Transfer Patients

Do I need an antibiotic before my dental appointment?

If you have a heart condition, antibiotics may not be needed. Learn more on the ADA's website about antibiotics for pain and swelling.

If you have an artificial joint you may not need antibiotics for your dental procedure. Learn more on the ADA's website regarding joint replacements and dental antiobiotics.

Download a copy of the Caries Risk Assessment form (PDF).

Saliva and oral health:

Saliva may seem just like water, but that is far from true. Saliva contains hundreds of the body’s “natural medicines” and parts of your immune system designed to keep your mouth healthy. Saliva contains chemicals that make speaking, chewing, and swallowing more comfortable. It also regulates the microorganisms (“germs”) that cause oral infections. Most people have a dry mouth (called xerostomia) as a side-effect of medications. Also chemotherapy, radiation therapy, and some diseases can cause your glands to produce less saliva. It is important that your dentist find out the cause of your dry mouth so you can be treated properly. Many people do not know they have xerostomia because one must lose about half of their saliva before it is noticeable.

Oral lubricants:

There are products designed to replace lost saliva. They are sometimes called saliva substitutes or “artificial saliva” but should be thought of as oral lubricants. Unfortunately, science has yet to produce anything that can replace all the functions of saliva. However, many people find that oral lubricants make their mouths feel more comfortable. Several oral lubricants come in a small spray bottle that can conveniently be carried in a purse or pocket. Some people prefer to just use water. Your dentist can suggest which product may be most helpful for your particular situation.

Eating with a dry mouth:

There are many problems you may have with your dentures if you do not have enough saliva. Because of inadequate lubrication, chewing and swallowing foods, especially dry foods, may be a problem. Using gravies and sauces with dry foods in addition to frequent sips of water while eating can help. Using an oral lubricate a few minutes before eating can also help. Be sure to remove your dentures before using the lubricant so it can coat the parts of the gums that support the dentures, and then place the dentures back in the mouth.

Dry mouth and denture “fit”:                                                          

Saliva helps your denture hold onto the gums, what dentists call retention. When your mouth is dry the denture tends to feel loose. This is made worse because the supporting tissues under your dentures continue to shrink throughout the rest of your life. The amount of shrinkage varies from person to person. As the gums shrink, the denture and the gums become mismatched.This happens little by little, but even a small change in the “fit” of the denture is more noticeable when the mouth is dry. Most people notice this more often with the lower denture. The size and shape of the upper gums usually make wearing an upper denture easier. As shrinkage occurs, you may need to have your denture remade or relined more frequently than someone who has enough saliva. A reline is a procedure in which additional denture material is added to the part of the denture that contacts the gums so that the denture once again closely conforms to the shape of the mouth. Even with a “perfect fit,” you may still experience some looseness due to the lack of saliva to help hold the denture in place. A denture adhesive may be of help in this case. There are many types of adhesives available, and your dentist can offer advice on which one best fits your needs. In addition to a feeling of increased looseness, you may have more sore spots under your denture due to reduced saliva. Without the saliva to provide lubrication between your denture and gums, the increased friction from the dry denture rubs a sore. Your dentist should first check to be sure the denture “fit” is as perfect as possible. If nothing needs be done to the denture, an oral lubricant or denture adhesive may help. If you continue to have problems ask your dentist if dental implants might be right for you. Replacing dentures with teeth supported by implants has been a life changing experience for thousands of people. This miracle of modern dentistry is as close as possible to having your own natural teeth again and will eliminate most or all of the problems listed above.

Dry mouth and oral infections:

Since saliva regulates the microorganisms in the mouth, a person with dry mouth is more prone to oral infections. In denture wearers Candida, a yeast-like fungus, is a frequent cause of infections. One such infection is denture stomatitis. It is more common under the upper denture, especially in those with dry mouth who wear their denture during sleep. Most cases do not cause enough pain to be noticed so they may exist for years. It is very important to eliminate denture stomatitis if new dentures are to be made. This may require treatment with both tissue conditioners and antifungal medications. Another condition usually caused by Candida is angular cheilitis, recurrent sores that occur at the corners of the mouth. Antifungal medications are also of help with this condition. Antifungals are often used incorrectly so be sure you understand how and when to use them.

