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Temporary Crowns or Bridges

 

You have just received a temporary crown.  This temporary crown is meant only to serve your needs while a permanent crown is being made for you.  Color:  The color of the plastic temporary crown does not resemble the final (permanent) crown in any way.  Shape and Size:  Temporary crowns are custom-made for each patient, but they will not, in any way, resemble the final crown, which is being made especially for you.  Tooth Sensitivity:  Your temporary crown will help protect the sensitivity of the prepared tooth.  However, it does not fit your mouth like the permanent crown will, so you may notice sensitivity to heat, cold, or sweets.  Sensations you won’t feel when your specially-made crown is in place.

 

Here are some other things you need to know about your temporary crown:

1.   The temporary cement requires about 30 minutes (one half-hour) to set.  Please do not chew during that period of time.

2.  Certain foods will stick to the temporary crown.  Please refrain from chewing gum, candies, or foods that might stick to the crown or even pull it out.

3.  Temporary crowns are not strong they may occasionally break or come off.  If this should happen to you, please contact our office immediately, bring your crown with you and we will replace it.  Should you be unable to contact us, simply go to a pharmacy, and get some Fixodent.  Replace the temporary crown on your tooth using the Fixodent to hold it in place until you can contact us.

4.  Please do not leave the temporary crown out of your mouth.  Without the temporary crown, your teeth may move and then the permanent crown may not fit!

5.     Do not brush or floss too vigorously around your temporary crown.  Remember that it is important to keep the area clean-but use caution.

6.     It is imperative that you return to our office at the appointed time for your permanent crown.  Failure to do so may result in the need to re-prepare the tooth and re-make the crown at your cost.

 

 

 

Extraction Post-Operative Care:

 

It is important to take care of your surgery site.  Please follow these instructions:

1. Bite on gauze for 30 minutes (one half-hour) to stop any bleeding.  If bleeding continues, place gauze and continue to apply pressure.

2. for at least 24 hours:

• Do Not Smoke (Best if you don't smoke for at least one week)
• Do Not Drink with Straw (drink from a cup)
• Do Not Rinse aggressively (gentle rinsing after brushing)
• Avoid Hot Food or Drinks and Hard Food
• Avoid Taking Hot Showers
• Avoid Major Physical Activities (sometimes up to 1 week)
  

Any of these things may cause the blood clot over the surgery site to dislodge from the “socket”, causing a “dry socket” and resulting in unnecessary pain.  (Should this happen, call this office to see the doctor as soon as possible.)

3. Maintain a soft diet for the remainder of the day—things like warm soup, ice cream, milk shakes (remember no straws), etc.

4. If your pain, discomfort, or bleeding continues or worsens, call the office for a re-examination.

5. If you were given medications, take them according to the instructions.  If you have pain medications at home, you may take them according to the instructions.

6.     On the morning after the surgery start rinsing gently with warm salt water (1/4 teaspoon of salt to 1 cup of water) every four (4) hours for two (2) days.

7.     If any problems or questions do arise, please feel free to call the office (415)986-7100) or Dr. Rahbar at (415)385-5775.

 

 

TMJ

Some 60 million Americans have TMJ.  Simply put, TMJ is the syndrome that happens when the muscles in the jaw and the temporomandibular joint are out of alignment or misaligned, causing problems when chewing.  In plain English, the ligaments, muscles, bones, and joints do not line up, causing pain.

Some Symptoms Associated with TMJ:

          1.  Clicking, popping, or grating sound when opening or closing the mouth

          2.  Headaches and/or dizziness

          3.  Tenderness in the jaw muscles

          4.  Earache

          5.  Jaws that sometimes lock open when yawning or if mouth is held open

          6.  Spasm or cramps in the jaw area (very common)

What Causes TMJ?  These are the most common causes:

          1.  Accidents

          2.  Developmental (natural) defects, including the wearing-down of teeth or fillings causing a misalignment of the teeth

          3.  Surgery

          4.  Orthodontics

          5.  Stress that causes clenching of the jaws and grinding of the teeth

          6.  Naturally misaligned teeth

What can be done to correct TMJ?

·         If the temporomandibular area has been damaged by arthritis or as a result of an accident, surgery may be needed to correct the TMJ and re-establish the proper occlusion.  Far more likely, your doctor will recommend a therapy that may include a bite splint and specific exercises to keep the teeth from touching and to allow the joint to remain lined up, allowing the jaw’s hinge area to relax.  Such therapy increases your comfort by diminishing the TMJ pain.  If a splint is prescribed for you, it is very important that you follow your doctor’s instructions regarding the amount of time and time of day you must wear it.

