Patient Information

Facts You Should Know About Dental Insurance

1. Dental Insurance is a contract between you, your insurance company, and your employer. Often the insurance company will not give us any direct information regarding your coverage.
2. Many businesses are concerned about cost when choosing an insurance plan. They may elect to have dental fees paid at a different rate than what is charged by the dentist. This means that even if your insurance coverage is 100%, you may be paid at a lower rate than what is charged by our office.
3. Information provided to you by your employer will assist us in helping you understand your insurance coverage. Please bring your newest information booklet along with your coverage numbers.
4. Some insurance companies have a $500 minimum before they will do a pre-determination for treatment. If you have a concern about a certain dental procedure which is less than $500 we will be happy to give you the procedure code so you can follow up with your insurance provider.
5. Almost all insurance companies have an annual maximum. This maximum may be based on a calendar year or may run for 12 consecutive months beginning any time throughout the year.
6. The amount of benefits you are entitled to is related to the plan your employer has purchased and not to the value of dental services received.

Congratulations On Your New Arrival

This is an exciting time for you and your family. Although your new baby seems so little, it is never too early to start them on the right track for a lifetime of good dental health. Here is some information to help you along the way. If you have any questions, please don’t hesitate to call our office.

Eruption sequence for primary teeth:

Upper Eruption

Lower Eruption

How soon should I start brushing my baby’s teeth?

Even though your newborn does not have teeth, we recommend you regularly wipe out their oral cavity with a small wet face cloth or gauze wrapped around your finger. This can be done at any time throughout the day and even at this early age you are preparing your child for routine dental care. When their first teeth erupt, you can begin to use a small infant-sized toothbrush.

How do I brush, as she/he seems to put up quite a fight?

Hold your baby cradled so their head is in the crook of your arm. Try to encourage your baby to mimic mouth movements. They are very eager to imitate you. Encourage them to brush their own teeth. They will not have the dexterity to brush well on their own until about age 5, so it will be up to you to make sure you are doing the thorough cleaning twice a day.

How do I choose the right toothbrush for my baby?

A toothbrush should have a small easy to grip handle, soft rounded bristles and 3 to 4 rows of bristles.

How often should I change my baby’s toothbrush?

We recommend changing your infant’s toothbrush every 2-3 months or more frequently if they have been sick.

What can happen to my baby’s teeth if they take a bottle to bed? Or if they use one frequently throughout the day?

A baby’s teeth can decay very quickly if they are constantly in contact with sugary fluids such as formula, breast milk or juice. This is known as baby bottle caries. It is important to limit when you allow your baby to have the bottle (e.g. at mealtimes). If your baby needs to have a drink throughout the day, offer fluids from a cup or give them water only from their bottle.

How can I help my child be more comfortable when he/she is teething?

Cold things relieve the discomfort of teething. A teething ring chilled in the refrigerator or a cold face cloth to chew on will often give your little one relief. If this does not provide needed relief consult with your pediatrician or give us a call.

Thumb sucking vs. pacifiers – What’s the best choice?

It’s a natural process for infants to suck their thumbs and most will give up this habit around the age of 2. Thumb sucking becomes a problem if it continues up to the age of 5 to 6. At this time there are dental development problems.

A pacifier is also acceptable for infants and some people argue it is easier to take away than the child’s thumb. We do recommend if your child is using a pacifier to use an anatomically correct one and to check it often for signs of wear.

Pacifier Safety Tips

• Wash your baby’s pacifier if it falls on the floor
• Check the rubber for any signs of cracking or drying by pulling on it
• One-piece pacifiers are better as there are no parts to break off
• Make sure pacifier is age appropriate (check packaging)
• Don’t coat the pacifier with anything sweet, as this could lead to cavities if primary teeth are present
• Do not hang pacifier around baby’s neck. Attach to clothing with a clip.

When should I bring my child to have his/her first cleaning and checkup?

It is recommended to bring your child in for their first visit around the age of one.

Early Childhood Caries

Early Childhood Caries (ECC): decay (cavities) in the primary dentition (baby teeth) at the age of 5 ½ years or less

• Can also be known as “nursing caries” and “baby bottle tooth decay.”
• Can cause pain and infection, which can affect your child’s ability to eat, potentially causing nutritional deficiencies.

These cavities can spread to the secondary dentition (adult teeth), which start erupting at age 5 to 6 years. Plus, baby (primary) teeth are required to hold space for the future adult teeth, some of which may not erupt until age 13.

What Are Some Risk Factors in Early Childhood Caries?

• Diet
• Frequent intake of fermentable carbohydrates (sugars), including liquids such as juice or pop.
• Sleeping with a baby bottle and prolonged sippy cup use, both of which cause pooling of liquids in infant’s mouth.
• Enamel defects on teeth
• Prolonged use of medications containing sugars
• Health conditions that restrict saliva flow
• Bacteria (S. Mutans) that can be transmitted through saliva from a primary caregiver (mom, dad, etc.) to your child.

