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Before Treatment

1. Q : Always eat a light meal before your dental appointments

Dental treatment on an empty stomach can cause syncope (light headedness or loss of consciousness). Diabetic patients taking insulin or other anti-diabetic medicines are at a greater risk of such a complication when they take their anti-diabetic medication but skip their usual meal.

2. Q : You might need Antibiotic prophylaxis

Patients with certain heart valve/wall defects, recent angioplasty/stent surgery and recent total knee/hip replacements might need antibiotic coverage before certain dental procedures. The stents, valve/wall defects and prosthetic joints can harbor the oral bacteria entering their blood stream during certain dental procedures.

The same goes for patients with ESRD (End stage renal disease), lower CD4 cell counts and uncontrolled diabetics. The antibiotic prophylaxis can prevent bacteremia in such cases.

Dr. Patel will take a detailed medical history and prescribe such antibiotcs for prophylaxis in consultation with your physician.

3. Q : Blood thinners

Patients might be taking one or more blood thinners such as Warfarin, Coumadin, Aspirin, Clopidogrel (Plavix), Apixaban (Eliquis), Dabigatran (Pradaxa), Edoxaban (Savaysa), Rivaroxaban (Xarelto).

Patients should not stop their blood thinner regimen without consultation with the prescribing physician. Stopping these without consulting with the physician can lead to untowards complications like heart attack or stroke.

Our office will transmit a clearance to the physician’s office to get the physician’s recommendations.

4. Q : Osteoporosis Medications and radiation

Patients with low bone density/osteoporosis (typically females above the age of 45) might be taking medicines such as Alendronate (Fosamax), Denosumab (prolia), Ibandronate or Risedronate. These medicines interfere with the natural healing process in the bone and can lead to severe jaw infections after extractions. Radiation of the head and neck for cancer/tumors can hinder bone healing as well.

Patients taking osteoporosis medications or undergoing radiation therapy currently or within past 6 months would be referred out to the Oral Surgeon who would be better equipped to treat any ensuing complications.


After Treatment

1. Q : Local anesthesia

Local anesthetic administered during routine dental procedures will render the soft tissue in that area numb for about 2 1/2 hours.

2. Q : Tooth colored fillings and crowns

It is normal to feel sensitivity to cold fluids for 4-6 weeks after filling/crown appointments. The sensitivity is a reaction of the pulp tissue (nerves inside tooth) to the heat generated from drilling. It is recommended that you sip cold fluids through a straw to avoid contact with tooth in question.

3. Q : Deep decays

Restoring tooth to their original form and function invloves removing all decayed tissue. Sometimes Dr. Patel may with your consent attempt to restore a tooth, with deep decay/questionable prognosis, after extensive testing. The tooth might continue to demonstrate symptoms such as sensitivity or the the tooth might have worsening symptoms. A follow-up visit would be warranted in such a case to determine if Root canal therapy is recommended for the tooth in question.

4. Q : Root canal therapy

Cleaning of the root canals may cause soreness around the root areas. The patient will be prescribed pain medication to prevent this soreness.

If you experience swelling or ulceration in the region please contact our office immediately. This might be from your tissue comming in contact with irrigation medicament.

5. Q : Extractions

Bleeding after tooth extraction usually stops within an hour post surgery when pressure is applied on the site with a moist gauze pack. A blood clot forms during this time. The blood clot plays a major role the healing process. The clot acts as a scaffold and has all the ingredients for successful healing. The clot is very weakly bound in the socket during the first 24 hours and can be easily dislodged by smoking/sucking/blowing/spitting. This can lead to a very painful condition known as “Dry socket”, which essentially means the bone at the bottom of the socket is now open to all kinds of contaminants. Dry-socket is a very common complication associated with smoking within 72 hours of extractions. Contact our office immediately if you experience excruciating pain and foul odor after extractions.

Sometimes oozing of blood may continue past the first hour. Biting on a moist tea bag might help stop the oozing.


Other FAQ's

1. Q : What is the best toothpaste?

All toothpastes contain abrasive particles to help remove tartar. All toothpastes are given a relative dentin abrasivity (RDA) number by the American Dental Association. Toothpastes with higher RDA numbers are more abrasive and can lead to long term problems including sensitivity to cold/hot, yellowing teeth (because yellow dentin shows more after enamel wears off). Toothpastes with a RDA value of 70 or less are considered safe for daily use over a long time, Whitening toothpastes have a higher RDA value. Please visit the following link to see how abrasive your toothpaste is.

Toothpaste Abrasiveness

2. Q : What is Gingivitis or Periodontitis? Why do my gums bleed? Why does my breath stink?

Food particles can easily build up between the tooth and gums because of insufficient or improper brushing. This build up is called tartar or plaque.

The plaque harbors bacteria that are harmful to the gum tissue. The body will mount it’s defense against these bacteria.

The defense includes increased blood supply to the gums so the blood cells can counter the bacteria and its toxins. This increased blood supply to the gums manifests as bleeding of gums from brushing. This inflammation and bleeding gums are a manifestation of gingivitis.

If the bacterial assault continues the body might not be able to counter sufficiently. The toxins from the bacteria will then start destruction of the gum attachemnt and bone tissue under it. This is called loss of periodontal/gum tissue support. At this stage the disease has progressed in to periodontitis. The loss of gum attachment results in gum tissue pockets around teeth. These are safe havens for the bacteria to further colonize and proliferate. The deep pockets become inaccessible to regular brushing and, can accumulate more tartar and bacteria which can cause bad breath.

A deep cleaning/scaling root planing are recommended at this stage to remove tartar and diseased tissue from under the gums. An escalated cleaning regimen might be recommended to prevent build up. In certain cases a gum surgery might be recommended to clean inaccessible areas, graft bone tissue and to get rid of the deep gum pocketing.


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