1. Your night-guard has been designed to protect your teeth, restorations, and TMJ (joint) from the damage that clenching and grinding can cause.

2. You should wear your guard every night while sleeping unless instructed otherwise by the dentist.

3. It is important to keep your night-guard clean. Upon removal use the denture brush provided by our office to brush out the soft plaque. If this plague hardens inside the night-guard it can change the internal fit of the guard. You may use mouthwash or toothpaste to aid in cleaning your night-guard. Effervescent tablets can be used 1-2 times in a month to help keep your guard bright. Keep in mind that the acrylic will still stain over time. Retainer Brite samples are given by our office but any effervescent cleaner bought over the counter will work fine.

4. Please keep your night-guard in the container provided, stored in your medicine cabinet when you are not wearing it. There are many reasons for this:

• It keeps your night-guard out of extreme heat and direct sunlight
• Left out, pets smell the saliva and may perceive it to be a chew toy.
• Night-guards are strong, but may break or get damaged if stepped or sat on.
• Never wrap your guard in tissue. They have been accidentally thrown away by doing this.

5. Whenever you come to our office, bring your night-guard. We will be happy to clean it for you in our ultrasonic cleaner.

6. Wearing your night-guard will take some getting used. Most patients see positive results in a short period of time. If you have any questions or concerns, please contact our office as soon as possible at (858) 454-2656.

You can download instructions for care and use here:

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The American Dental Association has changed its requirements regarding taking antibiotics prior to dental treatment! For many years the ADA has recommended certain individuals with existing conditions take antibiotics prior to dental treatment in an effort to prevent the serious infection known as endocarditis. It has since been discovered that some of these patients no longer need to pre-medicate. We invite all patients, especially those with joint replacements, heart mummurs, heart valve replacements or other heart-related issues, or a history of rheumatic fever to please click on the ADA link below and search infective endocarditis for a full description.

http://www.ADA.org/

Bleeding

Some bleeding is normal after any extraction. Bite on a gauze pad for 15 minutes. If bleeding has not subsided, use a fresh pad for an additional 15 minutes. Repeat if necessary.

Pain

Some discomfort may be experienced following oral surgical procedures. 1 or 2 Motrin or Tylenol will usually relieve the pain. Do not take aspirin. Repeat as necessary.

Mouthwash

Do not rinse mouth. Tomorrow use salt solution (1 teaspoon of salt dissolved in a glass of warm water) every 3 hours to cleanse the affected area.

Swelling

Some swelling may be noticed. Do not be alarmed by this normal reaction. Apply ice bag for a 10-minute interval. Remove for 10 minutes. Repeat until swelling is relieved.

Eating

Soft foods are desirable. Avoid very hot, cold, or spicy liquids. Avoid getting particles of food into empty space.

Remember to call promptly in case of severe pain, excessive bleeding, or any unusual development at (858) 454-2656.

1. Do not eat as long as your mouth is anesthetized (numb). It is okay to sip cool beverages during this time.
2. Take aspirin, acetaminophen (Tylenol) or IB Prophen (Advil) shortly after your appointment. The medication should be in your bloodstream while your mouth’s numbness is wearing off.
3. Rinse your mouth with warm salt water (1 teaspoon per ½ cup water). This can be done several times in the next few days.
4. Please be careful eating certain foods for the next few days. For example: popcorn, crusty bread, tortilla chips, and small seeds. Good choices are pasta, cottage cheese, eggs, and steamed vegetables.
5. Your teeth may be more sensitive to heat, cold, and pressure temporarily. This is normal and expected.
6. Do not smoke! Tobacco smoke is an irritant to healing.
7. Brush and floss gently the first day. The success of this procedure largely depends on your ability to keep plaque away from the teeth and gums.
8. Please call our office if you have any unusual bleeding, swelling, or discomfort at (858) 454-2656.

      You can download post-operative instructions here:

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Recipe
Add ½ teaspoon of unscented bleach (sodium hypochlorite) (since some individuals can be allergic to scented additives) to a full tank (1000 ml) of water in a water-pick system. If you are using a portable unit (model WP-360) you will only need 4 to 5 drops of bleach for each time you fill the water reservoir.

Instructions
Using low-pressure aim the water stream at the teeth at a 90-degree angle; not at the gum tissue. Repeat twice daily. The solution should be made fresh daily. Please call our office with any questions or concerns at (858) 454-2656.