·         If your condition is temporomandibular joint irregularity (TMJ), you need to wear your splint all the time unless directed otherwise.  Do not remove the splint when you eat, as this would compromise your treatment and diminish its effect.  The splint stops tooth-to-tooth contact and keeps your jaw lined up properly, allowing the muscles and joint area to heal.  As this healing takes place and the symptoms gradually disappear, your doctor will adjust your splint to keep your teeth properly aligned.  During this period of your therapy, you will begin wearing the splint fewer hours of the day and, after a period of time; you will no longer need to wear a splint.

          Grinding (“bruxism”) and Clenching:  These conditions require you to wear your splint only at night, while sleeping.

          Clean the splint by brushing it.  Keep it in water and mouthwash solution when it is not in your mouth

 

Important Information about Your New Complete Dentures

We have done our best to provide you with well-fitted, functional, and aesthetically pleasing dentures.  We feel confident that after a few weeks of adjustment, you will enjoy years of satisfaction and use.  In the meantime, the following is information you need to know.

1. Your 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.  Your mouth will most likely have a few sore spots about 24 hours after you first put your new dentures in.  Such sore spots can be relieved by your doctor with very little effort.  An initial readjustment appointment should be made, and another appointment about seven days later will usually eliminate any other sore areas

3. Chewing.  The new “bite” or occlusion will not feel comfortable for a period of days.  We will adjust the contacting surfaces of your teeth after 24 hours, and again in 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 extreme difficulty.

5. Cleaning the Dentures - and Your Mouth.  Your dentures can be cleaned easily by using a denture brush and toothpaste.  Denture soaks are also useful for the denture.  Brush your gum 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 a water-and-mouthwash solution.

6. The Future.  Your jawbones and gum shrink up to 1/32 of an inch per year when your teeth are missing.  This is one of the main disadvantages of dentures.  Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us once per year.  We will inform you when relining or re-basing of the dentures is necessary.  Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and very serious oral disease.  Even dentures that “fit” comfortably need to be checked on regular basis.

 

Implants 

We have just completed the prosthesis for your oral implants.  Such implants have been placed successfully for over 25 years.  The following information will be interesting and useful for you relative to future expectations for your implants and the prosthesis placed on them.

Acceptance of dental implants by bone and gum tissue has been excellent, however a few implants fail.  Additionally, the prosthesis that has been placed over the implants is subject to wear and/or breakage.  Any of the following conditions that occur require your immediate attention.  Please contact us if any of the following conditions occur:

        1.  Feeling of looseness

        2.  Peculiar

        3.  Clicking or metallic snap while eating

        4.  Breaking a piece of the prosthesis

        5.  Redness in the gum tissue around the implant

        6.  Feeling of the bite being different

        7.  Pain

We have done our best to provide to you the highest quality service available.  The continuing success of the implant and prosthesis is up to you.  Please do the following items checked

        1.  Visit us for examination, scaling, and polishing at least once every six months.

        2.  Clean the implant daily, especially before bedtime using:

                A.  Floss

                B.  Bridge cleaner

                C.  Toothbrush

                D.  Electric toothbrush              

Your failure to accomplish thorough cleaning of the implant prosthesis daily will compromise its longevity significantly.  We expect years of service from this therapy.  Over a number of years, you will gradually wear out the prosthesis portion.

 

 

Crowns or Bridges (Fixed Prosthesis)

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 should give you years of good service - provided you observe the following cautions:

Chewing:  Do not chew hard foods on the restorations for 24 hours from the time they were cemented - to attain optimum strength; the cement must mature for approximately 24 hours.

Sensitivity:  Don’t worry about mild sensitivity to hot or cold foods.  This sensitivity will disappear gradually over a few weeks.  Infrequently, sensitivity lasts longer than six weeks.  Please notify us if this occurs.

Preventative Procedures:  To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please use the following preventive procedures:

___ Brush and floss after eating and before bedtime.

___ Use a fluoride rinse, swish vigorously for at least 30 seconds daily.

___ Use fluoride gel as prescribed by our office. 

___ Use, ____________ (a Water Pik, an Interplak toothbrush, etc.) as advised by us.

 

Recalls:   The most significant reason for prosthesis failure is inadequate return for examination.  Visit us at regular six-month examination periods.  Often problems that are developing around the restorations can be found at an early stage and corrected easily.  Waiting for a longer time may require redoing the entire restoration.

Problems:  Call us immediately if any one of these conditions occurs:

·    Feeling of movement or looseness in the restoration

·    Sensitivity to sweet foods

·    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 restoration available today.  Only your continuing care and concern can assure long-term good dental health.

 

 

Cracked Tooth Syndrome

Teeth may crack when subjected to the stress of chewing hard food or ice, or by biting on an unexpected hard object.  Teeth with or without restorations may exhibit this problem, but teeth restored with typical silver-alloy restorations are most susceptible.

