Post Op Instructions eBook

February 20, 2004

Post Operative Instructions for Amalgam (Silver) Fillings

We've just finished your new silver (Amalgam) filling. If you've never had a silver filling placed before, I'd
like to give you some information that applies to this time tested restoration.
ror! Not a valid link.
Silver fillings, otherwise known as Amalgams, are an alloy of several metals (Silver, Zinc and
Tin etc.) and Mercury. Once mixed, they make up dental amalgam. This restoration has been
used successively for many, many years and has stood the test of time. Periodically, reports are
generated about the possibility of mercury toxicity from old existing silver fillings. To date, it
is the opinion of the American Dental Association that there is no substantial proof that dental
amalgam poses any threat to the safety of the dental public.
Initially, the decayed tooth is excavated and all the decay is removed,
The tooth is then shaped in a specific manner in order to accept a silver filling.
Finally, a band is placed around your tooth and the amalgam is condensed into the prepared tooth. The final
filling is then carved and adjusted to your bite.
Once placed, it takes almost two (2) weeks for your new filling to become fully hardened. You may,
however, safely chew on it after twenty-four (24) hours. But, please, chew carefully!
New silver fillings can be sensitive to hot and cold liquids and other foods for the first four to
six weeks or in some special cases, even longer. If the sensitivity should continue for an
extended period of time or if the discomfort is extreme, please give us a call so that we can
evaluate the situation and prescribe the appropriate therapy.

Sometimes, due to the effects of the local anesthesia, it is quite difficult to make sure that your bite is exactly
right. If you feel any discomfort in chewing, please let us know. A minor adjustment is usually all it takes to
make you comfortable. Don't wait too long! Teeth can become quite sensitive if the bite is “high “. You can
generate in excess of 40,000 pounds per square inch when chewing on your back teeth. Fillings which have
not had the appropriate amount of time to harden, or are “high ", cannot stand this kind of pressure and may
break .If you have any question, please feel free to call at any time.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 21, 2004

Care of your Temporary Crown:

There are a couple of additional facts you should know about regarding the care of your temporary
crown(s):

• Home care is extremely important while your temporary
crown(s)or temporary bridge is in place. The health of your gum
tissue and the success of your final treatment restoration depend
upon it. PLEASE do not be afraid to clean your teeth between
visits. With a minimal amount of home care, you should be able
to maintain the continued health of your teeth and gum tissue
during the time required to fabricate your new crown.

• Sometimes, even with meticulous care, temporary crowns or
bridges may become loose between visits. If this should occur,
please place the temporary crown or bridge back on your tooth immediately. Putting a drop of
Vaseline™ in the temporary crown or bridge will very often increase the retention and hold the
temporary in place until you can schedule an appointment. Once again, REPLACING THE
TEMPORARY CROWN IMMEDIATELY IS VERY IMPORTANT! It only takes a short time for
teeth to move if the temporary is not put back into its proper position. This could affect the final
restoration significantly and may necessitate new impressions and a great deal of time. If you can not
replace the temporary crown yourself, put it in a safe place and call the office. We will be happy to
recement it for you at the earliest possible moment.

• At your next visit (in the case of a bridge, additional visits are necessary) we will most probably place
your final crown. At that time we will check your crown for accuracy, adjust for any bite discrepancies
and evaluate the esthetics.

We hope that this brief instruction sheet will answer most of your questions regarding today's visit.
Following these simple guidelines will help us provide you with the finest in dental care. If you have any
questions regarding this or any other procedure, please do not hesitate to call. Our goal is to make your
dental experience as comfortable and rewarding as possible.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

Care of your Temporary Crown:

There are a couple of additional facts you should know about
regarding the care of your temporary crown(s):
• Home care is extremely important while

your temporary crown(s)or temporary
bridge is in place. The health of your gum
tissue and the success of your final
treatment restoration depend upon it.
PLEASE do not be afraid to clean your teeth between visits. With a minimal amount
of home care, you should be able to maintain the continued health of your teeth and
gum tissue during the time required to fabricate your new crown.
• Sometimes, even with meticulous care, temporary crowns or bridges may become
loose between visits. If this should occur, please place the temporary crown or bridge back on your
tooth immediately. Putting a drop of Vaseline™ in the temporary crown or bridge will very often
increase the retention and hold the temporary in place until you can schedule an appointment. Once
again, REPLACING THE TEMPORARY CROWN IMMEDIATELY IS VERY IMPORTANT! It
only takes a short time for teeth to move if the temporary is not put back into its proper position. This
could affect the final restoration significantly and may necessitate new impressions and a great deal of
time. If you can not replace the temporary crown yourself, put it in a safe place and call the office. We
will be happy to recement it for you at the earliest possible moment.
• At your next visit (in the case of a bridge, additional visits are necessary) we will most probably place
your final crown. At that time we will check your crown for accuracy, adjust for any bite discrepancies
and evaluate the esthetics.
We hope that this brief instruction sheet will answer most of your questions regarding today's visit.
Following these simple guidelines will help us provide you with the finest in dental care. If you have any
questions regarding this or any other procedure, please do not hesitate to call. Our goal is to make your
dental experience as comfortable and rewarding as possible.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230 Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Care of Your New Denture

