24 hours after your procedure. After 24 hours, you may begin gentle rinsing with peridex if it was prescribed to you. If so, please follow as instructed.

DIET: Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

ACTIVITY: 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.
ANTIBIOTICS: If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

SINUS: If your sinus was involved in the procedure, you should avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.

REMOVABLE APPLIANCES, DENTURES: Your dentist will give you specific instructions about your prosthesis. To avoid putting any pressure on the new implants before they have healed, your denture might be adjusted or significantly modified. In certain cases, you will need to go without your dentures for a period (days or weeks) after the implants are placed. Sometimes a temporary removable appliance is made for cosmetic purposes, until a new non-removable one can be made.

FOLLOW-UP APPOINTMENTS: You may need to return to the office within the first 14 days to have sutures removed, or just for a brief follow-up healing check. You may need to return after the implant has integrated for a small second procedure to expose it in preparation for the final restoration.

Please 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

Following these instructions very closely will greatly help your comfort, and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the procedure may be affected.

You have received an acrylic night guard/NTI. This treatment has been used for many years to keep the teeth from contacting while you sleep and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth. It is essential that you wear your night guard every night and you may also wear it during the day if you find yourself clenching or grinding your teeth. This appliance will help to relax any of your jaw muscles which are in spasm and to reduce any muscle pain, as well as, protect your teeth.

Things to Expect After Treatment

• Your teeth may become tender from being confined to the night guard. The tenderness lasts 1- 3 days and will not reoccur.
• You may notice an increase in saliva due to the extra material in your mouth. It does get better!
• WEAR IT EVERY NIGHT. To be effective, the night guard/NTI must be worn every night. If it is left out for extended periods, the teeth may move slightly and then, the night guard may not fit. Sometimes it has to be remade if the teeth have moved too much.

How to care for your Night Guard/NTI

• Brush and floss your teeth before wearing the guard.
• Clean the guard under running cold water every morning.
• Keep the guard in the provided case when not in use.
• Use Efferdent/Polident denture cleaner to soak your guard.
• Do NOT use toothpaste or a toothbrush to clean your guard.
• Keep the guard away from hot water/surfaces – Do not boil.
• Keep away from pets – They love to chew on the guard material.

Bring your night guard to your maintenance appointments and we will put it through the ultrasonic cleaner.

We have started or completed root canal therapy on your tooth. The nerve was removed, and the inside of the tooth’s root canal system was smoothed and cleansed of infection. Finally, if the root canal was completed, we used a root canal filler and sealer to seal the tooth at the end of the root.

1. Symptoms – When your tooth was infected, some infection may have spread out of the root into the bone. Until this infection is healed, you should expect tenderness and discomfort. These symptoms may persist for up to 10 days, but usually are gone in 48-72 hours.

2. Pain – For mild to moderate pain, take the over-the-counter pain reliever of your choice. If you have been given a prescription, take the medication according to the written instructions thereon. DO NOT drink alcoholic beverages while taking the pain relief medication.

3. Infection – In many cases, to aid the healing process and reduce the infection in the bone, we may have prescribed an antibiotic. Please be sure to take these medications as directed. WOMEN OF CHILDBEARING AGE SHOULD KNOW OF POSSIBLE REDUCED EFFECTIVENESS OF ORAL STEROID CONTRACEPTIVES DURING ANTIBIOTIC THERAPY and are advised to use additional forms of birth control during short term antibiotic use.

4. Swelling – If you have any swelling into the face or jaw area, please call the office immediately. This may indicate the localization of infection and require drainage. We may simply need to adjust or change your medication.

5. Restoring your tooth – Now that your tooth has had the nerve tissue removed, it is no longer a “live” tooth and it will tend to become brittle. We usually prepare the tooth for a crown along with root canal therapy to protect the tooth and provide the needed strength to chew. If you did not have the crown started today, you should plan to do so as soon as possible. The tooth may fracture or crack if left unprotected for any length of time.

6. Result – Following the crown restoration, this tooth, with the proper care and normal healing, should function as well as your natural tooth.

7. Take and finish ALL antibiotics!! Please call us at 469-351-6010 if you develop any allergic reaction, unexpected or unusual conditions, and if you have any questions.

A sealant is a thin, plastic coating applied to the chewing surface of molars, pre- molars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface. Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Things to Expect After Treatment

• Avoid chewing anything hard (i.e. ice, hard candies), they will wear sealants out fast and may cause them to fall out.
• Your bite may appear to feel off at first, this sensation will go away within a couple of days.
• Avoid brushing and flossing for 8- 12 hours. If possible, wait until tomorrow morning to resume normal oral hygiene.
• Teeth will feel sticky.
• After application, fluoride may appear white and streaky on the tooth surface. A thorough brushing and flossing will remove any remaining fluoride.

Remember, sealants alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and we will help you maintain a healthy smile.

You have just received a temporary restoration that will serve you for a short period of time while your final restoration is being made. This will protect the tooth and holds the tooth in position so the final restoration will fit properly. Temporaries are not strong, they are meant to function as they sound “temporary”. It is very important if you have temporaries to rinse them twice a day for one minute with 50% hydrogen peroxide and 50% water. This will aid in maintaining a clean and healthy temporary, and insure that the final restoration will fit properly.

Things to expect after treatment:

• Temporaries may break or come off occasionally. If so, you may slip it back on the tooth will something like denture adhesive or even toothpaste, or call if you need an appointment. Please do not leave the temporary out of your mouth because the teeth can shift and the final custom made restoration may not fit properly.
• Please clean around your temporary as instructed, and keep your gums healthy by brushing and flossing gently around the temporary.
• The size, shape, and color of the temporary may not resemble the final restoration. Furthermore, it may fade or change shades, especially when exposed to things like coffee, soda, red wines, etc. Candy and gum will very likely remove any given temporary, so please refrain from using them while your custom restoration is being made.
• Temporary restorations may leak saliva or food onto the tooth if left in place longer than recommended, even with proper care.
• Sensitivity to hot, cold, pressure or sweets is not uncommon.

Notify our office if any of the following occurs:

• You feel that your bite is not correctly balanced. It feels as if the filling is too high, or you are hitting the filling first when you bite down.
• The temporary breaks or falls out and you are unable to secure it.

Please call the office to schedule an appointment at no charge for a simple adjustment.

Before you receive your permanent veneer you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because it could become dislodged. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.

There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.

The long term restoration, in most cases, will be placed about 3 weeks after the initial appointment. The new restoration will feel smooth and like a natural tooth. You will care for your new restoration with regular brushing and flossing.

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue. They are made to closely resemble your natural teeth and may even enhance your smile. There are two types of dentures – complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills the spaces created by missing teeth, it prevents other teeth from shifting. Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.

Things to Expect After Treatment

• Sore Spots: Usually, your mouth will have a few “sore spots” after wearing dentures/partials for 24 hours. These areas can be relieved with very little effort in the office. Just call if you feel a sore spot..
• Chewing: The new bite may not feel completely comfortable for several weeks. We can adjust the contacting surface of your teeth after the dentures/partials have settled into place.

We have done our best to provide you with well-fitted, functional & esthetic dentures/partials. We feel confident that after a few weeks of becoming adjusted to the new dentures/partials, you will have years of satisfaction from them. Over time, your jawbone and gums shrink when there are teeth missing. When this occurs your dentures/partials will feel loose and may require relining. Wearing ill-fitting dentures/partials for too long, after they have settled into place, can cause severe bone loss and very serious oral disease.

Please call our office should your partial/denture feel loose due to the above reasons.