Instructions Prior to Surgery

• It is best not to eat for 4 to 6 hours before extraction or surgery appointments.
• For the first 2 days after treatment, eat and drink cold, cool liquids and soft foods.
• Consider having a friend or relative available to drive you home.
• Advise us before treatment begins of any changes in your medical history.
• To lessen post-surgery pain, take 200mg to 400mg of Ibuprofen every 4 hours, starting 24 hours before your appointment.
• If you must take any prescribed pre-surgery medications, please follow the instructions carefully.
• Please call us if you have any questions.

How to Brush your Teeth

The first step is to choose a good toothbrush. You always want to use a soft brush with a small head. A soft brush is hard enough to remove plaque and soft enough not to damage your teeth or gum.

The next issue is to choose a good toothpaste. In general any toothpaste that contains Fluoride will do the job, unless you have a special need that is determined by your dentist. Two of the best brands of toothpastes are Colgate Total and Crest Multicare.

The first rule of brushing is to start from a specific location and work your way to the opposite side and all the way through the whole mouth so that you end where you started. This way you won't miss any area. Also usually a pea size of tooth paste is enough. A good brushing should at lease take 2 minutes and ideally around 4 minutes.

There are many different techniques for brushing your teeth but one of the most popular ones is described here:

Hold the brush with a 45 degree angle toward the teeth and the gum. Gently press against the gum so the tips of the bristles go in between the gum and the teeth. Then apply lateral vibration for a few times and roll down the brush to sweep the plaque away from the teeth and the gum. Repeat this motion 6 to 10 times and move on to the next area of 2 to 3 teeth. If your mouth is full of foam, spit out and continue brushing. Your brushing is completed when you have brushed all the surfaces of your teeth and not when your mouth is full!

On chewing surfaces, short strokes will work best to get the plaque out of the grooves and pits. Also when brushing the front teeth from inside, hold your brush vertically to be able to reach the teeth better.

As far as frequency of brushing is concerned, ideally you want to brush your teeth after each meal. But if you can t, brush at least twice a day after breakfast and before going to bed.

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How to Floss Your Teeth

The surfaces that are between teeth are not accessible to brush; Therefore, the best way to clean them is with flossing. The frequency of flossing is like brushing and ideally after each meal, though one time a day (before going to bed) is the minimum necessary.

To start, cut a piece of dental floss (approximately 2 feet). Wrap both sides of the floss around your middle fingers. Using your index and thumb move the floss in between all your teeth one by one. When flossing, make sure you are not cutting your gum. The goal is to clean the teeth surfaces and not the gum. In each space in between the teeth, press the floss against each tooth (hug the tooth) and gently move it back and forth and up and down and then move to the opposite surface of the adjacent tooth.

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Electric Vs. Manual

There have been multiple studies comparing the effectiveness of manual brushes as opposed to electric brushes.

Although not all the electric brushes are the same, in conclusion of all these studies it is fair to say that in general electric brushes are more effective in controlling the plaque than manual brushes. Theoretically you could do a very good brushing with a regular hand brush but the movements of an electric brush makes the task easier and more efficient. Also, some electric brushes (Sonicare) have sonic vibration that is difficult to mimic with a hand brush! Other electric brushes like Oral-B and Rotadent have small heads that help you reach hard to reach areas of your mouth. This aspect is more important when you are talking about somebody with orthodontic braces or a history of gum disease.

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Bad Breath

There are a few different causes for bad breath. It ranges from stomach problems to diets and teeth problems. Most of the causes can be found in the mouth, they are:

1- Tongue (when bacteria grows in between the papilla) 2- Teeth cavities (especially when food particles get stuck in them) 3- Gum diseases 4- Extraction sites during healing 5- Dentures when not cleaned properly 6-Alcohol and tobacco

If you or someone you know is concerned about bad breath, the first step is a dental check up. Your dentist will be able to confirm or rule out teeth or mouth as the source of bad breath.

When the reason is found, treatment will be explained by your dentist. If the source of the bad breath is your mouth there is little chance that mouth washes or mints can treat the problem. They usually mask the problem for a short period of time. They can even sometimes make the situation worse (mouthwashes that contain alcohol cause dry mouth and that usually makes the bad breath worse).

These are a few other, non-dental reasons that cause bad breath:

1- Sore throat 2- Tonsillitis 3- Some foods 4- Infection of air passages.

Following a good oral hygiene routine and getting regular check ups with your dentist are best ways of preventing bad breath.

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Dental and your Diet

Sugar is the main cause of dental decay when there is bacteria present. More important than the amount of sugar you take is the frequency of it.

Probably the worst thing you can do to your teeth is to hold a soda and have a sip every few minutes during a long period of time; the same is true for snacking. It is recommended that if you want to have a snack or a soda or juice it is better to have it after food, as dessert or have it in one sitting. Eating or drinking something sweet during a long period of time creates a constant supply of sugar for bacteria that cause tooth decay!

It is important to know all the sources of sugar. It is not just everything that is sweet but anything that can turn to sugar like pieces of bread. Cutting down your sugar intake is good for cavity prevention as well as general health.

When you have to have sugar! The best way to prevent cavities is to prevent the sugar from staying next to your teeth. Brushing after eating sugar, rinsing your mouth with Fluoride mouth wash or chewing sugarless gum can help. But nothing has the effect of avoiding sugar!

Is there any kind of food that prevents tooth decay? Well, not really. Some people believed that chewing foods like apple and carrots may have some plaque removal effect, but they still contain some sugar so any advantage of them is not clear.

Another group of food that causes significant damage to teeth structure is acidic foods. Things like lime, lemon and grapefruit, if in frequent contact with teeth, can cause serious irreversible damage (erosion) to your teeth.

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Fluoride and Dental Decay

Many years ago scientists started to notice that children who were born and raised in areas with natural fluoride in drinking water had less cavities than children in other areas.

Fluoride that is absorbed by your body when teeth were forming (during mother s pregnancy to early childhood) integrates into the structure of enamel and makes it stronger.

After teeth eruption fluoride that is inside your toothpaste or mouthwash, or what your dentist places on your teeth still have a positive effect on your teeth. It strengthens the enamel and reduces the chance of tooth decay.

If you have children and live in an area that has no Fluoride in its drinking water you should consult your dentist and physician about Fluoride tablets that are available for children.

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