We have done our best to provide you with well-fitted, functional, and aesthetically pleasing partial dentures. We feel confident that after a few weeks of adjustments to them you will enjoy years of satisfaction and use from them. The following is information you need to know:

Your First Few Weeks: New dentures always feel strange when first placed into your mouth. Several days or even a few weeks will be required for you to feel accustomed to them. You may feel you salivate excessively and talk differently, this too will subside.
Sore Spots: Your mouth usually has a few sore spots about 24 hours after you first put in your prosthesis. An initial readjustment appointment should be made the following day after you receive your dentures and another appointment about seven days later. It may be necessary from time to time to have adjustments as your tissues naturally change.
Chewing: The new bite or occlusion will not be comfortable for a period of days. We will adjust the contacting surfaces of your teeth after 24 hours, and again in about one week after the dentures have settled into place.
Upper vs. Lower Dentures: Your upper denture will rest comfortably in place with moderate-to-strong suction. Although your lower denture will have good stability, it is infrequent that suction can be expected on a lower denture. We suggest that you avoid denture adhesives unless you really have difficulty.
Cleaning the Dentures and Your Mouth: Your dentures can be cleaned easily by using a denture brush and toothpaste. Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush once per day to toughen and clean them. You should remove the dentures at night and soak them in diluted mouthwash.
The Future: Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This is one of the main disadvantages of dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us once a year. We will inform you when relining or rebasing of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and very serious oral disease. Even dentures that fit comfortably need to be checked along with your tissue. Oral Cancer screening should be performed yearly.
We look forward to helping you adjust to and enjoy your new dentures.

You have just had a crown or a fixed bridge cemented to replace your missing tooth structure or missing teeth. It is expected that you will benefit from years of good service provided you observe the following cautions and general guidelines in caring for your crown or bridge:

Chewing: Do not chew hard foods on the restorations as they may fracture. Also, if you discover you are clenching or grinding your teeth, please inform us as we will arrange for a custom nightguard to be fabricated. If you feel your bite does not adjust on its own in the next week, please call for an adjustment appointment.

Sensitivity: Don't worry about mild sensitivity to hot or cold foods as this sensitivity will disappear gradually over a few weeks. Please notify us if you have long term sensitivity or sensitivity that lingers for some time after you swallow.

Preventive Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting-tissue breakdown, please use the following preventive procedures:

Brush and floss after eating and before bedtime.
Use a fluoride rinse: swish vigorously for at least 30 seconds daily.
Use fluoride gel as advised by us. (This requires a prescription.)
Use an electric toothbrush (such as the SoniCare or the Oral B).
RECALLS: Inadequate return for examination is the most significant reason for prostheses failure. Visit us at regular (3,4 or 6 month intervals) examination periods. Often problems that are developing around the restorations can be found at an early stage and correct easily. Waiting for a longer time may require redoing the entire restoration, or even a root canal.

PROBLEMS: Call us immediately if any of these conditions occurs:

A feeling of movement or looseness in the restoration.
Sensitivity to sweet foods.
A peculiar taste from the restoration site.
Breakage of a piece of material from the restoration.
Sensitivity to pressure.
We have done our best to provide you with the finest quality materials available today. However, only your continuing care and concern can assure long-term good dental health. Please call us if you have concerns: 919-562-2345.

1) PROTECTION OF THE BLOOD CLOT: maintain gentle pressure by biting on the gauze that has been placed over the surgical area. Keep steady, firm pressure for at least 1 hour, replacing the gauze as needed, until the bleeding stops. Do not chew on the gauze. Avoid spitting, smoking and drinking through a straw as well as blowing your nose for at least 24 hrs. It can take up to 24 hrs to form a good clot. If necessary, wrap a tea bag in gauze and bite with firm pressure to help stop the bleeding. You may notice bone spurs working out of the gums with healing.

