Patient Instructions

Instructions for Teeth Whitening with Custom Trays

  • Load gel into your custom bleaching tray. Place the gel on the front side of the tray, about halfway up, from premolar to premolar. Do not overload it, use no more than ¼ to 1/3 of the syringe per tray.
  • Brush and floss teeth before inserting your tray. Tap it lightly to adapt the sides to your teeth. Remove excess gel with clean finger or soft toothbrush.
  • Treatment time can vary from 30 minutes to several hours per day, depending on the patient’s needs, level of sensitivity and day-to-day activities. Nighttime bleaching regimes are a great option because they offer maximum results with less bleaching material use, due to decreased salivary flow during sleep. The lowered mouth activity prevents “pumping” of material from tray.
  • Remove tray and rinse twice; do not swallow rinsed gel.
  • To minimize tooth sensitivity, use MI paste right after whitening. Clean the tray with soft brush and cool tap water. Place MI paste into the tray and wear for 5 minutes.
  • If significant sensitivity occurs, stop the treatment and call our office

Whitening Precautions

  • Foods and drinks containing strong colors should be avoided for at least 48 hours after the treatment. This includes red wine, coffee, black tea, tomato sauce, blueberries, etc.
  • For best results, avoid smoking while whitening.
  • Some tooth sensitivity is expected after whitening. Should this occur, we recommend taking an over-the-counter pain medication, such as Ibuprofen or Acetaminophen. This is usually transient and lasts for 1-2 days.
  • To reduce tooth sensitivity:
    • Use a sensitivity toothpaste, such as Sensodyne or Prevident
    • Use MI paste right after a whitening session
    • Whiten every other day vs daily
    • Avoid foods and juices high in citric acid
      • Coffee, tobacco, and other products can re-stain your teeth over time. Should this occur, the teeth can be re-whitened with few touchups
      • Existing crown, bridges, veneers, and composite fillings will not whiten. They may need to be changed to match your new smile.
      • Keep whitening syringes out of the sun and heat. Store at room temperature.

For videos on how to use your custom whitening trays, please click here to visit our teeth whitening page. Do not hesitate to contact our office if you have any questions or concerns.

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Instructions for In Office Zoom Whitening

Before Treatment: It is recommended that you get a regular cleaning at least 2 weeks before your whitening treatment. This will remove any surface stains and optimize your results. Starting a regiment of twice daily brushing with an over-the-counter (OTC) sensitivity toothpaste (such as Sensodyne) or a prescription toothpaste (Prevident or MI Paste) 2 weeks before ZOOM! appointment will decrease tooth sensitivity. A 200-600 mg OTC Ibuprofen can be taken 1 hour prior to appointment to minimize sensitivity during the procedure.

During Your Treatment: Your ZOOM! Whitening appointment will be 90 minutes long and will include up to four 15 min whitening sessions and 30 minutes of pre-op and post–op instructions. We will be taking before and after pictures so you can see the result of the bleaching and will also be taking pre and post op shades.

After Treatment: The next 48 hours are important in enhancing and maximizing your whitening results for a long lasting, bright, and healthy smile. Your teeth will get lighter during the next 24-48 hours. The whitening continues as it has been absorbed into the teeth.

  • DO NOT consume any dark or yellow staining substances for 48 hours, such as: coffee, tea, soy sauce, berries, mustard, ketchup, red sauces, cola drinks, red wine, white wine, colored drinks using dye such as grape, cranberry, Gatorade, etc. Avoid colored lipstick, and tobacco products.
  • ZOOM! whitening gel is stronger than any over the counter or take-home bleach and can cause some tissue burns if it touches the gum tissue or skin. These are not permanent and will go away in a couple of hours.
  • Some teeth sensitivity is expected after whitening. Should this occur, we recommend taking an over-the-counter pain medication, such as Ibuprofen or Acetaminophen. This is usually transient and lasts for 1-2 days.
  • To reduce sensitive teeth continue using Prevident or MI paste twice a day after brushing and flossing. Place a pea sized amount on your finger and rub it onto your teeth, do not rinse, eat or drink for 30 min to allow the paste to penetrate the tooth.
  • At home whitening trays and gel or Philips Zoom! Quick Pro Whitening Varnish during your hygiene visits are a perfect follow-up and maintenance regimen to in-office whitening.
    If you have any questions or concerns, before or after your appointment please feel free to contact us.

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Instructions for Deep Teeth Cleaning

Following deep teeth cleaning procedure (scaling and root planning) you can expect to notice less redness, less bleeding and less swelling of your gum tissue. Your mouth will taste better and feel better. Your gum health can then be maintained with proper homecare and regular professional care.

What to Expect After Scaling and Root Planing?

  • Discomfort: You may have some discomfort, such as mild throbbing or aching immediately after treatment. This should subside within few hours. NSAIDS such as Ibuprofen can be taken as needed.
  • Tooth sensitivity: Teeth may be sensitive to temperature changes and/or sweets. This is because the procedure may open up dentin tubules after the tartar is removed which causes temporary hypersensitivity. In addition, the gums tighten as they heal and expose the root surface in areas where bone loss has already occurred. Fluoride application is a great way to reduce tooth sensitivity and prevent root surface decay in areas of recession.
  • Appearance: As the gums heal they may change their shape around the teeth. This is normal as they tighten. You will notice reduced bleeding when brushing and flossing.
  • 3 month periodontal maintenance visit: Scaling and root planning is a non-surgical approach to control periodontal disease. There is no cure for periodontal disease, it can only be managed or controlled. The bacteria that cause gum disease re-establish around 3 months after treatment. This re-care schedule disrupts this process in pockets 4 mm or greater. For patients with adult periodontitis, a supportive 3-month re-care is not optional, but a requirement for successful therapy.

