Patient & Post-op Instructions

Caring for Your Denture

Your beautiful new denture has been hand crafted to look as natural as possible. The individual colors in the gums will last the life of the denture if you properly care for them.

Storage

To avoid warping, your denture should always be stored in water when not in your mouth.

Adhesives

Denture adhesives can improve the retention and stability of your denture and reduce the accumulation of food particles beneath your denture.

1. Use three or four pea-sized dollops on each denture; if you begin to require an increasing amount of adhesive to maintain the same level of retention, please make an appointment to evaluate the fit and stability of your denture.
2. Completely remove denture adhesives from your denture and your mouth on a daily basis.

Daily Care

1. Remove the bacterial biofilm and any residual adhesive from your mouth with a washcloth.

2. Remove the bacterial biofilm and any residual adhesive from your denture by soaking* and brushing.

   * The temperature should never be hotter than you would wash your hands with.

   * To protect the colors, do not use bleaching products or any denture cleansers that contain bleach.

   Options:

   1. Soak for 15 minutes in a solution of equal parts water and white vinegar with hydrogen peroxide. This will make hard calculus/tartar deposits soft enough to remove with a toothbrush.

   2. Soak in an effective, non-abrasive denture cleanser, following the manufacturer’s recommendations.

      • Denture cleansers should ONLY be used outside of the mouth.
      • Always thoroughly rinse after soaking and brushing with denture cleanser before reinserting your denture into your mouth.

3. For the health of your mouth, do not wear your dentures for more than 24 hours continuously.

4. Leave your denture out of your mouth during showering.

5. Consider NOT wearing your denture when sleeping.

Yearly Recommendations

To minimize biofilm accumulation over time, bring your denture back to our office for an annual ultrasonic cleaning. Additionally, an annual check-up is recommended for maintenance of optimum denture fit and function and for an assessment of your overall oral health status.

Caring for Your New Teeth

Now that you have your new dental restorations, it is important you ensure their lasting strength and beauty. Proper homecare will preserve their original shine as well as maintain the health of your surrounding gum and bone. By avoiding certain foods and habits, you will minimize the threat of breaking or discoloring your new teeth.

Frequently Asked Questions

1. How can I best care for my dental restorations?

   Daily brushing and flossing are necessary to maintain the health of your teeth and dental work. Use a soft toothbrush with an appropriate toothpaste. Many types of toothpaste, including all “whitening” toothpastes, are too abrasive and will take the shine off your restorations. Your dental provider will suggest a toothpaste with a low abrasive index and preferably with fluoride to keep your natural teeth strong.

   The use of an appropriate mouth rinse is an effective way to promote your dental health. Your dental provider will suggest a non-acidic mouth rinse that contains both fluoride and xylitol. Avoid using mouth rinses that contain alcohol as these tend to burn your tissue and break down the cement that keeps your dental restorations in place.

2. What can I eat with my dental restorations?

   Your dental restorations should look and feel like a natural part of your mouth. You will be able to enjoy a wide variety of foods with your new teeth. Having said that, there are certain foods and eating habits that are prudent to enjoy in moderation or avoid altogether.

   To decrease the risk of chipping or debonding a dental restoration, try to avoid:

   • Using your teeth to scrape or pull meat off a bone
   • Biting into raw carrots or other very hard foods
   • Chewing toffee or other dense, sticky foods

   To decrease the risk of staining or dulling your restorations, try to enjoy the following in moderation:

   • Intensely colored foods and beverages such as berries, tea, coffee, red wine and dark soda or fruit juice
   • Acidic foods and beverages such as citrus fruits, iced teas and sodas
   • Smoking and chewing tobacco can cause severe discoloration of your teeth and should be avoided.
   • Alcoholic beverages will hasten the demise of bonded restorations and should be enjoyed in moderation.

3. Are there things that might harm my new teeth besides eating?

   Many oral habits can damage or dislodge dental restorations. You should not use your teeth for anything other than chewing food. Avoid such habits as:

   • Chewing pencils, toothpicks or ice cubes
   • Biting your nails
   • Opening bags, containers or bottles with your teeth
   • Cutting fishing line or sewing thread with your teeth

4. Will my teeth be sensitive after my new restorations are placed?

   Mild sensitivity is common following the permanent placement of your dental restorations. The gum surrounding your new teeth, as well as your jaw muscles, may be tender for a few days. Your teeth themselves may be sensitive to cold, hot and chewing. Sensitivity to cold takes longest to resolve, but generally your teeth will feel normal again within a month. If sensitivity persists for more than 3 months you should notify your dental office.

Caring for Your Temporary Restoration

1. Normal Expectations You May Experience

   • Some temperature sensitivity by the second day. This will likely resolve.
   • Some tenderness around the gum tissue for a few days.
   • Some biting soreness, but should only last a few days.
   • Anything beyond these mild symptoms, please contact the office.

