Composite (tooth colored) Restorations
  • The anesthesia will generally begin to wear off in 30 to 90 minutes. Until it has worn off, please avoid all hot foods or liquids and do not chew. This is to prevent accidently burning or biting the lips, cheeks, or tongue.
  • We are usually able to adjust your bite correctly at the time the filling(s) are placed. However, anesthesia can mask your “true” bite. If your bite feels “high” once the anesthesia has worn off, it is important to contact our office right away so we can adjust it correctly. Postponing adjustment can cause increased and prolonged discomfort due to bruising of the ligament around the tooth.
  • You may experience sensitivity to hot and cold following placement of a dental restoration, which can last 6-8 weeks or even longer. The duration and severity of the sensitivity varies considerably depending on the depth and severity of the cavity. Anti-inflammatory medications, such as aspirin and ibuprofen, are excellent for reducing post-treatment soreness and sensitivity.
  • The gums in the area treated may be tender for a few days following your visit. Warm saltwater rinses (1/2 to 1 tsp. salt in 8 oz. glass warm water) can be swished vigorously every 10 to 20 minutes for the first 2 to 6 hours. *NOTE: Do NOT rinse vigorously if a tooth was also extracted at your visit. Follow the extraction post-op instructions instead.
  • Sensitivity to temperature for an extended period of time may be an aggravating problem following composite restorations. The sensitivity will normally diminish over a period of a few weeks, but unfortunately in some cases it may linger for longer, even months. If you note symptoms of increasing sensitivity, spontaneous pain, or a toothache for several moments after exposure to cold, this may indicate irreversible pulpal disease in the tooth. Additional treatment, possibly involving root canal therapy, may be required to eliminate the problem.
  • Discoloration of the restoration due to highly staining foods, such as dark sodas, coffee, tea, etc., or smoking, may occur with time. In some cases, the color can be enhanced by simply polishing the restorations in the dental office.
  • In teeth with very large fillings or fillings in areas of high stress, fractures of the tooth and\or filling may occur. If this happens, it most likely indicates the need for a more substantial restoration, such as a crown (cap).
  • If you have any questions, please feel free to call the office. Thank you for trusting us with your restorative dental care and we look forward to serving you or anyone you refer to us in the future with the same courtesy and respect.

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Teeth Whitening
  • Tooth Whitening (bleaching) gel will only whiten natural teeth. It will NOT whiten (or harm) bonding, caps, crowns, bridges, fillings or any other restorative dental work. Upon achieving your desired result, you may notice that old dental work is darker than the new shade of your teeth, and you may wish to have the old work replaced to match your new shade.
  • Tetracycline (an antibiotic) stained teeth or grayish teeth can be more difficult to whiten and will have a less predictable result.
  • Gum recession can expose a portion of the root surface, and although it may lighten, it will not bleach to match the enamel of the tooth. If you have amalgam (silver) fillings in, near or behind the front teeth, long term bleaching can cause the surrounding tooth to appear to have a greenish tinge. Bleaching teeth which have a lot of translucency (see thru) can cause the teeth to become even more translucent and may give the tooth a darker appearance. It is important to consult a dentist if you have any of the above concerns.
  • You may experience some sensitivity of the teeth and\or gums while bleaching. This is common while using products containing peroxide based gels and it is not harmful. In case of increased sensitivity reduce usage time and/or frequency until the sensitivity subsides.
  • Keep bleaching gel out of reach of children. Do NOT use if pregnant or during nursing. Do NOT smoke, drink or eat while bleaching your teeth.
  • Brush and floss just prior to bleaching your teeth. The whitening gel is the most effective with clean teeth. Make sure that the bleaching trays are clean and dry before applying the whitening gel. Moisture reduces the efficiency of the whitening gel and slows down the whitening process
  • When you apply the gel make sure not to overfill the trays. Place a SMALL drop of tooth whitening gel approximately half way up on the inner front surface of the tray (in the front of each tooth in the tray), so that when the tray is placed in the mouth the gel is held against the surface of the tooth towards the lip\cheek. Do not spread the bleach around. Recap the syringe for next treatment until empty. The average treatment per arch requires approximately 0.5ml of whitening gel.
  • Insert whitening tray in the mouth over the teeth. Seat the tray firmly against the teeth. If any excess gel seeps over the brim of the tray onto your gums, wipe it off by holding the tray up with one hand wipe the excess gel off of the gums with your finger or Q-tip.
  • We recommend that if you have not whitened before, use for 30 minutes to 1 hour the first time to evaluate tooth sensitivity
  • 10% or 15% bleaching gel can be used 2 to 4 hours once or twice per day or overnight while sleeping if NO sensitivity.
  • 20% bleaching gel can be used for 30 minutes to 1 hour once or twice per day (do not exceed 1 hour per application).
  • Remove the tray and rinse thoroughly. Brush any remaining gel away. Brush, floss and continue routine dental cleaning.
  • Clean whitening trays with a toothbrush or Q-tip and cold water. Store trays in the tray holder and gel in cool dry place away from heat and direct sunlight.
  • Refrigeration prolongs the shelf life of the bleaching gel, but DO NOT FREEZE. Shelf life is 1 year un-refrigerated and up to 2 years refrigerated.
  • Thank you for trusting us with your bright smile and we look forward to serving you or anyone you refer to us in the future with the same courtesy and respect.

