• Post Oral Surgery/Extractions
• Sinus Precautions
• Implants and Bone Grafts
• Apicoectomy
• Soft Diet Instructions

Important Patient Information Before Oral Surgery

1. Patients receiving anesthesia in addition to local anesthesia should not EAT OR DRINK anything (except medications) for EIGHT hours prior to appointment.
   
   
2. A responsible adult who WILL STAY THROUGHOUT THE APPOINTMENT AND CAN DRIVE HOME must accompany patients receiving anesthesia in addition to local anesthesia.
   
   
3. Take all your regular medications with minimal amount of water unless you are instructed to do otherwise by a doctor of this office.
   
   
4. Patients receiving anesthesia in addition to local anesthesia cannot drive, operate hazardous machinery or make important decisions for 24 hours.
   
   
5. On the day of surgery, wear loose-fitting comfortable clothing with short sleeves or sleeves that roll up easily.
   
   
6. On the day of surgery, please do not wear contact lenses, or please remove them prior to surgery.
   
   
7. If for some reason you are unable to keep your surgery appointment, you must call this office 24 hours in advance. FAILURE TO CANCEL YOUR APPOINTMENT 24 HOURS IN ADVANCE WILL CAUSE YOU TO INCURE A MISSED APPOINTMENT CHARGE.

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Female Patients

Female patients who are sexually active and taking antibiotics should use a barrier method of birth control during the course of the antibiotic therapy (condoms or diaphragm with spermicide). This should be continued until the beginning of your next menstrual cycle. Birth control pills may not provide the same level of protection during this period.

Please consult the doctor or nurse if you have any questions concerning this matter.

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Post Oral Surgery Instructions

Frequently, the after affects of oral surgery are minimal so that not all of these instructions may apply. Common sense will often dictate what you should do; however when in doubt, follow these guidelines or call our office at any time for clarification.

The First Hour After Surgery

Bite down firmly but gently on the gauze packs that have been placed over the surgical areas, making sure that they remain in place undisturbed. DO NOT CHANGE THEM THE FIRST HOUR UNLESS THE BLEEDING IS NOT BEING CONTROLLED.

Steady Bleeding

Bleeding should never be severe; if it is, it usually means that the packs are being clenched between your teeth rather than pressing on the surgical area. Try repositioning fresh pads so that pressure is directly on the surgical area, and your remaining teeth are kept slightly apart by the pad. Sometimes a damp tea bag will fit better.

IF YOU EXPERIENCE CONTINUED BLEEDING WHILE BITING ON THE GAUZE, IT MEANS THE GAUZE IS IN THE WRONG POSITION AND NOT PRESSING ON THE BLEEDING SITE.

1. REMOVE GAUZE.
2. RINSE YOUR MOUTH GENTLY TO REMOVE ANY CLOTS OR EXCESS BLOOD.
3. REPOSITION A GAUZE OR TEA BAG SO THAT PRESSURE IS APPLIED TO THE BLEEDING SITE.
4. BITE ON THE GAUZE FOR 30 MINUTES TO 1 HOUR.

IF THE BLEEDING STOPS WHILE BITING ON THE GAUZE (30 MINUTES TO 1 HOUR) BUT BEGINS AGAIN AFTER REMOVING THE GAUZE, AND THIS HAPPENS MORE THAN ONCE, PLEASE CALL THE OFFICE.

Oozing

Intermittent oozing is normal. It may be controlled by placing a gauze pad over the surgical area and applying gentle, but firm pressure for 30 to 60 minutes.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. You should have the most discomfort after the anesthetics wear off. You should take the first dose of pain medicine before you start to feel the beginning of discomfort. This will help you to manage the discomfort better. Try not to take the pain medicine on an empty stomach. Bland foods like yogurt, cool soups, etc., will help settle your stomach.

Swelling

Swelling from oral surgery is normal and reaches its MAXIMUM IN 48 HOURS. Keeping the head elevated with two pillows when lying down can minimize facial swelling. Swelling can also be minimized by applying cold compresses to your face (20 minutes on, 30 minutes off) for the first 48 hours. After 48 hours, warm compresses will help reduce the swelling. These should be continued (30 minutes on, 30 minutes off) until the swelling has subsided.

