Periodontal disease has been shown to be responsible for approximately fifty percent of tooth loss. We will do our best to help you control this condition. If you have any questions, please do not hesitate to ask us.
After deep scale and root planing:

• If you smoke, DO NOT SMOKE for at least one hour. Consider quitting, as smoking aggravates periodontal disease.
• Avoid spicy foods until your mouth tissues feel better, approximately 24 - 48 hours. This varies with each person.
• Salt water rinses will ease soreness. Rinse as often as you like using one teaspoon of salt to one cup of warm water.
• If you feel it is necessary, take extra-strength acetaminophen (Tylenol) pain relievers that are not aspirin types. Avoid aspirin until tissues have healed.
• It is important to remember to brush and floss as usual, just be a bit more gentle until your mouth feels better. Leaving food debris on your teeth and gums will only invite more bacteria and soreness, so do your best to keep your mouth clean.
  
  Areas that negatively affect the health of gums and supporting bone area:
  
  
• Poor oral hygiene habits.
• Plaque bacteria and accumulation of calculus (tartar), as well as faulty restorations, fillings, crowns, bridges and food impaction.
• Nutrition specific deficiencies such as a lack of vitamin A, B complex, C, D, and the minerals calcium and phosphorus.
• Adverse habits such as smoking, chewing tobacco, regular drinking of soda and other sugared drinks between meals, chewing gum or candy that has sugar as the base, eating baked goods that have small seeds which may get into pockets around teeth.
  
  In cases of Advanced Periodontal Disease, when deemed necessary, we may refer you to a Periodontist.
  
  

After an extraction, it's important for a blood clot to form to stop the bleeding and begin the healing process. That's why we will ask you to bite on a gauze pad for 30-45 minutes after an extraction. If bleeding continues after you remove the gauze pad, place another gauze pad on the area and bite firmly for another 30 minutes. You may have to do this several times.
After the blood clot forms, it's important to protect it, especially for the next 24 hours.

It's important to NOT:

-Smoke for at least 3 days
-Suck through a straw
-Rinse your mouth vigorously or spit
-Clean the teeth next to the extraction site.
-These activities may cause you to develop a dry socket, which is an extremely painful condition that will take up to a month to heal.

After the tooth is extracted you may feel some pain and have some swelling. You can use an ice bag (20 minutes on, 20 minutes off) to keep this to a minimum. To control discomfort, take pain medication as recommended. Don't take medication on an empty stomach or nausea may result. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. Avoid taking any aspirin products as they will interfere with the blood clotting.

Also :

-Drink lots of fluids
-Eat only soft, nutritious foods on the day of the extraction
-Don't drink alcoholic beverages
-Avoid hot and spicy foods and aspirin


You can begin eating normally the next day, or if not by then, as soon as it's comfortable. Rinse your mouth gently, holding the water and letting it fall out of your mouth. After 24 hours, you may gently rinse with ¼ to 1 teaspoon of salt in 8 ounces of warm water three times a day. Also, rinse gently after meals. This helps keep food out of the extraction site.

It's very important to resume your normal dental routine after 24 hours. This should include brushing your teeth and tongue and flossing at least once a day. This will speed healing and help keep your breath and mouth fresh. Call your dental office right away if you have heavy bleeding, severe pain, continued swelling after two or three days, or a reaction to the medication.

Root canal therapy, often called Endodontic Treatment, takes two or more appointments to complete. A temporary filling or crown is placed to protect the tooth between appointments. After each appointment when anesthetic has been used, your lips, teeth and tongue may be numb for several hours. Avoid any chewing until the numbness has completely worn off. Between appointments, it's common (and not a problem) for a small portion of your temporary filling to wear away or break off. If the entire filling falls out, or if a temporary crown comes off, call our dental office so it can be replaced.

It's normal to experience some discomfort for several days after a root canal appointment, especially when chewing. To control discomfort, take pain medication as recommended. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

To further reduce pain and swelling, rinse three times a day with warm salt water; dissolve a teaspoon of salt in a cup of warm water, then rinse-swish-spit.

