Crowns and Bridges

Your tooth is prepared for a crown or bridge by cutting it down to the required size. After this appointment you may or may not be given a temporary crown or bridge while the permanent one is manufactured by the lab.

Since the temporary crown or bridge is fixed with a weak adhesive, it may come off. Call us if this happens, and bring the temporary with you so we can re-cement it. It is very important for the temporary to stay in place, as it will protect your teeth from shifting or moving, which may compromise the fit of the final crown.

To keep your temporaries in place, AVOID eating sticky foods (including gum) and hard foods. If possible, chew on the other side of your mouth. It is important to brush normally, but floss carefully as it may dislodge the temporary.

On the appointment the permanent crown or bridge is cemented, you need to wait for an hour before you bite on it. This is required for the cement to set completely in order to gain full strength and hold the crown/bridge in place.

Initially you may experience some sensitivity to cold as the tooth may be slightly irritated by the cement. Sensitivity toothpastes generally help (Sensodyne or colgate sensitive). You bite may take a few days to completely settle. After about a week’s time, if you still find your bite off or unsettled, you may contact us for some further adjustments.

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. Crowns and bridges are still susceptible to decay near the gum-line the same as a natural tooth. The crown strengthens the portion of the tooth above the gum-line but this margin area requires special care. Normal brushing and flossing is a must. Additional use of a fluoride rinse (Plax or amflor), and a high fluoride content toothpaste or gel (Tooth mousse or colgate 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 gum disease.

Most crowns and bridges have a ceramic outer layer or are all-ceramic. These materials are very strong and color stable, however, 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 bite ice on your crown/bridge. The extreme temperature change greatly increases the fracture of porcelain and natural teeth.

Fixed bridges require addition cleaning under the pontic (Missing tooth). Since this “False tooth” is connected to the adjacent teeth a bridge threader (superfloss) is used to thread floss under it to remove plaque. These are readily available at most pharmacies. We would be happy to demonstrate how to use them.

Extraction

After tooth extraction, it is 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 30 minutes after the appointment. If excessive bleeding or oozing still persists, insert another gauze pad and bite firmly for another 30 minutes. After an hour remove the gauze and have something cold like Ice-cream or yogurt to help arrest bleeding.

For the first 2-8 hours after surgery, ice packs may be applied to the face over the area of the extraction site and held in place for 15 minutes. This will help reduce discomfort and swelling. When little bit of blood mixes with saliva, it appears as though you have a lot of blood in your mouth when in reality, there is VERY little.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, spit, use straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 48 hours as this will increase blood pressure and may cause more bleeding.

The anaesthesia will wear off in 3-4 hrs. Till that time avoid biting yourself. The wound caused will start hurting after the anaesthesia wears off. Please eat only soft, cold food for the next 48 hrs. Hot and crunchy food will disturb the clot formation.

After 48 hrs you may rinse your mouth gently with salted luke warm water. Please take the medications as prescribed. If you have any concerns or questions regarding your progress, please do not hesitate to contact us.

Root Canal Treatment

During Root Canal Therapy, the nerve, blood, and nutrient supply to the tooth, are removed. This may cause the tooth to become more brittle and can fracture easily. A crown (cap) is needed to prevent the tooth from breaking. In the meantime, AVOID nuts and hard, crunchy food that could break the remaining tooth structure.

The anaesthesia will last for approximately 2 hours during which you should AVOID eating and drinking in the area, as you may bite your lip or tongue.

You may experience some discomfort and pain on the tooth that has been treated. This may last up to a week. Some swelling in the affected area is unlikely but possible. Please continue any medication as prescribed by the doctor.

A temporary filling will be used to seal the access in the tooth. This temporary material may partly chip or wear away. Most of the filling though will remain stuck in the tooth. It is only a problem if it becomes uncomfortable for you. If this happens, we can adjust the temporary filling for you to make you more comfortable. You need to allow the temporary filling to set for about one hour so it gains the maximum strength.

If you have any concerns or questions regarding your progress, please do not hesitate to contact us.

Dental Implants

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Sutures are placed in the gums to help the gums adapt and heal around the implant.

Some bleeding is normal for the first 24 hours. The bleeding can be arrested by eating something cold and soft like ice-cream or applying an ice pack on the outside on the cheeks. Excessive bleeding can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.

Swelling is a normal occurrence after implant surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice as many times as possible, for the first 48 hours starting immediately after surgery.

Drink plenty of fluids. Avoid hot liquids or food. Soft and cold food should be eaten on for the first 48 hours after surgery. Return to a normal diet as soon as possible unless otherwise directed.