Prevention of Early Childhood Caries

The Canadian Dental Association recommends that an infant’s first dental visit should happen as early as 6 months after their first baby tooth erupts and no later than 12 months of age.

This aids in the early detection of childhood caries, assess your child for the risk for caries and helps us develop a preventive program that suits your child’s needs.

Early Childhood Dental Care

When should my child see the dentist?

The first visit to the dentist is an important one. We recommend having your child seen around their first birthday.

When should my child have dental x-rays?

After a thorough exam, if we note any suspicious areas, we would take digital radiographs. Dental x-rays can detect decay in between the teeth. If left undetected decay in children can progress very quickly.

It looks like my child has dark spots on his/her back teeth – what could this be?

Dark spots are children’s teeth may be a sign of decay. The deep grooves and pits of back teeth are susceptible to decay because they are harder to clean than other areas.

How often should my child brush his teeth?

We recommend brushing 3 times a day for 2-3 minutes at a time. At one of those brushings it important that you brush with your child to ensure the plaque is thoroughly removed from all tooth surfaces. A child doesn’t have the dexterity to do a completely thorough brushing until around the age of 9.

What kind of toothpaste and how much should my child use?

When your child can ‘spit out’ the toothpaste, a pea-sized amount of fluoridated toothpaste can be used. If a child cannot ‘spit out” use a toothpaste with no fluoride added. Brand and flavour of toothpaste is an individual preference.

At what age should I floss my child’s teeth? How do I floss?

We recommend flossing as soon as your child’s primary molars are present. These teeth are usually tighter together than the front teeth and are more vulnerable to decay. Have your child in a lying down position with their head inyour lap. Have them open wide and using the floss, gently see-saw the floss in between your child’s teeth and pull up to remove.

How many primary teeth will my child have?

There are 20 primary teeth. 10 on the top and 10 on the bottom.

When will my child lose their first tooth?

Children usually start to feel their teeth loosen around the age of 6. Some children will have loose teeth as early as 4 years and some as late as 8 years.

My child has a tooth coming in behind his baby teeth on the bottom, and the primary tooth isn’t lose yet?

This is a common eruption pattern in children. As the permanent tooth erupts, it will begin to migrate forward and place pressure on the primary tooth to loosen it. Encourage your child to wiggle the tooth throughout the day until it is finally loose enough to come out. Occasionally these teeth will not loosen by themselves, and it is necessary to have us remove the tooth.

A word about nutrition…

Healthy snacks and meals are very important in our children’s development. The dental profession is seeing a rise in decay in very young children. Toddlers often snack on crackers and raisins throughout the day. This is often washed down with juice and is a very bad combination for their teeth. Please consider water instead of juice and brush more often when you can. If brushing isn’t an option, rinsing with plain water can help.

Infant Oral Care

We recommend you start cleaning your infant’s mouth before their teeth come in. This allows you and your child to be familiar with the routine of keeping a clean mouth.

• Use a soft toothbrush or a soft, clean, damp cloth wrapped around your finger.
• The goal is to wipe all surfaces of the gums after every feeding.

Once the first front tooth (incisor) erupts:

• Start using a soft toothbrush with water to brush teeth and gums two times a day (morning and bedtime).
• Floss once a day.

When all incisors are present:

• Use a soft toothbrush with a smear of toothpaste not containing fluoride, two times a day (morning and bedtime)
• Floss once a day.

Fluoride

Fluoride is a mineral found in nature that helps to make the outer layer of teeth (enamel) stronger.

Common sources of Fluoride:

• Drinking water, the food we eat, dental clinic, toothpaste

Soothers and Thumb-sucking

Sucking habits are common among many infants and children.

Do:

• Encourage your child to stop any sucking habits between the ages of 1 to 3 years
• It is important to stop well before adult teeth start to come in.
• This helps prevent problems with jaw growth and tooth development.

Do not:

• Put any sugar, honey, or corn syrup on a soother
• These sugary substances can cause cavities.

Custom Fluoride Trays

How often do I wear the trays?

The trays should be worn once a day, preferably before bed.

How much material do I put in the trays?

Place a small ribbon of fluoride in the base of the tray. If you have some excess material, please remove with a toothbrush or a tissue.

How long do I wear the trays for?

The trays should be worn for 4 minutes. After, please do not to have anything to eat or drink for 30 minutes.

What is the best way to clean the trays?

After the trays have been worn, the best way to clean the trays is to run them under warm water and to clean both the inside and outside with a soft bristled toothbrush.

How long do I continue this treatment?

We will have you continue this treatment daily until you are no longer considered high risk.

What do I do when I need more fluoride?

When you are low on your fluoride supply, please call the office and let us know. We will order some for you. It usually takes 2-3 days to arrive at our office.

Mouthguards

Who should wear a mouthguard?