You can download these instructions here:

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At Dougherty Dental we often recommend children under the age of 14, and some adult patients, have fluoride treatments at their regular cleaning visits. Fluoride is used for several purposes. Typically fluoride is used to fortify teeth enamel making them more resistant to caries (also known as “decay” or “cavities”). Fluoride is especially important for our younger patients, as this age group is most prone to caries. Many adults also benefit from fluoride if they personally are more susceptible to caries due to their genetic make-up or history of recurrent decay. Fluoride can also be used to aid patients with teeth sensitivity. If a patient experiences general teeth sensitivity from normal daily activities and not from an existing dental condition, or if a patient is planning to do an in-office whitening procedure, we often recommend prescription strength fluoridated toothpaste called “Fluoridex” or “Clinpro 5000“. Fluoride has been very successful in relieving many patients with mild to moderate sensitivity. If you feel you would benefit from a fluoride treatment or from the use of a more concentrated fluoridated toothpaste, speak with our hygienist or the dentist at your next appointment and we’d happy to discuss your options!

Please read all instructions prior to re-cementing your temporary restoration.

1. Clean out as much of the old cement from the inside of the temp and your tooth structure. Leaving some in place can affect the fit, therefore affecting your bite.

2. Use cotton provided to dry tooth structure and temporary. If these areas are wet, your temp will not stay in!

3. Mix even amounts of each side of the cement packet on the mixing pad provided. You will not need the entire contents of the packet. You can fold the edge over and use the remainder later if needed.

4. A butter knife or similar flat-ended tool works well to mix the cement. Work quickly so the cement does not begin to set.

5. Using one of the micro-brushes provided, line the inside of the temp with a small amount of the mixed cement. Remember to have both tooth structure and temp as dry as possible.

6. Place temp in place in your mouth and push down with your finger to make sure the temp is completely seated in place. The temp can only fit in one way. You may want to try it in prior to applying cement to make sure you are placing it correctly.

7. Use another micro-brush to wipe away as much of the excess cement as possible that expresses out onto the tooth structure and gum tissue.

8. Use a cotton roll to bite down on until cement sets, approximately 4 minutes.

9. Use floss to clean off the remaining temp cement. Remember to only pull the floss out the side. Do not pull up.

You can download these instructions here:

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At Dougherty Dental your comfort is a primary concern. Our office uses only the latest in dental technology and techniques available to ensure you are receiving the best, most comfortable care available. We cater to patients with dental anxiety and phobias and can discuss all options available for your specific needs.

When you come to your dental visit you have several parking options. There are 2- hour parking spots and residential parking on our street and the adjoining streets, which are available on a “first come first serve” basis. If for some reason you cannot find parking out on the street please feel free to park in the underground parking garage between Roppongi restaurant and Inn By the Sea on Fay Ave. We will be happy to validate your parking ticket.

While Dr. Dougherty does not have a contract with any dental insurance company; we have many patients who utilize their dental insurance with our office. Insurance companies consider our office an “out of network” provider and a list of your “out of network” plan benefits (if applicable) is usually available in your benefits booklet provided by your employer. If you don’t have a benefits booklet, many insurance companies have websites for your convenience or you can call the insurance company’s 800 number toll free! When you come to our office we collect at the time of the appointment, we send the claim on your behalf, and the insurance company reimburses you directly.

At Dougherty Dental we reserve your appointment exclusively for you. We make every effort to schedule appointments that work for your schedule within our business hours. We understand that your time is very valuable and are known for seeing our patients promptly at their appointed time. When patients come at their scheduled appointment time, this allows us to continue to run on time. When a patient is more than 10 minutes late to their scheduled appointment, out of respect for the next patient’s schedule, we may need to reschedule. If you know you are unable to keep a scheduled appointment, we ask that you notify as soon as possible. By doing so, this allows us the opportunity to offer your appointment time to another patient. We appreciate at least 48-hour notice. We understand sometimes the unexpected happens. If an appointment is cancelled less than 24 hours ahead of time or is missed completely, we will not charge the first time this occurs but a cancellation or missed appointment fee may apply thereafter.

At Dougherty Dental we believe in providing the highest standard of care for our patients and we abide by all American Dental Association guidelines. These guidelines include the stipulation of a cleaning must be diagnosed by a dentist. Making an appointment to see the dentist prior to your cleaning has several advantages. A new patient appointment includes an introduction to our office and staff, a thorough examination and review of your oral health, including any necessary x-rays, a careful evaluation of your dental status including periodontal charting of your gum tissue, a discussion of the most satisfactory treatment plan to meet your oral health goals, and a diagnosis of the type of cleaning you need. This allows you to move seamlessly from one professional in the office to another and ensures you are receiving the type of cleaning most suited for you.

Our hygienists are extensively trained and, like our dentists, they continue to educate themselves in their field by attending courses throughout the year. We offer several types of cleanings and the type of cleaning a patient needs is diagnosed by the dentist.