If you have some natural teeth, tooth decay is the most frequent cause of tooth loss in older adults who have a dry mouth. Without saliva to regulate the germs that cause decay, they are able to grow in number and cause more damage. Ask your dentist or dental hygienist for ways to reduce tooth decay.

Download our Dry Mouth and Dentures (PDF)

Here are some great websites with lots of information, activities, and videos to help parents and kids learn about children’s oral health!

• Mouth Healthy Kids
• Ad Council (2 minutes 2 times per day)
• National Institute of Dental and Craniofacial Research

Need a fun Video to keep brushing entertaining for a full two minutes?  Check out these videos.

• Elmo’s Brushy Brush
• Ad Council (lots of videos to choose from)
• The Nurdles

Here are some free apps that can keep kids engaged during brushing!

• Toothsavers
• Disney Magic Timer

What are denture adhesives?

Denture adhesives are creams, powders, or liquids that have the ability to stick to the tissues (“gums”) under a denture as well as to the denture itself. This improves what dentists call the retention of the denture – its ability to hold on to the underlying tissues.

If my new denture has been made correctly, why might I need a denture adhesive?

Denture adhesives are NOT a substitute for an expertly designed and crafted denture. You may find you can function well with your new denture without the use of adhesives. However, research has shown that adhesives can improve the retention and chewing function of many dentures. You may have certain conditions that make wearing dentures more difficult, such as dry mouth, a stroke, or loss of some of the bone support for the denture. These and many other conditions can compromise the ability to function with even the best denture. Adhesives may offer some help.

Which denture adhesive should I use?

Over 200 million dollars are spent each year in the US alone for denture adhesives. Additional millions are spent on advertisements to influence your purchase. Advice from friends or relatives can be misleading as each person has unique needs. As a general rule, powders do not last as long as creams but are easier to clean off the gums and dentures. Pads and cushions are best avoided as they may alter the occlusion (“bite”) of the denture and lead to other problems. Your dentist is trained to evaluate your individual needs and offer the best advice for your circumstances.

How should the adhesive be applied?

Powders: The mouth and denture should both be cleansed and kept wet. Tap a thin layer of powder over the entire tissue side of the denture. Gently shake off the excess. Insert the denture and press in place for 5 seconds. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds.  If you have a dry mouth, it may help to first coat your mouth with a saliva substitute or water before placing the denture on your gums.

Creams: Clean your mouth and denture well. Dry the denture. For the upper denture apply 5 pea-sized dabs of adhesive equally spaced to the side of the denture that contacts your gums. For the lower denture apply 3 pea-sized dabs. If you have a dry mouth, immerse the denture in cool water for 30 seconds to let the adhesive soak up moisture. Insert the dentures and press in place for 5 seconds with your fingers. Close your teeth together, swallow, and clench your teeth together tightly for 10 seconds. If you have used the right amount, only a little should ooze out from under the denture borders. Over time you will find out just how much cream you need.

How should I clean out the adhesive?

It is very important for the health of your mouth to remove all the denture adhesive from your mouth and denture daily. Powders can easily be brushed from the denture using warm water. Powders can be removed from the gums with a soft brush and toothpaste. Creams are more difficult to remove. To remove them from the denture, scrub the denture under very warm water with a denture brush. If the adhesive is very hard to remove, it may need to be soaked overnight and then brushed. Another method is to scrub the denture with an electric toothbrush while the denture is immersed in a sink of warm water. To remove the cream adhesive from your gums, first hold hot water in your mouth to help soften the adhesive. Next, scrub with a washcloth wrapped around one or two fingers and moistened with hot water.

Why are regular checkups still important?

You may think that since you no longer have your natural teeth, you only need to see your dentist if you notice a problem. That is a dangerous myth. The supporting tissues under your dentures continue to change throughout the rest of your life. As the gums shrink, the denture and the gums become mismatched. This change happens little by little and is often not noticed by the denture wearer until significant damage has been done to the tissues, sometimes requiring surgery. Your dentist is trained to detect these changes and correct them early. Your dentist will also closely observe your tissues for signs of oral cancer, about half of which occurs in people with dentures. 

