Home Instructions

• Because local anesthesia is usually administered, it is important to be cautious after treatment. Avoid chewing foods until normal feeling returns to avoid injury to the tongue, lips or cheeks.
• Smoking should be avoided for at least 72 hours after scaling and root planing procedures because tobacco use interferes with healing.
• Avoid any vigorous or strenuous aerobic activity for the remainder of the day.
• You may experience some discomfort when the anesthetic wears off. Injection sites may also be sore. Discomfort immediately after treatment is usually associated with a slight aching, which normally dissipates within a few hours. Very seldom does swelling occur.
• You may experience increased sensitivity to hot and cold temperatures or sweets. This is normal and may persist for the first several days but should quickly diminish thereafter. A sensitive formula toothpaste, such as Sensodyne or Prevident, may help alleviate these symptoms.
• Even before discomfort develops, it is helpful to start taking any one of the following over-the-counter pain medications: Ibuprofen (i.e., generic Motrin or Advil), Aleve, Aspirin or Tylenol.
• Warm salt-water rinses (1/2 teaspoon of salt in a full glass of warm water) several times daily are also helpful to alleviate any discomfort or tenderness.
• Eat only soft foods for the first 24 hours and avoid any hard or spicy foods which could cause irritation.
• Drink plenty of water for the first 24 hours.
• Although it is normal to experience some soreness, tenderness or slight bleeding during the first few days following periodontal therapy, it is imperative that daily brushing and flossing be maintained. A clean mouth heals faster.
• If you are using an electric toothbrush, you may continue to do so. If using a manual toothbrush, make sure it is always a soft brush. Brush with gentle circles on each tooth to help with plaque removal. Also, use fluoridated, tartar control toothpaste.
• We will work with you to develop a maintenance program that is customized for you in order for you to maintain good periodontal health. At each of your periodontal maintenance appointments, we will measure your pocket depths and evaluate your progress along with recommending an appropriate frequency for further appointments. In general, more frequent maintenance appointments of three to four months are customary to keep your periodontal condition as stable as possible.
• Daily plaque removal (brushing and flossing) and recommended periodontal maintenance appointments are crucial for the long-term success of your periodontal health.

After your appointment with Dr. Hoffman, it is normal to experience some pressure sensitivity for a few days and some temperature sensitivity for up to two weeks. The injection sites from the anesthetic may also be sore for a short period of time. If required, Motrin, Tylenol or aspirin can be used to alleviate any tenderness.

If you were given local anesthesia during preparation of your veneers, your lips and cheeks may be numb for a few hours. Be very careful when eating or drinking hot foods and liquids. After the numbness wears off, if your temporaries feel high or your teeth feel like they do not meet together properly, your bite may need to be adjusted. Please contact our office to schedule an appointment for an adjustment.

For your permanent veneers, remember that it will take some time to adjust to the feel of your new bite. When the bite is altered or the position of the teeth is changed, it takes several days to recognize and become used to the new position of your teeth or to their thickness as normal. If you continue to detect any high spots or problems with your bite, contact us so we can schedule an appointment for an adjustment.

It is normal to experience some hot and cold sensitivity for a short period of time after temporary or permanent veneers are placed. The teeth need some time to heal after removal of tooth structure and will be sensitive in the interim. Your gums may also be sore for a few days. A warm salt-water rinse will help and, if needed, a mild over-the-counter pain medication (Tylenol or Ibuprofen/Motrin) should ease any residual discomfort. Don’t be concerned if your speech is affected for the first few days. You should quickly adjust and be speaking normally. Daily brushing and flossing are critical for the long-term success of your new veneers, as are regular professional cleaning appointments.

Any foods that can chip, crack or damage a natural tooth can do the same to your new veneers. Avoid hard foods such as hard candies, peanut brittle and salt-water taffy. Also, try to refrain from certain habits such as chewing on ice or pencils and biting your fingernails. If you grind your teeth at night, please let us know so that we can make a custom-fit night guard for you. Adjusting to the look and feel of your new smile will take some time.

It is important to remember that your temporary restoration is not as sturdy as the permanent one will be; therefore, you should be careful when cleaning and eating. The area should be brushed gently, and you should not pull up on the tooth when flossing so that the temporary does not become loose or dislodged. You should also avoid hard, sticky or chewy foods while your temporary is in place.

