ApicoectomyYou are going to have an apicoectomy performed on a tooth. The following information will assist you to understand the procedure.1. A small incision is made in the gums near the end of the tooth root. This incision allows access to the infected area. Through this incision, the infected material at the end of the tooth root is removed. The tooth root is sealed to prevent the occurrence of further infection, the gum tissue is sutured to aid in the healing process. The stitches may or may not dissolve by themselves, and we will tell you what to expect.2. You will be given a prescription for an antibiotic. Take this medication as directed until it is gone.3. You will be given a prescription for an analgesic (pain reliever) to reduce any discomfort you may experience after the apicoectomy. 4. Slight bloody discharge may come from the site for a few days. It will gradually stop.5. As soon as it is convenient, place some ice cubes in a plastic bag, wrap the bag in a then towel, ad place the bag on the external of your face over the site of the apicoectomy. Place the ice bag off and on the external of your face over the surgical site every few minutes for the next few hours. This will reduce swelling and bruising. You may have some swelling ad bruising of external skin that will go away in a few days. 6. Within several days, you will recover from this procedure. Statistics show that there is a ninety percent chance that the involved tooth will continue to serve as a functional part of your dentition.

Endodontic Therapy (Root Canal)

You have a tooth with a diseased nerve in it and are in need of root canal therapy. The following information will help you to understand the procedure.Inside of all normal teeth is a cavity containing nerves, blood vessels, and live soft tissue. It is called the dental pulp. Occasionally the pulp tissue is abused by trauma, deep decay, large fillings, crowns or other factors, and the pulp tissue becomes necrotic (dead). Usually, pulp death results in pain and bone destruction visible on dental x-rays.Treating a necrotic (dead) pulp is a delicate procedure requiring the following steps:1. A small hole is made in the tooth to allow access to the dead pulp tissue.2. Using a series of small files, the dead pulp tissue is removed from the internal of the tooth.3. When the internal portion of the tooth is cleared of all debris and cleaned this area is filled with a rubber like material to seal the void inside the tooth.4. If the tooth has been severely weakened it may need a supportive post placed internally, and a subsequent crow (cap) for strength.Root canal therapy is about ninety five percent effective in restoring the tooth back to normal function. However, occasionally mild discomfort lingers for a few weeks before the tooth feels normal.We expect that your tooth that will receive root canal therapy will heal to become a healthy, strong, non-painful part of your dentition.

Post Reinforcement for Weakened Teeth

You are having root canal therapy for a diseased tooth. Root canal therapy requires the removal of a significant amount of the internal portion of the tooth to gain access to the root canals and to remove infected debris. If the tooth has had previous restorations (fillings), or has to support a fixed bridge, it may need internal reinforcement to ensure that the root and the crown portions of the tooth are connected together adequately. Various types of posts are used to connect the root and crown. A post is cemented inside the tooth root, and a core, or replacement of the missing portion of the crown of the tooth is placed on the top of the post.

We plan to place a post in your tooth. The root end of the tooth will remain filled with the root canal filling. The post will be cemented with a strong epoxy-like material that bonds the post and the tooth together.

The post and core provided for you allows optimum potential for this tooth to continue to serve in your mouth for many years.

Thank you.

Veneers, Temporary Restorations1You have just had some teeth prepared for veneers. The teeth have received plastic temporary restorations to cover the prepared tooth structure while the new veneers are made. The following information will help you to have these temporary restorations serve you until the new veneers are ready to be placed in your mouth:1. Temporary veneers do not resemble the final restorations in shape or colour. 2. Temporary veneers are attached only weakly to the underlying teeth. This weak attachment allows us to remove them easily. Be careful to chew only on your teeth without temporary veneers on them, usually the back teeth. 3. If a temporary veneer comes off, call us and we will replace it immediately. If you are in a location that will not allow you to come to our office, go to a pharmacy and buy some FIXODENT (denture adhesive) and place the veneer back in place. This is a temporary cement only. You must still see us as possible.4. Prepared teeth may be sensitive to hot, cold and sweets. When the final restorations are placed, the teeth will not have these sensations. 5. Your gums will be slightly irritated for a few days. Avoid heavy brushing of the temporary veneers. Do not use floss between the temporary veneers because you may pull them off.6. Your final ceramic veneers will be as close to the beauty and function of natural teeth as possible. We will have them for you in a few days. Please call us if you have any questions.Thank you.