2) DO NOT RINSE: do not use mouthwash or rinse your mouth for at least 48 hours. After 48 hours and for the next 2 days, rinse with warm salt water (1/2 teaspoon table salt in 8 oz. warm water) every 1-2 hours as recommended or needed. Do not use commercial mouthwashes for at least one week following surgery.

3) DISCOMFORT: it is normal to experience some discomfort following dental surgery. If medication has been prescribed, take as directed. Do not use aspirin to control pain as it may inhibit blood clotting. Swelling, bruising, cracked lips, fever blisters and intra-oral ulcers may occur. Jaw pain beginning a few days after surgery may actually be a dry socket; this usually requires additional care - please call us. Do not mix prescription medication with alcoholic beverages or any other drugs. You may feel bone fragments during your healing: call if there is associated pain. OTC medications for pain: 600mg Ibuprofen + 500mg Tylenol every 4-6 hrs.

4) CONTROL OF SWELLING: gently apply ice packs to the area for periods of 20 minutes on, 10 minutes off for the first 24 hours after surgery only. On the third day following surgery, you may apply a heating pad for 20 minutes on, 10 minutes off to help with swelling. If your swelling increases 48hrs after surgery, please call us.

5) THE TOOTHBRUSH: may be carefully used in the area of the mouth not involved by the surgical procedures. A clean mouth heals faster. It is normal to see a small amount of blood mixed in the saliva as you are brushing due to manipulation of the surgical site.

6) EATING/ DRINKING: adequate food (soft) and fluid intake following surgery is very important for your healing. Avoid heavy chewing, eat a soft diet and chew on the side opposite the surgical site if possible. Avoid consuming liquids through a straw as this may dislodge the blood clot and result in a dry socket, increased discomfort and delayed healing. AVOID SMOKING and ALCOHOLIC BEVERAGES for at least 48 hours.Taking medications on an empty stomach may cause nausea. Nutrition is extremely important to your healing.

7) SUTURES: if used, may need to be removed. You will be informed if this needs to be scheduled.

8) ALLERGIC REACTIONS: if itching or a rash is noticed, call our office immediately. If you find it difficult to breathe, call 911 immediately as an allergic reaction may compromise your airway.

9) Avoid excessive activity during the next 24-48 hours following surgery. Keep head elevated and get plenty of rest.

**CONTACT US IF YOU HAVE ANY CONCERNS AT: 562-2345 **

*RESULTS VARY FROM PERSON TO PERSON. FOR BEST RESULTS, FOLLOW UP WITH BLEACHING TRAYS TO ENHANCE AND MAINTAIN YOUR NEW BRIGHT SMILE.*

Avoid any colored liquids for the next 3 days (for example: coffee, tea, dark sodas and dark juices) as your teeth will absorb the stain and reverse the whitening results if consumed. Do not smoke. In general, drink through a straw to avoid staining your teeth after the initial 3 days.

You may notice temperature sensitivity for some time following your in-office whitening. We have provided a professional fluoride treatment as a courtesy to help alleviate some sensitivity. In addition, please brush with sensitivity toothpaste and avoid extreme temperatures until the sensitivity fades. Sensitivity usually lasts about 1 week. You may take Ibuprofen, or what you would normally take for a headache, for any discomfort.

Tissue irritation is very common and chemical burns sometimes occur from the whitening gel. If you notice gum irritation, swish with warm salt water every 2 hrs and apply a topical anesthetic prior to eating if necessary. Colgate makes a product called Sooth and Seal that you may purchase over-the-counter to cover any blisters and may help them heal faster.

We have recommended the use of an occlusal guard or "night guard." This appliance will aid in protecting your teeth from clenching or grinding, the harmful wearing and destruction of enamel that this habit causes to your teeth. People with nighttime grinding habits may wear their tooth enamel ten times faster than those without such abusive habits. You may also notice that your night guard can reduce or even alleviate headaches that also occur from clenching or grinding at night.