Rinsing

Avoid rinsing the mouth for 24 hours after surgery. It may disturb the clot. The following day, dilute 3 OUNCES OF PEROXIDE IN 6 OUNCES OF WARM (NOT HOT) WATER (a small amount of mouthwash should be added to improve the flavor) and rinse GENTLY three or four times a day.

Brushing

Do not brush your teeth the day of surgery. Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling will prevent you from brushing the areas of surgery, but gently brush those areas you are comfortable with.

Diet

A nutritionally balanced diet is very important. During the first 24 hours, eat soups and soft foods that are easily chewed and swallowed. Meats, vegetables and fresh fruit can be liquefied in a blender. Gradually progress to solid food. Do not skip meals. If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. Take any proscribed food supplement as directed. If you are a diabetic, maintain your normal diet and take medication as usual.

Nausea

Take one ounce of a carbonated drink such as ginger ale or cola every hour for five or six hours. Then drink mild tea, clear broth and eat soft foods like yogurt or ice milk before resuming your regular diet.

Discoloration of the Skin or Bruising

Sometimes surgery will produce bruising. This may not appear for 24 to 48 hours. Heat applications to the involved area (30 minutes on, 30 minutes off) will hasten a return to normal.

Smoking and Alcohol

Tobacco and alcohol should be eliminated during the first two weeks after surgery.

Stiff Jaw

Chew gum at intervals, especially while applying wet heat on the jaw. This helps relax the tension of the muscles and reduce swelling. The stiffness will abate as the swelling is reduced.

Sharp and Bony Edges

If you feel anything hard when you place your tongue on the surgical site, you may think it is part of your tooth. This is the hard, bony wall that originally supported the tooth. Leave it alone and it will heal nicely.

IN CASE OF EXTREME PAIN, UNCONTROLLABLE BLEEDING, OR ANY UNUSUAL DISTURBANCES, TELEPHONE THIS OFFICE IMMEDIATELY AT (732) 247-8083.

Our interest in your care does not cease with the completion of the operation. If any difficulty arises at any time, please telephone or return for treatment

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Root Canal - Apicoectomy - Incision and Drainage

Ice

Apply to surgical area for the first 48 hours to decrease swelling and keep area numb to decrease pain.

Swelling

Swelling and discoloration of skin are not uncommon and usually begin to subside after 48 hours.

Rinses

Use warm salt water - Dilute one teaspoon of salt in eight ounces of very warm water. Start today after meals, before bedtime and when you water up.

Food

No spicy foods and keep the temperature cool.

Pain

May be experienced after anesthesia wears off. Should this occur, take the prescribed medications as directed.

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Sinus Postoperative Instructions

To be followed for the first 24 hours.

1. Keep head elevated.
   
   
2. Do not blow nose.
   
   
3. If you sneeze, do not cover mouth - leave mouth uncovered and open.
   
   
4. Expect slight nose bleeds.
   
   
5. Call the office immediately for heavy bleeding.
   
   
6. Do not do anything that requires a sucking-in or blowing -out motion (such as smoking, sucking on straws or blowing up balloons).

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Postoperative Instructions - Implants and Bone Grafts

Science has made great improvements during the past decade in Dental Implantology. The implants that we use today are stronger and more successful than ever before. We have the greatest confidence in them. Despite these tremendous improvements in dental implants and surgical techniques, the ultimate success of your implants depends on your active cooperation and participation in treatment and post-operative care. We have developed set of guidelines to ensure the best possible results. The first two weeks after surgery are the most important. Healing of the bone around the implants takes three to six months.

Diet

A bland, mild temperature, nutritionally balanced, liquid diet should be consumed during the first week to avoid food particles from entering your wounds and causing an infection. Semi-liquid or blenderized food may be eaten the second week. Progression to a soft to regular diet may be done only after it is discussed with our doctor and after your denture has been relined.

Swelling

Swelling from oral surgery is normal and reaches its MAXIMUM IN 48 HOURS. Keeping the head elevated with two pillows when lying down can minimize facial swelling. Swelling can also be minimized by applying cold compresses to your face (20 minutes on, 30 minutes off) for the first 48 hours. After 48 hours, warm compresses will help to reduce the swelling. These should be continued (30 minutes on, 30 minutes off) until the swelling has subsided.

Steady Bleeding

Bleeding should never be severe; if it is, it usually means that the packs are being clenched between your teeth rather than pressing on the surgical area. Try repositioning fresh pas so that pressure is directly on the surgical area, and your remaining teeth are kept apart slightly by the pad.

