Welcome to www.RocklandSmiles.com

Dental Emergencies Toothaches, broken tooth, stuck objects

Deep Cleaning After-Care Suggestions
Oral Health Rinses Prescribed & Over-the-Counter
Temporary Bonded Restorations Care Instructions
Final Bonded Restorations Care for veneers, bonding, ‘white’ fillings
Temporary Crowns or Bridges Proper care, if they come loose, etc.
After Surgery Care Comfort Control & other
Root Canal Therapy Post Therapy Instructions
Desensitizing With Recommended Paste & Gel Products
BriteSmile After Care 24 Restrictions - Staying White
NiteWhite Smile Whitening At-Home Use Instructions

Dental Emergencies What to do if you have a toothache…

Rinse the mouth out with warm water to clean it out. Gently use dental floss or an interdental cleaner to ensure that there is no food or other debris caught between the teeth. Never put aspirin or any other painkiller against the gums near the aching tooth because it may burn the gum tissue. If the pain persists, contact us @ 845-627-SMILE.

What to do if you have a broken tooth…

Rinse your mouth with warm water to clean the area. Use cold compresses on the area to keep any swelling down. Call us immediately - 845-627-SMILE.

What to do if objects get caught between the teeth…

Try to gently remove the object with dental floss; avoid cutting the gums. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can’t dislodge the object using dental floss, contact us @ 845-627-SMILE.

Deep Cleaning

After-Care Suggestions
We have now begun the ‘deep cleaning’ therapy sequence. The goal of this therapy is to ‘cleanse’ your oral tissues of bacterial toxins and debris and start the process toward gum and tissue healing. Thus, your gum and supporting structures can be the stable foundation we are seeking; to complete your dental treatment.

•• What to expect!
- Immediately upon dismissal from our office - you may notice slight ‘oozing’ from the gums. This will decrease rapidly.

- Some sensitivity is expected following your ‘deep cleaning’ appointments. This may include:

•• extreme hot and cold
•• spicy foods
•• acidic foods (citrus; as an example)

- Over the next few days and weeks, as your teeth and gums become healthier, the gum tissue will actually 'shrink.' More tooth may be exposed. Increased sensitivity can occur with these teeth - which is transient in nature. The best way to decrease this sensitivity is to keep the area as clean as possible [brushing, flossing and rinsing; as directed].

•• How do I take care during therapy?

Every person is different; thus, all post operative instructions are ‘customized’ for you by our dental hygiene staff. However, basic rules do apply.
•• Salt/Water rinses [1 tsp. to 1 tsp. salt w/8 oz. warm water]; 3 times per day - for 30 to 60 seconds
•• Peroxide/Water rinses to assist with impacted debris
•• Listerine or Prescription rinses to begin 24 - 48 hours after therapy; per your hygiene staff recommendation.

•• Are any medications necessary?

Perhaps; however, not normally. In a vast majority of cases; should medications for sensitivity be necessary - over the counter anti-inflammatory formulations work very well. These include:
•• Ibuprophen [600mg {3 tablets} - 3x/day]
•• Aleve - Two Caplets follow by one caplet every 12 hours
An excellent method to reduce sensitivity post operatively is to take one of these medications one hour PRIOR to your appointment.
The success of your deep cleaning therapy is a team effort. Your commitment to proper care is essential for success!

ORAL HEALTH RINSES

Prescribed & Over-the-Counter

Periogard or Periodex:
These are prescription medications. Please keep safely out of the reach of children! Swish with 0.5 (1/2) ounces for thirty (30) seconds and avoid rinsing with water for 15 - 30 minutes thereafter! This should be done in the morning following breakfast and just before bedtime. If a Fluoride rinse is recommended, please use the Fluoride at a different time of day, i.e. not in conjunction with PerioGard or Peridex.
Remember:
PerioGard or Peridex can cause some increased staining of teeth. Thus, adequate brushing and flossing is a must! Also, some slight alteration in taste may occur.

Breath Rx:
(An excellent non-alcohol containing mouthrinse)
SWISH vigorously with 1/2 - 1 capful of BreathRx Mouthrinse for at least 1 minute. Remove excess mouthrinse and do not rinse your mouth or drink for about 30 minutes.
This mouthrinse works very well in combination with BreathRx tongue gel and toothpaste. The secret is the Zytex anti-bacterial ingredient in all of these products.

