Patient Home Care Following Crown or Bridge Appointment
If you have had anesthetic, please be careful not to bite your tongue or the inside of your cheeks. Avoid eating chewy foods until the numbness has worn off. It is important that the temporary crown (or bridge) stay in place until the permanent crown is placed. If the temporary crown becomes dislodged or feels uncomfortable, please call us so that we may see you as soon as possible. Do not attempt to “glue” the temporary crown back in yourself or “go without it” as the teeth may become sensitive or shift slightly preventing placement of the permanent crown. You can use a denture adhesive like Fixodent to temporarily hold the crown or bridge in until you can get to our office. Some cold sensitivity and tenderness around the gum is normal for the first few days.
Avoid: Avoid chewing anything very hard or sticky on the temporary crown. Examples to avoid: Gum, Hard Crusty Bread, Taffy, or hard candy.
Brush as usual, but floss with care. When flossing, remove floss from the side of the tooth. It is important to brush and keep gum tissue as clean as possible. Remember, we are happy to see you to check the temporary crown if you have a question prior to insertion of the permanent crown.
Long Term Care of Your New Crown or Bridge:
Now that your crown or bridge has been cemented there are a few things to expect and to care for. Initially you may experience some sensitivity to cold as the tooth may be slightly irritated by the cement. Sensitivity toothpaste generally helps (ie. Pronamel by Sensodyne or Crest for Sensitivity teeth). Also, if after a couple of days your “Bite” seems off or it just doesn’t feel normal, please call our office for a slight adjustment. It is extremely important to maintain excellent oral hygiene with your new crown or bridge. Some people have the misconception that a crowned tooth no longer needs to be maintained. That is simple not true. Crowns and bridges are still susceptible to decay near the gumline the same as a natural tooth.
The crown strengthens the portion of the tooth above the gumline but this margin area requires special care. Normal brushing and flossing is a must. Additional use of a fluoride rinse (ie. Act or Flurogard), and a high fluoride content toothpaste or gel (ie. Prevident 5000 or Gel Kam) are excellent for preventing additional root decay. These additional aids are extremely important for patient with a high decay rate and/or a history of periodontal disease.
Most all crowns and bridges have a ceramic outer layer or are all ceramic. These materials are very strong and color stabile but they still have potential to fracture the same as a natural tooth, as a rule of thumb, don’t do anything with a crown or bridge that could damage a natural tooth. DO NOT CHEW ICE! The extreme temperature change greatly increases the fracture of porcelain and natural teeth.
If you received anesthesia, do not eat or chew until the numbness has subsided.
Wait two hours after your procedure before eating, and eat only soft food for the first 48 hours (ideally, for 72 hours).
- Until healing has occurred, avoid hot spicy foods and alcohol.
- Avoid tobacco products for at least 72 hours.
- On the first night, brush the area lightly with a soft brush.
- Use a mouth rinse after 48 hours.
- Continue with all antibiotics for the full course even if symptoms have subsided. If you have any discomfort:
- Take a pain reliever before the anesthetic has worn off or as recommended.
- Rinse mouth with warm salt water.
- Contact our office if you experience bleeding that continues for more than three days or if you have any other concerns.
What is it? Arestin® is a bioresorbable gel containing minocycline (a tetracycline derivative) microspheres. It has been FDA approved for treatment of gum disease after a deep cleaning procedure known as scaling and root planing.
How does it work on gum disease? When placed in a periodontal pocket, Arestin® maintains a high-level of antibiotic right at the gum disease site without exposing the rest of the body to antibiotics. This allows treatment using one-hundredth the usual pill-form dose. It directly fights the gum disease infection for 14 days.
How do I get the best results from my treatment with Arestin®?
- No eating or drinking for 30 minutes following treatment
- Avoid touching the treated areas.
- Wait 12 hours after your treatment before brushing teeth.
- Wait 10 days before using floss, toothpicks, or other devices designed to clean between the treated teeth.
- Avoid foods for 1 week that could hurt your gums. (popcorn, chips)
- Don’t chew gum or eat sticky foods.
- After 10 days, resume cleaning between the treated teeth on a daily basis. Remember, you must do your part. After your Arestin® therapy, if you don’t brush at least 2 times per day and floss every day, then any dental treatment of your gum disease will not work effectively.
