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What to expect during your first new patient exam appointment
New patient exams take about an hour. We will take full-mouth digital X-ray and photo series. We will go over your medical and dental history and listen to what your concerns are. We do a head and neck exam, screen for oral cancer, and check your TMJ, teeth, fillings, gums. We will tell you what we have found and discuss possible options.
What to expect during an initial cleaning
Our dental hygienists will clean your teeth using a variety of instruments, including an ultra-sonic cleaner, hand scalers, and polish. If they feel they are unable to get you as clean as they like, they may suggest some additional time at a different appointment.
They will assess your home cleaning technique and offer suggestions, and techniques to help you get to where you would like to be. If you have any sensitive areas, or areas of decalcification or early decay, they may suggest a prescription fluoride, or other prescription.
After a cleaning, you may experience some gum tenderness, particularly if you have any gingivitis or periodontal disease. You can take a mild analgesic, such as Tylenol or Motrin, rinse with warm salt water, and use a soft brush to brush your gums for the first 24 hours. The discomfort should subside in 48 hours. If not, please call our office at 206-443-1788.
What to expect after a root planing, or deep cleaning
Root planing, or deep cleaning, is recommended if the hygienists are unable to get all the calculus and roughness off your teeth with a regular cleaning, or you have periodontal pockets that are 5 millimeters or greater. It is done in one to four increments, usually with anesthetic. We divide the mouth into four sections and do one or two sections at a time. Afterwards, you will be advised to take a mild oral analgesic, such as Motrin or Tylenol, and you may be sore for up to 48 hours.
Your teeth may be more sensitive after a deep cleaning, and you may want to brush with a desensitizing toothpaste such as Denquel or Sensodyne, or a prescription fluoride toothpaste that our office can dispense.
Often, you will be advised to return to the clinic three to four months later for a “Perio Maintenance” cleaning, so your pockets can be remeasured to see the progress. You will frequently be advised to stay on a three-to-four-month schedule to maintain your health.
What to expect after a filling?
We often do fillings with local anesthetic. Numbness can last two to four hours. Occasionally the site of the injection may be sore for a few days. Most often the fillings are “white” composite fillings.
Occasionally it is advantageous to do them in “silver” or amalgam filings. We will discuss both options with you to determine which is the best one for you. We almost always try to isolate the teeth with a rubber dam for your comfort and safety.
We always try to make sure that the fillings feel “right” in your mouth before you leave, but occasionally the anesthesia makes it difficult for you to tell how the “bite “is. If you leave and find out later that something does not feel right, call us and we will try to get you in immediately to adjust it.
Rarely, if a tooth has a lot of decay, has been traumatized, or just isn’t healthy, it may be sensitive after a procedure. You may want to wait 24 to 48 hours, take Tylenol or Motrin for a day or two, and see whether it settles down.
If it persists, please call us and let us know. Extreme temperature and bite sensitivity can be the harbinger of a tooth in trouble, and we should know about it.
What to expect with a crown
Crowns are indicated when the tooth has had a root canal, or is structurally weakened by decay, has old fillings or cracks, ir is painful to bite and needs to be covered by a stronger, outer material. The outer material or crown can be porcelain, gold, or a combination of porcelain and precious metal. We can discuss the options with you at the right time.
Crown appointments take about 1.5 to 2.5 hours. After we prepare the tooth and take an impression, we will place a tooth-shaped temporary over your tooth, to protect it from bacteria and to keep it from moving.
It is important to keep the temporary on the tooth until your next appointment. Floss the temporary by pulling the floss through the contacts, as opposed to pulling straight up. Avoid chewing sticky or hard foods, because these can break the temporary.
It is vital to keep the area clean and free from bacteria by brushing and flossing, even if your gums are a bit sore. If the temporary should fall off or become dislodged before your seat appointment, please call our office so we can replace it. If you are somewhere where you cannot get in to see us, you can place the temporary on your tooth and use denture adhesive or toothpaste to hold it in place temporarily. If you experience pain that does not get better within a week, call our office.
We often do crowns with local anesthetic. Numbness can last two to four hours. Occasionally the site of the injection may be sore for a few days. We isolate the teeth with a rubber dam for your comfort and safety. We always try to make sure that the temporaries feel “right” in your mouth before you leave, but occasionally the anesthesia makes it difficult for you to tell how the “bite” is.
If you leave and find out later that something does not feel right, call the office. If a tooth has a lot of decay, has been traumatized, or just isn’t healthy, it may be sensitive after a procedure. You may want to wait 24 to 48 hours, take Tylenal or Motrin for a day or two, and wait for it to settle down. If discomfort persists, please call us and let us know. Extreme temperature and bite sensitivity can be the harbinger of a tooth in trouble, and we should know about it.
The impressions we take are sent to a lab, and are ready to be seated two to three weeks later. You will return and we will fit and check the crown. We will clean the tooth and cement the crown. This usually takes about an hour.