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Scaling & Root Planing

Scaling and Root Planing is one of the most effective ways to treat gum disease. To minimize the post operative discomfort and encourage proper healing, please follow these instructions:

  • Take aspirin, acetaminophen (Tylenol®), or ibuprofen (Advil®) before the anesthetic wears off. Continue to take one tablet every four hours for the next two days if pain persists.
  • Do not eat anything or drink hot fluids until the numbness has worn off to avoid injury from accidental biting or burning of your tissues.
  • A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water) swished in your mouth for 2 to 3 minutes every hour for the rest of the day may make your mouth more comfortable.
  • Use a soft toothbrush at least two times a day. Be gentle and clean thoroughly. Slight bleeding may occur while brushing as the tissues begin to heal.
  • Avoid strong spicy seasonings and hard crunchy food for the next few days.
  • Smoking should be stopped. Success of the treatment will be substantially reduced by the cigarette smoke chemicals in your body.
  • Do not drink alcohol or use mouthwashes containing alcohol. Alcohol contributes to excessive bleeding and delays healing.
  • As the tissues heal, some temporary sensitivity to cold may occur. Use a desensitizing toothpaste (such as Sensodyne®), or fluoride gel (such as Prevident® or Gel-Kam®) frequently (at least 4 times/day) for 1 to 2 weeks. Also, the cleaner the teeth are kept, the less sensitive they will be.
  • Faithfully use any other oral hygiene aids that have been recommended (floss, Perio-Aid®, rubber tip, Sonicare®, Proxabrush®, Gel-Kam® fluoride, Peridex® mouthrinse, etc).
  • Faithfully return for all scheduled follow up visits to achieve the maximum benefit of scaling and root planning treatment.

If you have any questions or concerns, please call (919) 596-7447.

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Root Canal Therapy
  • DO NOT eat or drink anything for the next half hour.  DO NOT try to feel around your tooth with your tongue.  You have a temporary filling in the tooth and it takes about half an hour to harden.
  • DO NOT use the tooth to bite down on anything hard (peanuts, pretzels, ice, etc.) until the permanent filling and crown has been placed on the tooth.  The tooth is prone to fracture and if you bite down on anything too hard or crunchy you may crack the tooth, which could also result in loss of tooth.
  • You need to have a permanent filling and a crown placed on your tooth shortly after the root canal has been completed.  It is essential for you to follow up with your general dentist on this.  If this is not done, the tooth is very likely to fracture or to develop new decay underneath the temporary filling which may cause your root canal to fail.  You will be responsible for all costs incurred if you fail to follow this instruction.
  • It is normal for the temporary filling to “divot” in with use.  It is very rare for it to fall out entirely.  If the temporary falls out you should contact our office as soon as possible.  If it happens when our office is closed, we recommend you purchase some temporary filling material from any pharmacy and place a dab in the tooth until you have an opportunity to see us at our office.
  • Some minor discomfort in the area is normal following the root canalIt is normal for the tooth to be uncomfortable for up to 10 days after today’s treatment. Sometimes, depending on the circumstances, the tooth and surrounding tissues may remain sore for a few weeks post treatment. Most common discomfort following root canal treatment is soreness when biting down on firm or hard foods, in which you will try to avoid anyway.
  • If you do develop pain following root canal treatment we recommend taking analgesic/anti-inflammatory such as Ibuprofen 600 mg (3 over the counter pills of Advil or Motrin or generic equivalent) every 6 hours for the next 2 days. If you are unable to take Ibuprofen then take Acetaminophen 1000 mg (2 extra strength Tylenol or generic equivalent) every 6-8 hours for the next 2 days. If you can’t manage the pain with any of the above methods, please contact our office immediately to inform your doctor of your discomfort.
  • If you are given any prescription medications related to this treatment please take them as instructed by your doctor.
  • You may floss and brush your tooth as normal, unless told otherwise by the doctor.
  • If you have any questions or concerns, please contact our office. Thank you for trusting us with your endodontic care and we look forward to serving you or anyone you refer to us in the future with the same courtesy and respect.