Listerine (Original, Cool Mint, or Fresh Burst):
Listerine is an excellent nonprescription plaque fighting rinse.
Care should be taken with children. Excessive amounts are not meant for swallowing.
SWISH vigorously with one capful, twice consecutively for thirty (30) seconds. Make sure you swish for the full thirty seconds for each cycle. Try timing yourself by the clock. Swishing for thirty seconds takes some getting used to. A simple rinse will not achieve the same effectiveness as the recommended ‘swishing’ procedure. We recommend you rinse in this fashion at least twice per day.
Listerine is strong. It contains some alcohol. Thus, some burning may occur. After consistent use for a few days to weeks, this effect should not be a problem. If used correctly, Listerine will help. It takes time to work .. be patient
Remember:
We recommend Listerine (Original, Cool Mint, or Fresh Burst). Not - Listermint.
Original Listerine is golden in color, Cool Mint is blue, and Fresh Burst is green.

Temporary Bonded Restorations

Care Instructions
Immediate Care While You Wait For Your Final Bonded Restoration! Here are a few simple rules to follow as your final restoration is being custom fabricated for you by our laboratory.

DISCOMFORT:
After the tooth/teeth have had the decay removed and structure stabilized, you may experience some minor sensitivity. You can help reduce this by taking aspirin or ibuprofen every four hours. Please remember, if you have been given anesthetic, it should wear off in a couple of hours. Be careful not to chew on the tooth (teeth) until this occurs.

TEMPORARY CARE:
A temporary tooth-colored restoration may be placed to protect the tooth (teeth) while your new restoration is being made. DO NOT attempt to floss these temporary restorations. Avoid heavy chewing and sticky foods. If this temporary does dislodge before your next visit, call us! Please do not attempt to place restoration back into place with anything other than Vaseline. Superglue, for example, is not healthy in the oral environment. It also will greatly disturb the bonding process of your final cosmetic restoration!

CLEANING:
Proper care of the interim restoration - if placed - is a must! Brushing can be accomplished with a gentle motion on the sides of the tooth - flexing the soft bristles at the gum line. We may instruct you not to use dental floss, depending on the procedure. When flossing is recommended, place it gently between the teeth, clean the gum areas as usual, then release your inside finger and pull the floss through the space, toward the cheek. Do not draw the floss back between the two teeth. Correct care also includes rinsing - a must, should flossing not be accomplished! Use Listerine or the recommended non-alcohol rinse, as directed - a minimum of twice per day. This care will not only prolong the life of the restoration, but will also help to prevent problems elsewhere in the mouth.

Congratulations!
You are on your way to receiving the most advanced, state-of-the-art cosmetic and structurally sound restorative dentistry available today. We are excited with what Cosmetic Dentistry can do for you and your teeth, and are pleased that you are as committed to high quality dentistry, as we are. It's our privilege to provide this service for you.
Please call 845-627-SMILE if you have any questions.
We do care and want you to be as comfortable as possible.

Final Bonded Restorations

Care Instructions
Veneers, Bonding, Nonmetallic Fillings
You've received a beautiful - cosmetic - restoration. What Now??

1. First - SMILE - you now have a bonded restoration that looks great.
It also provides the ultimate in function; as well as strengthening the supporting tooth.
2. The cement is already set - and your bonded restoration is ready for immediate use.
3. If any minor discomfort occurs, it should diminish over a few days.
4. If anesthetic was used, please be careful not to bite your cheek or tongue. Also, do not eat or drink anything extremely hot or cold until all has worn off.
5. The bite should feel normal. If sensitivity to hot, cold or biting pressure is present; it should not linger! Call us so we can check things out, even before any scheduled follow-up polishing visit.
6. Chewing extremely hard or crunchy foods may affect your new bonded restoration. In particular, please refrain from chewing ice, tearing open packages with your teeth, and biting anything that may cause damage (such as fingernails, paper clips, etc.).
7. Proper care of your new bonded restoration is a must! Brushing and flossing can be accomplished nicely, as normal. There are no special precautions needed. Correct care also includes rinsing. Use Listerine or Breath Rx rinses as directed - a minimum of twice per day. This care will not only prolong the life of the restoration, but will also help to prevent problems elsewhere in the mouth.
8. We recommend professional 'recare' evaluations at least twice per year. We then can evaluate the wear of your new bonded restoration; touch-up and polish where needed.

Congratulations!
You have just received the most advanced, state-of-the-art cosmetic and structurally sound restorative dentistry available today. We are excited with what Cosmetic Dentistry can do for you and your teeth, and are pleased that you are as committed to high quality dentistry, as we are. It's our privilege to provide you this service. We care about you and want you to be as comfortable as possible.

Temporary Crowns or Bridges

While You Have Your Temps
Here are a few simple rules to promote healing and make yourself more comfortable as your final restoration is being custom fabricated by our laboratory.