Implant Prosthesis(ARTIFICIAL TEETH SUPPORTED BY IMPLANTS)We have done our best to provide you with a well-fitted, functional, and esthetic implant prosthesis. We feel confident that you will adjust to these artificial teeth rapidly, and that you will have many years of satisfaction from them.1. Your First Few Weeks: For several days, please chew more carefully than normal on these restorations. We will adjust the bite (occlusion) on future appointments until the teeth are well balanced. After you have adjusted to the prosthesis, it should function in a similar manner to natural teeth.2. Cleaning the Implants and Prosthesis: The continuing success of the implants and prosthesis is up to you. Please do the following(items are checked):a. Visit us for examination and cleaning of the teeth and prosthesis at least once every months.b. Clean the implant(s) and prosthesis daily, especially before bedtime using:ToothbrushMechanical toothbrushFlossBridge cleanerWater PikPeridex

Please ask us about anything that is unclear relative to proper cleaning.

3. The Future: Your examination and professional cleaning appointments are very important to the long-term success of your implants and prosthesis. If your personal and professional cleanings and your examination appointments are accomplished routinely, your restorations should serve many years. Please contact us if any of the conditions below occur: Awareness of looseness Peculiar taste Clicking or metallic snap while eating Breakage of a piece of the prosthesis Redness in the gum tissue around the implant Feeling of the bite being different PainWe look forward to helping you enjoy your new implant supported prosthesis.

Tooth-Coloured RestorationsWe have restored one or more of your teeth with tooth-coloured materials. The resin (plastic) material used contains small filler particles for strength and wear resistance. These restorations will serve you well for several years. They contain the finest and most up-to-date materials available today. Please be aware of the following information about your new restorations:Chewing: Avoid chewing excessively hard foods such as hard candy, corn nuts, ice, bones, etc., because the resin material can be broken from the tooth with extreme force. If breakage occurs, replacement of the restoration is not difficult.Recall Visits: Professional six-month examinations are necessary. Developing problems can be detected at an early stage and repaired easily. Waiting for a longer time may require redoing the entire restoration. We will contact you when it is time for your recall appointment. Preventative Procedures: To provide optimum longevity for your restorations ad to prevent future dental decay and supporting tissue breakdown, please use the following checked preventative procedures:a. Brush with a fluoride-containing toothpaste after meals, and clean your teeth with floss at least once a day.b. Swish vigorously for 30 seconds daily with a fluoride-containing rinse available from many stores without a prescription. Use the rinse before bedtime.c. Use a Water Pik as directed. d. Use 1.1% neutral sodium fluoride as a brush-on material. These products require a prescription from us.e. Use a mechanical toothbrush.The Future: We expect several years of service from these restorations. However, after a service period of years, we have seen the following situations occur:a. Slight stains may occur at locations around the juncture of the tooth restoration and the tooth. Often, we can remove these stains without redoing the restoration.b. Slight chipping at the juncture of the tooth and restoration. Usually these chips can be smoothed by us.c. The gums (gingiva) may shrink from the restorations, displaying an unfavourable appearance underneath. This condition may require remaking the restoration or modifying the gums. Thank you.