You should begin taking the medication before the anaesthesia wears off. Follow the doctor’s prescription for the dose, duration and frequency of medication. Be sure to take the prescribed antibiotics as directed to help prevent infection>

Good oral hygiene is essential to good healing. 48 hours after surgery, a mouthrinse should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt-water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth must continue as usual. Be gentle initially with brushing the surgical areas. Avoid rinsing very vigorously in the initial period.

Keep physical activities to a minimum for the first week following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Nourish yourself well during this period as it is important for healing.

You are advised not to smoke until the wound has healed as this severely limits healing in the mouth.

If you have any concerns or questions regarding your progress, please do not hesitate to contact us.

Orthodontic Retainers

You have successfully completed your orthodontic treatment and your braces are off. While you must be thrilled with your new look, you must remember the basics of the next phase. Your teeth will not stay where we put them. Yes! Your teeth will tend to move back to their original positions. This means your teeth might come forward, become crooked or gaps might open up.

But there is nothing to worry. We’ll put you on retainers which will hold your teeth in place till your teeth become firm in the new positions. The soft tissues, surrounding bone, the tongue and lips must adapt to the new dental alignment. Up to this point it has been a team effort, but now the retention phase is up to “YOU.”

Fixed Retainer – Your fixed retainers are fixed permanently on the inner sides of your front teeth. You need to ensure good hygiene around the fixed retainer. If the fixed retainer breaks even on one tooth, you must get it fixed immediately; otherwise that particular tooth will move away. Fixed retainers are generally left in place indefinitely. Do remember to visit your dentist once every 6 months for scaling.

Removable Retainer – depending on the need, you may or may not be given a removable retainer.

• Wear your retainers as prescribed - retainers do their best while in the mouth. Retainers are to be removed while eating and brushing
• The removable retainer must be used full time for the first 6 months and then indefinitely at bedtime
• Do not let your retainers get damaged or bent (keep it in the case when not in the mouth)
• Do not expose your retainers to any form of heat as this may distort them
• Do not leave your retainer within reach of pets
• Clean retainers thoroughly once a day with a toothbrush and a clear mouth rinse. Use warm but not hot water. Brushing retainers removes the plaque and eliminates odors.
• Visit your general dentist regularly for check-ups and cleanings

If you have any concerns or questions regarding your progress, please do not hesitate to contact us

Denture Instructions

We have designed and fabricated your denture paying a lot of attention to your concerns and present oral (mouth) condition, so that maximum function and aesthetics (looks) is restored. Remember! Your dentures are not and will not be the same as your natural teeth. With a little bit of patience, co-operation and practise, you will be able to function comfortably with your dentures.

1. Adaptation period

1. Your current oral (mouth) condition is unique. Your previous experience with dentures or the experience of other denture patients occurred under different circumstances and should therefore not be compared.
2. Your dentures will ‘settle’ in a month’s time. Please be patient and follow all instructions meticulously during this period to see good results.
3. The length of time it will take to adapt to your new complete dentures is modified by the oral conditions, age and your acceptance of the new dentures.
4. Some patients experience abundance of saliva which is stimulated by the presence of the new dentures. Soon the salivary glands will adjust to the presence of the dentures and resume their normal production. Until then, you should simply swallow more frequently
5. During this adaption period you may experience :
1. Sore spots
2. Difficulty in eating and speaking
3. Looseness or tilting of denture
4. Cheek/lip biting
5. Frustration

2. Eating with complete dentures

1. Balancing and looseness of dentures could be a concern initially, as it would interfere with comfortable eating. However, with practise, you will adapt very well to them.
2. Go slow and steady with your diet:
1. Day 1 and Day 2: Do not use the dentures for eating. As your dentures are new and are getting adapted to the oral (mouth) conditions, forces applied during chewing could disturb the ‘settling’.
2. Week 1: Limit your diet to soft, boiled food. Trying to eat hard or chewy food the first week can be difficult and cause sore spots and blisters.
3. As you learn to use them, you can gradually increase the hardness of the food you eat. Biting very hard food could always be a concern.
4. Biting with your front teeth will always cause the dentures to dislodge. Try to use your back teeth and bite food off using the corners of your mouth.
5. Excessive opening of the mouth will cause the denture to dislodge. Limit yawning with your palm placed against your chin, eat smaller bites of food, always sip fluids or drink with a straw.
6. It is advisable to avoid very hot and very cold beverages with the dentures.
7. Place one piece of food on both sides of your mouth before chewing. Chewing food on both sides of your mouth at the same time reduces tilting and dislodgement.

3. Speaking

It is common to experience changes in speech. Do not be overly conscious of the denture. Practise reading and talking aloud in front of the mirror or with family.

4. Adjustment and follow-up appointments

1. All new dentures require some adjustment. Adjustments for sore spots and other changes will be made at scheduled adjustment appointments.
2. During the process of adjustment, if sore spots or blisters are unbearable/ visible- please discontinue the denture and call/ visit us.

