Quality Patient Information

Sensitivity to cold and heat, as well as any soreness, should not last more than a few days.

Do not rinse your mouth with anything for 24 hours; however, continue to brush any remaining teeth carefully. After 24 hours, Dr. Berkal will see you for a follow-up visit. After your initial follow-up visit, resume your routine brushing and gently rinse your mouth with a lukewarm salt-water solution (made by dissolving 1/2 teaspoon of table salt in an 8 oz. glass of warm water.) Rinse 3 to 4 times a day for four or five days. Take care not to strain or empty your mouth with undue force.
Immediate dentures and partials will often need several adjustments in order to fit comfortably. Our patients should expect to see Dr. Berkal frequently after the initial delivery. This is part of the special impression technique we use to ensure the best fit of the denture. As your tissue heals, adjustments will need to be made.

All dentures should be removed overnight or for at least 6 hours a day (after the first week) to give your mouth and gums time to rest. At night, you should remove your dentures and clean them. They should be stored in a clean container filled with denture cleaning solution. Lightly brush the roof of your mouth, your tongue, and your gums after removing your dentures.

Make sure to visit our office at least once a year to have your dentures partially adjusted and checked by the doctor. Dr. Berkal will also make sure your mouth is in good health. Wearing ill-fitting dentures or partials without proper care and adjustment can cause bone loss in the jaw area and oral disease. Please call our office if you are experiencing ongoing pain or discomfort or if you have any concerns regarding your denture or partial.

• Avoid eating anything in the area being treated for two hours or until the dental anesthetic has worn off completely.
• To help soothe the area, rinse your mouth 2-3 times a day with warm salt water rinses.
• Resume your home care regimen immediately; brush gently and floss thoroughly in the area that was recently treated.
• Refrain from smoking for 24 to 48 hours after scaling and root planing. Tobacco will delay the healing of your gum tissue.
• You may take your usual over the counter pain reliever for any tenderness or discomfort.
• If you have persistent discomfort or swelling that occurs after scaling and root planing, contact our office as soon as possible for further instructions.

Please follow the instructions from your endodontist/root canal specialist.

1. No eating or drinking for the first 30 minutes following your treatment. Also avoid feeling around your tooth with your tongue. This is to allow the temporary filling sufficient time to harden.
2. If you were given any prescriptions, please have them filled promptly and take as directed. If no prescriptions were given, you may choose to take ibuprofen medications such as Motrin or Advil (as long as you do not have any allergies to these medications) for alleviation of discomfort and swelling. Alternatively, you may use Tylenol. Do not exceed the guidelines printed on the label for any medication. If you are unable to achieve adequate pain control, please call your specialist.
3. Applying a cold compress to the face near the treatment area will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off for the next 6-8 hours as needed.
4. Once you resume eating and drinking, avoid biting directly on the treatment area until your final restoration is placed. The temporary filling wears down quickly, and the tooth is at risk of cracking if too much pressure is applied to the tooth before your final restoration or crown. Please call Dr. Berkal at your earliest convenience.
5. Please keep the treated area clean by gently brushing and flossing regularly.
6. It is rare for a temporary filling to fall out although it may divot while in use. If the temporary falls out, please contact your general dentist as soon as possible. If your temporary falls out after office hours, you may purchase some temporary filling material from a pharmacy and follow the included instructions to cover the area until you can be seen in our office.
7. Some discomfort is normal for 2 to 4 days following root canal therapy. In some cases the tooth and surrounding tissue may be sore for a few weeks following treatment.
8. Please brush and floss as usual unless otherwise instructed by our office. Follow any other instructions provided by our office during your visit. Please take all medications as prescribed.

THIS SECTION IS VERY IMPORTANT, PLEASE READ CAREFULLY
While flare-ups are rare, they occur in about 5% of cases and may cause significant pain. They generally only occur with teeth that are extremely irritated and/or infected or with teeth that have a history of prior treatment. These sometimes occur randomly, even on patients that have had root canals done in the past without problems. If you have a flare-up, you may experience moderate to severe pain, swelling, throbbing, or general discomfort; please contact our office right away. You may be prescribed additional medication such as antibiotics, and/or you may be asked to come to the office for further treatment.