Download our What Are Denture Adhesives (PDF)

Treatments for TMD (Temporomandibular Disorders) range from simple self-care practices and conservative treatments to injections and surgery. Most experts agree that treatment should begin with conservative, nonsurgical therapies first, with surgery left as the last resort. Many of the treatments listed below often work best when used in combination.

Apply moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple stretching exercises for your jaw (as instructed by your dentist or physical therapist). After exercising, apply a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

Eat soft foods. Eat soft foods such as yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans and grains. In addition, cut foods into small pieces to decrease the amount of chewing required. Avoid hard and crunchy foods (like hard rolls, pretzels, raw carrots), chewy foods (like caramels and taffy) and thick and large foods that require your mouth to open wide to fit.

Take medications. To relieve muscle pain and swelling, try nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin, Aleve), which can be bought over-the-counter. Your dentist can prescribe higher doses of these or other NSAIDs or other drugs for pain such as narcotic pain relievers. Muscle relaxants, especially for people who grind or clench their teeth, can help relax tight jaw muscles. Anti-anxiety medications can help relieve stress that is sometimes thought to aggravate TMD. Antidepressants, when used in low doses, can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

Wear a splint or night guard. Splints and night guards are plastic mouthpieces that fit over the upper and lower teeth. They prevent the upper and lower teeth from coming together, lessening the effects of clenching or grinding the teeth. They also correct the bite by positioning the teeth in their most correct and least traumatic position. The main difference between splints and night guards is that night guards are only worn at night and splints are worn full time (24 hours a day for 7 days). Your dentist will discuss with you what type of mouth guard appliance you may need.

Undergo corrective dental treatments. Replace missing teeth; use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.

Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and avoid extreme jaw movements such as yelling or singing.

Don’t rest your chin on your hand or hold the telephone between your shoulder and ear. Practice good posture to reduce neck and facial pain.

Keep your teeth slightly apart as often as you can to relieve pressure on the jaw. To control clenching or grinding during the day, place your tongue between your teeth.

Learning relaxation techniques to help control muscle tension in the jaw. Ask your dentist about the need for physical therapy or massage. Consider stress reduction therapy, including biofeedback.

Download our What Treatments Are Available for TMD (PDF)

Why is saliva important?

Saliva keeps the mouth clean by washing away food debris and bacteria, keeps the tissues of the mouth moisturized, and neutralizes acids in the mouth.

A decrease in saliva (or a change in the consistency of saliva) can lead to tooth decay, gum disease and/or an increased susceptibility to oral infections such as thrush.  A change in saliva consistency or flow can make speaking, tasting, chewing, and swallowing difficult.  Poor saliva flow may lead to sores in the mouth, a loss of suction with existing dentures, and a less comfortable fit of existing dentures.

Why do I have dry mouth?

Dry mouth is most frequently a side effect of a medication that a person may be taking for a medical condition.  Dry mouth can be caused by other factors such as mouth breathing, dehydration, or medical treatments such as chemotherapy or radiation treatment to the head and neck for cancer.  Dry mouth can be the side effect of certain infections or syndromes as well.

What can I do for dry mouth?

• Sip water throughout the day, or drink water with meals if swallowing is difficult
• Suck on ice chips
• Chew sugar free gum to increase saliva flow
• Suck on SUGAR-FREE candy to increase saliva flow
• Use an alcohol-free mouthwash to avoid the drying effects of alcohol
• Use over the counter saliva substitute products such as Biotene gel, Biotene gum
• Avoid alcohol, tobacco, caffeine, and carbonated drinks which can contribute to dry mouth
• REMEMBER: Use SUGAR-FREE hard candies and cough drops.  Products with sugar as an ingredient combined with a dry mouth can rapidly lead to cavities!