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After Oral Surgery Procedures

Do not disturb the wound. In doing so you may invite irritation, infection and/or bleeding. The healing process begins immediately after surgery as your body sends blood to nourish the tooth socket. Simple pressure from a piece of gauze is usually all that is needed to control the bleeding and to help a blood clot to form in the socket. Sutures may need to be removed in 3-5 days. Be sure to consult with your dentist if bleeding persists.

Do not use tobacco products for 48-72 hours after tooth extractions. Smoke can interfere with the healing process, promote bleeding, and can cause a very painful situation know as "dry socket." Continuing to smoke during these first few days will slow healing and soft tissue will not be able to begin to fill in the socket to form the blood clot needed for healthy healing. Smoking can also interfere with the bone that surrounds the socket resulting in slowing its process of filling in the socket.

Brushing. For several days after the extraction, it is important to keep the area as clean as possible to prevent infection and promote healing. Do not directly brush the extraction site for the first three to four days after oral surgery to prevent dislodging of the blood clot from the socket. Instead this area can be gently and carefully wiped with a clean, wet gauze pad or cloth. After this time you may carefully brush your teeth around this area and floss gently.

Mouthwash. Avoid all rinsing for 24 hours after extraction. This is to insure the formation of a blood clot. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. After the first 24 hours you should rinse this area using warm salt water (1/4tsp. salt in 8oz of warm water) or mild antiseptic rinses like Chlorhexidine. Rinse very gently after every meal and snack, making sure that the water reaches the extraction site. Rinsing removes food particles and debris from the socket to help promote healing.

Do Not Spit/Suck Through A Straw. This will promote bleeding and may dislodge the blood clot.

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Dentures and Removable Appliances


  • When the appliance is not in your mouth, it should be stored in fresh tap water.
  • Brush the outside and gum side of the appliance. Do not scrub excessively as it can cause undue wear.
  • You can use dishwashing liquid or mild toothpaste.
  • Periodically, you can soak the appliance in an over-the-counter appliance cleaner.
  • Do not use bleach and do not boil.


  • Adhesives are available that can improve the grip of a loose appliance.
  • Ideally, you should not sleep with your appliance.


  • Immediate dentures need to be left in place for 24 hours. Several times a day, gently rinse the sites and gently expectorate.
  • A new appliance can take several appointments to eliminate sore spots and to customize the new bite.
  • Four to six months after the extractions, the dentures will need to be relined so they will fit snugly to the healed extraction areas.
  • Sore spots, especially with a new appliance, are expected.

Call the office at (919)596-7447 and we will adjust the area of the appliance causing the problem.

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Dental Implants
  • For the next 24 hours no spitting, smoking or drinking through a straw. Please keep fingers and tongue away from the surgical area. Spitting, the use of a straw, smoking, and poking can dislodge the blood clot that is forming, and will cause bleeding from the area. Also, smoking can increase the chances of an infection.
  • Some minor bleeding is expected after implant surgery. It will usually subside quickly, and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours, upper implants may occasionally trigger some bleeding from the nose; this is normal and will stop quickly.
  • If bone grafting procedure is done during the implant surgery, then you may notice few small granules appearing in the mouth.  This is not a cause of any concern and is completely normal.
  • If sinus bone grafting is done during the placement of upper implants, then you should avoid blowing the nose two weeks after implant placement surgery.
  • Most patients will experience some swelling after surgery in the mouth. It may be mild or severe, and is different for every patient. The swelling will get bigger for the first 24 to 48 hours before it starts to go away. It may last for several days to one week. Some bruising may also develop on the face. Use an ice pack on the cheek or face next to the surgical site. Keep it on for 15 to 20 minutes, then off for 10 minutes, and repeat this process for the next several days. Sleep with you head elevated slightly, above the heart this will keep swelling down.
  • You may eat soft foods as soon as the anesthetic wears off. Try not to chew directly on the surgical site. You may resume a regular diet as soon as you feel up to it. Please stay well nourished, and well hydrated, you will heal faster.
  • You may brush your teeth, avoiding the surgical area, either tonight, or tomorrow morning. Be gentle, and do not spit or rinse forcefully. Start brushing the surgical area on the second day, and be very gentle on the stitches, if any.
  • Success of implant surgery is dependent on oral hygiene of the patient. You should use a mouthwash within 24 hours after surgery; keep half a cap-full of mouth wash over the surgical site for a minute. It will help in cleaning the healing site. You should gently start brushing on the surgical site after few days. You can brush and clean your other teeth normally after dental implant surgery. Waterpik should be avoided.  Mouth should be kept as clean as possible. There should be no food deposits on the surgical site and you should rinse following eating.
  • Smoking delays the healing process so we advise you not to smoke until the wound has healed.
  • It is vital to follow all these instructions for success of implant surgery. When the bone grows around implants, then you may experience some discomfort around the area. It may last for several weeks. Ibuprofen or Acetaminophens can be taken by the patient for pain relief.
  • If there are signs of infection after implant placement surgery or if you experience nausea, fever or vomiting, then you should contact our office immediately.
  • You were probably given one or more prescriptions for medications. Take all medications with a full glass of water, and as directed on the bottle. Call us if you experience severe nausea, or diarrhea, or cannot swallow your pills. The following medications are subject to be prescribed: antibiotics, pain medication, and/or medicated mouth rinse such as Peridex (Chlorhexidine).
  • Thank you for trusting us with your restorative dental care and we look forward to serving you or anyone you refer to us in the future with the same courtesy and respect.