Night guards can be made in two appointments and are custom made on a model of your mouth to assure adequate retention and optimal comfort.

The treatment of bruxism (grinding) and clenching is very cost effective compared to no treatment. The alternative is to replace or repair the damaged and destroyed teeth with either fixed crowns, bridges or removable dentures.

Use of Appliance: Wear your occlusal guard nightly while sleeping. It may take a few nights to become comfortable with wearing it throughout the night. Do not be alarmed; just continue to wear it as much as possible.

Care: Remove your night guard and clean it by brushing it with your toothbrush.
**Always keep the appliance in it the case so it is not misplaced or mistaken as a toy by pets.

If we have recommended a "hard" night guard you may notice some sensitivity or pressure to the teeth. This is normal due to the tight fit of these appliances. Don't worry, this will subside. However, if it does not, we may need to make adjustments to your night guard. The alternative to a hard night guard is a soft, vinyl variety. This type is tolerated best by new night guard wearers, gaggers and those able and desiring to whiten their teeth.

Signs of nocturnal bruxism and/or clenching:

Stiff jaw in the morning
Difficulty opening, especially in the morning
Sensitivity to cold
Jaw muscles feel tired in the morning
Headaches - especially when you wake-up

We have done our best to provide you with well-fitted, functional, and aesthetically pleasing partial dentures. We feel confident that after a few weeks of adjustments to them you will enjoy years of satisfaction and use from them. In the meantime, the following is information you need to know.

Your First Few Weeks: New dentures always feel strange when first placed into your mouth. Several days or even a few weeks will be required for you to feel accustomed to them.

Sore Spots: Your mouth usually will have a few sore spots about 24 hours after you first put your partial dentures in. An initial readjustment appointment should be made; and another appointment abut seven days later will usually eliminate any other sore areas.

Chewing: The new bite or occlusion will not be comfortable for a period of days. We will adjust the contacting surfaces of your teeth after 24 hours, and again in about one week after the dentures have settled into place.

Cleaning the Dentures and Your Mouth: Your partial dentures can be cleaned easily by using a denture brush and toothpaste. Use special care to clean parts of the partial that contact any natural teeth. Both the partial denture and the natural teeth must be kept very clean on a daily basis to reduce the chance of new dental decay starting. Use toothpaste that contains fluoride. Denture soaks are also useful for the denture. Brush your gums with a regular toothbrush once a day to clean and toughen them. You may leave in or out of your mouth at night, de-pending on your preference. If they are out of your mouth, then leave them soaking in a water-and-mouthwash solution.

The Future: Your jaw bones and gums shrink up to 1/32 of an inch per year when your teeth are missing. This is one of the main disadvantages of dentures. Because of this shrinkage, you should plan to have your dentures and oral tissues evaluated by us at least every six (6) months. We will inform you when relining or rebasing of the dentures is necessary. Wearing ill-fitting dentures for too long without refitting can cause severe bone loss and very serious oral disease.

Root canal therapy is a last attempt to save a tooth. Keep in mind not all teeth are maintained even after root canal treatment. Endodontic treatment can take 1, 2 or 3 appointments depending on each case. A temporary filling may be used between each visit to seal the tooth. A final restoration will be necessary after the root canal is completed - a foundation and a crown is usually the recommended treatment.

Soreness is to be expected - both with your gums and with the tooth itself. You may also notice sensitivity to hot and/or cold, pressure and may experience swelling. If you experience swelling, call our office as an antibiotic or steroid may be necessary. In complicated cases, pain medication may be necessary.

Continue to brush and floss as directed.

Eat a softer diet or chew on the opposite side until the definitive filling or the crown is placed- this should be completed as soon as possible. If your tooth breaks, it may have to be crowned right away or may need to be taken out if it is non- restorable.

Please contact us if you are concerned about any symptoms, have increasing pain or experienced swelling: (919) 562-2345.

Please read and follow these procedures as they will help make you more comfortable and prevent any possible complications.

