Post Operative Instructions

Please click the links below to get to your individual Post Operative Instructions:

Receiving Filling Post Operative Instructions

• Do not eat or drink anything until the anesthetic has worn off.
• You may floss and brush your tooth as normal, unless told otherwise by the doctor.

What if my filling hurts? It’s normal to experience some sensitivity to heat, cold and pressure after your appointment. You can also expect some soreness in your gums for several days. 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, and then gently swish the water around the tooth and spit. If the soreness or sensitivity lasts for more than a week, please call our office.
Do I have to be careful with my fillings? White fillings set completely immediately after they are placed, so as soon as the numbness from  anesthetic subsides, you can chew as you would normally. If your bite feels uneven, or if you have any questions or concerns about your new filling, be sure to give us a call. you may have a “high bite” and your restoration may need adjusted.  You will need to return to the office for an adjustment to avoid breaking the tooth or injuring the nerve. It takes under 10 minutes to adjust.

Receiving Soft Liner Post Operative Instructions

What is a soft liner and instructions how to care for it

A temporary soft liner is placed in a new or old denture in order to (1) Help improve the health of your gum tissues by absorbing some of the pressures of chewing (acts as a tissue conditioning material) and (2) Helps to determine the maximum retention possible by

utilizing undercuts in the bone and gum which hard liners may not be able to negotiate without causing irritation.

 Soft liners tend to spring around these undercuts and allow for greater retention over hard liners. If we find that temporary soft liners provide this enhanced retention, we will then be able to determine if we should replace it with a more permanent type of soft liner in the future or whether a hard liner is indicated.

Important Instructions

Temporary soft liners require special care and attention in order for them to produce the desired results. The following suggestions are designed to assist you in the maintenance of your new denture.

1-Do not remove the prosthesis from your mouth for the first 24 hours. This is extremely important! The material that is placed in your denture will stay soft for the first 24 hours and will shape itself to your oral tissues during that first 24-hour period.

2. After the first 24 hours, you may remove the denture once every 12 hours for the first two days. At each removal, please rinse the denture with warm water only. If need be, you can brush the tooth part of the denture (the white teeth) with toothpaste and a soft toothbrush. The soft liner is still very fragile and will tear if subjected to chemical or mechanical cleaning.

3. During the next week you may remove the denture as often as you like, still keeping in mind that the liner is fragile and must be treated with care. The pink plastic may be brushed gently, trying to avoid the soft liner.

4. If possible, try not to use any denture adhesive, especially during the first 72 hours. We are, once again, trying to determine the amount of available retention. Using adhesives will only tend to confuse the issue.

5. For the first 24 hours you should try to maintain a softer diet. After that trial period, you should eat as regular a diet as possible so that the soft liner can mold itself to your tissues until normal function.

6. We may be replacing this soft liner on a regular basis until 1) The tissues heal adequately or 2) We have determined that the retention for your new denture is maximized. Further instructions will be given to you at that time.

Please be sure to bring your old dentures with you at each recall visit just in case the dentist determines that relining your soft lined denture is required. This would require sending your denture to the laboratory. If you have any additional questions regarding this treatment process, please ask the dentist.

Arestin Post Operative Instructions

• Don’t Touch. Avoid touching areas of your gums that your Hygienist has treated.
• Avoid waterpik and toothpicks for a few days based on your Hygenist recommendations.
• Avoid Eating Hard, Crunchy, or Sticky Foods for 1 week after treatment.
• Always Follow Up. Because the bacteria that cause periodontal disease are persistent, the infection can return. Please be sure to make follow-up appointments with your dental hygienist to maintain healthy gums and teeth.
• Keep Your Scheduled Appointments. It is important to keep all of your dental appointments so that your dental hygienist can reexamine your gums, make sure the infection is under control, and measure the success of your treatment.

Botox Post Treatment Instructions

The guidelines to follow post treatment have been followed for years, and are still employed today to prevent the possible side effect of ptosis (drooping of the eyelids).  These measures should minimize the possibility of ptosis.