• Immediately following surgery, maintain pressure on the surgical area by biting down on the provided gauze pad or roll until the bleeding stops. A certain amount of bleeding is to be expected following a surgical procedure. Placing the gauze pad over the area and biting firmly will help prevent excessive bleeding. Replace the gauze as necessary until the bleeding stops.
• Children should be supervised after having an extraction to make sure they do not bite or chew their tongue or lips as this can cause serious injury to the soft tissue.
• To lessen pain, take prescribed or over the counter medication as directed. If any medication we prescribed makes you drowsy, do not drive or operate equipment or machinery. Antibiotics may be prescribed to help prevent infection. If you have been placed on antibiotics, take the medicine as directed.
• Swelling around the face, eyes, and surgical site is not uncommon although it may not appear until the day following the surgery and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the extraction site will help minimize swelling. You may apply the cold compress for up to 10 minutes on and at least 10 minutes off as needed. After 48 hours the cold compress will have no further impact on swelling.
• For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke. Avoid hot and spicy foods as well as carbonated and alcoholic beverages. Restrict your activities on the day of your surgery. Avoid excessive work or play, and resume normal activity the following day as tolerated.
• After the first day, gently rinse with a warm salt water rinse at least three times a day.
• During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
• Sutures may have been placed. Most sutures placed by our office will dissolve on their own in 7-10 days, and it may not be necessary to return to the office for sutures to be removed. If you have sutures that do need a follow-up visit for removal, we will let you know at the time they are placed.
• Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns.

Do

• Use your fingers to put your aligners place. First place the aligners over your front teeth, and then use your fingers to push the aligner down gently over your molars. When aligners are correctly inserted, they will fit all the way down on the teeth, with no space between the top of the aligners and the top of the teeth. Aligners will fit tightly at first but should fit well at the end of the two week period.
• Keep aligners in except when flossing, brushing, eating. It’s also best to remove the aligners when drinking warm beverages such as coffee or tea.
  ‘Remove the aligner by pulling it off both sides of your back teeth simultaneously then lifting it off of your front teeth.
• Place your aligners in the case we provided any time they are not being worn.
• Clean aligners with a toothbrush and toothpaste.
• Wear each set of aligners for two weeks unless our office directs you to vary from this schedule.
• Wear aligners in the correct numerical order. (Each aligner is labeled by number and with a U or an L to designate upper or lower.)
• Keep all of your old aligners and bring them to your orthodontic appointments.

Don’t

• Don’t place your aligners in or on a napkin or tissue. Many aligners have accidentally been thrown out this way!
• Don’t use your teeth to “bite” your aligners into place.
  If you have pets, don’t place your aligners anywhere that your pets can reach them. Pets are attracted to saliva and would enjoy chewing on your trays!
• Do not use Denture cleaner, alcohol, or bleach to clean your aligners.
• Do not use boiling water or warm water on your aligners.
• Don’t chew gum with your aligners in.
• It would be best not to smoke while wearing aligners. The smoke can stain the aligners as well as your teeth. Just in Case
• If you lose the tab attached to your tooth that helps the aligner snap on, please call our office right away so that we can determine if you need to come in before your next scheduled appointment.
  If you lose one of your aligner trays, please wear the next tray if you have it. If you do not have the next tray, please wear the previous tray. It is extremely important to use a tray to keep teeth from shifting. Call our office to let us know which tray was lost so that we can determine if a replacement tray is needed. There will be a fee if replacement trays are required.

• It is not uncommon for your teeth to feel sensitive after whitening. Dr. Berkal recommends using anti-sensitivity or a high fluoride toothpaste to help alleviate some sensitivity. The sensitivity is temporary and should subside after a day or two.
• Following whitening, avoid staining foods or liquids (coffee, tea, sodas, wine, berries) for at least one week. Minimize tobacco use as well.
• When using custom trays, follow the instructions given by our office. Make sure to place the bleaching or anti-sensitivity gel in the center of each tooth position on the tray. The gel should rest against the front surface of the teeth once it is placed in your mouth. Wear trays for the recommended time. Rinse your mouth, and gently remove any gel remaining on your teeth with a soft bristle toothbrush. Always clean your trays with a toothbrush or Q-tip and make sure all gel is removed.
• Store trays in the provided container and store the gel in cool, dry place away from heat and direct sunlight.
• Patients should contact our office with questions, concerns, or if sensitivity worsens or fails to subside after a week.