CARE OF YOUR MOUTH: Rinse your mouth 2-3 times per day with warm (coffee temp.) salt water. One teaspoon salt / 8 oz. water. Start home care (brushing and flossing) immediately. In the beginning you may have to be gentle. Drink plenty of water.

DISCOMFORT: Your gums may become achy and over-the-counter pain medications will help minimize discomfort. Sensitivity to cold may temporarily occur. Removing all plaque from the tooth by brushing and flossing and placing a dab of fluoride toothpaste on the touchy tooth will stop cold or touch sensitivity in a few days. Take 600 mg Ibuprofen every 6 hrs for the first few days.

EATING: Your next meal should be soft. Avoid any hard chippy foods like Fritos, Potato chips, Popcorn, etc. for the next 3-4 days.

SWELLING: Swelling or jaw stiffness occur very rarely, however if it does, place warm moist towels to the face in the area of stiffness.

SMOKING: Please do not smoke following scaling and root planning procedures. Tobacco smoke is an irritant to healing. Refrain from smoking for 24 hours or longer.

The success of your gum treatments depends on the improvement of your oral hygiene and commitment to routine professional care.

If any problems arise feel free to call our office: 919-562-2345

Dental sealants are recommended by the American Dental Association, American Academy of Pediatric Dentistry and the United States Public Health Service as an effective means of preventing cavities. Sealants are simply a thin, plastic, resin coating applied to the chewing surface of back teeth to cover pits and grooves where bacteria and food lodge to cause tooth decay.

PLEASE AVOID:

Chewing hard or sticky foods and/or candy
Chewing ice
Chewing on hard objects (like pens or pencils)
It is recommended to repair or replace lost or partially broken sealants to maintain effectiveness over the years. We will check all sealants at your regular cleaning and exam appointment. They are guaranteed for one year after placement as long as you keep your regular recare appointments. It is important to remember that sealants are meant to be part of a complete program of dental health that includes dental checkups, fluoride, brushings, flossing and a good diet.

Athletic mouthguards should be worn by all contact sports participants. There are different types of sports guards. They range from "one fits all," available through sports stores, to "custom fitted" sportsguards, fabricated by your dentist, Dr. Davidian.

Custom sportsguards offer the most protection against dental injuries as they are form fitted to your mouth through a heat/vacuum process. This custom fit will also be the most comfortable and easiest to speak with while you are wearing it.

Dental injuries can be permanent and disfiguring. They are also universally expensive to treat. There is no question treating a dental injury is substantially more expensive than the cost of providing your players with a custom-fitted mouthguard. Decreasing your chances of dental injuries, during sports, starts with a sportsguard, especially a custom-fitted guard.

Take home whitening trays are a simple, relatively inexpensive and safe effective means of whitening/lightening your teeth. Although this whitening process can be very effective the results are somewhat unpredictable and may not yield the degree of lightening desired. Dark gray or brown tetracycline stained teeth do not respond as well to take home whitening. Please be aware the color of crowns, silver/amalgam and composite restorations (tooth color fillings) will not be affected by the bleaching procedure. Also note teeth are naturally darker along the gum line and may require more time to lighten than the rest of the tooth surface and usually remain slightly darker; acceptable results can usually be attained in 2-4 weeks. Regular dental check-ups and cleanings are important before and after whitening to maintain a healthy smile.