• No straining, heavy lifting, vigorous exercise for 3-4 hours following treatment. It is now known that it takes the toxin approximately 2 hours to bind itself to the nerve to start its work, and because we do not want to increase circulation to that area to wash away the Botox® from where it was injected.
• Avoid manipulation of area for 3-4 hours following treatment. (For the same reasons listed above.)  This includes not doing a facial, peel, or micro-dermabrasion after treatment with Botox®.  A facial, peel, or micro-dermabrasion can be done in same appointment only if they are done before the Botox®.
• Facial exercises in the injected areas is recommended for 1-hour following treatment.  This is to stimulate the binding of the toxin only to the localized area. 
• It can take 2 -10 days to take full effect.  It is recommended that the patient contact the office no later than 2 weeks after treatment if desired effect was not achieved and no sooner to give the toxin time to work.

Crown and Bridge Work Post Op Instructions

1. Sensitivity, especially to cold or pressure, is common for a few days following a dental procedure. Usually the deeper the cavity, the more sensitive the tooth may be.

2. Many crowns fit below the gumline. Therefore, you may experience some discomfort for a few days due to the irritation of that area during the procedures. 

3. Following the first appointment for a crown or bridge procedure, a temporary is usually placed on the tooth or teeth involved. This will protect and maintain the space while the custom restoration is made.

4. Temporary crowns are of a universal size and shade that also serve a cosmetic function for front teeth. Your final restoration will be shaped and shaded better that the temporary to match your other teeth in both color and function.

5. The use of temporary cement is for easy removal on your next appointment. If your temporary comes off between appointments, slip it back on and call us for an appointment. If you’re are unable to make it to the office, Fixodent (a denture adhesive) or temporary cement, may be purchased at a drugstore. Dry the tooth off as much as possible before temporary cementation.

6. If after a week or two, your teeth feel they do not touch correctly please call the office. This problem can be solved with a quick adjustment to the temporary or permanent restoration.

7. Crowns and bridges do not last forever. Like a new set of tires, they can wear and breakdown. Proper brushing and flossing is recommended to help you retain your final restoration. Having your teeth cleaned every six months and an exam and x-rays every year will help us prologue the life of your restoration.

Although the temporary crown should be very comfortable, you may need to alter your eating and oral hygiene habits slightly to ensure the temporary stays in place between appointments.

• Avoid chewing gum and eating sticky or hard foods.
• If possible, chew only on the opposite side of your mouth.
• Brush and floss carefully each day, pulling the floss out from the side as you floss next to the temporary. Pulling out from the top can cause the temporary to come loose. If you have problems flossing, let us know. We have a product called Superfloss — thicker, sturdier floss that may give you better control.

It’s vital to the proper fit of your final restoration that your temporary stays in place, if your temporary does come off, call us immediately so we can arrange to cement it back into place.

You should also call our office right away if:

• Your bite feels uneven
• You have persistent pain
• You have any questions or concerns

Dentures

Dentures Post Op Instructions

• Your mouth will feel “full” if this is the first time you’ve had a denture or if your teeth were missing for a while.
• Your speech may sound different until your tongue and lips adjust to the new denture. By reading aloud or talking, you can shorten the adjustment period. 
• Sore spots are common with a new denture and several adjustments will be necessary. Please wear the denture at least 1 day prior to the appointment so sore areas can be easily identified. 
• An increase of saliva flow is normal with a new denture and will decrease gradually. 
• Rinse your denture after eating and thoroughly brush them daily. 
• Denture adhesive may be necessary to keep the denture securely in place. Dental implants are an excellent option to secure dentures. 
• Do not sleep with your denture because the mouth tissues need a time to relax and recover. 
• As the shape and contour of your mouth changes over the years, you will need a reline to improve the fit. This is a separate procedure and not included in your denture fee.
• Return to your dentist at least annually for an exam of the mouth and denture.

Screw Retained Dentures Post Delivery Instructions

Brushing

• Brush your gums and implants twice a day with a soft brush and gel toothpaste.  A mechanical or ultrasonic brush, such as Sonicare, will help you to adequately remove plaque and bacteria.  In addition, most electric brushes have a timer that assists you in brushing for a full 2 minutes.
• Superfloss must be used to remove any irritants from the implants.
• Waterpicks and Sonicare AirFloss are helpful to flush a “hard to reach” areas under your implants.

Flossing

• Floss under your screw-retained denture at least once a day.
• Make sure that you insert your Superfloss under and in-between each implant area.
• Wrap the floss around each implant and move it up and down to loosen and remove food and bacteria.
• Use a new section of floss for each implant.

Rinses

• You may use Listerine as a daily mouth rinse.
• Avoid any rinse or dental dentifrice with hydrogen peroxide as it will react with the titanium and discolor your restorations.

Fluoride

• Prescription strength fluoride can prevent gum inflammation caused by bacteria.

Dental Visits

• You should have a dental cleaning every 6 months.
• At least once per year you will have an exam with Dr. Fakhri.  Please call our office at any time if you are experiencing any tooth or jaw problem or wish to see Dr. Fakhri.

Locator Dentures Post Delivery Instructions

Brushing

• Brush your gums and implants twice a day with a soft brush and gel toothpaste.
• Superfloss must be used to remove any irritants from the implants and the attachments.
• Waterpicks and Sonicare AirFloss are helpful to flush a “hard to reach” areas under your implants.

Rinses

• You may use Listerine as a daily mouth rinse.
• Avoid any rinse or dental dentifrice with hydrogen peroxide as it will react with the titanium and discolor your restorations.

Fluoride

• Prescription strength fluoride can prevent gum inflammation caused by bacteria.

Maintenance of Your Denture

• Remove your dentures each night to prevent fungal infections and allow your gums to rest.
• Use a denture cleaner and soft bristle brush to keep your dentures clean and stain free.

Dental Visits

• You should have a dental cleaning every 6 months.
• At least once per year you will have an exam with Dr. Fakhri.  Please call our office at any time if you are experiencing any tooth or jaw problem or wish to see Dr. Fakhri.  We are here to help.
• The consumable parts on your locator attachments will be checked at your exam with Dr. Fakhri and replaced as needed.  Please contact us if your locators need maintenance prior to your yearly visit.  Once your initial supply of consumables are used, there will be a charge to order and replace these parts.

Immediate Dentures Post Operative Instructions

1. Protection of the blood clot and surgical site
Slight bleeding after tooth extraction is normal and may last for several hours. Bite on folded gauze directly over the bleeding area the dentures are on. If there is no active bleeding, then leave the gauze out. Lay in a semi-reclined position. Avoid spitting, bending over, sucking through a straw, and rinsing for 24 hours. No strenuous activity or smoking for 48 hours. The blood clot is important for healing.

2. Rinsing
Rinsing may dislodge the blood clot and interrupt the normal process of healing. Carefully follow these steps in order.

Day 1 (Day of surgery – first 24 hours after surgery)
a. Keep dentures in for 24 hours
b. Do not rinse or spit.

Day 2 & 3 (24 – 72 hours after surgery)
a. Remove dentures 3 times a day to rinse them off.
b. While the dentures are out rinse your mouth gently using a glass of warm salt water (1/2 teaspoon per cup).

Day 4 – 30
a. Same regiment as day 2 & 3, however now rinse with a little more force.
b. Use your finger tip to gently rub your oral tissues and rinse your mouth each time you take your dentures out.
c. Brush and floss your remaining teeth (if any), 2 times a day; be gentle around the extraction sites.
d. Follow with the chlorhexidine rinse. (continue using until day 7)
e. Replace the dentures immediately. Do this for one week.
f. Continue rinsing and cleaning in this manner for 30 days. (note; you can stop the chlorhexidine at day 7)

*For the first week you will wear your dentures 24 hours a day. After the first week you will wear them 16 hours a day or less.

3. Care of remaining teeth / Cleanliness and Healing 
The teeth should be given their usual care. Brush and floss two times a day. Don’t clean the extraction sites.

4. Swelling / Fever 
A cool pack placed on face will be beneficial to help control swelling. This should be used for the first 4 days after surgery. If extreme swelling occurs or, a temperature above 101.5 contact my office.

5. Pain
Some discomfort is normal following oral surgery. If pain medication is prescribed, take only as directed. Often it is beneficial to take the medication after eating to help prevent nausea. Do not drive while using narcotic pain medications.

6. No Smoking or Alcohol
Do not smoke or drink alcohol for 48 hours following oral surgery. This may cause the disruption of healthy blood clot formation and increase in complications including dry sockets, prolonged healing, wound breakdown and postoperative infections.