It is important to follow instructions after you have oral surgery at our Bemidji dental office to ensure proper healing and to avoid complications. As a rule of thumb, you should always wait two hours after surgery before eating to let any anesthesia wear off. Trying to eat before this could result in soft tissue damage. The instructions found below are guidelines. After your surgery we will give you full, specific instructions on recovering from your procedure.

Root Canal Therapy

You can expect soreness after a root canal procedure for a few days. You should avoid chewing on the side of your mouth where the procedure was performed so you do not irritate the area and to ensure that the temporary restorative material properly sets. You will also need to take an antibiotic to treat any remaining infection in your tooth. If you notice an increasing amount of pain or tenderness, a reaction to the medication, or the loss of the temporary restoration (filling) call our Bemidji dental office immediately.

Crowns and Bridges

After a root canal, you can expect soreness for a few days. Before you receive your permanent crown or bridge you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because this could dislodge the temporary. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.

There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.

When the permanent crown or bridge is placed it may feel a little awkward for a few days as your mouth adjusts to the new tooth. It should feel like one of your natural teeth in less than a week. If your bite feels abnormal in any way, you should let us know. Caring for your bridge or crown is just like caring for your own teeth. You should brush and floss regularly.

White Fillings (Bonding)

After the anesthesia wears off, your teeth will likely be sensitive. You should avoid hot and cold food or drink for the next few days. After that initial period, your treated teeth will feel as good as new. Continue your normal hygiene plan to ensure that your fillings last for a long time.

Scaling and Root Planing

After this procedure, your gums will probably be slightly sore and irritated for a few days. You should rinse your mouth with warm salt water (1 tsp salt/8 oz water) 2-3 times a day. This will relieve the pain and cleanse the area. Brushing and flossing should be continued right after the procedure, but you should brush gently so that you do not further irritate the area. If you experience any swelling or stiffness in the area you can place a cold compress on the area and take some pain relieving medicine. Avoid any hard or chewy foods for 2-3 days after the surgery to ensure the area heals correctly. If you continue to experience pain or swelling after a few days, contact us.

Veneers

Before you receive your permanent veneer, you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because it could become dislodged. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.

There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.

When the veneer is placed it may feel a little awkward for a few days as your mouth adjusts to the new tooth. It should feel like one of your natural teeth in less than a week. If your bite feels abnormal in any way, you should let us know. When brushing and flossing, you should pay close attention to the area between the veneer and the tooth at the gum line.

Extractions

After the surgery, you will need to rest. You need to be driven home by a friend or family member because of the anesthesia. You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery, and you will need to change it when it becomes soaked. If bleeding continues for longer than 24 hours, you should call us. Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. We will prescribe you pain medication, so take as needed if you become sore. You can also use an ice pack for the pain. We may also provide you with a cleaning solution to clean the extraction site.

You will be limited to soft foods for a few days after your surgery. Some recommended foods are:

• Gelatin
• Pudding
• Yogurt
• Mashed Potatoes
• Ice Cream
• Thin Soups
•  …and other food you can eat without chewing

When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same goes for smoking. If you have prolonged pain, bleeding, irritation, or don’t feel that the extraction site is healing properly, please call our Bemidji dental office for a follow up.

The extraction of teeth is a surgical procedure. Carefully following these instructions can minimize discomfort and reduce the chance complications.  If at any time you have questions, call the office:  218.751.4216.

Women: Some antibiotics may reduce the effectiveness of your birth control pills. Please check with your pharmacist concerning the medications that you are taking.

The Day of Surgery:

Keep the gauze pad placed over the surgical area with firm biting pressure for a half hour. After this time, the gauze pad should be removed and discarded. You may repeat this until the bleeding is reduced.

Avoid rinsing or touching the extraction site following surgery. This may dislodge the blood clot and cause the area to bleed.

If you have been given a prescription for pain medications, start taking the medications as soon as you begin to feel discomfort.

Restrict your activities the day of surgery and slowly resume normal activity when you feel comfortable.

Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for an explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit semi-reclined rather than lying down and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will not become apparent until the day following surgery and may not reach its maximum until 2-3 days post-operatively. However, the swelling can be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs placed inside a thin wash cloth should be applied to the sides of the face where surgery was performed. The ice packs should be used on for 20 minutes off for 20 minutes while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling 

Pain

For moderate pain, two 200 mg tablets of Ibuprofen, (Motrin or Advil) may be taken immediately followed by one 200 mg tablet every 2 hours with something to eat, as needed OR 600-800 mg every 6 to 8 hours. For patients who are allergic to Aspirin, or cannot take Ibuprofen, one or two tablets of regular or Extra Strength Tylenol may be taken every four to six hours instead.

For severe pain take the tablets prescribed for pain as directed. The prescribed pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around heavy machinery. Avoid alcoholic beverages.

Diet

Do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. Drink from a glass. You may eat anything soft by chewing away form the surgical sites. Nourishment should be taken regularly. High calorie, high protein intake is very important during the healing phase. Your solid food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. Therefore, immediately following surgery, if you are laying down, make sure you sit for one minute or so before standing.

Keep your mouth clean

No rinsing of any kind should be done for the first 24 hours following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin verygentle rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt.

Bruising

In some cases, discoloration of the skin (Bruising) may occur. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Other Complications

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. Be careful not to bite your tongue or lip while it is numb.
• Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by your Doctor.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
• Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
• Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is normal post-operative event which will resolve in time.
• Sutures may have been placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will either be self dissolving or removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure.
• There will be a depression where the tooth was removed. The depression will gradually, over the next 6weeks, fill in with tissue. In the mean time, the area should be kept clean with salt water rinses, especially after meals.
• Gentle tooth brushing is okay, just one tooth away from the extraction sites.

Dry Socket

A dry socket is caused when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site radiating to the ear may occur 2-3 days following surgery. Please call the office if you are concerned.

Download our Post-Operative Oral Surgery / Tooth Extraction Instructions PDF

CONGRATULATIONS, today you have received your new dental prosthesis. This prosthesis is designed to restore function to areas where teeth are missing. All prosthetic devices require a period of adjustment during which time you will learn their uses and limitations. We would like to take this opportunity to detail the care of your new restorations.

First and foremost is that it will take time and patience to become comfortable with your new prosthesis. You will probably experience some degree of frustration trying to adapt to your new full or partial denture for a few weeks. This is normal. Initially, you may have to cut your food into small pieces and chew evenly on both sides. We cannot overemphasize that it requires time to learn to tolerate full or partial dentures. Please, be patient!

Home care of the prosthesis and oral tissues are very important. Dentures and partials will accumulate plaque and tartar just like natural teeth if not maintained regularly. A denture brush should be used with toothpaste or soapy water daily on all surfaces of the denture or partial. A soft bristle toothbrush with toothpaste should be used to gently brush your gums, the roof of your mouth, your tongue and in the case of partial denture, the natural teeth. Remember, we advise brushing your new dentures or partials, as soak-solutions alone do not always clean the prosthesis completely.

Full and partial dentures should not be worn 24 hours a day. We advise you to take the partial or full denture out at night (or as a less desirable alternative, for some part of the day for a minimum of four hours). This is necessary to allow the gum tissue and underlying bone to be relieved from constant contact or pressure. When placing the partial denture in your mouth, seat it in place with finger pressure. Avoid biting it into place, because this may cause clasps or precision attachments to break. Your prosthesis should be left in water when out of the mouth.

It is common to develop some irritation (sore spots) under a new denture or partial. When this occurs, please let us know so that an adjustment appointment may be scheduled.

Over time, your tissue under the denture will change. As these changes occur, you will need to have your denture rebased, relined or remade. A reline is a procedure for creating a new tissue surface for your prosthesis accommodating tissue changes. The time interval until one of these procedures is needed will vary individually, depending upon oral conditions (typically 1-3 years unless recent extractions were performed).

We hope you will enjoy your new prosthesis. Our staff will gladly assist you in any adjustment that may be necessary. Please let us know how we may be of assistance to you. We appreciate the opportunity to serve your dental needs.