A “regular” cleaning is known as a “prophylaxis” in dental terms. The American Dental Associations describes a prophylaxis “as removal of plaque, calculus, and stains from the tooth structures. A “regular” cleaning is recommended for patients who do not have any bone loss, periodontal disease, or infection around their teeth. There should also be no bleeding, mobility of teeth, receeded areas where the gums have pulled away from the teeth, or gaps where the spaces around the roots of the teeth are exposed. In other words, the mouth should be healthy with no gum and bone problems.

“Root planning” removes bacteria and their toxins, tartar, and diseased deposits from the surfaces of tooth roots. Scraping or “scaling” is required the full length of the root surface down to where the root, gum, and bone meet. Root planning is typically one of the first steps in treating gum and bone disease (periodontal disease).

If you have periodontal disease you may require root planning to remove diseased deposits from the roots of your teeth. Other treatment, including surgery, may be required. After the disease process is under control, a “regular” cleaning is not appropriate anymore. Instead, you will require special on-going gum and bone care procedures, also known as “periodontal maintenance” to keep your mouth healthy.

Periodontal disease is very common, but does not always have distinct symptoms. It is an inflammation and infection of the supporting structures of the teeth (gums, bone, ligaments, root structure) that eventually result in the loss of teeth. You may notice that your gums bleed easily, that you have a bad taste in your mouth, that your gums appear red or swollen, or that your teeth appear longer or have shifted. Or you may not notice anything at all!

At Dougherty Dental we begin seeing patients at age 13. We feel children under the age of 13 are best seen in an office that specializes for that specific age group called pediatric dentists. Pediatric dental offices are childproof, have child friendly environments, and typically offer many child oriented amenities.

At Dougherty Dental we are very conservative when it comes to taking x-rays. We provide digital x-rays with significantly less radiation than conventional x-rays for the health and safety of our patients. X-rays are excellent at detecting oral issues that are impossible to see by the naked eye. If you are a new patient to our office and have current x-rays at another dental office those can be sent over to us. Either call and request your previous dental office send them to us or give us their information and we will call their office for you! To properly treat and care for our patients x-rays are needed on a routine basis. “Check up x-rays” also known as “bitewing x-rays” show just the back teeth, which are most prone to decay. These are considered current for 1 year. A “full mouth set of x-rays” are considered current between 3 to 5 years. Because of our conservative approach, our patients are not typically asked to take full mouth x-rays sooner than a 5 years.

Every diagnosis for treatment made in our office is done by our qualified dentists and is only made after careful examination of your teeth, x-rays if needed, and a review of your medical status. There are many conditions that we may not feel but that seriously affect the integrity and/or longevity of our teeth. Leaving a tooth untreated may cost you more time and money in the long run. We always have our patient’s best interest at heart and are revered for our ethical treatment of our patients. Your trust is important to us. We are careful to explain all the risks, benefits, and alternatives to our patients for all treatment diagnosed and encourage questions at any time. If your tooth does not hurt, consider yourself lucky! It our job to keep it that way!

At Dougherty Dental we have an excellent hygiene team. Their job is to help you maintain your healthy smile. Everyone’s mouth is susceptible to bacterial growth that causes the formation of plaque and calculus. “Plaque” is a soft, sticky substance that forms on teeth, regardless of what types of foods are eaten, which is composed of bacteria and bacterial by-products. “Calculus” is also known as “tartar” and is a hard, mineralized deposit, somewhat like cement, that is formed from the plaque in the mouth and the minerals in a person’s saliva. Brushing and flossing regularly on your part helps to maintain that bacterial level within safe limits, however the formation of plaque, calculus, and stains can only be removed by a trained dental hygienist with professional dental instruments, including an electric device called an “ultra-sonic” or “sonic scaler”, that scrape and vibrate away deposits from the teeth.

The old system of everyone having their teeth cleaned only twice a year has fallen out of favor. While some people may be able to maintain their dental health with semi-annual cleanings, many patients find that their mouths stay in better shape when they have their teeth cleaned more frequently. Many dentists and hygienist, including our office, are now setting up a patient’s cleaning schedule based on their individual needs. We encourage our patients to do what’s recommended for their personal situation.

Many people know that brushing and flossing our teeth twice a day help our teeth and our gums stay healthy. What some people don’t know is flossing our teeth regularly is now associated with preventing many systemic diseases and conditions known to shorten a person’s life span. If left unattended, the bacteria in our mouth multiples every 8 hours. Flossing away food debris and their associated bacteria assists in preventing not only tooth decay and bad breath but also periodontal disease which contributes to some cancers, heart disease, diabetes, low-birth weights associated with pre-term deliveries in pregnant woman, and respiratory disease. Do you want to add years to your life? Floss your teeth!