Patient Instructions:

Night time Use:

At bedtime, brush and floss teeth, then rinse mouth well with water.
Place a pea size dot on the cheek side, of the first front eight teeth of tray.
Dry your teeth as much as possible.
Insert tray in mouth over teeth and allow the excess whitening material to run out of tray.
Gently wipe any excess material off the gum tissue. Rinse mouth and expectorate contents as necessary.
Wear the loaded whitening tray during sleep every night for 2-3 weeks. (The gel is active for 2hours)
After the prescribed time, remove the tray. Brush and rinse the residual gel from the teeth and inside of trays.
Avoid any dark liquids for at least 2 hrs after removing your trays (examples include: coffee, tea, sodas, dark juices, red wine) and as much as possible while bleaching
Day time Use

Brush and floss teeth, then rinse mouth well with water.
Place a pea size dot on the cheek side, of the first front eight teeth of tray.
Dry your teeth as much as possible.
Insert tray in mouth over teeth and allow the excess whitening material to run out of tray.
Gently wipe any excess material off the gum tissue. Rinse mouth and expectorate contents as necessary.
Wear the loaded whitening tray for 2-3 hours each day for 2-3 weeks. Remove tray for meals.
After the prescribed time, remove the tray. Brush and rinse the residual gel from the teeth and inside of trays.
Avoid any dark liquids for at least 2 hrs after removing your trays (examples include: coffee, tea, sodas, dark juices, red wine) and as much as possible while bleaching.
Sensitivity or Gum Irritation:

If significant discomfort occurs due to tissue irritation, ulceration, or tooth sensitivity, please follow the instructions below:

Some patients experience sensitivity during bleaching. It may be recommended that you bleach every second or third day. Use the tray during the day for 1-3 hours or use fluoride treatment/sensitivity toothpaste in your custom tray after you remove the tray. You may also brush your teeth with sensitivity toothpaste. Discontinue bleaching if your sensitivity is extreme. Food and juices high in citric acid can cause sensitivity to the teeth.

Some patients have noticed temporary discomfort to the gums, lips, throat, or tongue. Should any of these symptoms persist more than two days or progressively worsen, call our office. These side effects will usually subside with 1-3 days after treatment is discontinued.

PLEASE DO NOT:

Bleach teeth while pregnant or lactating.
Eat or drink while wearing your custom trays.
Use tobacco products while wearing your custom trays.
Use household products, products from the internet or unknown sources to whiten your teeth.
Expose the bleaching gel or trays to heat and/or sunlight as they will distort and not fit.
Freeze the bleaching gel. The bleaching gel can be refrigerated after completing all treatments.
Should the trays be lost or destroyed, there will be a charge for replacement.

Thank you for trusting us with your recent crown/bridge preparation. We look forward to seeing you again to cement your lab fabricated crown or bridge. You have just had a temporary crown or bridge cemented in your mouth. This temporary will need to remain in place until your crown or bridge returns from the lab. Your final restoration will be shaped better than the temporary to match your teeth in both color and function. Sensitivity to cold and pressure is very common - if extreme, please call us.

This temporary should be quite serviceable for the weeks needed to make and deliver your new crown or bridge. The cement used is not as strong as the permanent cement used. Therefore, it is necessary that you follow a few common sense rules while wearing your temporary crown or bridge.

Please DO NOT eat anything chewy, sticky, or doughy.
Please be careful of bagels and pretzels, etc...(any food with a stiff consistency).
When flossing, please PULL the floss out between the teeth. Do not pop it up or you could dislodge the temporary crown.
Please do not be afraid to brush around the temporary, it is important to keep your mouth clean and healthy.
If the temporary should come loose, please push it back in place and call our office as soon as possible. We still need to cement it back with the temporary cement. If it comes completely out, you may place a tiny spot of Vaseline or toothpaste in the crown and place it back in.
It is VERY important that you do not allow the temporary to come off and not replace it. The tooth needs to be protected until your final dental work can be cemented in place. Also, if the temporary crown is not reinserted once removed, your new crown or bridge may not fit properly due to the shifting of your teeth.
Please do not hesitate to call our office if you have any questions concerning your temporary crown or bridge. We can be reached at 919-562-2345.

We have placed tooth-colored restorations in your teeth. The resin material used is a plastic with small filler particles of glass-like material the finest and most up-to-date materials available today. These restorations will serve you well for several years. However, you should be aware of the following.