Mouthguards are for anyone who is involved in sports, including football, hockey, baseball, inline skating, skateboarding, squash, and bike riding.

How do they work?

They stop the upper and lower teeth from bumping into each other and spread the impact from a fall or collision between all the teeth and the jaws. They also help to keep the teeth from lacerating the gum tissue and lips and can help prevent neck injuries and concussions.

How are mouthguards made?

First, we take an impression of the top teeth. From this impression, a model is made to perfectly represent your upper teeth. A mouthguard is then made to fit this model. Because every mouthguard is custom-made, they fit perfectly, and you don’t need to worry about it dislodging.

How do I keep it clean?

After you wear your mouthguard, please make sure to brush and rinse it thoroughly. Always store it in the case provided so it doesn’t get damaged and stays clean. You may wish to occasionally place it in a cup with some mouthwash and water for a few minutes to help keep it fresh and clean.

How often should it be replaced?

For our adult patients we recommend replacing your new mouthguard every 3-5 years. Children do need to have theirs replaced more frequently because as they grow their teeth and jaw shape changes too. Feel free to bring your mouthguard to your regular exam appointment and we can check the fit.

Pit And Fissure Sealants

What are pit and fissure sealants?

Pit and fissure sealants are plastic coatings that are applied to the biting surfaces of teeth to help reduce the chance of developing cavities in those areas.

Which teeth do you seal?

Teeth with deep pits and grooves are good candidates for the procedure and typically the molars and premolars are selected. Both primary and permanent teeth can be sealed.

How are sealants applied?

First the teeth are cleaned to ensure no plaque is present. The teeth are isolated with cotton rolls to keep them dry. Then a cleaning agent is place and the tooth is washed and dried. The liquid plastic sealant is applied with a small brush and lastly a beam of bright blue light hardens the sealant in 20 to 30 seconds. No cutting of the enamel is necessary, and anesthetic is NOT required.

Why do you use a cleaning solution?

The cleaning solution opens pores in the enamel, allowing the liquid plastic to interlock with the enamel.

How long do they last?

Anywhere from 3 to 5 years or longer depending on your bite pattern. We routinely check the sealants at your regular exams.

Does my insurance cover this?

Most insurance companies cover sealants on children under sixteen. It is considered a preventative procedure. If you have any questions regarding coverage, a pre-determination could be sent to your insurance company to verify coverage.

Gingivitis

What is gingivitis?

Gingivitis is an inflammation of the gum tissue. It is the first stage of gum disease and the only stage of gum disease that is reversible. This means with good daily oral hygiene, gingivitis can be controlled and even eliminated.

What does gingivitis look like? Feel like?

The gum tissue becomes red and swollen and may bleed easily when touched by a toothbrush or our dental instruments. Often the gum tissue may be sensitive to touch.

Why do I have gingivitis?

When the plaque present in our mouth is allowed to remain at the gum line it starts to infect the gum tissue. You need to be thoroughly removing the plaque daily for your gum tissue to be healthy.

How do I prevent gingivitis from happening?

The only way to keep gingivitis in check is to brush and floss regularly. Brushing twice a day and flossing once a day should be adequate for most people. The more that you do the less likely gingivitis will occur. When brushing, make sure you are angling the toothbrush at about a 45-degree angle towards the gum line and using gentle circular motion. When flossing, hold the floss in a tight “C” shape around the tooth and gently scrape up and down 2 to 3 times on the side of each tooth.

Can gingivitis be in different areas of my mouth?

Gingivitis can be found in all areas of your mouth, or it can be localized to certain areas.

Can medication effect gingivitis?

Yes. Some medications can affect the gum tissue. If you think that this may be contributing to your oral health, please let our dental team know so we may help you with a dental care program best suited for your personal needs.

Laser Therapy Homecare Instructions

When we use laser therapy in your gum treatments, your aftercare is an important part of your recovery process.

The First 24 Hours:

• Avoid any foods that will irritate your gums. These include acidic foods like citrus, salsa, and vinegar-based dressings, and rough or crunchy foods like corn chips crusty bread, fried foods, popcorn, or nuts.
• Try foods like this instead: eggs, pasta, unbreaded fish or chicken, cooked vegetables, or yogurt

The First Week:

• Be gentle when cleaning the treated area. Carefully place your toothbrush on your gums below the tooth and brush without letting the bristles get below the gumline.
• Floss carefully to remove food debris from between your teeth, taking care not to let the floss get under your gums.

Remember – the best way to keep your gums healthy after treatment is to prevent issues from recurring with regular brushing & flossing, and attending the dental appointments that we’ve personalized for you based on your own unique needs.

Tooth Hypersensitivity

When your teeth are hypersensitive, we may suggest a varnish to help.

Why do I need to have this product applied?

You have been identified as a person with dentin hypersensitivity. This will help combat the sensitivity to temperature, sweets, and air.

How does this product work?