An unclean denture is neither healthy, attractive nor comfortable. Clean you
new denture every morning and night with either a denture toothbrush and
denture toothpaste (if necessary, any toothpaste can be used) or with one of the
commercially available denture cleaners. Please be sure to check with us to
make sure that the commercial cleaner will not interfere with the type of
denture liner you may have in your prosthesis. Permanent soft liners and
temporary soft liners react poorly to most commercial cleaners.

Can I Wear My Denture(s) At Night?

We prefer that you leave out one or both of your dentures at night. This allows your gum tissues to breathe
and also relieves them of the constant pressures of mastication. When left out of the mouth, all dentures
should be left in water to prevent warpage.

How Often Should I Have My Denture(s) Remade?

Gum tissues are in a constant state of change but dentures are not. Therefore, periodic relining of your
dentures may be necessary. If you find your denture getting looser and mastication more difficult, this may
be a sign that a reline may be needed. It is very important for us to see you regularly to evaluate the state of
your oral tissues and to determine if additional treatment is required. Dentures typically need to be relined
or remade every 3-5 years.
NEVER try to adjust your dentures yourself! Home remedies, although simple, will only lead to trouble. If
any problems arise, we're here to help.
Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

You've just had a tooth extracted. We hope to be able to avoid any concern on your part regarding the next
several hours by giving you the following information. Should anything occur that seems out of the normal,
please give us a call.

Post Extraction Instructions:

Do Not Disturb the Wound: In doing so you may invite irritation, infection and/or bleeding.

Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (i.e.
eating utensils etc.).

Mouth Wash: Avoid all rinsing for 24 hours after extraction. This is to insure the formation of a

healing blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased
bleeding. You may use warm salt water or mild antiseptic rinses after 24 hours only if prescribed.

Excessive Bleeding: When you leave the office, you will be given verbal instructions regarding

the control of postoperative bleeding. A rolled up gauze pad will be placed on the extraction site and you
will be asked to change this dressing every 20 minutes or so depending on the amount of bleeding that is
occurring. We will also give you a package of gauze to take with you to use at home if the bleeding should
continue. If you need to use the gauze at home, remember to roll it into a ball large enough to cover the
wound. Hold firmly in place, with finger pressure, for about 20-30 minutes. If bleeding still continues, you
may fold a tea bag in half and bite down on it. Tea contains Tannic Acid, a styptic, which may help to
reduce the bleeding. If bleeding still continues, call for further instructions.

Pain: Analgesic tablets (i.e. Tylenol, Ibuprofen etc.) may be taken under my direction. Please do not take

any products that contain aspirin. Aspirin can increase bleeding and should be avoided after an extraction.
Prescription medication, which may have been given to you, should also be taken as directed. If pain
continues, please give us a call.

Swelling: To prevent swelling, apply ice or a cold towel to the outside of your face in the area of the

extraction. Apply alternately, 20 minutes on then 20 minutes off, for an hour or longer if necessary.
ONCE AGAIN, REPORT ANY UNUSUAL OCCURRENCES IMMEDIATELY!

If you have any questions regarding these directions, please give us a call for clarification.
Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Your Final Restoration