Symptoms and Signs of Cracked Teeth (some or all of the following):

·         Pain while chewing;

·         Pain upon cold air application;

·         unsolicited pain (usually leakage of sugar into a tooth crack)

Treatment of Cracked Teeth: 

Simple Crack: The majority of cracked teeth—about 9 out of every 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 immediately.  If this is the case with your tooth, we will place the final crown on your next appointment, and the condition should be resolved. 

Complex Crack: Occasionally - about 1 in 10 - a crack is pronounced or severe enough to access the pulp (nerve) of the tooth.  If pain persists after placement to the temporary crown, you may have such a crack into the pulp of the affected tooth.  To verify, please call us.  The tooth may require endodontics (root canal therapy) before the crown is placed.

 

Occlusal Equilibration what is it?  Why do I need it?

Occlusal equilibration is the mechanical adjustment of your teeth, dentures, fillings, or other appliances to a position which allows your lower jaw to function as a natural hinge in relation to your upper jaw reducing needed tooth structure to assure that all teeth fit together with equal pressure on all teeth and surfaces.  This allows you a better chewing surface and comfort.  There are many reasons why teeth and jaws do not occlude (meet) in a comfortable position.  Some of them are:  numerous fillings or bridges over period of years, orthodontics, developmental defects, oral surgery, trauma, malocclusion (poor bite), bruxism (grinding one’s teeth), and clenching. 

Your mouth is being equilibrated because some problem exists; i.e. pain, abnormal wear, breaking of restorations, or other situations.  The problem is usually present because your teeth and/or fillings do not meet in harmony with your lower jaw at a proper position.  The teeth and fillings have not “worn in” properly.

 

 

 

 Tooth-Colored Restorations

We have placed tooth-colored restorations in your teeth.  The resin material used is a plastic with small “filler” particles of glass-like material—the finest and most up to date materials available today.  These restorations will serve you well for several years; however, you should be aware of the following.

Chewing:  As with natural teeth, avoid chewing excessively hard foods on the restored teeth (hard candy, ice, raw carrots, bones, etc.) because extreme force can cause the resin material to be broken from the tooth - just as it can in a natural tooth.  In the event that a breakage occurs, replacement of a restoration is not difficult.

Recalls:  Visit us at regular six-month examination periods.  Often problems that are developing around the restorations can be detected at an early stage and repaired easily.  Waiting a longer time may require redoing the entire restoration.  This could be a problem with the warranty, i.e. “I never got a call or postcard, and you said you’d tell me when to return”.

Preventive Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please brush and floss after eating and before bedtime.  We do recommend you swish vigorously with mouthwash for at least 30 seconds daily.

Please call us if you notice any change in your tooth-colored restorations, or if you have any questions at all about them.

 

 

Your “Routine cleaning” is not routine here! 

We want you to feel that your recall (check-up and cleaning) visit is as important as your other dental treatment visits.  Your continuing-care visit includes many services that are extremely important for your long-term oral health.  We don’t take these services for granted and we hope you don’t either.

The examination (check-up) portion of your recall visit includes a health history update and a soft-tissue/oral cancer screening.  Your dentist will:  examine your bite and your TMJ (temporomandibular joint); examine your entire mouth and look for any signs of disease, particularly caries (decay) and periodontal (gum) disease; prescribe any necessary films so that we can see the 75% of your mouth that we can’t see by looking directly in your mouth; and discuss these films with you before your visit is over.  We encourage you to ask as many questions as you feel necessary.

The prophylaxis (cleaning) portion of your recall visit will be provided by your hygiene team members in conjunction with your dentist.  Your team member may start with an “air polisher” (an air, water, and flavored baking soda spray) to remove stains and soften deposits.  Your team member will, of course, polish and floss to remove any remaining stains and give you that “freshly polished” feeling.  We use a 1.64% fluoride solution in our polishing paste for everyone, not only because it strengthens the teeth against decay but also because it has a proven anti-bacterial effect, which helps to prevent periodontal disease.  So you see, not only children, but also adults get fluoride treatments in our practice.  No matter what your age, you will be given personalized home care instructions and, at your discretion, a final mouthwash.

Your dentist will recommend the best recall interval for your dental needs – usually 3, 4 or 6 months.  Remember, the six-month interval is not ideal for many patients.  We want your recall visit to be a pleasant, personally rewarding experience.  As always, nitrous oxide (laughing gas) is available at no charge for your comfort and relaxation.  Please help us by notifying us if we fail to meet your comfort expectations.

 

 

 

“At Home” Tooth Bleaching

Hydrogen peroxide has been used for many years to bleach teeth.  In past years, it was usually applied only by dentists, who used heat and/or light to accelerate its bleaching action.  In recent years, a highly effective technique has been found that allows patients to bleach their teeth at home - although only when supervised by a dentist.*

 

The “at home” technique of bleaching teeth does not require heat or light, and allows you to monitor your own progress.  The amount of color change depends on the length of time you wear the tray each day and the number of weeks you continue the treatment.  The results can be unpredictable.  Although effects may be noticed as early as a few days, many patients report that a minimum of two weeks is required to see a color change.  Peroxide bleaching in custom-filled trays is thus the fastest and most painless method known.