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Crown & Bridge

      • Numbness of your lip, tongue or palate may persist for several hours. Do not chew gum, eat, or drink hot liquids until the anesthetic has worn off to prevent injury from accidentally biting or burning oneself.


      • Soreness may occur at the tooth, the surrounding gum, if this occurs, rinse with warm salt water; dissolving ½ teaspoon of salt in an 8 oz. glass of warm water. If there is soreness at the injection sites or the jaw joint, apply moist heat to the affected area and take an analgesic/anti-inflammatory, such as ibuprofen or similar product (if medically able to do so).


      • A temporary restoration made out of acrylic has been placed on your tooth. Avoid sticky or crunchy foods to avoid loosening or fracturing this restoration.


      • If the bite feels "high" on the temporary restoration, please call the office to have it adjusted. Failure to do so can result in a toothache or fracture of the temporary.


      • Brush your temporary restoration daily. When flossing, slide the floss out from between the teeth instead of lifting it back out to avoid loosening the temporary.


      • If your temporary restoration loosens, call the office to have it recemented. If you're unable to come in, you can try to apply a little Vaseline or denture adhesive or a crown repair kit material (such as Dentatemp), inside the crown as a measure to help hold it in place in the interim. Dentatemp can be found at your local CVS, Walgreens, and Wal-Mart in the dental section of the store.


      • The purpose for keeping the temporary crown in place is to protect the natural tooth, decrease sensitivity, and stabilize the position of your teeth. If the temporary crown is removed even for a short period of time the tooth can shift causing the permanent crown to not fit properly. Please make sure the temporary crown stays in place.


      • Make an appointment between 2 and 6 weeks from now to receive your permanent restoration.


      • When the final restoration has been placed, brush and floss accordingly. Do not chew on ice cubes or other hard objects or continue deleterious habits, such as biting on straws, pens, etc. Use sensitive toothpaste with fluoride if thermal sensitivity occurs. Also, if the bite feels unusual please call to have it checked.


      • On occasion, damage to the pulp of the tooth may occur following any restorative procedure due to a variety of reasons. If this occurs, further treatment, such as root canal therapy, may be necessary.


      • If you have any questions, please feel free to call the office. Thank you for trusting us with your restorative dental care and we look forward to serving you or anyone you refer to us in the future with the same courtesy and respect.


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Invisalign Survival Kit and Guide

Congratulations! Your big day has finally arrived and you’re now on your way to a more beautiful smile.

  • Review your Invisalign “Survival kit and Guide” for use and care of your aligners.
  • Your comfort and satisfaction is important to us. Do not hesitate to call us for any reason: (919) 596-7447


  1. Wear each aligner for 2 weeks starting with #1 aligners – Mark your calendar!
  2. Aligners can be identified by the letters and numbers on the aligner. Example: U4 upper arch 4th aligner.
  3. Use even pressure and both hands when placing the aligners and removing them.
  4. Wear each aligner at least 22 hours a day – The only time they should be removed is while eating, drinking, or brushing. It is OK to wear while drinking water.
  5. Keep your aligners sparkling – Brush your aligners daily with non-whitening toothpaste.

Blue Case – Use it to store your current aligners. Keep this case with you at all times.

Red Case – Keep your previous aligners as backups. Keep all used aligners in a safe place.

If something is broken or loose, or an aligner is lost, call us as soon as possible to avoid relapse or extensions of your treatment time.


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