Treatment
Information

Prior to the appointment:

We use child friendly terms to describe the process of local anesthesia, or “numbing.” We find that it’s always best to refrain from using words around your child that might cause unnecessary fear, like “needle,” “shot,” “pull,” “drill,” or “hurt.” We make a point to use words that convey the same message, but are pleasant and not frightening to children.

For example, we will describe the process as “Elsa’s Frozen water” or “sleepy juice” and we administer it with a “really small squirt gun.”

Post local anesthesia instructions:

When anesthetic has been used, your child's lips, teeth and tongue may be numb for up to 4-5 hours after the appointment.

Directly observe your child while numb to ensure they do not bite, chew, or pick at their lip.

Avoid chewing until numbness has worn off and avoid hot foods. It is easy for your child to bite or burn their tongue or lip while numb.

Recommended foods are popsicles, smoothies, milk shakes, yogurt, Jell-O, and mashed potatoes.

Many children get upset by the feeling of numbness, and may complain that it hurts, itches, or feels big. Continue to reassure them that it a temporary feeling and will go away. Cold foods such as popsicles can make the feeling of numbness less pronounced temporarily.

A bite injury is common following local anesthesia. The area may look large and red/white/yellow in coloration. It is not infected, and does not require antibiotics. If this does occur, we encourage you to call the office. You can also text the office a picture of the injury for Dr. Rebecca to review.

Post- op complication lip biting:

Unfortunately, for many of our patients, post-anesthesia lip biting does occur. Being numb or "frozen" can be an odd sensation, so your child may have picked, rubbed, bit or chewed on the lip, which can lead to swelling and ulceration in the area. First off, we are so sorry this happened to your child, but we will provide you with some helpful tricks to aid in a speedy recovery.

If you have noticed your child biting their lip the day of treatment, icing can be helpful within the first 24 hours. Apply ice for 15 minutes on, 15 minutes off for 1-2 hours at a time.

Swelling peaks around 48 hours and can worsen for up to 5 days. The swelling may get worse before it gets better-- don't be alarmed!

Taking Motrin (ibuprofen) is great because it will help control the pain and can decrease inflammation. If pain is not controlled with Motrin alone, you may alternate Tylenol with Motrin. Tylenol does not have the same anti-inflammatory effects, so it is only recommended in addition to Motrin if needed.

As the lip heals it will have a yellow/white coloration. This is not an infection, so do not fret! The mouth heals with a "scab" that is yellow/white in coloration. This injury does not require antibiotics.

Complete healing may take up to 10-14 days.

Brush teeth in the area as normal, just be gentle and try to avoid the injured lip as best you can.

Avoid foods that have hard edges (chips, hard taco shells) or are spicy. Avoid carbonated beverages. Avoid mouth rinses with a high alcohol content (Listerine). These things can cause more pain in the area.

If your child will tolerate saltwater rinses and are capable of spitting, these can be helpful to aid in healing. Mix 1 teaspoon of salt into 8 ounces of warm water and have them swish and spit the saltwater rinse after eating and before bed. If they do not swish, apply with a cotton-tip applicator

The procedure

Fluoride Varnish is used to help prevent tooth decay, arrest (or stop the progression) of initial tooth decay, and/or treat tooth sensitivity. Fluoride treatments are typically recommended every six months but may be applied as frequently as every 3 months if your child is high-risk for cavities.

This non-invasive treatment can be completed in approximately 30 seconds or less. First, air will be used to dry the area then a small amount of fluoride varnish will be painted on exposed tooth structure. The amount of fluoride applied is safe and appropriate for all ages of children, as a very small amount is ingested because the tacky texture of the varnish firmly adheres to teeth.

Fluoride treatments are an elective, supplementary procedure, and while they are extremely beneficial in preventing and arresting tooth decay, it does not guarantee or eliminate the need for dental fillings, or crowns to repair decay, function or esthetics. The application is completed within seconds and leaves a virtually clear and smooth coating on the teeth.

Benefits

Prevent tooth decay (cavities)

Stop tooth decay

Relieve dental sensitivity

Antibacterial effect

Risks

Temporary sticky/tacky texture on tooth surface

Potential unpleasant taste- the flavoring agent is sweet and short in duration. We also offer several flavors for your child to pick from and most children enjoy the taste

Allergic reaction

Post-application instructions

Your child can eat or drinks immediately after

Avoid hot foods and drinks, and hot, crunchy or sticky foods for 3 hours after application

Avoid mouth rinses containing alcohol

Avoid prescription fluoride toothpaste, rinses, or supplements for 24 hours.