2. The Tissue Around Your Temporary Must Be Kept Very Clean and Healthy

   Flossing and brushing are the most important things you can do to ensure good tissue health.

3. The Temporary Must Stay in Place

   Your temporary is held in place with weak cement. Occasionally, it may loosen or come off before it should. If this happens, it may cause inflammation in the gums, more tooth sensitivity, or the tooth may move. Any of these conditions may delay timely placement of the final restoration.

4. To Prevent Loosening

   Be careful with biting and chewing foods. Avoid hard, tough, crunchy and/or sticky foods. However, you will need to floss differently. After introducing the floss between the teeth, merely pull the floss through the side. Avoid pulling up on the temporary. Substitute floss with Opalpix.

5. 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 until you can arrange with our office to come in.

6. To Prevent Staining, Avoid the Following

   • Mouth rinses containing chlorhexidine
   • Oral tobacco products (Smoking, chewing tobacco, nicotine pouches, etc.)
   • Turmeric
   • Coffee/tea
   • Berries
   • Red Wine
   • Dark colored soda
   • Fruit juice
   • Beetroot

Please call us if you experience any conditions that in your opinion seem to be out of the ordinary

Patient Instructions: Kois Deprogrammer

The Kois Deprogrammer is an appliance that allows your jaw muscles to relax and function independently from the muscle and jaw position associated with your current tooth bite.

After a period of wearing the Deprogrammer, your former muscle memory pattern will be modified so we can determine the difference between your new jaw bite and your original tooth bite. You should be able to feel a different tooth that now first contacts when you remove the Deprogrammer.

Construction of the Kois Deprogrammer:

• The Deprogrammer has a small platform behind your upper front teeth.
• The platform allows for only a small area of contact with one of your lower front teeth. This will be the only contact point.

Wearing the Kois Deprogrammer:

• While you are wearing the Deprogrammer none of your back teeth will touch.

• Upon removing the Deprogrammer, you should notice that your teeth contact differently.

  * Please make a note of which tooth contacts first.

• It is important that you wear the Deprogrammer as much as possible to allow the jaw muscles to relax (deprogram) and achieve a repeatable closing position. Exceptions are eating and cleaning your teeth, or when it may interfere with quality of life.

• The Deprogrammer has achieved its purpose if every time it is removed and you close your teeth together, your teeth make contact in the same spot.

• Please make sure you are wearing the Deprogrammer at your next scheduled appointment.

• Any symptoms present prior to wearing the Deprogrammer should be resolved.

Care Instructions:

• Gently brush the Deprogrammer with toothpaste and rinse with warm (not hot) water at least twice a day.
• When not in use, keep it in its retainer case.

Concerns:

• If soreness or discomfort develops, discontinue wear, and immediately call the office.
• If you have any questions or concerns do not hesitate to contact the office.

It is necessary to bring the Kois Deprogrammer to your next appointment!

Patient Instructions: Teeth Bleaching

To Obtain the Best Bleaching Results:

• Before bleaching, thoroughly brush and floss your teeth to make sure you remove any plaque and food particles so the bleaching gel will make contact with the surfaces of your teeth.
• While bleaching, please do not drink liquids or foods that stain your teeth such as coffee, red wine, etc.

1. Fill the bleaching trays with a pea size amount of material provided. Properly filling the bleaching trays is critical to achieving maximum whitening results, because it ensures a proper seal of the bleaching trays.

   Dispense a dab of bleaching gel into each tooth on the inner side of the outer walls of the bleaching trays, EXCEPT in the second molars and around any porcelain restorations.

2. Seal the bleaching trays against your teeth.

   1. Place the bleaching trays over your teeth, and push the trays firmly onto your teeth.

   2. The thick gel will push the sides of the tray away from the teeth at the gum line a little. It is very important to gently push the tray back against the teeth.

   3. You should see just a little excess gel has squeezed out of the edge of the tray as the trays are gently pushed back against the teeth.

   4. If you see an excessive amount of gel, the trays have been overfilled. If you see no gel has squeezed out, the trays have been under filled.

   5. Adjust accordingly the next night.

3. Wear the trays for only 30 minutes the first night to determine if your teeth experience sensitivity.

   1. If you experience sensitivity, we recommend the use of CariFree PRO Gel 5000 or MI Paste to be placed in the tray immediately after bleaching for 30 minutes. Use this as your preferred toothpaste the entire time until the end of your bleaching process.

   2. Note: CariFree PRO Gel 5000 can also be used to replace your current toothpaste.

4. Then on the second day and subsequent days:

   1. Wear the trays for 15-30 minutes, remove the trays, rinse the trays with cool water.

   2. Reapply fresh bleaching material and then replace the tray back over your teeth in the same manner for another 15-30 minutes.