Post Operative Instructions

Today really turned out to be a terrific day! We hope that you are as pleased as we are with the final result of your new
restoration. Let me just take a minute to go over what occurred during today's visit.
First, after removing the “temporaries" we made sure that there was no remaining excess cement that would interfere with
final cementation of your new crown (crowns). The new crown(s) was then tried in to check for proper fit, contour, and
desired appearance. Any required occlusal (bite) adjustments were then made. The crown was then carefully removed,
cleaned and dried in preparation for final cementation.
Next, the prepared tooth received the final "go ahead" before cementation. Any remaining questionable areas of stain or
soft dentin were removed (these areas fill with cement during cementation). The tooth was then dried, and isolated from
saliva. We may also coat it with an almost microscopic layer of a dentin desensitizer in order to protect it as much as
possible from future hot and cold sensations.
Finally, the cement was mixed carefully to minimize heat reaction and the crown was cemented to place (By the way, the
word cap and crown can be used interchangeably). After removing the excess hardened cement, the bite was re-examined
and any necessary adjustments were made.
It is not uncommon for a tooth to be sensitive to temperature changes for a period of time following cementation. This type
of sensation usually lasts no more than a few weeks. If your bite should feel uncomfortable (sometimes it is difficult to
check the bite when you are numb), please let us know so that we can adjust it as soon as possible.
Remember that this type of dentistry needs to be kept meticulously clean. Success is literally in your hands. Please feel free
to call us if you have any questions. Needless to say, we enjoyed working with you.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

What Is An Immediate Denture?

You've been advised to have an Immediate Denture. But what is it and how is it done? We hope that this information
sheet will help to explain the concepts and clear up any of the questions you might have regarding this type of
prosthesis.

Let me explain what an immediate denture is by using an example. Suppose, for instance, that you have eight (8)
remaining upper teeth. These teeth are, unfortunately, poor and can not be utilized in any way to support a new
prosthesis. If you were to have a traditional denture made, it would be necessary to have all of these teeth extracted first,
the bone and gums would have to heal and then a denture could be fabricated. This process could take several weeks, if
not longer, and for that time period you would have to go around without teeth. In order to avoid this type of problem,
we utilize an Immediate Denture technique. This involves taking impressions of your mouth while your teeth are still
present. At the same time, when your teeth are extracted, we have a denture ready to be inserted. In this way, you never
have to walk around without teeth. Immediate Dentures do present certain situations which I would like to list for you.

Since we are unable to try in the denture prior to extracting your teeth, certain esthetic compromises may have to be
made. This should not present any significant problem, however, and your esthetic result should be more than
satisfactory. Since our goal is for you never to be without teeth, we will be inserting your new denture immediately after
the extraction of your remaining teeth. This may seem odd, but it is perfectly normal. Typically, after the extraction of
teeth, there may be some swelling. By placing your denture in immediately, this swelling can be kept to a minimum. If
you did not place the denture immediately, the swelling that occurs might not allow you to wear your denture until the
swelling subsided. It is very important that you follow the post-operative instructions of the oral surgeon very carefully.
You must wear you new immediate denture for three (3) days, after the surgery, without removing it. This will help to
control the swelling.
Once healing has occurred, after approximately three (3) months, you will either need a reline of your existing denture
or as we discussed, the fabrication of an entirely new denture. If a new one is to be made, we will then be able to make
any esthetic and phonetic changes that you want within the limits of denture prosthodontics. If a new denture is to be
made, you will then be able to use the immediate denture as a spare (emergency) denture. This can sure come in handy
if your new denture should break and need to be repaired at the laboratory. The fees for both the immediate denture and
the final denture will have been discussed at your consultation appointment
If you have any questions regarding these directions, please give us a call for clarification.

Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

POST-OPERATIVE DIRECTIONS

FOR PATIENTS RECEIVING OSSEOINTEGRATED IMPLANTS
It is essential for the early healing process that the following directions are observed during the first two
weeks after the placement of Osseointegrated implants:
1. A soft diet during the first six days in order to avoid inadvertent food particles contaminating the
wound. Semi liquid (mashed) food may be added to the diet during the second week. Smoking and
consumption of alcoholic beverages should be avoided during this period of time.
2. If possible, an elevated head rest (an extra pillow) should be used during the first two nights after the
operation, to reduce the possibility of swelling in the operated areas.
3. Should any oozing or bleeding occur in the operated jaw, it usually may be stopped by softly biting for
15 minutes on a roll of gauze dressing. A wet teabag may also be used. Tea contains Tannic Acid which
will assist in controlling any minimal bleeding. If the bleeding does not stop by doing so, your surgeon
should be contacted.
4. After each meal the mouth should be thoroughly rinsed with salt water solution.
5. Specific mouth rinses or other disinfectants should NOT be used.
6. As you were told during your consultation, old dentures may not be worn until refitting adjustments
(relining) have been made. Insertion of dentures too early may jeopardize a successful healing process.
7. If you are in doubt or there is any sign whatsoever of a disorder related to the healing of the implant
area, you should contact your surgeon.
If you have any other questions, please give our office a call. We are always here to help in any way we
can.
Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Care of Your Dental Implant Prosthesis