Silver diamine fluoride (SDF) is an antimicrobial liquid. SDF can be used to treat cavities to help stop tooth decay and/or treat tooth sensitivity. SDF treatments require an initial application, then a second application 2-4 weeks after. Then, SDF will be applied on a biannual or annual basis at cleaning appointments

Anesthesia is not necessary for this procedure. This non-invasive treatment can be completed painlessly in a matter of minutes. First, air will be used to dry the affected teeth, then a small amount of silver diamine fluoride will be applied with a small brush or floss. After one minute, the excess fluoride will be suctioned and the area dried

Silver diamine fluoride treatments are an elective, supplementary procedure and does not guarantee total caries arrest. Silver diamine fluoride treatments are an elective, supplementary procedure and will not eliminate the need for dental fillings, or crowns to repair decay, function, or esthetics. However, it can delay treatment in individuals with behavior or medical management concerns.

Benefits

SDF can help stop tooth decay or slow down the cavity progression.

SDF can relieve sensitivity.

SDF can help delay treatment for those patients who are young, fearful, or have behavioral/medical management concerns that may otherwise require sedation for traditional dental treatment

Risks

The affected area will stain black permanently. Healthy tooth structure will not stain. In the future, stained tooth structure can potentially be replaced with a filling or covered with a crown.

Tooth-colored fillings and crowns may discolor if SDF is applied to them. Color changes on the surface can normally be polished off.

The edge between a tooth and filling may remain stained.

If accidentally applied to the skin or gums, a brown or white stain may appear that causes no harm. Although it cannot be washed off, it will disappear in one to three weeks.

A temporary metallic taste, which will go away rapidly

Allergic reactions to materials used during SDF application may rarely occur, and this is typically associated with a known silver allergy.

Patients should not be treated with SDF if: they have a known allergy to silver or there are painful sores or raw areas on gums (i.e., ulcerative gingivitis) or anywhere in the mouth (i.e., stomatitis).

Post-application instructions

Your child may eat or drink immediately after application.

A normal brushing and flossing routine can be resumed.

A 2nd application is recommended in 2-4 weeks.

If SDF gets on the skin, it will temporarily stain the skin for 7-14 days.

The purpose of the space maintainer is to hold the space until the permanent tooth erupts. The space maintainer may be in your child’s mouth for years while we wait on the permanent tooth to erupt.

The space maintainer will feel different to your child’s teeth, tongue and cheeks. Ensure that your child is not picking or prying at the space maintainer, as this will make the space maintainer bend in an unfavorable way or come out.

Tooth “glue” sometimes fails, and the space maintainer may come out. If this occurs, please place the space maintainer in a plastic baggie and call the office to schedule a simple re-cement appointment.

If you feel that the space maintainer looks different, is bent or broken, or it comes out, please call the office to schedule an appointment within the next business day. Please, do not delay a re-cementation appointment. With time, teeth quickly shift, and the space maintainer will no longer fit. A new one would have to be remade, which is additional appointment and expense.

Post op care instructions

Brush the metal and the plastic as you would your own teeth. The bands around the teeth in the back can accumulate food and plaque, please brush well around the bands and gums on the molars.

On occasion, appliances can come loose, as the cement can wash out over time. Please, check it periodically to ensure it is not loose. If you feel that the appliance is loose, please contact the office for an appointment. We will evaluate it and re-cement it as necessary. We will also check it every 6 months at cleaning appointments.

If the appliance comes completely out, place it in a plastic baggie for safekeeping and give us a call to re-cement it within the next business day. If the appliance remains out for an extended period of time, the teeth will shift, and a new one will have to be made. It is much easier to re-cement the existing appliance than have to make a new appliance!

Initially, speech may sound different, but your child’s mouth and tongue will adapt within a few days. Have your child read out loud and encourage conversation, as this will be good practice.

Your child should avoid certain foods, as this can break the appliance or cause it to become un-cemented.

Avoid sticky and chewy foods/candies such as gum, caramel, taffies, tootsie rolls, gum etc.

Avoid hard and crunchy foods/candies like jolly ranchers.

Post op care instructions

Brush the metal and the plastic as you would your own teeth. The bands around the teeth in the back can accumulate food and plaque, please brush well around the bands and gums on the molars.

