Helpful guidance for your care.

Before your procedure

• The night before your procedure, take 4 Tums.
• The morning of your procedure, take 4 Tums.
• One hour before your procedure, take 4 Tums.
• Refrain from cannabis use for 48 hours before your procedure.

Short-term use only

This protocol should be used for short-term relief of 3–5 days only.

Alternating schedule

• Take a loading dose of ibuprofen (600–800 mg).
• Two hours later, take 2 tablets of 325 mg acetaminophen.
• Two hours later, take 2 tablets of 200 mg ibuprofen.
• Continue to alternate the last two steps.

Maximum in a 24-hour period

• Do not exceed 3250 mg of acetaminophen.
• Do not exceed 3200 mg of ibuprofen.

Help the blood clot form

• Apply gentle pressure with gauze. Use the gauze we sent home with you and keep it in for 15–20 minutes per pack.
• Fold gauze in half twice to make a thick enough pack to apply pressure.
• Dampen the gauze before you place it. Otherwise, the clot may stick to the gauze and come out when you remove it.

For the first day or two

• Do not smoke for 3 days.
• Do not use a straw to drink fluids.
• Do not rinse with mouthwash or spit for 24 hours.
• Do not drink acidic or carbonated beverages.
• Do not work out too vigorously. This is not the day to run a marathon; use this as your excuse to relax for a day or two.
• Do not place your tongue or fingers into the extraction site.
• Keep up oral hygiene, but be gentle at the extraction site.
• Keep your diet soft, room temperature or cooler, and mild. Avoid acidic or spicy foods.

What to expect

• You may ooze for up to 24 hours. That is normal. If bleeding persists, moisten a tea bag and bite down on it for 20 minutes.
• If you experience swelling, place ice packs on your face near where the tooth was removed for 10 minutes at a time. Swelling and bruising may get worse for up to 3 days after surgery.
• If stitches were placed, they will dissolve in 2–5 days.

When to call

Call the office if you have heavy bleeding, severe pain, or continued swelling after 3 days. Dr. Katie monitors voicemail messages after hours.

After scaling and root planing

After your scaling and root planing procedure, follow these care instructions to support healing of your teeth and gums.

Immediately after your procedure, follow your doctor's recovery instructions for the type of anesthetic used. It is best to limit physical activity for the first 24 hours.

To ease discomfort before the anesthesia wears off, your doctor may allow you to take an over-the-counter pain medication, such as ibuprofen, or a prescribed medication.

If antibiotics are prescribed, take them for the indicated amount of time, even if symptoms and signs of infection are no longer present.

Be careful not to rinse vigorously for at least the first 24 hours after surgery, as this may prolong bleeding.

It is common to experience some cold sensitivity and gum swelling after the procedure. This should subside within several days.

After 24 hours, you can rinse with warm salt water three times per day to reduce pain and swelling. Propping your head up with pillows when lying down will help with swelling and bleeding.

For the first 48 to 72 hours, restrict your diet to soft foods that require minimal chewing. Avoid hard or sticky foods, as well as spicy foods that can irritate the treated area.

Resume regular brushing and flossing as soon as you are able, being gentle around the treated area.

Your doctor may prescribe antimicrobial mouthwash to be used two to three times per day, as directed.

Contact your doctor's office for assistance if you have persistent discomfort or swelling.

Protect your sinus area

• Do not blow your nose. Avoid increasing air pressure in the nasal or sinus cavities; wipe as much as possible.
• Try not to sneeze. If you do, keep your mouth open to prevent an increase in air pressure in the sinus cavities.
• Do not use a straw.
• Do not spit.
• Do not rinse vigorously for several days. Chew on the opposite side as much as possible.
• Do not fly in an airplane.
• Do not swim or submerge your head.
• Do not do vigorous exercise.
• Do not smoke.
• Take all prescribed medication.
• Use StellaLife immediately.

Daily care and maintenance

Clean your aligners before each insertion. Use a soft-bristle toothbrush with water and a small amount of dishwashing liquid.

• Do not use denture cleaners to clean aligners.
• Do not soak aligners in mouthwash.
• These products can damage the surface of the aligner, causing it to become dull and more visible.

Proper oral hygiene

• Remove your aligners for eating and drinking. You do not need to remove them to drink water.
• Brush and floss your teeth after each meal or snack before reinserting your aligners.
• If you do not have access to your cleaning system or a toothbrush, rinse your mouth and hold your aligners under warm running water. Thoroughly clean them at your earliest convenience.

Daily cleaning

To keep your flexible partial looking and feeling like new, follow these recommendations:

• Continue to brush your natural teeth and gums as directed by your dentist.
• Clean your appliance daily. Rinse it under warm running water for approximately 10–30 seconds to remove food particles.
• Brush your appliance with a soft denture brush using water only, then rinse again.
• Place your appliance in a denture cleaner for at least 15 minutes daily. When possible, keep it in water or a denture solution when you are not wearing it.
• Do not use bleach, toothpaste, or similar cleaning products; these may scratch or discolor the surface of your appliance.

What is TMD?

TMD describes a variety of conditions affecting the jaw joints and muscles. Problems may occur on one or both sides. Many people have some sign of TMD, but only a small number suffer pain.

What causes TMD?

The exact cause is not known. For years, dentists thought TMD was caused by the way the jaws and teeth lined up. Research has shown that misalignment of the jaws and teeth is not a major cause. TMD is now understood to involve several contributing factors, some of which may have little or nothing to do with the teeth. Much discomfort is related to overuse of the joints and muscles.

• Clenching your teeth, which may happen when concentrating, feeling busy or worried, or in cold winds.
• Grinding your teeth, often at night but sometimes during the day.
• Straining the joints and muscles by chewing pencils, biting nails, holding things in your mouth, or holding a telephone between your neck and shoulder.
• Overworking the muscles with constant chewing, such as chewing gum.

Will it get worse?

TMD does not usually keep getting worse. The problem tends to come and go, often feeling worse during times of stress. The handout notes that studies show it does not generally worsen with age and may improve over time.

Symptoms you may experience

• Jaw pain or soreness that may be worse on waking or in the evening.
• Jaw pain when biting, chewing, or yawning.
• Clicking from the joint when moving your jaw.
• Stiffness or locking of the jaw joint.
• Earache without an infection.
• Difficulty opening or closing your mouth.
• Frequent headaches.

How is TMD treated?

There are many effective and simple treatments, although there is no single cure. The handout says studies show up to 90% of patients get better with self-care, exercises, and a splint (bite guard) to reduce tension in the facial muscles. Other possible treatments mentioned include laser therapy, physiotherapy, adjustment of the biting surfaces of the teeth, or medication. Orthodontics or surgery is indicated only very rarely.

What you can do

The handout emphasizes that your participation is important for treatment to be effective.

• Keep your teeth apart when you are not wearing your splint. The proper resting position is with your teeth slightly apart and your lips gently together. Your teeth should touch only during chewing, swallowing, and sometimes speaking.
• Avoid opening your mouth very wide.
• Avoid habits such as chewing fingernails or gum.
• Avoid straining your neck and shoulders with poor posture.
• Eat nutritious meals that do not require hard or prolonged chewing. A soft diet may help when symptoms are more intense.
• Avoid caffeine and smoking. The handout notes that stimulants can make pain seem worse and increase muscle fatigue.
• Painkillers you would normally take for a headache, such as paracetamol or ibuprofen, can be taken for short periods if pain is particularly intense.

Exercise program

The original handout recommends setting aside 10–15 minutes each day, or at least five minutes three times per day, for exercises. Always move slowly and gently, relaxing the muscles as much as possible. All movement should be relaxed and pain-free. Practice regularly. If the exercises seem to make your jaw problem worse, stop. Your dentist may prescribe other exercises for your needs.

• Exercise 1 — Smooth opening: In front of a mirror, place your fingers over your jaw joints and curl your tongue back to the roof of your mouth. Keeping your tongue in place, open slowly and smoothly in a straight vertical line. Repeat 5 times, twice a day.
• Exercise 2 — Balanced opening: Begin with your jaw at a comfortable resting position and teeth slightly apart. While opening your mouth, use your hand to balance the pressure of your jaw. Hold for 5 seconds and repeat 5 times each day.
• Exercise 3 — Side stretch: Apply slight pressure with your hand as you move your jaw to one side. Hold for 5 seconds, then repeat on the opposite side. Repeat 5 times per day.
• Gentle facial massage may also help. Use three fingers and slowly work from beside your ear down toward your chin.

A note from the handout

Symptoms may come and go and can flare during times of stress. If symptoms return, the handout advises resuming your nightguard and exercises.

Healthy tooth anatomy

• Enamel is the outermost layer of the tooth crown and the hardest tissue in the body, made of hydroxyapatite, a natural mineral.
• Dentin supports the enamel and protects the pulp.
• The pulp is the innermost vital part of the tooth and contains blood vessels and nerves.
• Cementum is a thin layer that helps attach the tooth to the jaw bone.

How does decay occur?

Decay, also known as caries, occurs due to acid produced by bacteria, which causes mineral loss in the tooth. This process is called demineralization. Decay does not start with a hole; it develops invisibly in enamel below the tooth surface. At this stage, it may still be possible to reverse without drilling.

Untreated early decay can progress, involve the dentin, and form a cavity. The handout explains that a cavity can require drilling and filling.

About Curodont Repair

The handout describes Curodont Repair as a painless, drill-free solution for arresting and reversing initial tooth decay. It says the patented Monomer-Peptide formulation can help regenerate lost minerals by attracting calcium and phosphate from saliva.

It describes the treatment as an in-office application by a dental professional, taking less than 10 minutes, and says it is suitable for all ages.

Science inspired by nature

The brochure describes vVARDIS technology as developed in Switzerland and based on peptide science, with over 25 years of research. It explains that the technology aims to mimic nature by forming new hydroxyapatite crystals.

Guided enamel regeneration

The brochure describes Curodont Repair as a treatment for initial caries and calls it non-invasive, painless, and easy to use. It states that it is suitable for all patients, including children.

Application

The brochure describes an application time of 5–8 minutes, performed by a dental hygienist or dentist. It outlines professional tooth cleaning, cleaning the affected tooth surface with 2% sodium hypochlorite for 20 seconds, applying 35–37% orthophosphoric acid for 20 seconds, rinsing and drying gently, and applying Curodont Repair.

Indications and precautions

The brochure says one applicator can treat up to 1–3 initial carious lesions. It lists initial approximal caries D1 and D2 (and non-cavitated D3), initial occlusal caries, initial smooth-surface caries, and initial caries in deciduous teeth.

Curodont Repair should only be used by dental professionals.

Annual plan includes

Reuther Family Dental says the VIP Smiles Club was developed for patients looking for an alternative to dental insurance.

• 2 regular cleanings per year with exams.
• Any necessary X-rays.
• Fluoride varnish to help prevent cavities.
• One emergency exam per year.
• 20% off treatment, including cosmetic care, Invisalign, whitening, fillings, bridges, implant restoration, and dentures.
• No maximums and no waiting period.

Annual fees

The handout values included services at up to $797. Call the office to ask about enrollment.

• Adult: $435 annually.
• Child under 18: $225 annually.

Periodontal plan includes

Reuther Family Dental says the VIP Smiles Club with Periodontal Disease was developed for patients looking for an alternative to dental insurance.

• 4 periodontal maintenance cleanings per year.
• 2 exams per year.
• Any necessary X-rays.
• Fluoride varnish to help prevent cavities 4 times per year.
• One emergency exam per year.
• 20% off treatment, including cosmetic care, Invisalign, whitening, fillings, bridges, implant restoration, and dentures.
• No maximums and no waiting period.

Annual fee

Adult: $805 annually. The handout values included services at up to $1000. Call the office to ask about enrollment.