Within the First 24 Hours
Bite firmly on a gauze pad for at least 30 minutes and as long as necessary to deal with the heavy oozing that is normal after an extraction. Insert a clean gauze pad after one hour if there is profuse oozing. Oozing may continue for 24 hours.
- Avoid spitting, sucking on candy, or sucking through a straw.
- Avoid rinsing your mouth, and do not brush or floss next to the extraction.
- Avoid tobacco products for at least 72 hours.
- Use allergy medication to prevent sneezing and coughing.
- To reduce bleeding, avoid vigorous activity, and elevate your head when lying down.
- Avoid hot, carbonated, or alcoholic beverages and hot or spicy foods.
- When numbness has subsided completely, drink plenty of fluids, eat only soft foods, and chew on the opposite side. For discomfort: Take a pain reliever before the anesthetic has worn off or as recommended. Use an ice bag over the area to minimize swelling, applying it for 20 minutes on and 20 minutes off.
After 24 Hours
- Brush and floss as usual, using care around the extraction site for the first week.
- Continue with all antibiotics for the full course even if symptoms have subsided.
- Apply moist heat to any swelling & rinse with warm salt water.
Now that your new filling or fillings have been placed there are a few directions you need to follow.
First, be sure that the local anesthetic has completely worn off before chewing. This is to prevent you from biting or injuring your lip, cheeks or tongue. Also, refrain from drinking anything hot in temperature or smoking to prevent burning. Sometimes patients also find it difficult to swallow while they are still numb, so please be careful.
Our office only places tooth colored resin type fillings. These fillings are completely hardened when you leave the office. You can eat on them as soon as the numbness wears off. Although the fillings are polished before you leave, they may feel slightly gritty at first. This should go away after a couple of days. If not please call back.
Immediate post visit cold sensitivity is also possible
This is usually from a normal reaction of the nerve following the procedure. Give it a couple of days and try a sensitivity protection toothpaste (i.e. Sensodyne or Crest for Sensitivity) until it subsides.
Finally, if your bite seems off or if you cannot bite normally please call the office to have your filling adjusted. Do not wait for it to wear down on its own as the tooth may become tender.
- Total treatment time is usually 2 – 3 weeks.
- Some cases may take longer, especially if treatment is interrupted.
- Make sure you brush and floss thoroughly prior to each treatment. The bleaching gel can work better if it is in contact with the tooth rather than plaque buildup.
- Mild sensitivity to cold liquids or air may occur.
This usually passes a few days after treatment is completed.
If the sensitivity is severe or persists, discontinue using the gel and contact our office.
35% Bleaching Solution- Wear trays for 1/2 hour or less if sensitivity occurs.
o 15% Bleaching Solution- Wear trays at least 1 1/2 hours or less if sensitivity occurs. If you use the 15% bleach you can wear them while you sleep, this is the preferred method since you swallow less and create less saliva.
Whitening works best on yellow stained teeth. Gray teeth are more difficult to whiten, or may not respond to treatment. Such cases may require porcelain veneers to achieve the desired result.
* Long term results vary from patient to patient. This can depend on many factors including habits such as coffee, tea, wine, or cola consumption If you have any questions please call our office.
It has been a pleasure working with you and providing the active phase of your non-surgical periodontal treatment. We are proud of what we have accomplished together to manage this non-curable disease. You are no ready to begin the vitally important maintenance phase which will monitor, stabilize and control your periodontal disease.
According to the American Academy of Periodontology, “following a course of active periodontal treatment and periodic ongoing care at regularly prescribed intervals is essential. The majority of clinical studies have shown that 3 months is the most effective in controlling disease”
Periodontal disease or infection can recur. Continuous maintenance is absolutely necessary to prevent this periodontal infection from becoming active once again and destroying what healing has occurred. Scientific studies support the belief of experts that the most important aspect of periodontal treatment is the long term maintenance therapy.
Individuals vary in their response to periodontal disease and resistance to the disease varies at different times of life. When periodontal disease recurs following treatment, it may do so without signs or symptoms to the patient. This is why regular, frequent periodontal maintenance visits are so very important. The following treatment is included in a periodontal maintenance appointment.
- Evaluation of oral health to detect subtle signs of disease recurrence
- Appropriate debridement of teeth and gums (professional cleaning)
- Antimicrobial therapy to destroy difficult to reach bacteria
- Evaluation of homecare regimes and aids
- Oral health evaluation including oral cancer screening