On occasion, appliances can come loose, as the cement can wash out over time. Please, check it periodically to ensure it is not loose. If you feel that the appliance is loose, please contact the office for an appointment. We will evaluate it and re-cement it as necessary. We will also check it every 6 months at cleaning appointments.

If the appliance comes completely out, place it in a plastic baggie for safekeeping and give us a call to re-cement it within the next business day. If the appliance remains out for an extended period of time, the teeth will shift, and a new one will have to be made. It is much easier to re-cement the existing appliance than have to make a new appliance!

Initially, speech may sound different, but your child’s mouth and tongue will adapt within a few days. Have your child read out loud and encourage conversation, as this will be good practice.

Your child should avoid certain foods, as this can break the appliance or cause it to become un-cemented.

Avoid sticky and chewy foods/candies such as gum, caramel, taffies, tootsie rolls, gum etc.

Avoid hard and crunchy foods/candies like jolly ranchers

What is laughing gas?

Nitrous oxide or "laughing gas" is a safe and effective anxiolytic gas, meaning it will reduce anxiety. It also provides mild analgesia effects, meaning it lessens the pain response. Nitrous oxide is not a sedative or general anesthetic agent. Your child will remain awake, alert, and be able to communicate throughout the procedure.

Why is it recommended?

We also want children to have a positive experience at the dentist and develop a trusting, life-long relationship with their dental providers. Nitrous oxide can facilitate an easier appointment. Laughing gas may be recommended if your child is nervous or anxious about the procedure, and it can be very helpful with diminishing local anesthesia discomfort. It also can help diminish severe gag reflexes so that dentistry may be completed. In addition, it can be very helpful due to the length of the procedure in children/teens, even if they are fully cooperative.

How is it given?

Your child will wear a nasal hood, which we call a piggy nose. The nitrous oxide will be administered with oxygen through this nasal hood, which will facilitate them breathing in the laughing gas. They will receive more oxygen than is readily present in room air throughout the procedure. Laughing gas has no odor. Your child will be able to pick out a scent such as fruit punch, cotton candy, or strawberry to apply to the nasal hood if they wish.

Can my child eat before?

The only rare side effect of laughing gas can be nausea and vomiting. We recommend a light meal/snack free from dairy (dry cereal, toast, crackers) and water only to drink 3 hours before the appointment. After that, no food or drink is ideal. We understand that due to a medical diagnosis such as diabetes, fasting for 3 hours may not be acceptable, so please talk to the dentist in special circumstances.

Can my child go back to school after having laughing gas?

Yes. Nitrous oxide is a non-absorbed gas that is quickly cleared from the system by the administration of oxygen at the end of procedure. To put it simply, no laughing gas will remain in your child's system at the conclusion of the procedure.

Post-operative instructions:

Nitrous oxide is a non-absorbed gas that is quickly cleared from the system by the administration of oxygen at the end of procedure. To put it simply, no laughing gas will remain in your child's system at the conclusion of the procedure.

Your child may be tired after the appointment. This is more likely linked with lying down during the procedure and following instructions for an extended period, and not related to nitrous oxide.

Your child may return to school and normal activity as tolerated, as there are no lingering side effects. Activity limitations will be set by the dental procedure performed, and not the administration of laughing gas. Patients of driving age are also fine to drive themselves home.

Your child's new fillings are fully hardened before they leave the office; however, it is wise to chew on the opposite side from the location of the newly placed filling(s) until the anesthetic has fully worn off.

Pain Management

If a filling was done between the teeth, gum sensitivity is expected for a 3 day duration or less. Continue to properly brush the area, as clean gums heal better. Some bleeding on the toothbrush can be expected.

You may give your child over the counter Motrin or Tylenol as indicated on the packaging for their weight or age if they are experiencing gum pain.

It is normal to experience some hot, cold and pressure sensitivity after your appointment. Hot or cold sensitivity may linger for a week after the placement of the fillings. Usually, these symptoms will subside over time. If they do not, please call our office (727) 577-4911.

Bite adjustment
Your child's bite may feel "off" or "big" initially after placement. We always check their bite prior to dismissal, but sometimes when your child is numb, they may not be biting in their typical position. Additionally, this could be due to sealant material placed over the restoration, which will grind away with normal eating in about 3 days. If their bite still feels off after 3 days, please call our office for a "bite adjustment" which is a simple procedure to correct the issue. This is very rare in baby teeth, but can occur in permanent teeth.

Your child's new fillings are NOT fully hardened before they leave the office. Please avoid very hard or crunchy foods or candies for 48 hours until the filling material is fully set. Suggested foods include soup, yogurt, macaroni & cheese, apple sauce, scrambled eggs, oatmeal, Jell-O, smoothies, ice cream, mashed potatoes.

Pain Management

If a filling was done between the teeth, gum sensitivity is expected for a 3 day duration or less. Continue to properly brush the area, as clean gums heal better. Some bleeding on the toothbrush can be expected.

You may give your child over the counter Motrin or Tylenol as indicated on the packaging for their weight or age if they are experiencing gum pain.

It is normal to experience some hot, cold and pressure sensitivity after your appointment. Hot or cold sensitivity may linger for a week after the placement of the fillings. Usually, these symptoms will subside over time. If they do not, please call our office.

Bite adjustment

Your child's bite may feel "off" or "big" initially after placement. We always check their bite prior to dismissal, but sometimes when your child is numb, they may not be biting in their typical position. Additionally, this could be due to sealant material placed over the restoration, which will grind away with normal eating in about 3 days. If their bite still feels off after 3 days, please call our office for a "bite adjustment" which is a simple procedure to correct the issue. This is very rare in baby teeth, but can occur in permanent teeth.

Crowns are commonly indicated with: hypoplastic enamel, extensive missing tooth structure, cavities between the teeth with high cavity risk, or following a baby root canal. Baby teeth crowns have a 95% success rate and typically do not require any future treatment. Crowns are started and completed the same day, they do not require multiple visits like they commonly do with adult teeth crowns.

Diet

Your child may experience tenderness or discomfort for the first 3 days after their procedure.

To keep your child comfortable, soft, easy to chew foods are recommended. Examples include: yogurt, oatmeal, smooth soups, mashed potatoes, refried beans, ice cream, pudding, fruit smoothies/protein shakes, macaroni and cheese, cooked noodles, soft-boiled /scrambled/ poached eggs, and soft sandwiches.

Avoid tough or crunchy foods, such as pizza, rice, popcorn, and hamburger.

Avoid spicy and acidic foods. Most patients may resume their normal diet within a day or two.

Pain Management

Crowns fit below the gumline, so gum discomfort is expected for 2-3 days.

Motrin is great for controlling pain and inflammation, so please give your child Motrin before the numbness wears off. Motrin may be indicated for 24- 48 hours to keep your child comfortable. If pain persist longer than 2 days, please call us. If your child cannot take Motrin, please give them Tylenol.

Post operative instructions

A clean mouth heals faster. 24 hours after the crown is placed, begin brushing and flossing, but remember to be very gentle in the area of the crown. Bleeding when brushing and flossing is expected, but continue to brush the area, and do not avoid it while brushing. Plaque buildup along the crown can slow healing and make bleeding persist, which creates a perpetual cycle.

Your child’s bite may feel different to them. They may appear to shift their jaw or bite differently than before. This is normal. They will adapt within a few weeks, at most.

Your child may also complain that the crown feels “tight.” This is normal too, as pressure on the adjacent teeth can occur after crown placement. They will adapt to this feeling within a few days.

On rare occasion, crowns can be pulled off. Avoid sticky and hard candies such as taffies and gummies.

When a cavity is to the nerve, a root treatment is indicated. This can also be indicated following a traumatic accident. A pulpotomy, or a baby root canal, is a quick procedure that removes the top portion of the nerve that is inflamed. Then, a medication to reduce the bacteria is applied, and the tooth is built back up with various dental materials and covered with a crown. In some instances, a filling may be placed after a pulpotomy if the tooth has a life span of <2 years or if it is a front permanent tooth.

Using the best materials available, the success rate at 2 years is ~90%. If a pulpotomy unfortunately fails, an extraction will be recommended. There may be initial discomfort from the crown or filling, but once this has subsided, pain is a potential indicator for pulpotomy failure. Also of concern is abscess, and this would look like a “pimple” or localized inflammation adjacent to the tooth. If pain or an abscess occurs, please call our office to be seen.

Post treatment

There are no special care options for a pulpotomy, please refer to the stainless steel crown or filling sections for care instructions.

We will take annual radiographs to ensure the health of a tooth following a pulpotomy. If a pulpotomy is unsuccessful, an extraction is indicated.

Prevention is always better than treatment! Sealants are very useful in preventing tooth decay and stopping initial tooth decay progression.

What are Sealants?

Sealants are a plastic resin that is flowed into and bonded to the natural grooves that occur on the chewing surfaces of the back primary and permanent teeth. Sealing the grooves of a back tooth is a procedure to prevent dental decay from occurring in the pits and fissures (deep grooves) in the chewing surfaces. 90% of cavities occur in the areas protected by the sealant, so it is important for the sealants to be placed and retained. However, sealants do not protect the smooth surfaces of teeth including the surfaces between teeth, so flossing is still a must!

What are the benefits?

Sealants have been clinically shown to reduce the need for a tooth filling by 72%, and have a success rate as high as 80-90% when properly maintained. Your child's sealants will be evaluated at each cleaning visit to make sure that they are intact and in no need of repair.

Are there any guarantees?

As a service to our patients, as long as our patients come back for their 6-month preventive re-care visits on a consistent basis, we will repair any of the sealants we placed on their teeth at no fee if it has been 2 years or less since placement. Outside of that time period, we will let you know if a new sealant is recommended for an additional fee.

Post-op instructions

In order to give your child's sealant the longest possible lifespan, please have your child avoid the following foods: ice or ice cubes, hard candies, taffy, caramels, and jawbreakers.

Prior to the appointment

We find that it’s always best to refrain from using words around your child that might cause unnecessary fear, like “needle,” “shot,” “pull,” or “hurt.” We make a point to use words that convey the same message but are pleasant and not frightening to children. We will describe the procedure as a “push” or a “tight hug” on the tooth.

Pain management

Your child may experience some discomfort following the extraction. Pain levels vary from child to child and from tooth to tooth, but overall, children do very well following an extraction. Discomfort is managed with over-the-counter Motrin/ibuprofen, there no need for prescription medications in the pediatric population. Follow the instructions on the packaging for the appropriate dose based off the age/weight of your child. If Motrin is not adequately managing the pain, alternate with Tylenol and again follow the instructions on the packaging for the appropriate dose based off the age/weight of your child.

Bleeding

Have your child keep the gauze "band-aid" in place in place for the next 10-15 minutes by biting with firm pressure. If there is still bleeding when the gauze is taken out, moistened an additional piece of gauze with water, and put it in for another 15 minutes. Repeat until bleeding has stopped or slowed to a slight ooze.

It is normal for some minor bleeding to continue for the first few hours. If your child continues to bleed heavily after 4-6 hours, please call the office immediately. Remember that blood mixes with saliva in the mouth and the volume appears to be more than it is.

Have your child avoid anything that will remove the newly formed clot from the extraction site for 2-3 days . Avoid sucking on a straw, spitting, blowing your nose or anything else that will push or pull the clot out of the socket.

Diet

For 2 days after the wiggle, we recommend your child drink liquids and eat soft foods only such as milkshakes, yogurt, oatmeal, cottage cheese, smooth soups, mashed potatoes, refried beans, ice cream, pudding, fruit smoothies, macaroni and cheese, eggs, and protein shakes.

On day 3 after extraction, they may gradually start incorporating soft foods that do not require much chewing, such as macaroni and cheese, cooked noodles, soft-boiled /scrambled/ poached eggs and soft sandwiches. Avoid tough or crunchy foods, such as pizza, rice, popcorn, and hamburger initially. Avoid spicy and acidic foods. Increase the hardness of foods as tolerated by your child. Most patients may resume their normal diet 3-4 days after.

Post-op instructions

If the extraction was a surgical extraction or extraction of a permanent tooth, use ice compressions on for 10 minutes, off for 20 as needed. Do not use heat compressions. Heat can increase swelling and cause unnecessary discomfort.

DO use spoons for soft foods and liquids.

DO NOT suck through a straw, or swish vigorously with mouthwash/water.

Although we do recommend not brushing the extraction site for 1-2 days, we suggest continuing to brush and floss all of their other teeth as your child normally would. If brushing hurts, they may be getting too close to the extraction site.

Mouthwash should be avoided for the first 2 days after, and can be resumed after day 3.

Gel foam, which helps with healing is sometimes placed, typically in permanent tooth extraction sites. This may look white when you look in your child’s mouth. The gel foam can come out, which can be scary, but rest assured that it does its job within the first few hours, and this is okay!

Depending on how much baby tooth root structure was remaining, or if it was a permanent tooth, the dentist may suggest limited physical activity for 24 hours.