7. Diet
No hot liquids, acidic foods or drinks for the first 24 hours. Eat something when you feel ready. Cool liquids are best to start but avoid sucking through straws. Then, when the numbness starts to wear off, progress to a pureed diet, no chewing. After two weeks progress to a soft diet and gradually to a regular diet.

8. I.V. Injection site
After having intravenous anesthesia, the arm vein may become hardened and tender. Apply moist heat over the area for one hour three times a day for three days. Contact me if there is no improvement

9. Sharp bony edges/ Dry sockets
You may feel hard, sharp areas on the surgical site. This is the hard-bony wall, which originally supported the tooth. “Dry Socket” is a term describing a tooth socket where the blood clot has dissolved leaving an exposed bony area which is painful. A “Dry Socket” will usually heal on its own. Pain control is the issue. Try using an anti-inflammatory medicine like ibuprofen in addition to the narcotic pain medicine. If unsuccessful, then this can be treated in our office by placing a medicated dressing in the surgical site.

10. Nausea
Nausea is a normal side effect of narcotic pain medications. If you have severe nausea or vomiting you may need to stop the pain medications or take an additional anti-nausea medication.

11. Antibiotics and Contraception
Contraceptives may be ineffective while taking an antibiotic. Use extra protection if you have been prescribed an antibiotic.

Dermal Filler Post Treatment Instructions

DO NOT: touch, press, rub or manipulate the implanted areas for the rest of the day after treatment. Avoid kissing, puckering and sucking movements for the rest of the day as these motor movements can undesirably displace the implanted dermal filler materialYou can cause irritation, sores, and/or problems, and possible scarring if you do.
AVOID: Aspirin, Motrin, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A., Vitamin E, or other essential fatty acids at least 3 days after treatment.
AVOID: Alcohol, caffeine, niacin supplement, high-sodium foods, high sugar foods, refined carbohydrates (you may eat fruit), spicy foods, and cigarettes 24-48 hours after your treatment.
AVOID: Vigorous exercise and sun and heat exposure for 3 days after treatment.
DISCONTINUE: Retin 2 days after treatment. It is best to wear no makeup or lipstick until the next day. Earlier use can cause pustules.

One side may heal faster than the other side.

You can expect some bruising and swelling around the areas that were injected. Apply ice for the first hour after treatment for ten minutes on and ten minutes off.
You must wait 2 weeks before any enhancements.
Please report any redness, blisters, or itching immediately if it occurs after treatment.

Extraction Post Operative Instructions

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 45 minutes after the appointment. If the bleeding or oozing persists, insert another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

• Do not rinse or spit for 24 hours after surgery.

• Keep your fingers and tongue away from the socket or surgical area.

• Use ice packs on the surgical area (side of face) for the first 48 hours; apply ice 20 minutes on and 10 minutes off. (Note: Bags of frozen peas work well.)

• For mild discomfort, take Tylenol^® or ibuprofen every 3–4 hours.

• For severe pain, use the medication prescribed to you.

• Drink plenty of fluids. (Do not use a straw—this creates suction in the mouth that could cause complications.)

• We suggest that you do not smoke for at least 5 days after surgery.

• Avoid strenuous activity and do not exercise for at least 3–4 days after surgery. After that, be careful: your regular caloric and fluid intake have been reduced, so you may get light-headed, dizzy, or weak.

• If the muscles of the jaw become stiff, the use of warm moist heat to the outside of your face over the spots that are stiff will relax these muscles.

• After the first post-operative day, use a warm salt water rinse following meals for the first week to flush out particles of food and debris that may lodge in the surgical area. (Mix ½ teaspoon of salt in a glass of warm water. Mouthwash can be added for better taste.)

• Your diet should consist mainly of soft, easily swallowed foods and cool drinks. Avoid anything that might get stuck in your teeth, so no seeds, nuts, rice, popcorn, or similar foods.

Flipper Post Delivery Instructions

Please follow these instructions to properly care for your flipper.

1. Clean daily with a “soft” toothbrush and a non-abrasive tooth paste.  Do not soak in mouthwash or other chemicals.

2. Keep your flipper out of reach of pets and children, especially dogs.

3. Call this office should you require an adjustment to your flipper.

4. Only wearing your flipper daily will ensure that it properly holds the space needed for future restorations.

5. Remove your flipper nightly to prevent gum inflammation and infection.

6. When not in public, remove your retainer while eating to prevent potential damage and stain.

7. Remember that your flipper is a temporary space holder, usually no more than a year, but proper care will help it last until your final restoration is placed.
8. Failure to properly care for your flipper may result in damage and therefore additional charges for repair.