When a tooth is hypersensitive the dentin is exposed. The dentin of the tooth is porous and not covered by enamel and therefore is not protected against the elements of hot, cold, air, or sweets. The dentin of the tooth has small microscopic tubes (tubules) that run towards the center of the tooth and transmit sensitivity. The varnish is designed to flow into these tubules and block them. This prevents the transmission of the sensitivity.

How often do I need to have this product applied?

Often relief is achieved in just one application. Depending on the severity of dentin hypersensitivity 2 or 3 more applications may be required.

How is the product applied?

The area is dried with air or cotton gauze and then using a small applicator the varnish is painted onto the area.

Can I eat or drink after application?

After application, please restrict your diet to soft foods and try to avoid hot liquids for the rest of the day.

When should I brush and floss?

Try to wait until bedtime before brushing and flossing.

Should I use any other products to help with the sensitivity before my next checkup?

We have reports from our own patients that a desensitizing toothpaste such as Sensodyne used daily, time will dramatically reduce the amount of sensitivity over time.

Complete Dentures

• Before cleaning your denture, fill the sink half full of water. This will provide a cushion for the denture in case it’s dropped.
• After a meal, remove and rinse your denture with lukewarm water. We also recommend you rinse your mouth before replacing your denture. This will remove any debris under your denture and keep your gum tissue feeling healthy and clean.
• Using a denture toothbrush (a denture brush has a larger cleaning area with stiffer bristles than a regular toothbrush) and the toothpaste of your choice brush your denture well. Brush the teeth, making sure to clean the tooth contacts and gum line area. The inside of the denture needs to be cleaned as well. Plaque will adhere to the surfaces of the denture as it does to natural tooth structure.
• Rinse denture under warm water when finished cleaning.
• A denture cleaning tablet such as Polident^® can be used daily or a few times a week to help with removal of stains. Soaking dentures will not remove plaque. Dentures must be cleaned with a brush prior to soaking. It is safe to soak dentures overnight in Polident. Please follow directions on the packaging.
• Complete dentures may be worn overnight, and we encourage you to do so as this will help with maintaining your jaw positioning.
• Gum tissue under the dentures should be cleaned gently with a soft bristled toothbrush or a face cloth. To do this, run the bristles of the toothbrush under warm water to help soften them. Then gently massage the gum tissue using a circular motion. Clean the palate, cheek area, tongue, and ridges of your mouth. This will remove any plaque or debris and promote blood circulation to the area.
• Denture storage containers should also be cleaned regularly with hot water and soap to prevent microbial buildup.

We recommend coming in for a regular dental examination at least once per year to have your soft tissue examined and to check the fit of your dentures.

Partial Dentures

• Before cleaning your denture, fill the sink half full of water. This will provide a cushion for the denture in case it’s dropped.
• After a meal, remove and rinse your partial denture with cool-warm water. It is also recommended to rinse your mouth before replacing your denture. This will remove any debris under your denture and keep your gum tissue feeling healthy and clean.
• Using a denture toothbrush (a denture brush has a larger cleaning area with stiffer bristles than a regular toothbrush), and toothpaste of your choice brush your denture well. Brush the teeth, making sure to clean the tooth contacts and gum line area. Pay close attention to the metal framework and clasp areas. The inside of the denture needs to be cleaned as well. Plaque will adhere to the surfaces of the denture as it does to natural tooth structure.
• Rinse denture under warm water when finished cleaning.
• A denture cleaning tablet such as Polident^® can be used daily or a few times a week to help with removal of stains. Soaking dentures will not remove plaque. Dentures must be cleaned with a brush prior to soaking. It is safe to soak dentures overnight in Polident. Please follow directions on the packaging.
• Smoking, red wine, coffee, and tea can also stain your denture.
• Partial dentures may be worn overnight. It is recommended that for a few hours during a 24-hour period the partial denture be out of your mouth to allow the gum tissue a chance to breathe and relax.
• Gum tissue under the dentures as well as natural remaining teeth should be cleaned gently with a soft bristled toothbrush. To do this, run the bristles of the toothbrush under warm water to help soften them. Then gently massage the gum tissue using a circular motion. Clean the palate, cheek area, tongue, and ridges of your mouth. This will remove any plaque or debris and promote blood circulation to the area. Brush natural teeth with a small circular motion with the toothbrush at a 45′ angle.
• Denture storage containers should also be cleaned regularly with hot water and soap to prevent microbial buildup.

We recommend coming in for a regular dental examination and hygiene appointments at least twice per year to have the soft tissue and remaining natural teeth examined and to check the fit of your partial denture.

Braces

Taking care of your teeth with braces on

How to relieve any discomfort:

Ortho Wax: place wax over area that is causing you discomfort. Drying the area before placing the wax will help it hold better.

Ibuprofen or Advil: Our first recommendation on relieving discomfort – please take according to package instructions. If Ibuprofen/Advil cannot be taken due to allergies or other health reasons, you can use Acetaminophen or Tylenol instead.