Periodontal Root PlanningYou have need of extensive tooth scaling. This procedure is similar to typical tooth scaling during a routine oral hygiene visit, but it is different in the following ways:1. Extensive pockets existing around your teeth require more comprehensive scaling. The deep gum pockets block vision of the tooth root structure. Small scaling devices (either manual or ultrasonic) will be carefully placed into the gum pockets, and systematic smoothing of the tooth root surfaces will be accomplished. Debris that has collected on tooth surfaces will be removed along with diseased soft tissue. 2. Deep tooth scaling, smoothing of the tooth roots, and gum curettage requires significant time and expertise. Usually only one or two segments of your mouth will be treated on one appointment. Other appointments may be needed to complete the therapy. 3. Your gums and teeth will be slightly uncomfortable for a few days after the deep scaling and root planning, but they will gradually feel normal again. After the gums have healed a few days, you will be able to maintain oral hygiene much better than in the past.4. Your gum tissue may shrink somewhat as it heals. This condition is desirable because it reduces the depth of the pockets and allows you to clean the areas under the gums.5. Tooth scaling and root planning are the most conservative methods to treat periodontal disease. We look forward to slowing or stopping your periodontal disease with this procedure, and we will keep you advised of the status of your periodontal condition as it heals.6. Conventional tooth cleaning procedures are usually indicated in the future.

Cracked-Tooth SyndromeOften, teeth may crack when subjected to the stress of chewing hard foods, ice, or hard objects, or just from normal chewing. Teeth with or without restorations (fillings) may exhibit this problem, but teeth restored with typical silver alloy or tooth-coloured restorations are most susceptible. Older persons have more cracked teeth than younger people. SYMPTOMS AND SIGNS INCLUDE THE FOLLOWING:1. Pain on chewing2. Pain on cold-air application3. Pain when eating sweets4. X-ray evidence of the problem is not present5. Dental decay is not present6. Easy verification of the crack by the dentist when the tooth is prepared for restoration.TREATMENT OF CRACKED TEETH:1. Simple Crack: The majority of cracked teeth (about 9 out of 10) can be treated by placement of a simple crown (cap) on the tooth. When the tooth is prepared for the crown and a temporary restoration is placed, the pain usually leaves within a few days. If this is the case with your tooth, we will place the final crown without a problem on your next appointment. The condition should then be solved.2. Complex Crack: Occasionally, (about 1 in 10) the tooth cracks into the pulp (nerve) of the tooth. If pain persists after placement of the temporary crown, you may have a crack into the pulp of the affected tooth. Please call us. This tooth may require endodontics (root canal therapy) before the crown is placed. This procedure requires about two additional appointments before the crown is placed.3. Tooth Cracked in Half: Occasionally, a tooth cracks into two separate pieces, requiring removal of the entire tooth, or removal of one of the pieces, root canal therapy, and a crown on the remaining piece. Thank you.

Crowns and Fixed Prostheses (Bridges)You have just had some crowns or fixed bridges cemented onto your teeth. They will replace your missing tooth structure or missing teeth very well, and they should provide you with years of service, if you will observe the following suggestions:1. Chewing: Do not chew hard foods on the restorations for 24 hours from the time they were cemented. The cement must mature for several hours to have optimum strength. 2. Sensitivity: Dont worry about initial mild sensitivity to hot or cold foods. It will disappear gradually over a few weeks. Infrequently, sensitivity lasts longer than six weeks. Please tell us if this occurs.3. Aggressive Chewing: As with natural teeth, do not chew ice or other hard objects. Avoid chewing sticky foods such as hard tack candies and caramels because they can dislodge your restorations.4. Preventative Procedures: To provide optimum longevity for your restorations and prevent future dental decay and supporting tissue breakdown, please use the following preventative procedures that are checked:

a. Brush and floss your teeth after eating and before bedtime.b. Swish vigorously for at least 30 seconds daily with a fluoride-containing mouth rinse available at many stores without a prescription. The best time is immediately before bedtime. c. Use a mechanical toothbrush.d. Use a strong fluoride gel such as Colgate PreviDent as you would use toothpaste. (This product requires a subscription from us.)e. Use the provided strong fluoride gel in the provided trays for 5 minutes per day. You should have been provided with an additional information sheet for this technique. 5. Recall Appointments: Visit us for regular six month examinations. Often, problems that are developing with your restorations can be found at an early stage and corrected easily. Waiting for a longer time may require redoing the entire restoration. Failure to return for professional examinations is the most significant reason for restoration failure. We will contact you when it is time for your next recall appointment. 6. Problems: If any of the following conditions occur, contact us immediately to avoid further problems: Restoration movement or looseness. Sensitivity to sweet foods. A peculiar taste from the restoration site. Breakage of a piece of material from the restoration. Sensitivity to pressure.We have done our best to provide you with the finest-quality oral restorations available today. However, only your continuing excellent oral hygiene and professional recalls can ensure optimum service longevity.Thank you.Temporary Crowns and Fixed Prostheses (Bridges)You have just received a plastic temporary restoration that will serve you for a short period of time until the final restoration(s) are made. The following comments about these temporary restorations will be helpful to you.Chewing:a. The temporary cement holding the interim restoration in place requires about half an hour to set. Please do not chew during that period of time, as you may dislodge the temporary restoration. b. Temporary restorations are not strong. They may break or come off. Do not chew on hard or sticky foods in the area of the temporary restoration(s). If the restorations come off, call us and we will replace them. If you are where you cannot contact us, go to a pharmacy and purchase some Fixodent (denture adhesive). Replace the temporary with Fixodent holding it in place. This denture adhesive will retain the temporary restoration until you can see us. Please do not leave the temporary restoration out of your mouth because the teeth will move, and the final restorations will not fit.c. DO NOT USE superglue to cement the restoration.d. Certain foods will stick to the temporary restoration. This will not happen with the final restoration to be cemented soon.Colour: The colour of the plastic temporary does not resemble the colour of the final restoration.Shape, Size: The shape and size of the plastic temporary does not resemble the final restoration. Tooth Sensitivity: Temporary restorations may leak, allowing saliva or food to contact the tooth. Sensitivity to cold, hot, or sweet is not uncommon. This sensitivity will not be present with your final restorations. Please call us if you have any questions.Thank you.

DenturesWe have done our best to provide you with well-fitted, functional, and aesthetically pleasing dentures. We feel confident that after a few weeks of becoming adjusted to the new dentures, you will have years of satisfaction and use from them.The following information will be helpful for you:1. The First Few Weeks: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.2. Sore Spots: Usually, your mouth will have a few sore spots, after wearing the dentures for twenty four hours. Dont worry about these areas. They can be relieved with very little effort during your next appointment. Another appointment about seven days late will usually eliminate any additional sore areas.3. Chewing: The new bite may not feel completely comfortable for a period of days. We will adjust the contacting surfaces of your teeth in twenty four hours and again about one week after the dentures have settled into place. 4. Upper vs. Lower Dentures: Your upper denture will rest comfortably in place with moderate to strong suction. Although your lower denture will have good stability, it is infrequent that suction can be expected on a lower denture. We suggest that you avoid denture adhesives unless you have significant difficulty, because they alter the fit of the denture over a period of time.5. Cleaning the Dentures and Your Mouth: Your dentures can be cleaned by using a soft bristle toothbrush and mild toothpaste such as Complete (Procter & Gamble). Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water to avoid warping the plastic. Denture soaks are also useful to dissolve debris from the denture. Please ask us if you are interested in small sonic cleaners available for home use. 6. What to Expect in the Future: Your jaw bones and gums shrink up to 1/32 of an inch per year after your teeth are extracted. This shrinkage is one of the main disadvantages of artificial dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated once per years by us. We will inform you when refitting of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and serious oral diseases. We look forward to helping you enjoy your new dentures.