Download Our Care Instructions For Your New Full and Partial Dentures PDF

Do not remove your immediate denture during the first 24 hours. Let it act as a bandage during the initial healing of the surgical area. If the denture is removed during this period, the gums may swell and make it hard to get the denture back in place. Take your pain medication as directed. It is helpful to take the first dose as soon as possible so it is in your system before the anesthetic (“numbness”) wears off. Research has shown that it is much better to take pain medication regularly as directed instead of trying to wait until you “really need it”. It can also be helpful to apply an ice pack over the area during the first few hours: on for 20 minutes, off for 20 minutes. If you follow these directions, often after the first 36 hours mild pain medications alone will be strong enough to relieve any discomfort.

It is normal for some bleeding to occur during the first 2-3 days. When bleeding occurs, close your teeth together tightly for 10 minutes and the pressure from the denture will slow down the bleeding. Do not rapidly clench and release as this only “pumps” the site and can increase the bleeding. If you have excessive bleeding, contact your dentist immediately. Do not take any additional medications or herbal products during this time unless prescribed by your dentist or physician. Many seemingly harmless products can cause increased bleeding. Of course, if you are on any prescription medications for medical conditions, continue to take these as directed. If you forgot to tell your dentist about any medications you are taking, tell them at once. Clean the rest of your mouth and any remaining natural teeth as usual. Keeping a clean mouth can aid the healing process.  Do not spit forcefully during this time or the denture could become dislodged. If you need to remove liquid from your mouth, let it drool out gently over a sink. Avoid mouthwashes during the first 24 hours unless prescribed by your dentist.

At the end of 24 hours remove the denture

Mix ½ teaspoon of salt with a cup of warm water. Place some in your mouth, and with your lips tightly closed, begin to force the water under the denture to loosen it. Gently spit the water out. The lower denture is usually easy to remove by lifting straight up. Often, the upper denture comes out best in a downward and forward direction. The upper may be harder to remove, especially the first time. If it is stubborn, take your index finger and place it between your denture and cheek moving up and back until you feel the back upper corner of the denture. Move your finger onto the top of the denture border in this area and pull down gently, increasing the force until the denture is dislodged. The exact way your denture most easily comes out is dependent on your mouth’s unique shape. After a couple of times, you will know just what to do. There may be very dark blood inside your denture. This is normal. You may also develop some dark spots inside your mouth or on your face over the area of the surgery. This condition, called ecchymosis, is not of any lasting importance; it goes away in a couple of days.  Brush your denture inside and out with dishwashing liquid and rinse well with warm water. Put some of the warm salt water you made in your mouth. Use your tongue to gently scrub the gums that were covered by the denture. Do not spit; let the salt-water drool out of your mouth into the sink. Put your denture back in place and press it on to your gums for 10 seconds. Close together, swallow, and hold together an additional 10 seconds to correctly seat the denture.

Eating during the first week

It is very important to maintain good nutrition during the healing process. It is especially important to drink plenty of fluids. During the first 24-36 hours you need to eat food that does not require chewing. Some suggestions are:

• Bread/cereal group:  thin oatmeal or Cream of Wheat
• Vegetable group:  juices, thin soups
• Fruit group: juices, blended drinks and shakes
• Milk group:  Milk, cheese soup, yogurt, Carnation Instant Breakfast, Ensure
•                     Sustacal (these last two products are nutritionally complete,
•                     lactose free drinks)
• Meat group:  Pasteurized eggnogs, meat broths or soups, pureed meats

After the first or second day you can slowly increase the consistency of the food. In addition to the foods above, consider soft foods like small pastas, well-cooked carrots and green beans, mashed potatoes, creamed vegetables, soups, well-cooked fruits (no seeds), canned fruits, scrambled or soft-boiled eggs, and chopped meats.

Cut your food into small pieces and eat slowly. Eating with a denture is very different from eating with natural teeth. You may find it helpful to put food on both sides of your back teeth and chew straight up and down. Biting food off is generally better done at the corners of the mouth instead of the very front as is common with natural teeth. However, it is hard to predict exactly what biting and chewing movements will be best for you because they vary widely from person to person. You will soon learn what works best for you. Be patient with yourself.

Speech

Certain sounds may be hard to pronounce when you first get your denture. Some people find it helpful to read out loud to themselves for the first few days to train their speech. Over time your speech will improve.

Becoming accustomed to your denture

Having a denture in your mouth can be overwhelming at first. This initial reaction is to be expected. Our mouths are designed to detect even very small foreign objects. Therefore, something as large a denture can be quite a “shock.” You will probably notice additional saliva in your mouth. This is because objects in the mouth are usually food so saliva is increased to aid the eating process. It may take a couple of weeks for your mouth to realize the denture is now “part of you.” In most cases, a lower denture will cause more problems than an upper denture. Even with a “perfect fit,” the shape of the lower gums usually prevents suction, so a lower denture feels looser than an upper denture. A denture adhesive may be of help in this case. There are many types of adhesives available, and your dentist can offer advice on which one best fits your needs. If you continue to have problems with the lower denture, ask your dentist if implants might be right for you. Patients have fewer problems with the upper denture. In some cases, a feeling of fullness in the roof of the mouth may cause some gagging at first. This declines as the mouth realizes the denture is not a foreign object but is now “part of you.”

Sore spots

Sore spots can occur even in a denture with a “perfect fit.” This is due to the fact that the tissue the denture rests upon varies from place to place. Some areas are very thick and tough; others are thin and easily injured. You should contact your dentist as soon as a sore develops so an adjustment can be made; trying to “tough it out” can lead to a larger sore that is harder to treat. You can buy ointments to numb the area until you can get to the dentist, but these can mask the problem area and lead to larger sores if used too long. Never attempt to adjust the denture yourself.

Dry mouth (xerostomia)

If you have a dry mouth, you can expect more problems wearing dentures. Saliva helps hold dentures in place and helps to reduce sore spots by providing lubrication under the denture. Your dentist can suggest products made for this condition that can make denture wearing more comfortable.

Caring for your denture after the first day

Starting from the day you remove your denture for the first time, remove your denture and rinse it out after every meal or snack, and then place it back in your mouth. For the first 5 days, keep your denture in at all times except to clean. Avoid mouthwashes the first 5 days unless prescribed by your dentist; some mouthwashes may slow the healing process. You can use salt water rinses as described above during this time. To clean the denture, partially fill the sink with water to cushion the impact if the denture is dropped. A liquid dishwashing detergent is used with a denture brush to clean the inside and outside of the denture. Toothpastes made for natural teeth are too abrasive for denture materials and should be avoided. However, after healing has occurred, a soft toothbrush with toothpaste is helpful for cleaning the gums where the denture rests. Your tongue should be cleansed as well as it harbors many of the germs that cause bad breath. After the first 5 days, it is best to leave the denture out at night and let it soak in a denture cleanser. This allows the gums to relax and maintain optimal health. Under certain circumstances it may be necessary to keep your denture in all night. If this is the case for you, you are at an increased risk for some problems such as oral yeast infections. Discuss this with your dentist for additional ways to keep your oral tissues healthy based on your individual situation.

Regular dental care is still important

You may think that since you no longer have your natural teeth, you only need to see your dentist if you notice a problem. That is a dangerous myth. The supporting tissues under your dentures continue to change throughout the rest of your life. The amount of change varies from person to person. As the gums shrink, the denture and the gums become mismatched. This change is especially great during the first 6 months to a year following the removal of natural teeth. If this change is expected to be very large, your dentist may call this immediate denture a temporary denture because it is only meant to function until healing has occurred after which a new denture will be made to match the new shape of your gums. At other times only a reline may be needed. A reline is a procedure in which additional denture material is added to the part of the denture that contacts the gums so that the denture once again closely conforms to the shape of the mouth. In some cases, your dentist may place a tissue conditioner (temporary soft liner) in your denture during this healing stage. The liner can be changed from time to time as the gums shrink to help keep you comfortable during the healing stage. As mentioned above, your gums continue to change throughout life. These changes happen little by little and are usually not noticed by the denture wearer until significant damage may have been done to the tissues, sometimes requiring surgery. Your dentist is trained to detect these changes and correct them early when the treatment is less expensive and less troublesome for you. Your dentist will also closely observe your tissues for signs of oral cancer. Nearly half of the oral cancers diagnosed in North America occur in people that have dentures.

Myths about dentures abound

Although well meaning, friends and relatives may give you advice that can be damaging to your new dentures and your mouth. Each individual is very different, and what might work for some may create problems for others. Never adjust your denture yourself; a minor alteration might be very expensive to correct. Your dental staff is trained to give you the best advice based on your unique needs. Ask questions – they want to help!

Download our Patient Instructions for Immediate Dentures: The First 24 Hours PDF

TOPICAL FLUORIDES MUST BE KEPT OUT OF THE REACH OF CHILDREN

Topical fluoride is for use only on the surfaces of teeth and should not be swallowed. Children under the age of six should not use this product. Frequent ingestion by children may result in dental fluorosis, the development of white or brown spots on the unerupted, developing permanent teeth. Children under the age of twelve should be directly supervised while using this product.

Instructions for Use

Topical fluorides come as a concentrated fluoride gel. When used daily, it will prevent new cavities, remineralize areas of early decay, strengthen the areas around restorations (fillings) and reduce sensitivity to hot and cold.

In the morning, use topical fluorides as you would use your regular toothpaste. In the evening, floss and brush your teeth and rinse. Brush with a little more topical fluoride, spit out any excess, but do NOT rinse. This will allow the topical fluoride to be in contact with the teeth longer while you sleep.

TOPICAL FLUORIDES MUST BE KEPT OUT OF THE REACH OF CHILDREN

Download our Instructions For Usage of Topical Fluorides PDF

Treatments for TMD (Temporomandibular Disorders) range from simple self-care practices and conservative treatments to injections and surgery. Most experts agree that treatment should begin with conservative, nonsurgical therapies first, with surgery left as the last resort. Many of the treatments listed below often work best when used in combination.

Apply moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes. Do a few simple stretching exercises for your jaw (as instructed by your dentist or physical therapist). After exercising, apply a warm towel or washcloth to the side of your face for about 5 minutes. Perform this routine a few times each day.

Eat soft foods. Eat soft foods such as yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans and grains. In addition, cut foods into small pieces to decrease the amount of chewing required. Avoid hard and crunchy foods (like hard rolls, pretzels, raw carrots), chewy foods (like caramels and taffy) and thick and large foods that require your mouth to open wide to fit.

Take medications. To relieve muscle pain and swelling, try nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin, Aleve), which can be bought over-the-counter. Your dentist can prescribe higher doses of these or other NSAIDs or other drugs for pain such as narcotic pain relievers. Muscle relaxants, especially for people who grind or clench their teeth, can help relax tight jaw muscles. Anti-anxiety medications can help relieve stress that is sometimes thought to aggravate TMD. Antidepressants, when used in low doses, can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs, and antidepressants are available by prescription only.

Wear a splint or night guard. Splints and night guards are plastic mouthpieces that fit over the upper and lower teeth. They prevent the upper and lower teeth from coming together, lessening the effects of clenching or grinding the teeth. They also correct the bite by positioning the teeth in their most correct and least traumatic position. The main difference between splints and night guards is that night guards are only worn at night and splints are worn full time (24 hours a day for 7 days). Your dentist will discuss with you what type of mouth guard appliance you may need.

Undergo corrective dental treatments. Replace missing teeth; use crowns, bridges, or braces to balance the biting surfaces of your teeth or to correct a bite problem.

Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and avoid extreme jaw movements such as yelling or singing.

Don’t rest your chin on your hand or hold the telephone between your shoulder and ear. Practice good posture to reduce neck and facial pain.

Keep your teeth slightly apart as often as you can to relieve pressure on the jaw. To control clenching or grinding during the day, place your tongue between your teeth.

Learning relaxation techniques to help control muscle tension in the jaw. Ask your dentist about the need for physical therapy or massage. Consider stress reduction therapy, including biofeedback.

Download our What Treatments Are Available for TMD PDF