As you sit and read this letter, you've just had your implant prosthesis inserted and are wondering, I hope, about the
procedures that are necessary for the proper maintenance of your new prosthesis. Well, here's the whole story in a
nutshell! The home care needed for dental implants is probably more important than that required for your natural teeth.
The appliances that we fabricate on top of dental implants are wonders of engineering but unfortunately, can not be
designed to be maintenance free. There are many areas around the implants and the prosthesis that needs special
attention to make sure that dental plaque does not accumulate. As with your own teeth, plaque, a sticky substance that
adheres to teeth and is a breeding area for bacteria, must be removed at least every 12 hours to avoid potential
periodontal (peri-implant) disease. What are the tools needed to combat peri-implant disease and how should they be
implemented.

The care of your Implant Prosthesis consists of three steps:
• Educating and training you about proper oral hygiene techniques.
• Removal of calculus (tartar) and plaque on a regularly scheduled basis by our Hygienist,
• Maintaining meticulous oral hygiene between your recall visits.

Home plaque control is a critical component of your implant care. The following devices have proved extremely
helpful in plaque removal and as tools in the proper maintenance of dental implant/prostheses.

• Soft Toothbrush, End Tuft Brush, Proxy Brush™
• Dental Floss ( i.e. Post Care Dental Implant Floss, SuperFloss™ )
• RotadentTM
• Oral Irrigation Devices ( i.e. Water Pik™)
• Mouthwashes containing essential oils ( i.e. Listerine™ )

Individual Instruction sheets are available for each of the above mentioned cleaning aids. Our Hygienist, is also
available to assist you in any way she can. Remember, it's not the tool that counts, but the elbow grease behind it. The
proper maintenance of your dental implant prosthesis must be a good blend of proper hygiene technique, appropriate
instrumentation and adequate frequency. Our hygienist will suggest a suitable recall schedule for you based upon the
complexity of your dental restoration. She will also demonstrate each and every technique so that you can become
familiar with the tools that are required for implant care. Then it's up to you. With a little effort, your dental implant
prosthesis can provide you with years of comfort, satisfaction and service.

If we can be of any further assistance, please let us know.

Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 21, 2004

Maintenance of Your New Porcelain Laminates:

The maintenance of your Porcelain Laminate Veneer is relatively simple. A few suggestions, however, are
in order:
1. Some sensitivity to hot and cold may be experienced after the placement of your laminates. This

relates to the amount of enamel left on your tooth after preparation, the proximity of the nerve as well
as several other factors. Some sensitivity is absolutely normal and usually dissipates after one-two
weeks. If this sensitivity should remain or concern you at all, please give us a call.
2. As mentioned before, a normal diet should pose no problem at all. Please avoid anything that will tend
to bend or twist the laminates.
3. If you are known to be a bruxer or clencher, please let us know. We will fabricate a soft nite guard for
you to wear to minimize the stresses placed upon your teeth while you sleep.
Please brush and floss as you normally would to prevent oral hygiene problems. Once placed,
Porcelain Laminate Veneers are typically the kindest restoration to the gum tissues that we currently have
in our prosthetic armamentarium. Do not be afraid that you will damage your laminates by either flossing
or brushing. Any non-abrasive toothpaste is acceptable. A good home care regimen will insure the esthetic
success of your laminate restorations for years to come.
Approximately one week after the placement of your laminates you will be asked to return to the office for
a treatment evaluation. This visit is extremely important. It gives us the opportunity to evaluate the
placement of the laminates, the tissue response and to answer any questions you might have regarding your
new smile.
We hope that your Porcelain Laminate Veneers have fulfilled all of your esthetic goals. With proper home
care and scheduled evaluation visits, they can provide you with a beautiful smile for years to come. If you
have any questions concerning any aspect of your dental care, please give us a call.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Laser Post Operative Instructions

During your visit today we had the opportunity to use a dental laser. I'd like to take a few moments of your time to
tell you what was done and what you can expect over the next several days.

Before I begin, I want you to know that lasers are a very exciting new technology in dentistry. They have been used
by our medical colleagues since the early 1960's. The Food and Drug Administration has approved the dental laser
for use on both hard and soft tissue. When used appropriately, the laser has been proven to allow the dentist to
provide a variety of procedures with significantly less bleeding and minimal, if any, postoperative discomfort. The
dental laser, due to its physical properties, seals blood vessels and nerve endings as it cuts. It has also been shown to
be very effective in controlling swelling and sterilizing the wound.