Chewing: As with natural teeth, avoid chewing excessively hard foods (or objects) on the restored teeth (hard candy, ice, raw carrots, etc.) as extreme force can cause the resin material to be broken from the tooth just as a natural tooth can be fractured. In the event that a breakage occurs, replacement of a restoration is not difficult, but a crown may be necessary.

Your anesthetic may last several hours: please be careful not to bite your lips, cheeks or tongue while they are numb (also watch your child if they were anesthetized for their fillings).

Your bite will feel different for approximately 1 week. Your tongue will magnify the tooth shape difference and this too will accommodate itself in approximately 1 week. If your bite or the shape of the tooth is such that you cannot accommodate it after a week, please contact us so we can make an appointment to adjust your filling.

Sensitivity: Sensitivity to cold is normal and may last for several months. Some sensitivity to warm/hot is experienced by some people. Most sensitivity disappears once you swallow. In general, the deeper the filling, the more sensitivity you will experience. Your gum tissue may have been irritated during the procedure and may be sore for a few days.

Recalls: Visit us at regular 3, 4 or 6 month examination periods. We will notify you of the interval that will meet your needs best. Often problems that are developing around the restorations can be detected at an early stage and repaired easily. Waiting a longer time may require redoing the entire restoration and may dictate additional treatment, such as a root canal and/or a crown.

Preventive Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please brush and floss after eating and before bedtime. In addition, swish with a fluoride mouthwash vigorously for at least 30 seconds daily (such as ACT that can be purchased over-the-counter).

Please call us at 919-562-2345 if you have any questions.

Congratulations! You have just received the most up-to-date, state-of-the-art composite resin Porcelain veneer / porcelain crown dentistry has to offer. Your cosmetic bonding has been accomplished with the following materials.

To ensure maximum beauty and longevity, a few points should be mentioned:

Brush with an ultra-soft toothbrush at least two times a day. Floss at least once a day, preferably before bedtime.
As with your natural teeth, the bonded material can pick stains: try to avoid or keep to a minimum tobacco, coffee, tea, soy sauce, curry, colas, grape juice, blueberries or red wine. Routine dental cleanings will usually remove stains. Do not use baking soda or any abrasive toothpaste, including whitening toothpaste. The toothpaste we recommend for veneers are Rembrandt.
Do not rinse routinely with mouthwashes, as they are high in alcohol. Alcohol softens bonding and weakens the bond of porcelain. If mouthwash is desired, a solution of hydrogen peroxide and water could be used or select a non-alcohol containing mouth wash such as Breath Rx or Rembrandt, which can be purchased from our office.
Sodium fluoride is the only home fluoride that should be used. Stannous fluoride or acidulated phosphate fluoride are not recommended for composite resin bonding or porcelain. ACT and/or Fluoridex are sodium fluoride rinses and can be recommended for home use.
Habits such as opening packages with your teeth, biting thread, chewing ice, nail biting or pipe smoking should be avoided. Avoid direct biting into ribs, bones, hard candy, nuts, or hard bread and rolls, as this puts stress on the material and could result in a fracture. Be aware that certain foods such as spare ribs, corn on the cob, carrots and apples can also put added stress on bonded teeth and possibly increase the need for repairs. Most kinds of sandwiches are not a problem.
If a chip or a fracture does occur, it frequently requires only a simple renewal using the same or similar material. It is a short appointment and the fee is similar to that for a restoration on a front tooth.
How long bonding lasts depends on many things. It's a lot like getting a new set of tires. How long they last depends on the quality of the tire, the type of road surfaces traveled, the way you drive and how many miles you drive in a year. In the same manner, longevity of your veneers depends on your habits and how much stress is placed on the front teeth.
Since your cosmetic bonding is accomplished in one or two office visits, your teeth will feel different to your lips and tongue when you first close your mouth. This is normal and to be expected when changes have been made to the shape and size of the teeth. Sometimes, your speech may change or be affected in the beginning until