Maintenance:

• Be more aware of brushing and flossing techniques to keep teeth clean and free of bacteria.
• Eat a proper diet to keep your body and braces healthy and free from any damage.
• Please call for an appointment if you notice any loose or broken wires, brackets, hooks, and if you are experiencing any discomfort that you’re not able to control.

Eating with braces…

If something is too big to bite – cut it up

• Bread/pizza crust – cut into small pieces
• Fries – small pieces
• Meats – cut from the bone
• Raw fruits and vegetables – cut into small bites

If something is too hard to chew – do NOT eat it

• Beef Jerky – do NOT eat
• Candies – do NOT bite
• Gum – sugarless only (no bubblegum)
• Ice – do NOT chew
• Nuts – do NOT eat
• Pens and pencils – do NOT chew
• Popcorn – do NOT eat kernels

Crib Appliances

What is a crib appliance?

It is a retainer that is used to help stop oral habits such as thumb sucking or tongue thrust. It is cemented in place, preventing your child from placing their thumb in the usual comforting spot.

How long will my child need the appliance in place?

Although the habit may seem to be broken quickly we recommend leaving the appliance in place for 6 months.

How do we clean the appliance?

A regular toothbrush and floss is fine. You and your child will need to pay close attention to cleaning the teeth, which anchor the appliance. The wire can be cleaned by running the toothbrush bristles over them when you are cleaning the rest of your child’s teeth.

Are there any foods to avoid?

Hard or sticky foods such as hard candy, licorice, gum etc. should be avoided as these can cause the cement to loosen.

What do I do if the appliance is loose?

Please contact our office. If it is loose be careful not to dislodge it and make sure it’s in its proper place. The appliance will need to be recemented.

Disking

What is disking?

Disking is a procedure that makes primary teeth narrower in order to make more space for the permanent teeth. Approximately 1 to 1.5mm of tooth structure is removed.

Which teeth are disked?

Most often the primary cuspids (eye teeth) are the ones that are disked, as usually there is some crowding of the 4 central incisors. By disking these teeth there is more room for the incisors to straighten.

Is anesthetic required?

Each case is individual. Often, we do give some surface freezing with both topical and local anesthetic.

Does the procedure need to be done more than once?

Depending on how much tooth structure is removed, and what kind of tooth movement has occurred, the procedure may be repeated in 4-6 months.

Are the teeth sensitive after the disking?

The teeth may be sensitive to temperature for a few days after the procedure. There may also be a bit of bleeding of the gum tissue.

Essix Retainers

• When inserting each retainer, gently push the retainer over your front teeth and then apply equal pressure to the tops of your back molars until the retainer snaps into place.
• Retainers should fit comfortably and not be forced into place.
• DO NOT bite retainers into position.
• To remove retainer use your fingers and start on one side at the molars and slowly work your way around to the other side.
• You may experience dental tenderness when first inserting the retainer, similar to when you changed to a new set of aligners.
• Retainers should be worn full-time for the first 6 months.
• After the 6 months retainers should be inserted at bedtime every night. Remove retainer in the morning. Failure to do so may result in tooth movement.
• After removal, rinse with water, brush with gel toothpaste and shake off excess water. STORE in retainer case.
• Keep retainers away from hot water, any heat source, and harsh chemicals
• Keep retainers out of the reach of small children or pets (dogs especially will chew retainers).
• Do not put in dishwasher.
• Always store in a cool dry place.

Holding Arches

How long before my child can eat or drink?

Please wait a half-hour before eating or drinking to ensure the cement has set completely.

Should my child avoid certain foods?

Sticky and hard foods such as licorice, chewing gum, hard candies and popcorn should be avoided.

How do I clean the appliance?

Using a regular toothbrush, brush all teeth, taking extra care to clean well around the bands and along the arch wire. You may also need a special flossing aid to help clean between the teeth.

What to do if the appliance is loose?

Please call our office as soon as possible, so we can schedule an appointment to have the appliance recemented. Have your child remove the appliance if possible. If not please be very careful when eating and avoid any chewy foods.

How long does the appliance stay in place?

Each case is individual. We will let you know at the time of the cementing appointment the expected time the appliance will be in place.

How often does the appliance need to be checked?

Appliances may be monitored monthly, bi-monthly or semiannually. We will let you know the maintenance schedule we would like to set up.

My child is complaining of discomfort. How long will it last?

It is virtually impossible to fit an appliance without some aches and pains. The extent of discomfort varies with each child and usually lasts a few hours to a couple of days. Children’s Tylenol can be beneficial in the early days along with a soft food diet.