There may be some temperature and pressure sensitivity after the temporary or permanent restoration is placed. This is normal and usually subsides a few weeks after the final restoration has been placed. Warm salt-water rinses will help, and mild over-the-counter pain medications may also be used as directed by our office.

When a permanent crown or bridge is placed it may feel a bit strange or very “new.” Your mouth will adjust to the new restoration, and it normally feels like your other teeth in about a week. Also, daily brushing and flossing of your permanent crown or bridge is vital to the long-term success of your new teeth, as are regular professional cleaning appointments.

• Avoid using any tobacco products. Ideally, you should quit altogether because tobacco slows healing and increases the risk that your body will reject the implants. Tobacco is the leading cause of implant failure.
• Avoid grinding and clenching your teeth because this can damage the implants and restorations. If grinding and clenching continue to be a problem, Dr. Hoffman may need to adjust the restorations and construct a custom-fit night guard.
• To protect your implants and restorations, avoid chewing ice and other hard objects.
• Brush and floss around your implants thoroughly but gently. Our dentist may recommend special floss, brushes, mouth rinses or other cleaning aids to keep the area free of bacteria. Brush and floss your gums and natural teeth normally.
• Take antibiotics or other medications as directed.

• Avoid drinking hot beverages or chewing until numbness from the local anesthetic has completely worn off.
• To prevent the temporary filling or tooth from fracturing, avoid eating hard or sticky foods and do not chew excessively on the affected side until your root canal treatment is completed and your tooth is permanently restored.
• Sleep with your head in an elevated position for the first few nights if you do not have any physical limitations.
• It is not uncommon for your tooth and surrounding gum tissue to be uncomfortable due to tenderness and pressure sensitivity (especially when biting or chewing) or even exhibit a dull ache for a few days or weeks after receiving root canal therapy. These conditions exist because the nerves around the tooth have been inflamed prior to initiating treatment and because of manipulation of the tooth during treatment. The amount of post-operative discomfort is due to the treatment received and is often related to the degree of pulpal inflammation and infection of the tooth prior to treatment. Do not be alarmed by this discomfort as it is normal and should subside within a few days or weeks.
• To alleviate any discomfort, we recommend that you take over-the-counter Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). In general, two to four tablets of Ibuprofen taken four times a day for the next several days is usually adequate to relieve any pain or discomfort. Aspirin and aspirin-containing products are NOT advisable, as they tend to increase bleeding from the area that was treated.
• Continue to take any prescribed antibiotics for the indicated full length of time, even if the signs and symptoms of infection are gone.
• Occasionally, a small “bubble” or “pimple” will appear on the gum tissue within a few days after completion of the root canal. This represents the release of pressure and bacteria which can no longer be sustained around the tooth. Do not be alarmed by this as it normally disappears within a few days after its’ initial appearance.
• It is important to continue with your regular dental hygiene regimen of brushing and flossing daily.
• Your tooth is more prone to fracture immediately after root canal treatment. Remember to avoid chewing excessively on the affected side until your tooth has been protected with a permanent restoration, usually a crown. It is only a matter of time before your tooth will fracture if you do not have it restored with a permanent restoration. If the strength of the tooth is seriously compromised, it may be necessary to place a post and core build-up inside the tooth before placing the permanent crown on the tooth. Please make an appointment at your earliest convenience to have your tooth permanently restored.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on a straw, smoke or drink alcohol for 72 hours after tooth extraction. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted, you may feel some pain and experience some swelling. An ice pack applied to the area will keep swelling to a minimum. The swelling usually subsides after 48 hours. Take pain medications as prescribed.

If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of any infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours, yet try to avoid the extraction site for 72 hours. This should include brushing and flossing your teeth at least twice per day. This will accelerate healing and help keep your mouth fresh and clean.

Adjusting to Dentures

Most new dentures require a “breaking in” period before they become comfortable. You must show patience and perseverance in order to master wearing a denture. This can only be done by keeping the dentures in the mouth versus not wearing the dentures.

You must first learn what is necessary to keep them in place. New dentures will feel awkward and bulky in your mouth, especially because they create a feeling of fullness of the lips and cheeks. This is the case even for a patient who has previously worn dentures. They may have become very used to a previous set of dentures for many years. But, just as someone who is wearing dentures for the first time, they must become accustomed to and adjust to new dentures. A great deal of control of complete dentures results from manipulations of the tongue, cheeks, and lips. Salivary flow may be excessive for several days until the glands in the mouth adjust to the presence of the new dentures.