To protect the tooth and help keep your temporary in place:

-Avoid eating sticky foods (especially gum)
-Avoid hard foods and hard substances, such as ice, fingernails and pencils.
-If possible, chew only on the opposite side of your mouth.
-It's important to continue to brush and floss normally. Usually, the last step after root canal treatment is the placement of a permanent crown on the tooth. A crown covers and protects the tooth from breaking in the future.

If you have persistent or unusual pain, or you have any other questions or concerns, please call our office.

Your temporary is made to last for at least a few weeks. This allows us to evaluate any potential problems prior to your final restoration.

IMPORTANT CONCERNS

The temporary must stay on:
Your temporary is held on with strong cement. Occasionally, it may loosen or come off before it should. If this happens, the tooth may move, become sensitive or cause inflammation. Any of these conditions may prevent timely placement of the final restoration.

To prevent loosening:
Be careful with biting and chewing foods. Avoid hard, tough, crunchy and/or sticky foods. Floss carefully. Avoid pulling up or down on the temporary. After introducing the floss between the teeth, merely pull the floss out the side.

What to do if it comes off:
Call us. We would like to recement it for you in a timely manner. If you cannot come in, replace the temporary with finger pressure or secure it with a small amount of denture adhesive such as Poli-Grip or Fixodent.

The tissue around your temporary must be kept very clean and healthy:
Flossing and brushing are the most important things you can do to insure good tissue health. If you were prescribed PerioGard, it was to improve the tissue health and to facilitate the placement of the final restoration. Dip your brush in a small amount of the solution; massage it into the tissue around the tooth for 20 seconds, twice daily.

Normal Expectations:
- Some tenderness
- Some soreness, but only for a few days. Please call us at (702) 877-6608, if you experience any conditions that, in your opinion, seem to be out of the ordinary.

Swelling: In some cases, puffiness and swelling may result and should not
cause alarm. This may be kept at a minimum by holding an ice bag on the outside of the face, adjacent to the surgical to area for the first 6-8 hours after your visit. Leave it on for 15 minutes, then off for 15 minutes.

Bleeding: It is normal for saliva to be slightly streaked with blood. In order to
stop bleeding, place a moist piece of gauze or cold wet squeezed tea bag over the surgical site and bit down for 20 minutes. Repeat if necessary. Keep fingers and tongue away from surgical site.

Rinses: Do not rinse mouth until the following day. On the morning
following surgery, rinse mouth thoroughly with Peridex, Listerine, or warm salt water (1/2 teaspoon salt + 6 oz. warm water). Repeat this after each meal or the first two weeks.

Denture: Dentures should not be worn until the denture has been relined or
adjusted. Insertion of dentures too early may jeopardize a successful healing process .

Diet: To prevent any inadvertent food particles from contaminating or
injuring the surgical site, you should only consume liquid or mashed foods during the first two weeks. Some example are: Fruit juices, ice creams, soups, ensure carnation breakfast custards, mashed potatoes, peas, corn, and any food mashed in a blender. Smoking and consumption of alcoholic beverages should be avoided during the first two weeks.

Sleeping: Keep your head elevated with two pillows while sleeping.

Medication: Following dental surgery, it is normal to experience some
discomfort. If medications have been prescribed, take as directed. Please note the following:

a. All medications may produce allergic reactions and/or side effects.
b. Narcotics will impede driving, using machinery and mental alertness.
c. Antibiotics may negate birth control medications. Use alternative methods.

Oral Surgery

Bleeding: Do not be concerned if traces of blood are noted in the salvia for several hours after the procedure. Do not rinse the mouth vigorously for the first few hours as the disruption of the clot may occur. It is best to avoid hot foods or fluid until the day following surgery. If continuous or excessive bleeding occurs, please contact the office at 702-877-6608.