• Some pain, bleeding, swelling, and seeping are normal following oral surgery. Avoid rinsing, spitting, or touching the wound on the day of your surgery. Slight bleeding is normal for the first 24 hours. If you experience excessive bleeding or discomfort after 24 hours, please call your oral surgeon immediately.
• You should begin taking pain medication as soon as you feel the local anesthetic wearing off. Prescription or over the counter pain medication should be taken per the instructions provided to you by the oral surgeon. Antibiotics may also be prescribed to prevent infection.
• Swelling is a normal occurrence around the face, eyes, and surgical site after surgery. This may become more noticeable two to three days following surgery. To minimize swelling, apply an ice bag, or towel filled with ice in the area of your surgery. Apply the ice 20 minutes on, 10 minutes off, as much as possible, for the first 48 hours.
• Warm salt water rinses (1 teaspoon of salt in a cup of warm water) should be done at least 4-5 times a day. Use prescription rinses as directed by your oral surgeon; usually twice a day for 30 seconds at a time.
• Good oral hygiene is essential to healing. Brush your teeth and the healing abutment gently.
• For 24 hours following your surgery, keep physical activity to a minimum. Do not suck on a straw or smoke any type of cigarette. Avoid hot and spicy foods as well as alcoholic beverages.
• During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
• It is extremely important to keep your follow up appointment(s) so that we can monitor the healing process.
• If pain and swelling are increasing after a few days, please call your oral surgeon right away.

• Avoid spicy (such as salsa), acidic (citrus fluids, wine) or sharp foods (such as nachos) or liquids for the first 72 hours.
• Use of mild anti-inflammatories (Ibuprofen) may be needed initially.
  Secondary intention healing means that a ‘white soft scab’ will appear for the first 7-10 days. It is not an infection and is covering the soft tissue forming.
• Apply Vitamin E or Antioxidant oil to area twice a day for 5 days.
• Cold fluids, ice, popsicles, can be used for the first 24 hours to minimize swelling.
• Use a soft tooth brush carefully around the wound.
• Perform tongue and smile exercises as explained
• Patient should return in 7-10 days to evaluate healing.

• Do not be alarmed with any color changes or appearance of tissues following laser therapy. The changes are a normal response to laser treatments.
• It is OK to spit, rinse, and wash your mouth today. Rinse as directed with Herbal Tooth & Gum Tonic morning and night. As for chewing on the treated side, let comfort be your guide.
• DO NOT brush or floss for 2 days after treatment. After 2 days, brush gently around treated area with extra soft toothbrush. DO NOT floss the treated area(s) for 2 weeks following treatment. Try to keep your mouth as clean as possible in order to help the healing process. Brush, floss, and follow other home-care measures in all other areas of your mouth.
• Take 2-4 Advil or 2 Extra Strength Tylenol every 4-6 hours for the first two days. This is to control inflammation.
• It is very important to maintain a good food and fluid intake. Try to eat soft foods until you can comfortably return to a normal diet. Do not eat spicy or excessively hot foods.
• Do not apply excessive tongue or cheek pressure to the treated area(s).
• Do not be alarmed if one of the following occurs:
  • Light bleeding
  • Slight swelling
  • Some soreness, tenderness, or tooth sensitivity
• Please call the office if any of the following occurs:
  • Prolonged or severe pain
  • Prolonged or excessive bleeding
  • Considerably elevated or persistent temperature
• Do not be alarmed that beginning 2 weeks after therapy and extending as long as 1 year or more, the teeth may become sore, tender, or sensitive as the bone and ligaments around the teeth regenerate and become more firm. This is just a sign of healing.