Pre-OP
Instructions
General Anesthesia and IV Sedation:
Examination and review
of medial history and medications at
an appointment prior to and separate
from the surgical appointment is
required.
Nothing to eat or drink 6 hours
prior to the anesthetic /
surgical appointment is required if
the patient desires to be deeply
sedated.
An Escort, a competent
adult, must bring the patient to the
appointment, and is expected to remain
at the office, available during the
surgery, and will sit with the patient
during recovery. The escort is
expected to drive the patient home
after treatment, and to remain with
the patient for at least 2 hours after
being home, or at least until patient
seems to be fully awake and alert.
No driving, operating machinery,
or important decision making and
signing of legal papers is to
be done in the first 24 hours after
general anesthesia or deep sedation.
IV sedative medications can alter
awareness and competency for up to 24
hours.
Oral
Medication Sedation:
Taking the medication @ 1 hour prior
to surgery will provide adequate time
for the medications to be absorbed and
effective. Again, as with
General Anesthesia, the patient
is not to drive after taking the
medication, and so this
includes driving to the appointment in
the case of medications taken at home.
Nitrous Oxide
and / or Local Anesthetic:
Neither laughing gas nor local
anesthetic require any pre-operative
preparation, nor post-op limitations.
Post-OP
Instructions
Control of Bleeding:
As the surgery was completed, you were
biting on gauze packs to provide
pressure over the socket or surgery
site. This diminishes the
bleeding and allows the clot to form
which may take 2 to 6 hours. Extra
gauze is provided so that the packs
may be changed as necessary. When
bleeding is controlled, the packs are
no longer required. If there is
persistent bleeding, make sure that
the gauze pack is placed over or
against the surgery site.
Biting on a moistened Tea Back (Tannic
Acid in the tea) can help to encourage
the clot to form. Smoking, drinking
through a straw or vigorous rinsing
can all contribute to delayed
clotting.
Control of Swelling: Ice
packs should be applied to the outside
of the face for a minimum of 3 – 4
hours. The ice packs sever two
purposes, they help the establishment
of the blood clot, and the help
minimize swelling.
Control of Pain: A
prescription for pain medications
(analgesics) should have been given at
the completion of your surgery. Do
not wait until the numbness has gone
away completely, as the pain
medication takes about 45 minutes
after being swallowed to be
effective. Do not drive a vehicle,
drink alcohol or operate machinery
while taking narcotic pain medication.
If pain worsens after 3-5 days, please
call the office. Often additional
treatment can make things feel better
more quickly.
Diet: During the first 24
hours, you should restrict your diet
to cooler soft foods and liquids. Do
Not Become Dehydrated. Even though
you are unable to chew you may drink
down as many liquids as you wish.
Protein is essential to the healing
process, and so Protein Drinks and
Diet Drinks (SlimFast) are good
initial sources of nutrition. As
chewing becomes more comfortable, you
should include such foods as eggs,
cheese, fish, chicken, and et.
Vitamin supplements are recommended
post-operatively: Vitamin C 2000 mg.
daily; Multivitamins (2 or 3 regular
“one a day” type or 1 Therapeutic
Multivitamin.
Oral Hygiene: During the
first 24 hours following surgery,
brush gently, avoiding the surgery
sites. After 48 hours, it is helpful
to use a weak salt solution to rinse
the mouth. The salt rinse may be made
by adding ½ teaspoon of salt to a
large glass of very warm water. The
saltwater rinses may be used until
there is noticeable improvement is
healing.
Swelling and Bruising:
Swelling may arise within a few hours
after surgery, or even up to @ 48
hours after surgery. It may
persist for a few days or up to one
week. Depending on the amount of
work done in the surgery sites.
Be sure to follow instructions
regarding the icepacks for the first
24 hours. After 48 hours, it is
helpful to place warm pads (heating
pad, warm wash cloth, hot water
bottle, etc) along the jaw line, in
the area of the swelling. There
is no cause for alarm if the face,
neck or cheek area has a purple-yellow
hue following extractions.
Bruising can arise several hour or
several days after the surgery.
It occurs because body fluids sent to
the surgery sites during the healing
process collect in the cheek tissues
and discolor the skin. In some
instances it may even appear beneath the eyes.
Exercise and Activity:
Exercise other than normal walking
should be avoided because the blood
pressure rises with exertion. The
increase in blood pressure may cause
increased bleeding and/ or throbbing
pain in the jaw. Also heavy lifting,
straining or bending over may cause
blood pressure changes in the head
with similar effect.
The effect of surgery will often cause
a person to feel tired, weak and
generally “down” for several days.
Plan to take it easy for at least 2
days after any significant amount of
surgery. Occasionally a week or more
is required before normal activities
can be resumed.