 

The Procedure:

       1.  One or two hours before bedtime, brush and floss your teeth, in order to clean them before placement of the tray.  Rinse well.

       2.  Place one or two drops of bleaching gel in the tray at each tooth position to be bleached.  Use the gel only in the tray provided by us to fit your teeth.

       3.  Place the tray firmly over your teeth.  Spit out excess gel and foam, and wear loaded tray for one (1) hour.  Then remove the tray, wipe it with tissue paper to remove the gel (do not wash it out at this time), reload the tray, replace it, and wear it for another hour.

       4.  Anytime you remove the tray for longer than 15 minutes, place new bleaching gel in it before you use it again.

       5.  Re-apply the bleaching gel approximately every 3-4 hours.

       6.  To receive maximum bleaching potential, the tray should be worn a minimum of twelve (12) hours per day.

 

Possible Side Effects:

       1.  Some patients have reported that teeth become sensitive to cold and biting pressure for a short time during and after treatments.  The discomfort normally does not last for an extended time.  If, however, your teeth continue to be sensitive, stop using the bleaching gel and call us.

       2.  Your gingiva or gum may react to the bleaching gel by creating gum sensitivity.  If it does, simply decrease the amount of bleaching gel in the tray, or return to the office so we can trim the appliance in order to reduce the amount of bleaching gel in contact with your gum tissue.

       3.  If bleaching trays are worn too long during any given day, discomfort in your jaw points may occur.  This discomfort will go away when the bleaching trays are removed.

 

* In the past, hydrogen peroxide was considered to be a cosmetic agent only.  However, the US Food and Drug Administration is now considering registering this chemical as a drug to assure its proper use and dentist supervision. 

 

 

What Is Cancer?

 

 

Cancer is a number of diseases caused by the abnormal growth of cells.  Sometimes cells grow out of control, divide, and form masses known as tumors.

 

 

Facts on Oral Cancer

Oral cancer accounts for only 3 percent of all cancers.  It is treatable when detected early by your dentist.  If treated promptly, there is a very good chance that it can be cured.  More than 90 percent of oral cancers are squamous cell cancers, which develop in the lining or covering of the mouth, lips, tongue, and throat.  It can also be spread through the lymph nodes and into the neck.

 

Signs, Symptoms & Early Detection

The most common sign of oral cancer is a sore which does not heal and bleeds easily.  A lump or thickening in the mouth or white patches which last longer than two weeks, difficulty in chewing or swallowing food and the inability to move the tongue freely can also be signs of oral cancer.

 

Dentists detect oral cancer during routine check ups.  The American Cancer Society recommends getting a dental exam every 6 to 12 months.  Dental x-rays are the only way your dentist can see if tumors are present in your jaw and beneath the gum surface.

  

Guarding Against Oral Cancer

 

·         Don’t use tobacco in any form.  Don’t smoke cigarettes, cigars, or pipes, or use chewing tobacco or snuff.

·         If you drink alcohol, drink only in moderation.

·         Avoid exposure to strong direct sunlight.  Those who must be in the sun should use a sunscreen and apply it often.

·         Have regular dental checkups.  Any jagged teeth or irritating dentures should be fixed.

·         Any white patch, lump, or scaly area on the lips or in the mouth that last longer than two weeks should be checked by a doctor.

 

If you have questions or concerns about your oral health, contact your dentist.  For free pamphlets from the American Cancer Society, call 1-800-422-6237.

 

 

“But do I really need a dental x-ray?”

 

 

 If you think you can’t afford x-rays this time around, just think about whether you can afford to skip them…

·         In the United States, 29,600 people will be diagnosed with oral cancer in 1994 and 7,925 will die from it.

 

·         In Arizona, 350 people will be diagnosed with oral cancer in 1994 and 100 will die from it.

 

·         besides tobacco consumption, drinking more than 3 oz. of alcohol a day (2 beers per week) puts you at an increased risk for oral cancer.

 

·         About 1 of 2 people diagnosed with oral cancer will survive 5 years.

 

·         in the early states, oral cancer is usually not painful.  This is the ideal time for your dentist to identify it in the mouth or by x-ray.  Without regular dental x-rays, it’s no surprise that by the time it’s detected, the cancer has grown, perhaps spread, and survival rates drop.

 

·         The American Cancer Society recommends getting a dental examination every 6 months.  Also, according to the American Cancer Society:  “Most medical and dental x-rays are adjusted to deliver the lowest dose possible without sacrificing image quality”.

 Dental X-Rays are the only way your dentist can see if tumors are growing in your jaws and beneath the surface of your gums