5. Care of your tissue

1. Remove your dentures every night. This allows your gums to heal and recover from wearing the dentures.
2. Dentures may get dislodged in your sleep and may prove dangerous. As a safety measure, please remove the denture whenever you go to sleep.
3. Massaging the gums with your clean finger will keep them firm and resistant to denture irritation.
4. Unhealthy gums could deteriorate the stability and fit of your denture.

6. Insertion and Removal

If you are new to dentures, it may take a while to adapt to inserting and removing your dentures. With practise, you will be able to do the same with ease.

1. The lower denture should be inserted first, followed by the upper denture.
2. Once inserted, hold the denture in place until its set comfortably in the mouth to avoid embarrassing dislodgements (removal) during the day.

7. Care of your new dentures

Remove and rinse your dentures after every meal. Then rinse your mouth and replace the dentures.
1. Remember to rinse after Tea/ Coffee and other coloured drinks.
2. At least once a day:
1. Use a toothbrush to scrub the teeth and outside surface of dentures clean.
2. Apply a small amount of regular mild hand/body soap/toothpaste while brushing under water. This will remove debris and odor causing bacteria.
3. Wet dentures are slippery. Be careful not to drop your dentures. Dentures dropped onto a hard surface may result in fracture.
3. When removing dentures at night:
1. Keep them wet by soaking CLEAN dentures in water at room temperature. Never use hot/ warm water to clean or soak the dentures. Replace the water every day.
2. If and as instructed- use denture cleansing tablets/ powder once a week.

8. Yearly dental visits

1. All complete denture wearers should visit their dentist once a year to help maintain their oral health.
2. Over time, the supporting gum tissues and bone will shrink due to age and hormonal changes resulting in looseness and ill fit of the dentures. To an extent, the fit can be corrected. Beyond a point, the dentures will have to be replaced. Continuing to wear ill fitting dentures can be detrimental to your oral condition.
3. Dentures may chip/ wear with time.

Orthodontic Patients

DIET - In general, avoid anything very hard or sticky! These foods may loosen bands or break off brackets from the teeth causing damage and delay in your treatment. Cut your foods into small pieces and chew slowly and carefully to avoid breaking, bending or loosening your appliances (braces). Almost anything can be eaten as long as it is cut into small pieces and eaten slowly with care.

• Specifically, avoid eating the following: Chewing gum, candy, apples, toffee, peanut brittle (chikki), hard candies, gummy bears.
• Also avoid biting: Hard cookies, hard rolls, nuts, and pizza crust.
• Don’t even think about chewing on: ice, pens or pencils and bone.

You can still enjoy most food, if you are just careful: apples, pears, raw carrots, celery, corn on the cob, crusty bread sandwiches, bagels and meat on a bone can be cut up in small pieces or strips and eaten on your back teeth. Pizza is okay. Just use your knife and fork instead of your front teeth!

Oral Hygiene - Careful tooth brushing is of critical importance. Braces trap food, bacteria and plaque that can cause tooth decay, gum disease, and leave white marks (decalcification) and cavities, which will never come off the teeth! Brush after every meal and before bedtime. Pay special attention to the gum line and the area between the braces and gums. Keep your braces and teeth sparkling clean! A fluoride mouth rinse (provided in your kit) is highly recommended (colgate phosflor or amflor). Use the interdental brush (provided in the kit) to remove any food stuck between the braces.

Wax - If the bands scratch your lips, gums, cheeks or tongue, place a small piece of wax (provided in your kit) over the sharp spot after drying off the area with a tissue. Usually such irritations disappear after a few days. You can also use a small piece of wet tissue instead of wax.

Discomfort – Your teeth might feel a little sore during the initial few days as the braces begin to work on moving your teeth. In general, rinsing with warm salt water can relieve soreness of the mouth: (one teaspoon of salt in a half glass of very warm water). Rinse for 60 seconds, then spit out. Rinse few times a day for best results. If pain persists, use an over the counter pain killer. Do not use the pain killer for more than 3 to 5 days.

You may develop ulcers or bruises in the initial period till your lip and cheek movements get adjusted to the presence of braces. If you develop multiple ulcers suddenly, please report it to us immediately as this may indicate some sort of allergy.

Check for Loose Braces Daily - If any braces or wires break or come loose call the office. Place wax over any sharp areas, and save any loose pieces and bring them in with you. Loose or broken braces prolong treatment.

Regularity in keeping Appointments is Essential – Missed appointments increase treatment time. Your subsequent appointment is fixed beforehand. Please call us in case you need to change it.

If you have any concerns or questions regarding your progress, please do not hesitate to contact us.