Dentures, Placed Immediately after Tooth ExtractionYou have just had an immediate denture placed in your mouth. The following information will assist you to understand the sequence of events during the healing period: Teeth have been removed from your mouth. Stitches may have been placed to help the mouth heal. If so, they will dissolve by themselves over several days, unless we tell you differently. Dentures have been placed to replace your missing teeth and gum tissue. Initially, these dentures will feel large and bulky until your gums have healed and shrunken slightly, at which time we will make the dentures thinner and less bulky. The dentures may cause your speech to be altered for a few days, but this feeling will disappear soon. Do not take the dentures out of your mouth today. We will remove them tomorrow. The new dentures serve as a bandage similar to a cast on a broken arm during initial healing. After the initial denture removal and adjustment by us, you should remove the dentures frequently for cleaning. Some discomfort is usually present when teeth are removed and immediate dentures are placed. The discomfort is due to one or two reasons:a. The trauma of removing teeth. Within a few days the discomfort will go away.b. The denture may have pressure spots that become sore. If so, the pressure spots will be observed and removed by us as soon as you tell us about the discomfort. They will not go away by themselves. If you have been given antibiotics, it is important to continue with the therapy until all of the tablets have been taken. Use the pain relieving pills while you are experiencing discomfort. Your immediate dentures have been relined today with a soft material that makes them easier to wear and speeds healing. That material may be replaced during the initial healing period of six weeks or more. It is not the final denture material. Be careful not to dislodge this soft material when cleaning. As soon as convenient, place ice cubes in a plastic bag and place the bag externally on the areas of your face where the teeth were removed. The cooling effect of the ice will reduce swelling and bruising. However, some swelling and bruising may still occur for a short time. After six weeks (minimum) your denture will be relined to refine its fit to adapt to the healing supporting tissues. The reline is included in the cost of your denture. At this time the denture will appear, fit and function as intended. The majority of the healing from tooth extractions continues for up to eighteen months. Shrinkage of gums and bone is obvious during that time, but it slows thereafter. You may elect to have a second reline of the denture about eighteen months after the initial surgery. This reline is not included in your initial fee. After healing, denture cleaners are useful to remove debris from the denture. Please ask us if you are interested in small sonic cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water to avoid dehydration and shrinkage. Immediate dentures are a major change for your body. Dont worry if you are somewhat slow to adapt to them. Millions of others have been through this experience. We expect your denture to serve well for many years after an initial period of adapting to it.

Partial Removable DenturesWe have done our best to provide you with well-fitted, functional and esthetic removable partial dentures. We feel confident that after a few weeks of becoming adjusted to the new partial dentures, you will have years of satisfaction and use from them.1. The First Few Weeks: New dentures always feel strange when first placed in your mouth. Several days or even a few weeks will be required for you to feel accustomed to them. 2. Sore Spots: Usually, you mouth will have a few sore spots after wearing the dentures for twenty four hours. Dont worry about these areas. They can be relieved with very little effort during your next appointment. Another appointment about seven days later will usually eliminate any other sore areas. 3. Chewing: The new bite will not feel comfortable for a period of days. We will adjust the contacting surfaces of your teeth in twenty fours and again about one week after the dentures have settled into place. 4. Cleaning the Dentures and Your Mouth: Your dentures can be cleaned by using a soft bristle toothbrush and a mild denture cleaning paste. Use special care to clean the parts of the partial denture that contact natural teeth. Both the partial denture and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting. Use fluoride-containing toothpaste for the natural teeth. If suggested by us, use high fluoride-containing toothpaste such as PreviDent (Colgate) as a brush-on material on a daily basis. This product requires a prescription from us. Denture soaks and cleaners are also useful to help in removing debris from the denture. Please ask us if you are interested in small sonic cleaners available for home use. Brush your gums with a regular toothbrush once per day to toughen and clean them. You may leave the dentures in or out of your mouth at night, depending on your preference. If they are out of your mouth, leave them soaking in water to avoid dehydration and warping. 5. The Future: Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This shrinkage is one of the main disadvantages of artificial dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us at least once every six months. We will inform you when refitting of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and serious oral diseases.We look forward to helping you enjoy your new partial dentures.