5. When You Remove Trays:

   1. Upon removing the trays, rinse your mouth and clean your bleaching trays with cool tap water.

   2. Avoid using warm or hot water, as it could affect the fit of your trays.

   3. Shake the excess water off the trays and place them back into the tray container. Do not close the container. Leave the case open so the trays will dry out before the next use.

6. In most cases, the desired results can be obtained in 2-3 weeks but in some cases of very discolored teeth, the process may take longer.

What Is Proper Tooth Brushing and Flossing Technique?

An effective oral hygiene routine starts with a few simple steps:

A Proper Brushing Technique for your Teeth

A proper tooth brushing technique is the first step to maintaining healthy teeth and gums. Plus, it helps minimize the risk of tooth decay and gum disease, the major causes of tooth loss.

Before You Begin

While there are several tooth brushing techniques with a manual toothbrush, always ask your dental professional for their recommendation and be sure to follow their instructions. To start, use fluoride toothpaste with a soft-bristle toothbrush, and don’t forget to replace it every three months.

Two Minutes, Twice a Day

To brush your teeth correctly, spend at least two minutes using a recommended brushing technique, which includes 30 seconds brushing each section of your mouth (upper right, upper left, lower right and lower left), both morning and night. Since most manual toothbrushes don’t have built-in two-minute timers, you may want to have a clock handy so you can be sure you’re brushing long enough.

Positioning the Toothbrush

How you hold the toothbrush depends on which part of the tooth you’re brushing.

1. Start with outer and inner surfaces, and brush at a 45-degree angle in short, half-tooth-wide strokes against the gum line. Make sure you reach your back teeth.
2. Move on to chewing surfaces. Hold the brush flat and brush back and forth along these surfaces.
3. Once you get to the inside surfaces of your front teeth, tilt the brush vertically and use gentle up-and-down strokes with the tip of brush.
4. Be sure to brush gently along the gum line.
5. Brush your tongue in a back-to-front sweeping motion to remove food particles and help remove odor-causing bacteria to freshen your breath.

Now that you’ve learned proper brushing technique, a little discipline in practicing it every day will help make it feel like second nature. It’s one of the easiest things you can do to maintain the health of your teeth and gums.

Proper Flossing Technique

1. Use about 18 inches of floss, so you have a clean piece of floss to use on each tooth in the cleaning process.
2. Curve the floss into a C-shape as you slide it up and down along the side of each tooth.
3. Don’t forget to floss the back sides of your back teeth on both the left and right of the upper and lower teeth.

Proper brushing and flossing technique as part of your daily oral care routine are the most important components in the fight to keep your teeth plaque free – and protecting your teeth and gums for a lifetime.

Patient Instructions: Instructions Following Oral Surgery

Pain Reduction Protocol:

You may have moderate discomfort after the anesthetic wears off. Most discomfort can be controlled with a combination of non-steroidal anti-inflammatory ibuprofen (2 tablets Advil, 400 mg in total) and analgesic acetaminophen (2 tablets extra strength Tylenol, 1000 mg total). These should be taken every 8 hours. If you have any contraindications to taking either of these medications, please check with your physician.

Post Operatively:

• Do NOT rinse your mouth for the first 24 hours following the procedure.
• Keep your head elevated during the first evening.
• Discontinue your usual exercise regime for 1-2 days.
• Restrict yourself to a soft diet.
• Do NOT smoke which delays healing and irritates the tissues.
• Do NOT drink from a straw.

Bleeding:

• Do not be concerned if you see traces of blood in your saliva for several hours after the procedure. It is not uncommon to have slight bleeding.
• If the site continues to bleed apply constant pressure with gauze or a moistened tea bag for up to 1 hour and repeat if necessary.

Swelling:

Some swelling is to be expected. To help reduce this, ice packs may be applied to the outside of the face over the area of surgery for twenty minutes on and twenty minutes off for the first 24 hours following surgery. (Ice cubes in a plastic bag work as nicely as an ice pack). If swelling and discomfort persist, warm wet compresses may be used over the area on the second and subsequent days. These are to be applied for twenty minutes on and forty minutes off for three hours each day. However, if swelling persists and continues to increase, you may have an infection. Call your dental office.

Oral Hygiene:

After surgery it is important to keep your teeth and mouth as clean as possible. Beginning the day after the procedure, warm salt-water rinses (1/2 tea spoon salt mixed with 6 - 8 oz. of warm water) can be used 2 times a day. Please practice excellent oral hygiene as instructed for the rest of your mouth.

Antibiotics:

Antibiotics may be prescribed depending upon the surgical procedure. It is important that they are taken as directed.

Nutrition:

Maintaining an adequate diet after surgery is important. Chew on the opposite side of your mouth and avoid extremely hard or spicy foods. Select foods that provide nourishment with little, if any, necessary chewing. Avoid the use of straws for drinking to prevent blood clot dislodgement.

Post-Operative Appointment:

You may be seen for a post-operative appointment within 10 days – 2 weeks following surgery.