Removable Appliance

• Appliance should be worn for the required number of hours.
• Do not wear the appliance when eating, brushing teeth or when engaging in active sports such as hockey, football, soccer.
• Clean appliance after each meal and before bed.
• When the appliance is removed natural teeth should be brushed, flossed, and rinsed. If you cannot brush and floss, please rinse vigorously with water to help with the removal of food debris.
• ALWAYS store appliance in a container with water to keep it from drying out.
• Label the storage container with your name and phone number.
• The plastic taste will usually disappear 2 to 3 days after insertion.
• You may notice an increase in your saliva flow. This will return to normal as your mouth adjusts to the appliance.
• Your speech may be affected by the appliance as now your tongue will be restricted in its movements. The fastest way to help with this is to read out loud.
• Appliance should be inserted using the thumb or finger pressure on the plastic areas or clasp areas. Never “BITE” an appliance in place.
• To remove appliance, grasp the clasp area and pull vertically. They should not be removed by applying any force as the wire may become distorted or break.

Cleaning a removable appliance

• Use toothpaste.
• Hold appliance in palm of hand by gripping the acrylic rather than the wire. This will prevent wire distortion.
• Clean over a sink filled with water or a wet washcloth as this will cushion the fall you accidentally drop the appliance.
• Carefully brush outside, inside, and around the clasps
• Rinse thoroughly under cool water. Hot water can ruin the acrylic resin.
• If the appliance is not being returned to the mouth, it should be allowed to soak until you use it again.
• Containers used to store orthodontic appliances should be cleaned regularly with soap and water to prevent microbial buildup.

Separating Discs

What is a separating disc?

It is a small plastic ‘doughnut’ placed in between two teeth to create space for a band. The band will be fitted around the tooth at the next appointment and is used to anchor appliances.

Will they cause discomfort?

Occasionally some discomfort may be felt. It is like having an apple peel or popcorn husk stuck between two teeth. Usually the discomfort will subside in a day. Children’s Tylenol can be used if your child is having a hard time adjusting.

How long are they in place?

We place them 1 to 3 days before your appointment to have the bands seated and the final impression taken. Once the impression is taken we replace the ‘doughnuts’ until the next appointment, when we will cement the appliance.

What do we do if one of the doughnuts falls out before our next appointment?

Please contact our office as soon as possible to schedule a quick appointment to have them replaced.

Does my child need to watch what they are eating?

Yes! Sticky foods like gum or fruit bars may pull out the disc. Avoid these foods and do not floss in between the teeth where the donuts are placed.

T4K Trainer Appliances

What is the T4K^® Trainer?

This is a dental appliance that looks like a mouthguard and helps to correct myofunctional habits such as incorrect tongue position and function, as well as mouth breathing, excessive overjet, and crowding.

When is it used?

It is used during the mixed dentition stage of the child’s development.

When is it worn?

We would like your child to wear the appliance at least one hour a day and then all night. It can be worn when your child is watching TV, doing homework, etc. While wearing the appliance during the day, have your child practice closed lip posture.

Will the teeth be sore at all?

The front teeth will become slightly tender in the early stages. This is normal but if soreness becomes excessive, decrease the wear time, and then increase to normal use when tenderness has passed.

How long is the appliance in place for?

6 to 12 months

Trainer tips for parents

Your child must persevere with use while sleeping. Once your child can sleep through the night with the appliance in place you’ll know you have been successful.

• Your child’s mouth should be closed for most of the time and if necessary remind them to keep their lips together and breath through their nose.
• Remind your child to have their tongue in the correct position even when the appliance is not in place.
• If overnight use is not possible, increase wear time during the day.
• Don’t expect to see dental changes within weeks, however you should see an improvement in function within a short time (look for improved nose breathing, lip and jaw position, posture)
• If your child is having a tough time at night a piece of medical tape could be placed over the child’s mouth to help keep the appliance in place. We have this medical tape available in our office.

Vivera Retainers

Care of Vivera Retainers

• Review the “Use and Care” Instruction Brochure.
• Rinse new retainer thoroughly with cold water prior to insertion.
• When inserting each retainer, gently push the retainer over your front teeth and then apply equal pressure to the tops of your back molars until the retainer snaps into place.
• Retainers should fit comfortably and not be forced into place.
• DO NOT bite retainers into position.
• To remove retainer use your fingers and start on one side at the molars and slowly work your way around to the other side.
• You may experience dental tenderness when first inserting the retainer, similar to when you changed to a new set of aligners.
• Retainers should be worn full time for the first 6 months.
• After the 6 months retainers should be inserted at bedtime every night. Remove retainer in the morning.

Failure to do so may result in undesired tooth movement.

• After removal, rinse with water, brush with gel toothpaste and shake off excess water. Store in retainer case.
• Keep retainers away from hot water, any heat source, and harsh chemicals
• Keep retainers out of the reach of small children or PETS (dogs especially will chew retainers).
• Do not put in dishwasher.
• Always store in a cool dry place.
• You are supplied with 4 sets of Vivera retainers. Please change the retainers when you notice they are not as tight as they were at the beginning. It is recommended by Invisalign to change them at least every 3 months. Your first 4 sets are included in the cost of the Invisalign. We can order you additional retainers from Invisalign and the cost is based on their current pricing.