IF YOU EXPERIENCE CONTINUED BLEEDING WHILE BITING ON THE GAUZE, IT MEANS THE GAUZE IS IN THE WRONG POSITION AND NOT PRESSING ON THE BLEEDING SITE.

1. REMOVE GAUZE
2. RINSE YOUR MOUTH GENTLY TO REMOVE ANY CLOTS OR EXCESS BLOOD.
3. REPOSITION THE GAUZE SO THAT PRESSURE IS APPLIED TO THE BLEEDING SITE.
4. BITE ON THE GAUZE FOR 30 MINUTES TO 1 HOUR.

IF THE BLEEDING STOPS WHILE BITING ON THE GAUZE (30 MINUTES TO 1 HOUR) BUT BEGINS AGAIN AFTER REMOVING THE GAUZE, AND THIS HAPPENS MORE THAN ONCE, PLEASE CALL THE OFFICE.

Rinsing

Avoid rinsing the mouth for 24 hours after surgery. It may disturb the clot. We suggest a rinse of 1 TEASPOON OF SALT IN AN 8-OZ GLASS OF WARM (NOT HOT) WATER OF 3 OZ. OF PEROXIDE (3%) DILUTED WITH 6 OZ. OF WARM (NOT HOT) WATER. A small amount of mouthwash should be added to improve the flavor. Rinse after each meal beginning 24 hours after surgery. A special prescription mouthwash may be given to you. Follow the instructions on the bottle. Use this rinse twice daily until you are instructed to stop.

Discoloration of the Skin or Bruising

Sometimes surgery will produce bruising. This may not appear for 24 to 48 hours. Heat applications to the involved area (30 minutes on, 30 minutes off) will hasten a return to normal.

Dentures

Follow the directions as indicated by your doctor below:

• Leave dentures out of your mouth until you are instructed to wear it. (It must be realigned prior to wearing it).
• Leave your dentures in place for 48 hours then remove them. Wear them only as instructed by your doctor.
• Leave your bridge in place.
• If any sores or swelling develop around or under your denture, leave them our of your mouth and call the office.
• If you cannot place your dentures back in your mouth, leave them out and call the office.

Cleaning

If an implant protrudes through the gums, the metal must be kept clean. Use a cotton-tipped applicator with peroxide and water for the first 3 weeks and a soft bristly toothbrush after every meal.

Smoking and Alcohol

Tobacco and alcohol should be eliminated during the first two weeks after surgery.

Infection

Although antibiotics may be prescribed to prevent an infection, a wound infection may occur a day or several days after surgery. You may be suspicious of an infection if there is a sudden increase in swelling, throbbing pain, or a foul tasting drainage from the wound. If you suspect infection, call the office as soon as possible.

Summary

Your recent investment in your dental implants reflects your commitment to improving your health, jaw function and appearance. We are equally committed to helping you preserve your investment by assisting you in any way we can as well as monitoring the condition of your implants on a regular basis. If you are ever in doubt about any instructions we have given you or you are concerned about the healing of condition or your implants, please contact our office and schedule an appointment for a thorough evaluation as soon as possible to ensure the best results.

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Soft Diet Instructions

Follow for the first 24 hours after surgery

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Fractured Jaw Diet

A nutritious and energy producing diet is necessary for good healing and general health. There is a limit to the amount of fluid or semi-fluid that can be ingested comfortably at any meal. Therefore, to maintain a sufficient intake of protein and calories, it is necessary to feed at frequent intervals. For the first few days, you will only be able to manage fluids through a straw. With practice, you will be able to force semisolid foods through the spaces between and around your teeth.

After each meal, rise your mouth thoroughly with warm water and a (Scope, Listerine, Lavoris, Colgate, Chloraseptic, Micrin) mouthwash. Use a soft child-size toothbrush (Oral B20, Oral B Sulcus, Pycopay) or a water pic to remove debris from the wires and teeth.

A liquid diet does not always meet all the essential requirements, so it will be necessary to supplement each meal with one serving of any one of the following Sustagen, Meritene, Nutrament, Ovaltine or Carnation Instant Breakfast. Occasionally, the doctor will prescribe a liquid vitamin supplement. This should be taken as directed. Alcoholic beverages which may cause vomiting should be avoided. An electric blender will facilitate preparation of the semisolid food.

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