DISCOMFORT:
After the tooth/teeth have been reshaped, you may experience some minor sensitivity. Aspirin or Ibuprofen usually works very well. Your gums may be irritated! We highly recommend rinsing with warm salt water or a half/half mix of hydrogen peroxide and water; three times per day. This is an excellent method for soothing sore gums. We may recommend gentle digital message, as well! The jaw joints may be sensitive, as well. This can easily be soothed with the application of warm compresses on the jaw joint. We suggest a heating pad that can be moistened. Place the moist heat on the jaw joint areas - open and close the mouth slightly during this application. The heat should be applied at 10 to 15 minute intervals with 15 minutes of rest between placements.

MEDICATION:
We may prescribe medication to control discomfort. Please use only as directed. If this medication does not seem to work for you, do not increase the dosage; or mix with other pain medications. Call us! Medications work differently on each individual. It is common to change medications; and a new formulation may work very well. If the discomfort is prolonged; there is swelling, excessive bleeding or fever - again call us.

DISLODGMENT OF THE TEMPORARY CROWN or BRIDGE:
If your temporary comes loose, do not be alarmed. Call our office and we will arrange a time so things may be placed in their proper positions. Even if there is no discomfort involved, it is very important that we re-cement this restoration; so that the teeth don't drift - making placement of your final restoration very difficult. Please do not attempt to place restoration back into place with anything other than vaseline. Superglue, for example, is not healthy in the oral environment.

CLEANING:
Proper care of your temporary restoration is a must! Brush with a gentle motion on the sides of the tooth - flexing the soft bristles at the gum line of the interim restoration. We also would like you to use dental floss. However, place the floss gently between the teeth, clean the gum areas as usual, then release your inside finger and pull the floss through space, toward the cheek.

Congratulations!
You are on your way to receiving the most advanced, state-of-the-art restorative dentistry available today. We are pleased that you are as committed to high quality dentistry, as we are. It's our privilege to provide this service for you.

Please call 845-627-SMILE if you have any questions.
We do care and want you to be as comfortable as possible.

AFTER-SURGERY INSTRUCTIONS

1. Swelling Control:
Place an ice bag on the outside of the face that corresponds to the operative site. Alternate 15 minutes on and 10 minutes off for at least two to three hours.

2. Bleeding Control:

A) Keep firm pressure with gauze over the surgical site for at least two hours - changing the gauze frequently, as it becomes soiled.
B) Do not rinse your mouth for at least 24 hours.
C) Do not drink from a straw for 24 hours.
D) Avoid smoking for at least 24 hours - and longer, if possible.
E) If bleeding still persists, place a moist tea bag over the surgical site, and apply firm biting pressure.

3. Comfort Control:

A) Take pain medication as prescribed.
B) Stay away from extremes in temperature and spices.
C) Keep to a softer diet for at least 24 hours.

4. Hygiene control:

A) Starting 24 hours after the surgery, begin salt & water
or peroxide and water rinses four times per day for one to two weeks.
B) Light brushing around the surgical site should be started at this time, as well. Brush more vigorously each day as comfort allows.

We ask that you follow the above instructions carefully. They will greatly assist you in having a smooth recovery from your surgical dental care.
Please do not hesitate to call us should there be any questions or excessive discomfort.

Root Canal Therapy

After Therapy Instructions:
Your Root Canal treatment may take one or more visits to complete. During treatment, we will remove the diseased pulp (nerve), then clean, shape and fill the space where the pulp was (the nerve canal of the tooth; which is in the root). The filling material is specially designed for this purpose, to help prevent recontamination of the nerve chamber.

What to Expect During Treatment

•• Because cleaning the root canals may cause inflammation of the tissue surrounding the tooth, you may experience some discomfort for a day or so.
•• Some initial minor swelling may also occur. It is advisable to place an ice bag on the outside of the face that corresponds to the site of the tooth. Alternate 15 minutes on and 10 minutes off for at least two to three hours. If the swelling should linger more than a few days, or increases, call us!
•• Over-the-counter pain relievers usually assist with the discomfort. We will advise you as to which medicine to take. At times, a prescription pain medication will be suggested. If the discomfort continues for more than a few days, or if severe pain occurs, call us!
•• Sometimes antibiotics will be prescribed to help control infection. It is very important that you take the medication as directed!