“Silver fillings” in dental terms are referred to as “amalgams”. There have been problems with amalgams over the years therefore they have fallen out of favor in the dental community. Amalgams are composed of a hard metal and it’s been discovered when they are placed against the hard surface of a tooth, this makes the tooth more likely to fracture. Once a fracture in the tooth occurs, the tooth is then more prone to decay and often results in the need for a more extensive procedure to repair the damage done. Amalgams have small traces of mercury in them so the removal of previously placed amalgams in our office is always done with great care and in adherence to all American Dental Association guidelines. “Composite fillings” or “white fillings” are made of an assortment of materials that makes them more flexible against the tooth. They are mercury-free and match the color of your natural tooth. These are the only fillings our office places as they provide the best results for our patients.

Most insurance companies recognize that amalgams are now considered an outdated procedure and pay for composite fillings. Occasionally an insurance company will opt to pay for composite fillings but at an amalgam rate. Please refer to your benefit booklet, ask your Human Resource department, or visit your insurance company’s website to see the benefit plan your employer has chosen for you.

“Occlusal guards”, commonly referred to as a “night-guard” are a clear appliance that sit on the biting (or “occlusal”) surface of the teeth. When a patient suffers from “bruxism” or “grinding” and/or if they clench their teeth, an occlusal guard is often recommended to protect their teeth enamel and extend tooth longevity. Often patients don’t know they brux or clench their teeth because they may do so at night when they are asleep and are not aware. A dentist can detect if a patient suffers from bruxism or clenching by the grooves and wear facets in their teeth surfaces. Much like a retainer, occlusal guards are custom fit to you personally to sit comfortably on your teeth. Since it is often recommended that they be worn at night while you sleep, this is where they get the nickname “nightguard”. Once a patient is accustomed to wearing one, most patients state they hardly notice it’s there and when worn consistently, they are very successful at preserving teeth enamel.

Yes! Tooth whitening is a well-established procedure in cosmetic dentistry. Research and clinical studies indicate that whitening teeth under the supervision of a dentist is a safe and effective way to improve your smile. There are several options to whiten your teeth. The fastest whitening procedure available on the market today is called Zoom! Dougherty Dental assistants have been trained in the Zoom whitening procedure and offer it year round. Zoom! in-office tooth whitening is a procedure designed to lighten the color of teeth using a combination of hydrogen peroxide gel and a specially designed ultraviolet lamp. The Zoom! treatment involves using the gel and lamp in conjuncture to produce maximum whitening results in the shortest possible time. The Zoom! procedure at Dougherty Dental takes 2 hours and includes all isolation of your gums and soft tissues and touch up trays to be used anytime at home. Many patients have undergone this procedure and have seen stunning results! If in-office whitening is not for you, a home bleaching kit may be another option. Special impressions are taken of your teeth, which are used to make thin custom trays designed specifically to fit you. Whenever convenient for you and in the privacy of your home, you dispense whitening gel into your custom trays and place the trays on your teeth. Wear for the specified amount of time while the whitening gel disperses over the entire facial surface of your teeth, brush and floss your teeth, then enjoy your whiter smile. Whitening your teeth is one of simplest and most effective ways to enhance your appearance. So go ahead and smile with confidence!

Yes! If you snore, you are not alone. It is estimated that more than 80 million people in North America snore, that is one in three people! Snoring and sleep apnea is more than just an annoyance for loved ones, it’s also a serious health risk. Sleep apnea can cause strokes, heart attacks, chronic sleepiness, heartburn, morning headaches, depression, impotence, and high blood pressure. During sleep, the muscles and soft tissues in the throat and mouth relax making the breathing airway smaller. This decrease in the airway space increases the velocity of air flowing through the airway. As a result the soft palate and uvula vibrate causing snoring. Sleep apnea is when this airway restriction is so severe the airway seals. Because this person isn’t receiving enough oxygen the brain will trigger the snoring person to unconsciously close their mouth returning the tongue and throat to a normal position. Next the person will continue this cycle of falling asleep, jaw relaxing, airway collapsing, unconsciously awakening with a gasp, and falling back asleep. This cycle can repeat itself 50 or more time per hour during the night! Treatment for snoring and sleep apnea over the years has been limited to soft tissue surgeries with only a moderate (20%-40%) success rate and the use of a large and somewhat uncomfortable machine to sustain the airway. New advances have introduced a more comfortable, less invasive, and less expensive solution; snore & sleep apnea guards. These guards are customized trays, similar to a nightguard, which fit over the biting surface of your teeth. What makes them unique is they have a special connector bar, which gently pulls the lower jaw forward increasing the space available for airflow. If you feel you, or a loved one, would benefit from a snore or sleep apnea appliance; let us know! We offer sleep apnea tests, snore, and sleep apnea guards and are happy to discuss your options. At Dougherty Dental, we believe everyone deserves a good nights sleep!