Orthotic Appliances

• Please wear your orthotic for approximately 22 hours per day. You can eat with the appliance in place.
• Clean your orthotic by using a soft bristled toothbrush and your toothpaste of choice. This should be done after every meal and before bed.
• Never leave the appliance in extreme temperature conditions (e.g. in a car in the summer or winter)
• Do not allow your orthotic to dehydrate for more than 24 hours. Keep the appliance in a humidor when not in use. Your retainer case should work nicely. Simply place a small piece of wet paper towel in the case. You can also keep your appliance moist by soaking it in a container with ½ mouthwash and ½ water.
• With normal use, the appearance of the resilient portion of the appliance may vary from crystal clear to mildly opaque.
• To remove the appliance, use equal pressure on both sides of the mouth. This will minimize the chance of damage to the appliance.

Pre-TENS

Relaxing your jaw muscles to their most relaxed position through the application of TENS (mild electrical stimulus), this diagnostic procedure will provide us with valuable information about your bite that is not otherwise obtainable.

What is TENS?

TENS is an abbreviation for Transcutaneous Electrical Neural Stimulation. The TENS device we use is battery operated, contains fail-safe circuitry and has a safety record of nearly 40 years. The tiny electrical stimulus it provides travels through nerves that control the muscles of your head and neck. This causes the muscles to exercise mildly, forcing out accumulated waste products of metabolism and providing the muscles with fresh nutrients and oxygen. Only in this way can we truly relax or “de-program” any persistent muscle tension that may be present and find an optimal bite position.

What to expect

• The skin over your jaw joints (just in front of your ears), behind your ears, along the side of your neck and at the nape of your neck will be cleansed with an alcohol pad.
• Adhesive electrodes will be applied to these locations and a TENS device will be attached to them by means of these wires.
• A tiny electric current will gradually pass to the electrodes through the wires. This will cause the nearby muscles to “pulse” rhythmically every 1.5 seconds.
• The session will typically last approximately 60 minutes, during which you will sit quietly either reading, watching TV, or with your eyes closed.
• The process may be disconcerting, but most patients quickly adjust to it and may find it to be very pleasant once used to it – often having a tendency to doze off. If you ever experience any discomfort whatsoever, please notify us at once.

Preparing for the appointment

• Wear a comfortable shirt or blouse, loose enough that we may apply electrodes at the nape of your neck. Please do not wear a turtleneck.
• Do not apply makeup or cosmetics except as absolutely necessary. Dead skin, cosmetics or other materials on the skin interfere with the conduction of the tiny electrical signal. We will clean the skin with alcohol prior to placing the electrodes, but your cooperation will contribute to the comfort of the procedure.
• Do not come to the office hungry. While not significantly documented, experience has indicated that it is more difficult to relax the muscles of people with low blood sugar.
• Men, please be clean shaven. Avoid long sideburns if possible.

Crown Lengthening

These instructions are intended to assist your healing and minimize discomfort.

• Use the mouthwash we provide you twice a day – morning and evening. Rinse for 30 seconds and do not put anything in your mouth afterwards for 30 minutes.
• Clean the surgical area using the small toothbrush we’ve provided you. Soften it in hot water first, dip in thebprovided mouthwash and gently clean the area twice a day.
• Once a day flossing is encouraged starting tomorrow. Be gentle.
• Ice your face today because it will decrease swelling. Place on/off every ½ hour. Remember to protect your skin by covering the ice with a cloth.
• We’ll see you in 3 to 5 days for suture removal.

Oral Surgery

How long will the freezing last?

The freezing will last between 1 and 5 hours. Please avoid having anything to eat or hot liquids until you are able to feel your tongue and cheeks.

How long do I keep biting on the gauze? And why?

Please keep biting on the gauze for at least 45 to 60 minutes. This will help establish a good blood clot, which will aid in healing. Please replace gauze as needed. Continue to do this until the bleeding subsides.

Can I play soccer, baseball, etc. after my extraction?

We recommend limiting physical activity for 24 to 48 hours to ensure the healing process has begun.

Can I smoke or drink alcohol?

No, not for at least 24 hours. Either of these interfere with the formation and retention of the blood clot.

What can I eat?

Cold or lukewarm liquids may be taken for the first 4 to 6 hours. After this any soft food is permissible. We do ask you to avoid using a straw for 24 hours as this can also dislodge a blood clot.

When can I brush, floss and rinse?

Please continue your regular home care. Be sure to clean carefully around the extraction site but avoid any vigorous rinsing for 24 hours. After 24 hours using warm salt water (1 teaspoon salt in 6 ounces of water) will help promote healing.

Will the site hurt after the tooth is removed?

If you do have discomfort after tooth removal a mild painkiller such as Advil or Tylenol can be used. The following dosage is recommended: Extra strength Advil 400mg X 2 = 800mg. 4 hours later take one 500mg acetaminophen and continue to repeat as needed. Dr. Kuharchuk or Dr. Nijjer may have prescribed stronger pain relief and if so, please take it as directed.