Special instructions

  • Fluoride: Prevident is a prescription strength fluoride toothpaste that contains 1.1 % sodium fluoride and can be used once or twice daily instead of regular toothpaste. Do not rinse, eat or drink for 30 minutes after.
  • Chlorhexidine rinse (CHX): Chlorhexidine is a prescription antimicrobial rinse that can be used after brushing, usually once or twice daily. Swish the solution for 30 seconds and spit it out. Do not swallow the rinse and wait at least 30 minutes before eating or drinking. Do not use longer that 7-10 days as this rinse may temporarily stain your teeth.
  • Foods to avoid (24-48h): seed like foods (seeds and nuts, popcorn, chips); dense/chewy foods (steak, bagels).
  • Recommended: electric toothbrush with disclosing tablets and Waterpick in addition to flossing.

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Post-Op Instructions for Teeth Extractions

Follow these instructions carefully to ensure the successful healing of your tooth extraction:

During the first 24 hours:

  • Bleeding: Do not disturb the wound. It is important that a blood clot forms on the extraction site to stop bleeding, reduce pain and promote healing. Bite on a gauze pad firmly for 20-30 minutes and change the gauze as needed. If bleeding continues moisten a tea bag with water, fold it in half and bite down on it for 30 minutes. Some oozing is normal. The site could ooze for as long as 24 hours.
  • Food: Do not spit, and do not suck on candies or drink through a straw. This may dislodge the cloth and promote bleeding. Do not drink hot, carbonated, or alcoholic drinks, and avoid hot or spicy foods. Choose colder foods with smoother texture.
  • Oral hygiene: Avoid all rinsing including mouthwash containing alcohol for 24 hours after the extraction. Do not directly brush the extraction site. The extraction socket can be gently wiped with a clean, wet gauze or cloth, and the adjacent teeth gently brushed and flossed.
  • Smoking: Do not smoke or use tobacco. It may slow healing and promote dry socket.
  • Discomfort: To control discomfort, take pain medication before the anesthetic has worn off or as recommended. Tylenol is a good choice as it does not interfere with blood clot formation.
  • Swelling: To keep the swelling down, use an ice pack over the area, 20 minutes on, 20 minutes off

After the first 24 hours:

  • Begin to eat normally as soon as it is comfortable.
  • Resume brushing and flossing, but clean gently around the site for about a week. Further reduce swelling by rinsing your mouth very gently with warm salt water. Use about one teaspoon of salt per glass of warm water. Rinse two to three times a day for the week following the extraction.
  • If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
  • Reduce soreness or swelling by applying moist heat. Swelling usually starts to go down after 48 hours.

Call us right away if:

  • Bleeding is heavy or increased
  • Pain or swelling increases or continues beyond 2-3 days
  • You have a bad taste or odor in your mouth

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Self-Management for TMJ and Jaw Pain

These steps will help you reduce muscle pain and discomfort:

1. Use hot or cold packs

Apply moist heat, ice or a combination of the two to the painful area(s). Most people prefer heat, but if that increases your pain, use either the combination, or ice alone.

  • Apply moist heat for 20 minutes 2-4 times each day. Wet a towel with a very warm water, keep it warm by wrapping it around a hot water bottle or by placing a piece of plastic wrap and a heating pad over it. The towel can be rewarmed in a microwave, oven, or under a very warm tap water.
  • Use the combination of heat and ice 2-4 times each day. Apply the heat as recommended above for 10 minutes, then lightly brush the painful area with an ice cube wrapped in a thin washcloth. Repeat the sequence four or five times.
  • Apply ice wrapped in a thin washcloth to the painful area until you feel some numbness (usually in about 10 minutes), then remove it.

2. Eat soft foods

Confine your diet to soft foods such as casserole, canned fruit, soups, eggs, and yogurt. Do not chew gum or eat hard foods (such as raw carrots) or chewy foods (such as caramels, steak or bagels). Cut other food into small pieces, and chew on both sides of your mouth to reduce the strain on one side.

3. Rest your jaw muscles

When you are not chewing, your teeth should never touch (except occasionally when you swallow). Closely monitor your jaw position for signs of clenching. Try placing your tongue lightly on the top of your mouth, behind your upper front teeth, allowing the teeth to come apart and relaxing the jaw muscles.

Good head, neck and back posture help you maintain good jaw posture. Try to hold your head up straight and use a small pillow or rolled towel to support your lower back. Avoid habits such as resting your jaw on your hand or cradling the telephone against your shoulder.

4. Use physical therapy exercises

Use a Lucia Jig few times a day and lightly close on it. Slide your jaw forward and back on the jig, pause and hold in the back for 30 seconds. This helps break up any spasm in the muscles. The Lucia Jig is not a substitute for a night guard and should not be used while sleeping. A pencil placed behind the upper canine teeth can be used instead of the Lucia Jig.

5. Use medication

Use anti-inflammatory and pain reducing medications such as Ibuprofen to reduce joint and muscle pain.

6. Talk to your dentist to learn if a night guard is a good option for you.

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Get in touch with us if you have any questions regarding any of the instructions or to schedule an appointment.