Fainting: Occasionally a
person who has been through a
stressful experience such as oral
surgery will have a tendency to faint
or pass out. There are several
factors which contribute to this.
a). Do don’t rise rapidly from a lying or sitting position.
Get up gently and allow the body
systems to accommodate.
b). Get plenty of fluids into you system. Dehydration is a
major reason for low blood volume and
thus fainting.
c). Eat or drink foods with calories in them. Low blood
sugar can cause feeling of illness and
/or fainting. The immediate
post-operative period is not the time
to attempt to diet.
d). Use narcotic / sedative medication carefully. Remember,
the sedative effects of medication are
added to the depressant effects of the
surgical experience.
Nausea: Some patients will
experience nausea after surgery. As
with fainting, several factors
contribute to the feeling of nausea or
other feelings of illness.
a). The emotional stress created by the surgical experience
may make a person feel ill, either
before, during or after treatment.
Calm reassurance by those people
around the patient is most helpful.
Rest and time will cause these feelings
to resolve.
b). Narcotic medications have a side effect of causing
nausea. If pain is not severe, try to
discontinue the narcotic and use
Acetaminophen (Tylenol, Datril),
Aspirin, or Ibuprofen (Motrin, Advil).
Changing to a different pain
prescription might be required.
c). Low blood sugar may make a person feel ill as stated
above. Sips of clear liquids
containing sugar (Popsicles, apple
juice, 7-up, and etc.) are helpful.
d). Treatment: Anti-nausea medications, e.g.
Dramamine, are available without
prescription. 1 or 2 tablets may
relieve the nausea, or prevent it if
taken 20 minutes before taking a pain
pill. If nausea persist or is severe
call the office. The Doctor or
assistant may be able to give
additional suggestions, or the Doctor
may prescribe other medication.
Post-OP Expectations and Instructions
after Dental Implant or Bone Graft
Most of the suggestions listed above
as general surgery post-up instructions apply
to the Dental Implants or Bone Graft.
Bleeding is expected, and
may last for a few hours. Pressure
with the gauze packs (as provided) or
with dentures, will help to control
bleeding and allow the protective clot
to form. Please call the office
regarding heavy bleeding or bleeding
after the fist day.
Dentures: Leave dentures in
place overnight (if present, and
inserted by your surgeon). If relined
after surgery, rinse with cold water
initially, and after the first few
days, dentures may be brushed with soap
or tooth paste. The use of
Stain-a-Way denture cleanser is
recommended if a soft reline has been
used. Avoid “fizzing” type cleansers,
as they will distort the denture
liner.
Soft foods are important
during the early healing phase.
Minimal chewing power in the area of
implant or graft is recommended for about 6
weeks. Bone Graft
granules and Titanium Implants can be
moved or may not heal as desired if
pressure is applied to the area in the
first weeks. It is common to see a
few granules of graft material (if
used) come through the incision site
in the days to weeks after surgery.
Swelling is expected with
the tissue injury due to surgery, and
is expected to increase for about 36
hours. Swelling will begin to resolve
in 2 to 5 days, but can last for up to
10 days.
Bruising of lips,
chin, face and eyelids are common.
Occasionally bruising will spread to
distant areas, usually with gravity,
down to the neck and chest. Bruising
usually lasts 7 to 14 days.
Cold: Cold packs and cool
foods during the first 36 hours may
help prevent the swelling and
bruising.
Heat: After 2 days, warm
moist packs and warm mouth rinses will
help to speed the removal of fluids
and blood from the injured tissues.
Warming the tissues also speeds the
healing reactions, makes the areas
feel better, and relieves stiffness.
Analgesics: Pain medications are usually
prescribed. Use them as instructed on
the bottle. Often, instead of taking
2 tablets every 4 hours, 1 tablet
every 2 hours will be more effective
with less risk of side effects.
Nausea is common with anesthetics
and pain relief medications.
Anti-nausea medications such as “sea
sick pills” (Dramamine, etc) may help
prevent or relieve the nausea.
Numbness is expected to last 3 to 8
hours. Prolonged numbness is
uncommon, but can occur. If numbness
persists into the day after surgery,
please notify your surgeon.
Follow-up Visits will be scheduled
for the next several weeks as
required, and long term follow-up is
routine after this type of Oral
Surgery. Please call the office if
you were not given a follow-up
appointment.
Pressure on the surgery site: It
is important to not apply pressure
over the implant or graft during the
first 6 weeks. Micro-movement of the
implant under the gum tissues can
cause failure of the bone to unite
with the implant as needed. Soft diet
and limited chewing as well as
frequent checks on the fit of the
dentures (if present) is important.
It is the desire of everyone in
this office to see that you surgical
experience goes as smoothly and to be
as pleasant as possible. If you have
any questions, please contact the
office.