It is also important to note that the lower denture is almost always much harder to become accustomed to versus the upper denture. This is because the bony ridge support of the lower denture is usually not as good as that of the upper denture. Also, the lower denture does not normally have the suctioning that helps with retention of the upper denture, and tongue movements usually affect retention of the lower denture more so than the upper denture.

Although great effort is involved in constructing dentures that are compatible with the surrounding tissues, the dentures move on the tissues. Soreness, or “sore spots” will usually develop at different locations in the mouth as a result of uneven pressure on the gums. You must have these sore spots in the mouth corrected. They are best corrected by wearing the dentures at least three to six hours before returning to the office for an adjustment appointment. This allows for a more precise detection of the sore areas inside the denture which will be corrected by trimming.

Patients should never attempt to adjust the dentures themselves. The tissues surrounding the dentures will function and conform more naturally after the dentures have been adjusted and have been worn for several weeks.

• Speaking normally with dentures requires practice and patience but is usually not a major problem. Reading aloud is an excellent way to learn to enunciate distinctly and you should repeat any words or phrases that are not clear or difficult to pronounce. Effort should be made to try to avoid movements of the lips and tongue that tend to cause the dentures to click or become displaced. You should also try to learn to position the tongue further forward so that it rests on the back of the lower front teeth. This positioning of the tongue helps to develop stability for the lower denture.
• Learning to chew well with dentures normally requires at least one to two months. You should begin chewing relatively soft foods. Take small bites and chew slowly. Do not try to chew with the front teeth. Try to keep the food distributed evenly on both sides and chew on the back teeth. If chewing can be done on both sides simultaneously, the tendency of the dentures to tip or “rock” will be lessened. When biting with dentures, the food should be placed between the back teeth to break it apart rather than pulling downward and outward as one would do with natural teeth. This will produce an inward and upward force, which tends to seat the dentures on their bony ridges rather than to displace them.
• Harder or more difficult foods will require a gradual learning curve. Initially, you should not attempt to eat sticky or adhesive foods.
• Do not use denture adhesives under ill-fitting dentures. They should only be used in well-adapted and satisfactory dentures. These adhesives should be applied in small pea-sized increments on the denture base as needed, preferably prior to meals. The adhesive may require 2 or 3 re-applications throughout the day.
• Dentures should be taken out of the mouth at night to give the supporting tissues adequate rest and to allow normal blood flow to return to the bony ridges for about eight hours a day. This prevents resorption (bone loss) from becoming greater than normal.
• Dentures should be removed from the mouth and thoroughly brushed after every meal with a denture brush using denture toothpaste or liquid hand soap. Regular toothpaste is too abrasive for dentures and can dull the acrylic finish of dentures.
• When dentures are left out at night, they should be placed in water at room temperature to prevent drying and possible dimensional changes. Denture cleansers, such as Polident effervescent denture tablets, can be used in the storage water with the dentures in place.
• Patients who had teeth extracted or oral surgery on the same day that their dentures were delivered should not remove their dentures from the mouth for the first 48 hours. Removal of the dentures in the first 48 hours may cause too much swelling, which will not allow the patient to replace the dentures. Also, for these patients, their dentures may feel loose due to the gum and bone shrinkage that takes place during the healing process. Complete healing of the gums and the underlying bone takes from three to six months. During this time, the dentures can be temporarily re-lined to help with retention. Once healing is complete, the dentures can then be permanently re-lined, and in some cases, may need to be re-done.
• You should never go back to using old dentures because you will not get used to your new dentures, and the tissues will not adapt to the new dentures.
• Patients who wear dentures still require routine dental examinations. Dentures become ill-fitting and can damage the supporting tissue without the patient being aware that anything is wrong because it occurs over an extended period of time. Lesions can develop in the oral cavity that may or may not be associated with dentures. Patients should have a dental examination at least once a year. 
• Dentures are not meant to be permanent. They will become worn over time and lose their fit due to changes in the bony ridge. A replacement should be considered approximately every seven to 10 years and a re-line may be occasionally necessary (an average of every two to three years).
• If you wear a partial denture, it is important to remove it from your mouth using the clasps only. Do not try to take the denture out of your mouth by pulling on the denture teeth or the acrylic as this may cause breakage of the teeth or the denture. Use your fingernails to push up on the clasps or pull the clasps off the teeth. In time, the clasps can lose some of their retention causing the partial denture to feel loose. Do not try to adjust the clasps on your own because they can break.