Will I have swelling?

Most times no. If the extraction was difficult some swelling and/or bruising may occur. If this happens, ice pads may be applied for the first 4 to 6 hours only alternating 20 minutes on, 20 minutes off.

How long before the stitches are removed?

Non-resorbable stitches will remain in place for 7 to 10 days. If resorbable stitches are placed these will dissolve on their own.

Periodontal Surgery

These instructions are intended to assist your healing and minimize discomfort.

• Use the mouthwash we provide you twice a day – morning and evening. Rinse for 30 seconds and do not put anything in your mouth afterwards for 30 minutes.
• Clean the surgical area using the small toothbrush we’ve provided you. Soften it in hot water first, dip in the provided mouthwash and gently clean the area twice a day.
• Once a day flossing is encouraged starting tomorrow. Be gentle.
• Ice your face today because it will decrease swelling. Place on/off every ½ hour. Remember to protect your skin by covering the ice with a cloth.
• We’ll see you in 3 to 5 days for suture removal.

Root Canal Therapy

How long will the freezing last?

The freezing will last between 1 and 5 hours. Please avoid having anything to eat or hot liquids until you are able to feel your tongue and cheeks.

Why does a tooth need Root Canal Therapy?

A tooth needs Root Canal Therapy when the pulp tissue has become permanently damaged. This is caused by decay, cracks in teeth, injury to teeth, aging teeth, and teeth that have been heavily restored.

What is involved in Root Canal Therapy?

Root Canal Therapy involves removing the pulp tissue in your tooth roots. The tooth will need to be anesthetized to ensure your comfort. Once the tooth is frozen, we begin our treatment by placing a dental dam over the area and gaining access to the pulp, by preparing a space through the crown portion of the tooth. To gain access to the tip of the root a number of different size files are used.

Why are radiographs required during the procedure?

Radiographs are required periodically to check the position of the files.

What type of filling material is placed in the canals of the tooth?

A heated rubber substance called gutta percha is used to fill up the space that was previously occupied by the pulp.

Will the tooth require any further treatment now that Root Canal Therapy is completed?

A tooth that has had root canal therapy is often no longer as strong as when it was healthy. These teeth often require crowning.

What kind of medication do I take for pain management?

Before the freezing comes out, take one 500mg tablet of  cetaminophen and one 400mg tablet of Ibuprofen. Continue to take both medications together for the next 24 hours as needed. If this doesn’t seem to be helping, contact us immediately.

Will I require antibiotics?

Not usually but if you require antibiotics, Dr. Kuharchuk or Dr. Nijjer will prescribe them for you.

How long will the freezing last?

The freezing will last between 1 and 3 hours. Please avoid having anything to eat or drink hot liquids until you are able to feel your tongue and cheeks.

How will I feel after treatment?

You will be sore. Please avoid chewing on the affected tooth. Let pain be your guide. We do recommend Advil/Tylenol for the first 24 hours.

Temporary Crowns

Why do I need a temporary crown?

Temporary crowns protect your teeth from fractures and extreme temperatures while your permanent crown is being made. It prevents the teeth close to the site from drifting and keeps your gum tissue in a favorable position.

How long will my temporary be in place?

In most cases the temporary crown is in place for a couple of weeks. Sometimes we need more time for you to adjust to changes we’ve made and we will leave the temporary in longer.

Do I have to avoid any foods while it is in place?

Yes. It’s best to avoid any hard or sticky foods.

What do I do if it comes off?

If the temporary comes off and it is still in one piece, place a small amount of toothpaste inside the crown and place back over the tooth. If the temporary crown is broken, please call us as soon as possible so a new temporary can be made.

How do I clean around the temporary crown?

Please treat this temporary as a natural tooth. Brush regularly as you would all your teeth. While flossing be careful to only slide the floss down through the space between your teeth rather than pull up on the floss.

Zoom Teeth Whitening

• Brush and floss teeth. Rinse with water.
• Place a drop of teeth whitening paste in the tooth compartment of the tray.
• Insert tray in mouth and wipe off any excess paste using a toothbrush, taking care to remove all excess paste from your gumline.
• Wear tray for 30 to 60 minutes. Tray can be worn with product overnight if you wish.
• Remove tray and brush teeth with a wet toothbrush to remove any residual paste.
• Rinse tray under lukewarm or cool water and use a wet toothbrush to remove any remaining paste.
• Store trays in plastic box.
• Please do not eat or drink for 30 minutes after a teeth whitening treatment.
• If you have an increase in sensitivity to hot, cold, or citrus fruits, reduce the amount of time you are using the product.
• To help decrease sensitivity you can place a small amount of Relief gel in the tray and wear for 10 to 30 minutes.
• Store in a dark, dry place at room temperature.
• If you are having any problems please stop using the product and contact our office right away.