How To Take care of your mouth

•• Between appointments, a temporary filling will be placed over the entry to the nerve space. Because temporary restorations may loosen, call us if there is significant loss of this filling.
•• Avoid chewing or biting with excessive force directly on the treated tooth until the root canal is completed.
••Do not ignore brushing and flossing this tooth; as comfort allows.
Please Note:
Retreatment may occasionally be necessary. Even though the pulp of the tooth was removed, the tooth is still nourished from surrounding tissues. As with any living tissue, treatment is occasionally unsuccessful and retreatment or even tooth removal may be indicated.

Desensitizing with Recommended Paste & Gel Products

Many of these products do clean teeth well. However, as a desensitizing tool, we recommend you increase the effectiveness of the desensitizing chemicals incorporated within them -- that is by the process of…

Smash, Massage and Brush.

Step 1: Put a ‘dab’ of the paste/gel on the end of a cotton swab, or fingertip, and "smash" on the tooth at the gum line where the sensitivity is occurring.
Step 2: "Massage" this paste onto the tooth surface. Keep the product on the same surface for at least 5 - 10 seconds.
Step 3: Put another dab of the paste on your regular toothbrush and gently "brush" all your teeth.

An additional benefit can be obtained, just before bed, by placing another dab of paste on your teeth in the sensitive areas, "massaging" it in, and leaving it there, as you sleep!

BriteSmile After Care

24 Restrictions - Staying White
Restrictions
••Important: BriteSmile requires that you abstain from staining substances such as coffee, tobacco, wine, other colored liquids and dark foods for 24-hour.

How can I maintain my new white teeth?
We recommend the following to maintain your new BriteSmile:
••Brush your teeth twice daily or after each meal; floss daily
••Use the BriteSmile Whitening Toothpaste and a soft bristle toothbrush
••Visit us for regular cleanings and checkups (minimum: every 6 months)

The long-term results depend primarily on the individual. Certain habits, such as the use of tobacco products, drinking a lot of coffee, tea, dark soft drinks, and infrequent visits to the dentist for regular cleanings, etc., can work against the results. Regular dental visits and use of the BriteSmile Professional Whitening System will help maintain the BriteSmile up to 2 years. Some people may prefer to do the BriteSmile whitening treatment more frequently.

NiteWhite Smile Whitening

At-Home Use Instructions
Congratulations - you are beginning the treatment process that will most definitely improve your appearance. The amount of whitening that you obtain during the tooth whitening process is dependent on three factors:

a) The length of time the appliance is worn
b) The number of times the appliance is worn
c) The susceptibility of your teeth and it's internal contaminants to the whitening agent.

Procedure

1) Thoroughly brush and floss your teeth prior to applying the whitening gel
2) Load the appliance, as demonstrated, by gently depressing the syringe cap - expressing the material only on the front 8-10 teeth - the surfaces that face toward the lip.
3) Place the appliance completely and firmly onto the teeth, but gently. Excessive pressure will express too much material out of the appliance.
4) Gently wipe off excess gel with a toothbrush or Q-tip.
5) Expectorate any excess material.
6) Wear for a minimum of 2-4 hours/day. This can be accomplished during 'sleep time' or during waking hours. The thin tray is very comfortable and can be worn easily while accomplishing other tasks.
7) When the appliance is removed brush teeth and gums thoroughly. The 'tray' should be rinsed thoroughly and placed in the appliance case - ready for the next application.

Possible Side Effects
Occasionally patients will experience sensitivity to cold with some minor gum irritation during treatment. This difficulty normally resolves on its own in 1-3 days after interruption or completion of the whitening treatment. We also have the option of supplying a fluoride gel that can be placed in the appliance in place of the whitening agent. Alternating the fluoride therapy with the whitening therapy is of great assistance, should sensitivity persist. Simply waiting a day or two after sensitivity occurs before restarting the whitening process is another method to alleviate symptoms.

Precautions:
Please keep the whitening carriers out of heat and/or direct sunlight at all times. The whitening agent will break down and become ineffective, should this occur. It is best to store the material in a refrigerator. Never attempt to use any household or commercial bleaching agents in your mouth. Only use the teeth whitening agents that we prescribe for you - those that have been tested and approved for intraoral use. Over-the-counter whitening agents normally have a very high acid content - which can dissolve your teeth, permanently ruining your smile.

Please Note:
Normal tooth whitening starts at the biting edges of the teeth and works its way up. Normal color of teeth is darker toward the gum line. We have never had one patient experience any irreversible effects to the teeth from the whitening process!

Contact our office with any questions or problems.
Store Whitening Gel in the refrigerator to maintain shelf life.
KEEP OUT OF REACH OF CHILDREN -- KEEP OUT OF HEAT & SUNLIGHT

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