Pain: You may have moderate discomfort after the anesthetic wears off. Most can be controlled with a mild analgesic. A prescription for a strong analgesic may be issued if necessary, and should be used as directed.

Swelling/Stiffness: In some cases, swelling is to be expected. It is normal and should not cause alarm. To help alleviate this, ice packs may be applied to the outside of the face over the area of surgery for ½ hour on and ½ hour off for the first 3-4 hours. Ice cubes in a plastic bag work nicely for an ice pack. If swelling discomfort persist, warm wet compresses may be used over the area on the second and subsequent days. These are to be applied for 20 minutes on and 40 minutes off for three hours each day.

Oral Hygiene: Meticulous oral hygiene should be continued in all other areas of the mouth but the area of surgery should be avoided to prevent the dislodging of the blood clot. Gentle rinsing after meals with warm salt water rinses, (½ tsp salt/ 8 oz. water). You should continue to brush your teeth and stimulate the tissue elsewhere in your mouth. Rinsing helps flush out the debris, which collects around that area.

Nutrition: Maintaining an adequate diet after surgery is important. You can chew on the opposite side of your mouth, and should avoid 0extremely hard and spicy foods. We have listed some foods that supply nourishment with little, if any chewing necessary for swallowing.

- Broths
- Soups
- Ice Cream
- Chopped or ground meat
- Eggs
- Baby Foods
- Custards or pudding
- Malted milk or shakes

YOU WILL ASSIST THE HEALING RESPONSE BY OBSERVING THE FOLLOWING PROCEDURES:

A.) Maintain an adequate home care level.
B.) Decrease or eliminate smoking as smoking significantly delays the healing of oral tissue.
C.) Utilize warm salt water rinses to remove debris. Tooth Sensitivity Tooth sensitivity following surgery is almost totally related to inadequate plaque removal. It is very important then to be very meticulous with your plaque control procedures.
DO NOT use a Water Pik in surgical areas for three weeks.

Remember that you just had minor surgery. Be kind to yourself.

1.) Dentures should be removed and placed in water or cleanser while you sleep.

2.) Place dentures in Clorox-Calgon Solution overnight or at least 30 minutes daily. (This will kill most bacteria at a minimum of 30 minutes.)

FORMULA:

1 Teaspoon Clorox
2 Teaspoons Calgon* Minimum in 6 oz.Water *Calgon is a water softener which is available at grocery stores. DO NOT USE CALGONATE, which is a dishwasher detergent, or Calgon bath oil beads.

3.) After soaking, thoroughly remove all cleanser with light brushing under tap water. If tarter remains, a mild vinegar can be used to soak and brush stubborn calculus (tartar) deposits.
Do not place dentures with metal parts in this solution. It will destroy the linking.

4.)Lightly brush dentures with a soft nylon toothbrush. (Oral B-40, Lactona S-19, Py0co-pay Softex.) Denture brushes with stiff, coarse bristles can cause wear to denture materials.
To prevent breaking dentures, brush dentures over a towel or over a basin half filled with water.

5.) Massage gums daily with a thumb, finger, or soft toothbrush for five minutes in the morning and five minutes in the evening or as directed.

CLEANING DENTURES
(With soft temporary liners)

1.) Use Kleenite as a soaking cleanser. Follow directions on the package for mixing cleanser, except use warm water, almost cool – NOT HOT.

2.) Do not experiment with other cleansers, as they may damage the lining.

3.) Soak dentures in this solution up to 30 minutes daily. Do not leave dentures in cleanser solution over night.

4.) Use cotton balls to swab liner during the first several days. After this, the surface of the lining can be lightly brushed with a soft toothbrush.

5.) Avoid hot foods and foods requiring chewing for the first day. Warm food and light chewing will not harm the lining.

6.) Avoid foods with seeds, as they can become embedded in the lining.

7.) Keep dentures in water when it is out of your mouth for any period of time. It should not become dry.

NOTE: Following these instructions will extend the life of the lining: