212-267-1884

    General Guidelines for all procedures:


    Do not chew on hard, sticky or chewy foods for a least 24 hours.  Never chew on ice.  Avoid aggressive chewing and sticky foods such as “hard tack” candies that can loosen or damage a restoration. Carefully follow all guidelines provided by the doctor and their staff and most importantly practice good oral hygiene.  Additional instructions following various types of treatment are listed below. Please click on the below topics for detailed instructions.  In the event of an emergency, please call our office.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

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    Dietary Suggestions Following Surgery

    FOR THE FIRST 24 HOURS, your diet should be SOFT and COLD. Some suggested foods are:

    • Malts Ginger ale or 7-Up
    • Milk Shakes
    • Natural Fruit Juices (high in Vitamin C)
    • Ice Cream
    • Plain Yogurt Applesauce
    • Milk
    • Blended fruits and vegetables (drinkable)
    • Iced Tea
    • Instant Breakfast
    • Baby Food
    • Small Curd Cottage Cheese

     

    DIET FOR ONE WEEK

    Your diet after the first 24 hours and until your dressing removal should be quite soft and include nutritious foods
    that are high in vitamins and minerals to aid in healing. Such foods are:

    • Milk
    • Blended fresh fruits and vegetables (drinkable)
    • Cheese (Soft, no hard pieces)
    • Custard
    • Yogurt,Eggs, any style
    • Cooked cereals
    • Fish
    • Cottage Cheese
    • Plenty of fluids (especially water)
    • Soup

    Any of the items from the 1st 24 hours diet may also be used.

     

    MAKE CERTAIN TO FOLLOW RECOMMENDATIONS ON THE POST-OPERATIVE CARE SHEET

    Please avoid foods that are hard, sticky or spicy during the week after surgery. Such foods are:

    • Popcorn
    • Dried Fruits
    • Nuts
    • Peanut Butter
    • Sesame Seeds
    • Crackers
    • Pizza
    • Pastries
    • Candy
    • All breads
    • Gum

    Patients who eat good nutritional soft foods feel better, heal faster and remain more comfortable. The importance of a nutritious diet cannot be overly stressed!

    Please feel free to call our office if you have any questions. If any problems arise, our 24 hour emergency telephone
    number is 212-267-1884.

    Instructions Following Dental Extractions And Other Oral Surgery

    Tooth extractions or other oral surgical procedures are similar to other surgery; your own care in following the doctor’s instructions will speed recovery. Please read and follow these directions carefully.

    1. HEALING- Please do not disturb the wound by touching it with your fingers, a toothpick or your tongue; irritation, bleeding and infection could result. The blood clot, which forms over the area, is nature’s method of healing and should not be disturbed. Avoid all rinsing for 24 hours after leaving office. After 24 hours, you should rinse your mouth with lukewarm saltwater at least 4-6 times a day.

    2. BLEEDING- Some bleeding following tooth extraction is to be expected. If you experience bleeding, place gauze over the surgical site and bite down for 30 minutes. If bleeding continues, bite on fresh sterile gauze for 15 additional minutes. Repeat if necessary. If this is unsuccessful, try biting on a moistened tea bag. Avoid hot liquids.

    3. SWELLING- Use ice bag or towel wrung out of ice water against cheek for 15 minutes. Repeat half hour later. Swelling may start after the tooth has been removed, but is no cause for alarm and should resolve in a day or two.

    4. DIET- Soft foods are advisable during first 24 hours.

    5. SMOKING- Please do not smoke following surgery. Tobacco smoke is an irritant to healing. Refrain from smoking for 24 hours or longer if at all possible.

    6. PAIN- Use the prescribed or recommended medication according to directions.

    In case of extreme pain, uncontrollable bleeding or any unusual disturbances, please call this office immediately or you can reach us at our emergency number, which is left on our office answering machine.

    Instructions Following Implant Surgery

    Some pain, bleeding, swelling and seeping are normal following oral surgery.  A cold compress placed on the face near the surgical site for 30 minutes every hour on the day of your surgery can be helpful. This will help reduce pain and swelling. Do not miss your follow up appointment(s) with your dentist and do not probe the area with your tongue or fingers.  Please do not touch your lips to see or feel the area treated. Avoid brushing your teeth near the surgery site but brush and floss the rest of your mouth as instructed by the office.  You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by your doctor as needed.  A warm salt water rinse, approximately ½ teaspoon in an eight ounce glass of water, three times a day can be helpful.

    For the first 24 hours you may experience some cold and heat sensitivity.  Do not eat, drink, chew or consume foods and beverages that are extremely hot or spicy until the numbness has worn off following the anesthetic.  Avoid vigorous physical exercise for the first 24 hours and do not consume alcoholic beverages or smoke for at least 48 hours.  Do not brush, rinse or spit. Do not use a straw for drinking.  During the first few days after surgery a diet of liquids and soft foods such as soups, yogurt, juice and smoothies are recommended.  If you experience excessive bleeding or discomfort after 48-72 hours, please call our office immediately.

    Follow any other instructions provided by the office on your visit.  Please take all medications as prescribed including your prescribed antibiotics to help prevent infection.

    Instructions Following Curettage/Root Planing

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

     

    • CARE OF YOUR MOUTH: Rinse your mouth 6-8 times per day with warm (coffee temp.) salt water. One teaspoon salt to 8 oz. water. Start brushing and flossing immediately. You may have to go easy at first.
    • DISCOMFORT: Your gums may become “achy” and a couple of aspirin will eliminate any discomfort. Sensitivity to cold may temporarily occur. Removing all plaque from the tooth and placing a dab of fluoride toothpaste on the “touchy” tooth will stop cold or touch sensitivity in a few days.
    • EATING: Do most of your chewing on the untreated side. Your next meal should be soft. Avoid any hard “chippy” foods like Fritos, Potato chips, Popcorn, etc. for the next few days (3-4).
    • SWELLING: Very seldom does swelling or jaw stiffness occur, however if it does, place warm moist towels to the face in the area of stiffness.
    • DRESSING: If a dressing is used leave it in place until the time specified by the doctor. Peel it off with a fingernail and brush teeth to remove small pieces.
    • SMOKING: Please do not smoke following curettage/root planing procedures. Tobacco smoke is an irritant to healing. Refrain from smoking for 24 hours or longer.

    Instructions Following Temporary Onlays or Crowns

    A temporary, is a filling that is placed until the permanent filling is made and ready to be placed. It is normal for the gum around your tooth to be a little sore when the anesthesia wears off. This will disappear by tomorrow. Do your best to chew on the opposite side until your next appointment. Chewing sticky foods can sometimes dislodge it.

    It is not uncommon to have the following reactions or problems with the temporary:

    IT FEELS ROUGH. (Please call us if it is making the tongue sensitive)

    IT CAME OFF. (This is probably the most common problem. It is supposed to come off easily and avoiding some foods will help with this. Stay away from sticky foods or gum. Its important for it to be there, so call us so we can re-cement it or you can put it back in with a denture adhesive until you can get in.)

    IT FEELS HIGH. (Come in so we can adjust it. You can bruise a tooth if it is high.)

    IT IS SENSITIVE. (The temporary will not always fit as well as the permanent will, so there may be some sensitivity to hot and cold aswell a chewing. If it is too uncomfortable, please call.)


    The temporary is very important. It protects the exposed dentin so it is not sensitive, prevents food from gathering in the preparation, and prevents the prepared tooth from shifting and moving, making seating of the permanent more difficult. Use your toothbrush to clean the temporary as you normally do your other teeth. You will not be able to floss around your temporary as you may dislodge it.

    If you have any questions concerning the temporary, please feel free to call. Remember, it will only be a short while and it will all be worth it when you get your beautiful permanent restoration.

    Instructions Following an Alloderm Graft

    PERIDEX: Beginning the day after surgery, rinse 2 times  a day for next 2 weeks.

    ANTIBIOTICS:  Amoxicillin 875 mgs Disp: tabs #20

    Begin taking the antibiotic the morning of surgery, and then twice a day for 10 days until the entire prescription is finished.

    ANTI-INFLAMMATORY:  Dexamethasone 0.75mg Disp: 7

    Take 3 tablets the morning of the procedure; followed by 2 tablets that evening; and finally 2 tablets the following morning.

    PAIN MEDICATION:  Advil or Tylenol as needed

    BLEEDING:  You may taste a few drops of blood in the saliva the day of the surgery. This is normal. Avoid hot liquids, rinsing or spitting within the first 24 hours. If bleeding persists, place a cold, wet tea bag (regular tea not herbal or decaffeinated) on the area and apply pressure for 10 minutes. Wait 10 minutes and repeat the process.

    SWELLING: Some swelling can be expected. FOR THE FIRST 48 HOURS FOLLOWING THE SURGERY APPLY AN ICE PACK TO THE OUTSIDE OF THE FACE-15 MINUTES ON—15 MINUTES OFF. If area is extremely swollen please call the office. It is helpful to sleep with your head elevated on 2 pillows for the first night after surgery. You may want to place a towel on your pillow in case there is some oozing throughout the night.

    RINSING: Avoid rinsing for the first 24 hours post surgically and longer if persistant bleeding occurs. Begin rinsing with the Peridex the day after surgery.

    EATING: Do not eat or drink until the anesthesia wears off, usually in one or two hours. Soft foods (fish, eggs, soup (not piping hot), cooked vegetables, yogurt, ice cream, etc.) are recommended for the first few days. Avoid eating anything hard, (nuts, popcorn), Highly seasoned foods , citrus and spices may be irritating but will not affect healing. Eat on the opposite side of the surgery. No straws or hard candy until the sutures are removed.

    ORAL HYGIENE:  No brushing or flossing for 24 hours. Avoid contact with the surgical area. Normal hygiene in the area will be restored at your post operative visit. Avoid the use of an electric toothbrush until further notice by your doctor.

    Instructions Following Fillings

    Do not eat or chew until any numbness from anesthesia has worn off.  If you are supervising a child who had treatment, make certain that they are not eating or chewing while numb.  Please make sure they do not bite their lips or tongue as it can cause serious injury to their soft tissue.  Avoid sticky, crunchy or hard foods for 24 hours.

    Sensitivity to cold and heat, as well as any soreness, shouldn’t last more than a few days.  Please call our office if you experience pain or discomfort for more than a few days.

    Instructions Following Crowns and Bridges

    Crowns and Bridges may take one to three visits to complete.  The dentist will inform you of your treatment options and the time needed to complete the procedure.  You may have some sensitivity following treatment with tenderness around the gum and tooth for a day or two.  If the tenderness or sensitivity lasts longer than this please contact our office. If anesthesia is used, avoid chewing, biting, and eating until the numbness has worn off.  If you have a temporary placed eat softer foods and avoid foods that are particularly crunchy, chewy or hard.  If the temporary restorations become loose or break, please call us immediately.

    Carefully clean around the restoration, brushing and flossing daily.  When flossing, take extra care not to loosen the temporary restoration by removing the floss too roughly.  You can slowly thread the floss out by one end if necessary to avoid too much pressure on the temporary.

    Once your final restoration has been placed avoid chewing on hard, crunchy or sticky foods for 24 hours in order to give time for the cement to fully bond.  Mild sensitivity to hot or cold foods is not unusual and should dissipate after a few weeks.  If sensitivity lasts more than six weeks please let the office know, although this happens infrequently.

    Ongoing care for your restoration includes brushing your teeth after every meal and snack, and flossing at least once a day before bedtime.  Rinsing your mouth with water or mouthwash will also help to remove any additional particles that may have been missed during brushing and flossing.

    Please call our office if you are in pain or have any questions regarding your treatment.

    Instructions Following Lamenant Placement

    Porcelain laminate treatment time: Usually two office visits. Teeth will be prepared and impressions made on the first visit, which can take from one to three hours. Laminates will be fitted and inserted on the second visit, which also will take a minimum of two to three hours, and sometimes longer.

    • Temporaries: In most cases, temporaries will be placed. Initially, your teeth will feel rough and many times will be darker. We recommend curtailment of any major social functions or important business engagements between the preparation visit and seating visit. Also, try to restrict brittle foods from your diet and maintain regular oral hygiene therapy. Most patients require very little or no anesthesia. Some post-operative sensitivity has been reported, but usually this doesn’t last long.
    • Special precautions: Do not traumatize the laminates with extreme temperature changes for the first 24 hours. The luting agent that has bonded the laminates to your teeth goes through a curing process and extreme temperatures could interfere with this process. As always, we caution you to take some precautions with eating. With bonding, crowning, or laminates, you should especially be careful when chewing into hard foods or incising with your restored teeth.
    • At-home maintenance: Meticulous oral hygiene is essential. We request that you follow the program that has been outlined for you.
    • Tooth brushing: If you have a good brushing technique with a manual toothbrush we recommend that those toothbrushes be disposed of every six to eight weeks. Otherwise, we recommend that you use an electric toothbrush, such as the Interplak, Braun Oral-B, Rotodent, or Sonicare.
    • Floss and paste: Flossing your teeth once a day, usually in the evenings, is highly recommended. A non-abrasive fluoride- containing toothpaste or anti-plaque toothpaste should also be used. You may need a fluoride rinse gel, used once in the evening. If you follow this regimen, we do not anticipate any complications periodontal or gingival inflammation or recurring decay.
    •  In Office maintenance: Your teeth should be professionally cleaned and examined a minimum of two times yearly.

    Instructions Following Denture or Partial Delivery

    You may have discomfort for a few days after receiving your final dentures or partials.  Dentures and partials will often need several adjustments in order to fit comfortably.  To help adjust to your dentures you can practice reading aloud for a little while each day.  At night you should remove your dentures and clean them. They should be stored in a clean container filled with denture cleaning solution.  Dentures should be removed for at least 6 hours a day to give your mouth and gums time to rest.  Food particles can become trapped under dentures causing inflammation or sore spots.  Brush the roof of your mouth, your tongue and lightly brush your gums after removing your dentures.

    Ongoing care for your restoration includes brushing your teeth and surrounding tissues after every meal and snack, and flossing at least once a day before bedtime unless you have full dentures, in which case brushing them is very important.  Rinsing your mouth with water or mouthwash will also help to remove any additional particles that may have been missed during brushing and flossing.

    You should visit our office at least once a year to have your dentures or partial adjusted and checked by the doctor.  Wearing ill-fitting dentures or partials without proper care and adjustment can cause severe bone loss and very serious oral disease.  Please call our office at the first signs of any symptoms or if you are experiencing ongoing pain or discomfort.

    Instructions for Teeth Whitening

    1) Squeeze out a thin continuous rope of gel around the arch into the tray of the teeth to be bleached so that when the tray is placed, the teeth are just coated with little excess.

    2) Place the tray in the mouth, and spit out the excess. Use the tray 1-2 hours per day. Continue the treatment until the syringes are used up (2-3 weeks) or until the desired result is achieved. If you have darker gray stains, extra syringes may be needed.

    3) Treat both arches together. If tooth sensitivity or sore throat develops, discontinue wearing until symptoms subside and start back at a reduced wearing schedule. If any problems develop, discontinue wearing and consult Dr. Shapiro.

    4) The amount of whitening is variable and unpredictable. A whitening of teeth can be expected, but the amount of change and the time required to achieve it are unknown. The average patient achieves considerable change with 2-3 weeks of use as directed. The duration of the color change is unknown. There is evidence the change is stable, but occasional touch-up treatment may be necessary every one to two years.

    5) Some patients experience a relapse when treatment is discontinued. This is usually seen on patients with the darkest or grayest discoloration. The amount of relapse is variable; on the average patient, it is very slight. Coffee, tea and tobacco will stain teeth after treatment in the same manner as before treatment.

    6) You may experience any or all of the following during treatment:

    • sensitivity to hot or cold,
    • soreness of teeth and/or changes in the bite,
    • burning sensation of gums and/or throat,
    • soreness in your jaw joint (TMJ).

    These are usually slight and temporary and stop when treatment is discontinued.

    7) Pregnant women should not be treated. If pregnancy is anticipated, treatment will be postponed.

    Instructions for Following Root Canal Therapy

    We hope you had a positive and pain free experience with us.  Root canal therapy is done to disinfect a compromised tooth.  Because each treatment is unique, the expectations of healing are sometimes unpredictable.  Typically, it is common to experience pain for several days but can last for several weeks in more complex treatments.  Do not be alarmed if the tooth is sore to touch or biting, so it should be avoided for the next several days.

    You can expect your numbness to wear off in 2-3 hours so you should be cautious when eating or drinking, especially foods that require a lot of chewing and drinking hot beverages. 

    The following instructions are meant to guide you through the healing phase as comfortably as possible.

    For pain management, you can take one of the following:

    • 600 mg of ibuprofen 6 hours for 2-3 day which is equivalent to 3 tablets of Advil or Motrin
    • 1000 mg (two tablets) of acetaminophen every 6 hours for 2-3 days which is equivalent to Extra Strength Tylenol
    • 220mg of Aleve every 8 hours for 2 -3 days

    If antibiotics  were prescribed, please be sure to take them as directed and finish the entire prescription.

    Rinsing the inside of your mouth in the area of the treatment several times a day with warm salt water rinses can relieve mild irritation of the gum tissue around the tooth.

    Avoid chewing on the treated tooth for the next several days to minimize irritation and allow proper healing of the tooth. If your bite feels high or you cannot close your mouth without pain, please let us know so that your bite can be adjusted.

    If you are experiencing a lot of discomfort or you notice swelling which is getting worse, please call us.