If your child will tolerate warm saltwater rinses, this can also help speed up healing. Mix ¼ teaspoon of salt with 1 cup of warm water. Have your child rinse and gently (not forcefully) spit. Do this after meals if possible, to keep the area clean.

For the next 48 hours (2 days), avoid:

All tobacco products- you should not be using these anyway! If you are, please ask me for help with quitting!

Blueberries, raspberries, strawberries

Colored lipstick or lipgloss

Mustard, ketchup, soy sauce, salsa, red sauces such as hot sauce or BBQ sauce

Soft drinks, coffee, tea, cranberry juice, grape juice, (wine if you are 21+years old) or any dark colored beverage

Colored toothpaste, gels or mouthwashes for the first 48 hours (2 days). A plain white toothpaste such as Colgate Total Clean Mint Paste can be used to brush the teeth.

Your teeth may appear spotty, but this may even out as your teeth get rehydrated.

Your teeth may feel sensitive after this procedure. This is normal after treatment and should resolve within 3-7 days. If sensitivity is extreme, please take Tylenol or Motrin. Avoid very hot and cold drinks and beverages initially, and drink/eat more room-temperature foods and beverages until you feel that you can tolerate more extreme temperatures. Sensodyne toothpaste can help control sensitivity, and you can use this in place of your regular toothpaste.

White fillings in the front teeth can be difficult to maintain. They frequently de-bond (fall out) or fracture because the front teeth are heavily functioned on. We would like to provide you with instructions that can increase the longevity of these restorations.

White fillings can cause sensitivity after placement, and this is normal. But, if the sensitivity persists after 1 week, please let us know.

These fillings take time to complete and are created with layers of varying colors and translucencies. We may schedule at a specific time of day, so that we have enough time to complete this type of filling.

These fillings are guaranteed for a period of 1 year. If the filling is lost or broken after this point, we will determine the cost to replace it, based off the size and remaining filling material.

Post-op instructions

Avoid biting into foods with the front teeth. DO NOT bite into hard foods such as apples, carrots, nuts, etc.

DO NOT use your teeth to open bottles or can tops.

DO cut up hard foods and place in the back of the mouth, and chew with your molars.

DO wear a mouthguard when engaging in sports or recreational activities.

Instructions

If you have the time, switch to a sensitivity toothpaste such as Sensodyne 2 weeks prior to starting whitening.

Brush and floss your teeth before each use.

Place the tray in your mouth, if the tray seems too large when you place it, spend time adapting it closer to your teeth and away from your gums by pinching the sides.

Wipe any excess gel away from gums with a Kleenex or dry cloth. (If excess gel stays on the tissue, it may temporarily become white in color. Tissue will return to its normal color within 24 hours. If the tissue has a burning sensation, Vitamin E Oil can be placed on the area to sooth the tissue.)

The first time you use your whitening trays, leave in for 30 minutes. If your teeth are not sensitive after the initial 30-minute application, you can increase the duration of wear in 15-minute increments up to a maximum of one hour.

After each session remove trays, rinse mouth with water and discard trays.

Do 5 trays as quickly as you can tolerate for maximum initial results.

Use the remaining 5 trays to "touch up". Use these before pictures, prom, etc.

Your teeth may appear spotty after you use the tray due to dehydration of the enamel, but this will even out as your teeth get rehydrated.

If your tooth has a white or a hypoplastic spot prior to whitening, whitening could cause this area to brighten even more.

While whitening

While wearing whitening trays, do not eat or drink.

We recommend whitening before bedtime to allow your teeth to be free of food/drinks that could re-stain or otherwise affect your results.

Do not use trays past expiration dates.

Store extra trays in a safe location, out of reach from children and pets. The refrigerator is a great place to store trays to maintain optimal effectiveness.

If you have an upcoming dental appointment where fillings will be completed, stop whitening 14 days prior to this procedure date. Whitening can decrease the strength of the restoration if not stopped 2 weeks prior.

Ouch! Post-operative pain

It is normal to experience zingers, and cold sensitivity throughout your whitening treatment. If sensitivity persists, you can try the following:

Do not use whitening toothpaste while using whitening trays.

A sensitivity toothpaste such as Sensodyne is recommended or a basic toothpaste or gel without whitening.

Lower the frequency of your whitening to every other day, every couple of days or weekly. Only do what you can tolerate, as everyone has different levels of sensitivity.

Shorten whitening duration per session.