Fluoride Varnish Post Operative Instructions

Please follow these instructions following your fluoride varnish treatment.

1. Fluoride varnish will remain on your teeth for approximately 4-6 hours. 
   Please follow the guidelines below during that time only:

• Do not brush or floss.
• Avoid hot beverages.
• Avoid hard or crunchy foods.
• Avoid products containing alcohol.
• Avoid other “over the counter” fluoride items such as toothpastes, gels, and rinses.

2. Please resume the activities above following the expiration of the 6 hour
   window.
3. DO NOT use your prescription fluoride medications such as Gel-Kam or Periomed for three days AFTER treatment.
4. A thorough brushing and flossing of your teeth (after the six hours window) will remove any remaining traces of your fluoride varnish.

Implant Bridges Post Delivery Instructions

Congratulations!  You have chosen to make an investment in your smile.  Follow these recommendations so that you may enjoy your new smile for years to come.

Brushing

• Brush twice a day for at least 2 minutes.
• A mechanical or ultrasonic brush, such as Sonicare, will help you to adequately remove plaque and bacteria.  In addition, most electric brushes have a timer that assists you in brushing for a full 2 minutes.

Flossing

• Floss under your implant bridge at least once a day.
• Make sure that you insert your Superfloss under and in-between each implant area.
• Wrap the floss around each implant and move it up and down to loosen and remove food and bacteria.  Use a new section of floss for each implant.
• Waterpicks and Sonicare AirFloss are helpful to flush a “hard to reach” areas under your implants.

Rinses

• You may use Listerine as a daily mouth rinse.
• Avoid any rinse or dental dentifrice with hydrogen peroxide as it will react with the titanium and discolor your restorations.

Dental Visits

• You should have a dental cleaning every 6 months.
• At least once per year you will have an exam with Dr. Fakhri  Please call our office at any time if you are experiencing any tooth or jaw problem or wish to see Dr. Fakhri.  We are here to help.

Occlusal Guards

• Clenching and grinding exerts pressure that can be generated across the teeth that can range from 100 to 600 psi (pounds per square inch). That incredible amount of force can cause many different problems related to your gums and jaw.

• An occlusal guard is an appliance designed from dental models of your teeth and made of a rigid plastic.  It prevents the teeth from coming together while sleeping at night.   It also provides a guide for your jaw so that muscles can relax and bite problems will not trigger the bruxing action.

Invisalign Post Operative Instructions

• Aligners should be worn 21-22 hours per day. They should only be removed for eating and brushing. After eating, we recommend that you brush, floss, and insert your aligners as soon as possible.
• Most people experience some mild soreness for a day or two after starting each new stage. This is normal. It is a sign that the aligners are working and moving your teeth. For pain or discomfort, you can take Tylenol or Advil.
• When inserting aligners begin with your front teeth and gently move backward. When removing aligners begin with your back teeth. Unseat your aligners with your fingernail at the back, then gently wiggle your way forward. Do not remove the aligner by pulling straight down from the back. This will crack the aligner in the middle.
• Do not eat with your aligners in your mouth. After eating brush, floss, and insert your aligners as soon as possible.
• You may drink water with the aligners. Do not drink hot liquids, as it may distort the aligners. Do not drink sugary or acidic liquids with your aligners in as this will damage your teeth.
• Clean your aligners prior to each insertion. Use a soft bristle toothbrush with water and a small amount of toothpaste. Do not soak aligners in hot water or mouthwash.
• Wearing aligners that are not clean or wearing aligners on teeth that are not clean will cause cavities and gum disease.
• When not wearing your aligners, always store them in the Invisalign storage case. NEVER WRAP YOUR ALIGNERS IN A NAPKIN, they will get thrown away.
• Never discard your aligners. When finished with a set, clean them, and place them back in their original pouch. These can be used as back-ups in case an aligner is lost or broken.
• Please bring previous worn aligners to your appointment to track back if necessary.
• If one of the bonded attachments falls off your tooth during treatment, please notify the office during your next visit.

