1. What are the medical conditions that may mean I have to have antibiotic premedication?
For years, we would routinely premedicate for heart murmurs. The recommendations from the American Heart Association and the American Dental Association have changed regarding that. Still, there are some rare heart conditions that continue to necessitate antibiotic coverage even for routine dental treatment.
Also, it is recommended that some patients with artificial joints receive antibiotic premedication. A consultation with your physician may be needed. With any condition, keep us aware of your health history and condition so that we may tailor our care for your best interest.
2. Are there any medications I need to discontinue before treatment?
Most medications are compatible with routine dental treatment. The two main exceptions are blood thinners and bone-sparing drugs, either of which may cause complications during or after surgery. Blood thinners inhibit clotting and prolong bleeding. Your prescribing physician will need to be consulted and will tell us how long before and after treatment you need to be off your blood thinner.
Researchers have recently found that bone-sparing drugs can in rare cases cause bone necrosis (bone death) after dental surgery at the surgery site. This is because these drugs while keeping the bone dense can also retard bone remodeling, which is a healing mechanism that must happen after a surgery even as simple as an extraction. We may refer you to an oral surgeon if we believe the risk is too great.
3. What can I do before treatment to make treatment more comfortable?
Relax. Wear comfortable clothes. If you are very nervous, we can give you nitrous oxide, “laughing gas,” to help reduce your anxiety. We are here to help you. The most important thing is prevention through proper daily hygiene, healthy diet, and routine maintenance. We like to catch problems early before they get too involved.
The first thing is to remember you have braces. The teeth will remind you for the first week, but after that, you must keep yourself in check. Avoid sticky and hard foods as these will break the brackets, bend the wires, and loosen the bands.
2. Rubber Bands, Rubber Bands, Rubber Bands
Wear your elastics as instructed. The rubber bands coordinate the two arch wires and drive your orthodontic treatment forward. Get use to them now as teeth move very slowly without elastics. Four hours without elastics will set you back two days. The bone responds to steady, light force, but will ignore you if you’re not serious. Your estimated treatment time is based on the assumption of faithful elastic wear.
Keep your teeth sparkling clean, making sure to take time to use all your brushes. Look closely in the mirror for any plaque hiding between teeth or under brackets. Plaque will look like soggy white bread. Get it out of there! We don’t want to take you out of braces and then have to do a bunch of fillings. Decrease your sugar intake and use your special toothpaste to keep your teeth strong and gorgeous.
4. Hang in There
The first week in braces is tough. Teeth are sore, and lips and cheeks are irritated. Use the ortho wax provided over any rough brackets or bands. If a wire is poking you or if anything loosens, call us. Use Tylenol or ibuprofen as needed, though it has been shown that long-term use of ibuprofen or other non-steroidal anti-inflammatory drugs will slow tooth movement down. By the second week in braces you’ll be feeling a lot better. Keep up your with the other three steps because you’ll eventually get to that great smile.
After a Filling
After a silver filling is placed, avoid eating for the rest of the day on the side of the mouth where the filling is. With all fillings, silver and tooth-colored, take care to not inadvertently bite your cheek, lip, or tongue while numb. If you have the taste of iron suddenly, you’ve bitten yourself and your mouth will complain once it wakes up. Be cautious with hot foods while numb so as not to burn your numb mouth. Watch your kids after their treatment that they follow these rules.
After a Crown or Bridge
While you have a temporary crown or bridge in place, avoid hard or sticky food that could break or dislodge the temporary. If the temporary does come out, call us and in the meantime replace it gently using toothpaste as type of temporary cement – kind of a temporary temporary cement, if that makes sense. It is normal for gums to be slightly sore after the impression for a crown or bridge. For this, keep the area clean and rinse with Peroxyl or salt water. Ibuprofen helps greatly with this type of soreness.
After an Extraction
Keep pressure on the extraction site for one hour by biting on the gauze we will supply you. Take any pain medicine while you’re still numb, making sure to follow Dr. Ellenwood’s instructions for that particular prescription. If you continue to have bleeding after an hour, bite on a tea bag for another hour, and this should take care of it. The socket will normally seep a scant amount of blood for the rest of the day. If you have copious bleeding even after the tea bag, don’t hesitate to call us. Sometimes pain may return in 3-4 days; this is mostly a dry socket. If this happens, call us and we’ll have you come in to pack the dry socket which gives relief as the socket is healing. Dry sockets take 10 days to heal with or without treatment, but proper treatment will bring comfort back. To prevent a dry socket, avoid smoking, drinking straws, and heavy rinsing and/or spitting for 2-3 days after the extraction. If you must smoke (and this would be an excellent time to quit), place a gauze over the extraction site and use only short, shallow puffs.
After Scaling and Root Planing (Deep Cleaning)
The main thing to do after scaling and root planing is to keep your gums clean. Plaque forms every 24 hours on teeth no matter who you are. Taking this plaque off by toothbrush, floss, and your prescribed rinse will keep the plaque from doing further damage and allow your gums time to heal and become less inflamed.
After a Root Canal
After a root canal, avoid eating on the affected tooth for about a week and even then, stay away from hard or sticky foods while the tooth is either temporized or waiting for a crown. For posterior teeth and some anterior teeth, a crown needs to be placed within three months to prevent tooth fracture. After the work of a root canal, we certainly don’t want to lose the tooth. What a waste!