After today's laser procedure you may notice that there is a dark layer of tissue
around the lased area. This is totally normal. A 'natural ' bandage is placed on the
wound with the laser after the final surgery is completed. This laser bandage acts as a
protective covering during the initial healing phase.

Although it is important to keep the area clean, brushing should be kept to a minimum
for the first 24 hours. After that period, normal hygiene procedures should be followed.

Approximately one week after surgery, a yellowish coating may be seen on the laser
site. This is a normal part of healing process for a laser wound and should not be of any
concern.

Minimal if any postoperative discomfort should be felt during the healing phase. Should there be any pain associated
with the surgery; a mild analgesic (Tylenol™, Ibuprofen™) can be taken. Please let us know if you find it
necessary to take any medication.

Should any additional problems or concerns arise, please fell free to call upon us at any time. The dental laser has
become an integral part of our practice and has provided exceptional treatment benefits to our patients. Your
thoughts are extremely important to us. As always, we will continue to provide you, our family of patients; with the
finest that dentistry has to offer. With your help, dentistry can be a rewarding and valuable experience.

Sincerely,

Cary Ganz DDS PC

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Care of Your New Bridge

Now that you've received your new bridge, it is very
important that you follow the hygiene instructions
given to you by our hygienist. Just in case you've
forgotten or were confused at that time, here is a list
for your review. If you have any additional questions,
please give us a call.

• Treat your new bridge as you would treat your own teeth. It should be brushed and
flossed as usual.

• If you have a tooth that was missing and it has been replaced by a tooth on your
bridge, it will be necessary to thread the floss between the teeth using Floss
Threaders™. If you need a demonstration on Floss Threading, please let us know.

• If we prescribed either a Rotadent®, AutoFlosser®, SoniCare® or some other oral
hygiene device please be sure to use it on the new bridge as well as on your natural
teeth.

We hope you enjoy your new bridge and that it continues to serve you well for many
years to come. If you have any problems, or questions, please feel free to give us a call at
any time.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004

Your Denture Soft Liner

What is a soft liner?

A temporary soft liner is placed in a new or old denture in order to (1) help improve the health of your gum
tissues by absorbing some of the pressures of mastication (acts as a tissue conditioning material) and (2)
helps to determine the maximum retention possible by utilizing undercuts in the bone and gum which hard
liners may not be able to negotiate without causing irritation. Soft liners will spring around these undercuts
and allow for greater retention than hard liners might be able to produce in the same mouth. If we find that
temporary soft liners provide enhanced retention, we will then be able to determine if we should replace
them with a more permanent type of soft liner in the future or whether a hard liner is indicated.
Temporary soft liners require special care and attention in order for them to produce the desired results.
The following suggestions are designed to assist you in the maintenance of your new denture. Soft lines
may be white or pink in color

Care of your Soft Reline

Do not remove the prosthesis from your mouth for the first 24 hours. This is extremely important!
The material that is placed in your denture will stay soft for the first 24 hours and will shape itself to your
oral tissues during that first 24 hour period.
After the first 24 hours, you may remove the denture once every 12 hours for the first two days. At each
removal, please rinse the denture with warm water only. Do not use any of the commercially available
cleaners. If need be, you can brush the tooth part of the denture (the white teeth on) with toothpaste and a
soft toothbrush. The soft-liner is still very fragile and will tear if subjected to chemical or mechanical
cleaning
During the next week you may remove the denture as often as you like, still keeping in mind that the liner
is fragile and must be treated with care. The pink plastic may be brushed gently, trying to avoid the soft
liner.
If possible try not to use any denture adhesive, especially during the first 72 hours. We are, once again,
trying to ascertain the amount of available retention. Using adhesives will only tend to confuse the issue.
For the first 24 hours you should try to maintain a softer diet. After that trial period, you should eat as
regular a diet as possible so that the soft-liner can mold itself to your tissues until normal function.

The Prosthodontic Practice of Cary Ganz DDS
Tel. 516 741-1230
Fax 516 741-2257

http://www.ganzdental.com email:[email protected]

February 20, 2004
Page 2

We may be replacing this soft-liner on a regular basis until 1) the tissues heal adequately or 2) we have
determined that the retention for your new denture is maximized. Further instructions will be given to you
at that time.

Please be sure to bring your old dentures with you at each recall visit just in case we should
determine that relining your soft lined denture is required. This would necessitate sending your
denture to the laboratory.

If you have any additional questions regarding this treatment process, please feel free to give us a call.

Sincerely,

Cary Ganz DDS PC