Metal Bar Supported Dentures Post Delivery Instructions

Brushing

• Brush your gums and implants twice a day with a soft brush and gel toothpaste.
• Superfloss must be used to remove any irritants from the implants and the attachments.
• Waterpicks and Sonicare AirFloss are helpful to flush any “hard to reach” areas under your implants.

Rinses

• You may use Listerine as a daily mouth rinse.
• Avoid any rinse or dental dentifrice with hydrogen peroxide as it will react with the titanium and discolor your restorations.

Fluoride

• Prescription strength fluoride can prevent gum inflammation caused by bacteria.

Maintenance of Your Denture

• Remove your dentures each night to prevent fungal infections and allow your gums to rest.
• Use a denture cleaner and soft bristle brush to keep your dentures clean and stain free.

Dental Visits

• You should have a dental cleaning every 6 months.
• At least once per year you will have an exam with Dr. Falkhri.  Please call our office at any time if you are experiencing any tooth or jaw problem or wish to see Dr. Fakhri.  We are here to help.
• The consumable parts on your attachments will be checked at your exam with Dr. Fakhri and replaced as needed.  Please contact us if your locators need maintenance prior to your yearly visit.  Once your initial supply of consumables are used, there will be a charge to order and replace these parts.

Night Guard Post Operative Instructions

Please follow these instructions for care and use of your new Comfort HardSoft Night Guard.

1. Clean daily with soap and water.  Do not soak in mouthwash or other chemicals.

2. Do not place your night guard in direct sunlight.

3. Rinse your night guard before and after use and store dry.

4. Keep your night guard out of reach from pets and children, especially dogs.

5. Avoid sleeping on your stomach. Sleeping on your stomach forces your head to be turned to the side, which may cause significant muscular strain.

6. Your night guard is guaranteed for 1 year from the date it is fabricated by the laboratory.  Perform a periodic inspection of your appliance and call this office should you notice a crack or other issue with your night guard.

7. Call this office should you require an adjustment to your night guard.

8. Only wearing your night guard nightly will ensure that it protects your teeth from damage.

Dental Sealants Post Operative Instructions

Please follow these instructions following the placement of dental sealants.

1. Once sealants are light cured, may resume normal eating and drinking.

2. The sealants placed today are guaranteed by this office for 2 years if you attend your check-up and cleaning appointments every 6 months.

3. Avoid hard candies and chewing ice to prevent fractures of sealants.

4. Avoid sticky candies that could pull out sealants.

5. Sealants do not prevent all decay. Flossing is still needed to protect the sides of your teeth.

Space Maintainer Post Operative Instructions

We have recommended and placed a space maintainer(s) in your child’s mouth to either maintain the space for erupting permanent teeth, or to maintain the current position of already erupted teeth. Please read the information below which will allow you to care for your child’s space maintainer in the best manner possible.

Diet – All of our space maintainers are cemented with strong dental cement, however, the space maintainer still can be dislodged if the wrong types of food are eaten. We do not recommend that your child eat any of the following: caramels, taffy, hard candy, chewing gum (any type), gummy bears, jolly ranchers, ice cubes, hard crunchy foods, or any sticky, chewy food. Sugary foods should be kept to a minimum. 

Oral Hygiene – While almost all of our space maintainer designs are easy to clean, your child must have above average oral hygiene. Space maintainers will catch extra food debris and plaque so your child will have to make an extra effort in brushing and flossing to maintain healthy gums and teeth. 

Periodic Evaluation – Patients with space maintainers should be seen by the dentist at a minimum of every 6 months for routine examination and evaluation of the bite, fit of the bands, and proper tooth eruption. Failure to return for follow-up visits can lead to gum problems, cavities, and crooked teeth. The dentist will monitor your child’s development and remove and/or adjust the appliance when needed. 

Patient Cooperation – The space maintainer is not a toy. Do not “flip” the appliance with the tongue, because it may loosen the fit. Do not pick at the wires or bands with fingers. 

Loose Space Maintainer – Should the space maintainer come loose for whatever the reason, call the office immediately. If the space maintainer is loose enough to come out of the mouth, place it in an envelope, store it in a safe place, then call the office. Many times a loose space maintainer can be easily re-cemented if the appliance has not been bent or broken and your child is seen as soon as possible. A delay in getting in for an appointment could cause the need for the space maintainer to be remade. 

Patient Comfort – There should not be any pain or discomfort with space maintainers since they are passive appliances (they do not move the teeth like braces). Pain or discomfort could be an indication that something is wrong. Please call the office if your child has any pain or discomfort. With a new space maintainer there may be an initial accommodation period of a few days to a week. During this time there may be an initial difficulty in speech. This will typically resolve in the first few weeks. Having your child read aloud will help their speech adjust more quickly. If your child is having trouble adjusting to the appliance in any way, please call our office.

Zoom Whitening Post Operative Instructions

Congratulations on completing the Zoom Whitening Process! Now that your teeth are significantly whiter, there are a few guidelines to help maintain the look of your new smile. The teeth have a protective layer called the protein pellicule. This layer contains the surface dental stains and is removed during Zoom whitening treatments. It takes 24-48 hours for the barrier to fully develop again. During this time it is important that you follow certain guidelines and monitor which foods, drinks, and products you intake. 

Please avoid these items for the time you are bleaching + one additional week.

• Drinks: Coffee, Tea, Red Wine, Cola
• Condiments: Ketchup, Mustard, Red Sauces, Soy Sauce, Steak Sauce
• Food: Berries, Red Meat (Steak or Hamburger)
• Toothpaste: Colored toothpaste (Would suggest using Sensodyne toothpaste)
• Mouth rinse: Colored Mouthwash, Fluoride treatment, Chlorohexidine

Take Home Whitening

3 Days after ZOOM whitening session in office, start the Whitening gels at home

• Please make sure the custom tray is completely dry. Place a small amount of gel on each of the teeth in the custom tray. Use caution not to overload the tray. Insert the tray over the teeth and gently wipe away any excess gel. Do not leave any gel on the gums because this will cause irritation to your gums.

• Wear the bleaching trays with the gel for 2 hours
• Use all the bleaching gel given. This could last from a few days to a week
• If sensitivity is uncomfortable, stop and reduce time and/or frequency of treatment. If too uncomfortable, stop all together.

Things not to do when bleaching tray is in your mouth:

• Do not rinse your mouth, since this may dilute the bleaching agent.
• Do not swallow the whitening gel.
• Never drink, eat, or smoke while wearing your tray.

After completing the daily bleaching session, remove the tray and gently clean it with a toothbrush.
Rinse it completely, and let dry thoroughly before the next session. Excess water in the tray can dilute the gel.

Post-operative sensitivity

Some patients experience sensitivity such as “zingers” or thermal sensitivity 12 to 24 hours after Zoom! Whitening and during at home whitening. Here are things you can do to help relieve this sensitivity:

• Place Relief ACP gel on the problem area in the take home trays and seat them over the teethyou could do this before or after the bleaching session.
• Take over the counter pain relievers such as Advil or Tylenol
• Brushing your teeth with Sensodyne toothpaste.
• Drink plenty of water

Watch this video www.youtube.com/watch?v=FX3az7qMepg&t=3s

Pre Zoom Protocol

• Brush with potassium nitrate toothpaste for 2 weeks (no stannous fluoride). 1a. Prevident, Pronamel ect..

• ACP on lingual surface during Zoom treatment

• 600 mg Ibuprofen 1 hour prior to Zoom procedure
  • 3 Advil

Zoom Pen Whitening Instructions

• Store pen in a cool dry place – pen does not need to be refrigerated, but should not be exposed to heat for a prolonged period of time.
• Saturate pen brush by twisting base of the pen. It may take up to 20 clicks to saturate the brush.
• Brush a thin layer of gel on your front teeth. 
• Replace cap when you are finished. ). For the best results, brush teeth before application and refrain from eating or drinking for 30 minutes after application to allow time for the gel activation.
• Philips whitening pen can be used day or night. Apply to teeth twice daily for two weeks. Philips whitening pen is an easy way to maintain your bright smile at work or on the go. 
• Philips whitening pen is not designed to be a substitute for professional teeth whitening or regular dental care. Please visit your dentist regularly. Philips whitening pen will not whiten crowns, veneers, fillings or dentures. Store this product in a cool location out of direct sunlight. This product’s effectiveness will decrease as it nears its expiration date or 6 months after it has been initially opened