Post-Op

Pre-Surgery Instructions

1: MULTIPLE EXTRACTIONS, YOU  MUST TO:

  • Bring blood coagulation time lab test
  • To take antibiotic a day before your surgery and after
  • Eat well before the surgery
  • Avoid aspirins, heparin, waparin (or any anticoagulat medicines at least 5 days before your sugery)
  • Cancel your surgery o visit to the dentist if you are sick (if you have anormal low or high presure, or any infection (flue, amigdalitis, etc)

2. IMPLANT PLACEMENT, YOU MUST TO:

  • To take antibiotic a day before your surgery and after
  • Eat well before the surgery
  • Avoid aspirins, heparin, waparin (or any anticoagulat medicines at least 5 days before your sugery)
  • Cancel your surgery o visit to the dentist if you are sick (if you have anormal low or high presure, or any infection (flue, amigdalitis, etc)

3. SINUS LIFT, GINGIVECTOMY, CROWN  LENGHTENING, SINGLE EXTRACTIONS, AND OTHER MINOR SURGERY, YOU MUST TO:

  • To take antibiotic a day before your surgery and after
  • Eat well before the surgery
  • Avoid aspirins, heparin, waparin (or any anticoagulat medicines at least 5 days before your sugery)
  • Cancel your surgery o visit to the dentist if you are sick (if you have anormal low or high presure, or any infection (flue, amigdalitis, etc)
Diet

Discomfort and swelling of the affected side may occur for 24-48 hours. Tenderness when chewing may persist for up to a week.

  •  A small amount of bleeding for a few hours is not unusual and can be controlled by biting on a piece of gauze or a wet tea bag. A lot of saliva mixed with a little blood can look deceiving. Seepage may occur 3-4 days after the extraction. If you are concerned about the amount of bleeding, DO NOT hesitate to call.
  • Ibuprofen (ie. Advil. Motrin) 400-800 mg every 6 hours usually will provide sufficient pain relief. Be sure to take this medication with food. Additional medications will be prescribed if needed.
  • Antibiotics may be prescribed for infection. All of this medication should be taken as directed unless an allergic reaction develops. If there are signs of an allergic reaction
    (ie. Rash, itching, unusual swelling), stop taking the medication immediately and call us. If the reaction is severe (ie. difficulty breathing), go to the nearest Emergency Room.
  • NO ALCOHOLIC beverages should be consumed while taking these medications.
  • To keep swelling to a minimum, apply an ice pack to the affected side for 20 minutes on, 20 minutes off. Do this as often as possible for the first day and as needed on subsequent days. Avoid heat to the outside of the affected side.
  • Brush your teeth as usual but brush gently around the surgical site. You may use salt water rinses after 24 hours (dissolve 1 tsp salt in 1 cup warm water).
  • Do not smoke or drink through a straw for at least 24 hours; these can cause delayed healing and/ or dry a socket. When you do resume smoking, take small puffs rather than deep drags to keep from loosening the clot.

Until the site is not tender, eat a soft diet (ie. pasta, fish, potatoes). Be sure to drink plenty of water (8 glasses/day). Adequate nutrition aids in healing.

  • sleep works wonders for the body, so take it easy for the rest of the day. Go to bed earlier than usual with your head slightly elevated.
  • Upper back-teeth are close to your sinuses. If you have had these teeth extracted, you may have a slight opening between your mouth and sinus. As a precaution, you should blow your nose very gently. Do not stifle or suppress sneezes. Avoid excessive blowing or sucking pressure with either your nose or mouth. Keep cotton gauze in the extraction site for the first few days, changing it frequently
Soft Tissue Graft Surgery
ACTIVITY: After leaving our dental office today, we suggest you consider relaxing or at least limiting your activity as much as possible for the remainder of the day. Avoid strenuous activity and all aerobic exercise for the next 3 days as this might cause the graft to separate from the underlying tissue due to an elevation in your blood pressure.

DISCOMFORT: Some discomfort may be present when the anesthesia wears off. You have been given a prescription for an anti-inflammatory (NSAID) analgesic. Please take one tab per day for the first 3 days. This drug will greatly decrease the possibility of post-surgical swelling and pain and has been shown to accelerate healing. After the first 3 days, 1-2 Tylenol, or 1-2 Advil taken every 4-6 hours as needed, should keep you comfortable. Should intense discomfort occur at any time after the surgery, please telephone the doctor and he will phone in a prescription for you.

SWELLING: It is normal for some swelling to occur after surgery, particularly in the lower jaw. To minimize swelling after surgery, apply an ice bag wrapped in a light tea towel or handkerchief to the outside of your face over the operated area. This should be left on your face for about 20 minutes, then removed for 20 minutes, or alternated from side-to-side, between operated areas, for 2-3 hours after surgery. The use of both ice and the NSAID analgesic as described above will reduce the amount and duration of facial swelling.

BLEEDING: It is common to have slight bleeding for a few hours following soft tissue graft surgery. Try to avoid repeatedly spitting or rinsing your mouth during the first 3-4 hours after surgery as this will encourage bleeding. If bleeding persists, rinse your mouth or remove blood by wiping with a Kleenex tissue to identify the location of the bleeding site and then apply a tea bag to the area with firm but gentle pressure for 15-20 minutes. Let yourself rest for 15 minutes then repeat the application of the tea bag for a second time if you still have slight bleeding. If excessive bleeding continues, please call us. Remember, most of the blood you may see in your mouth is actually a little bit of blood mixed with a lot of saliva - blood is a very strong “dye” and a little bit of blood will color your saliva dramatically.

ORAL HYGIENE: Brushing and oral hygiene procedures should be done as usual in all untreated areas starting the night of surgery. In exposed, operated areas limit your oral hygiene to gentle brushing using a soft bristled toothbrush brush only the chewing surfaces of teeth. Avoid dental flossing in operated areas during the three weeks following surgery. No undiluted mouthwash, salt water or peroxide rinses should be used during the first week following surgery. Also avoid the use of water irrigation devices such as Water-piks or electric toothbrushes in the operated areas for 2-3 weeks following surgery. The exposed operated areas should be gently swabbed with a Q-tip (cotton tipped applicator) saturated with Peridex (Chlorhexidine) as a last oral hygiene procedure at bedtime and again in the morning, after eating and drinking.

EATING AND DRINKING: Do not try to eat until all anesthesia (numbness) has worn off. High protein foods and liquids are desirable for 3-5 days following surgery. Semi-solid foods may be eaten as long as this may be done comfortably. . Eggs, custard, yogurt, pasta, steamed vegetables, casseroles, cooked cereals are some things that you might consider eating during the first few days following your surgery. Avoid spicy, salty, acidic, very hot or very cold foods or liquids. Also, avoid hard foods: toast crust, nuts, chips or crunchy or fibrous foods such as raw carrots that may become caught between your teeth or traumatize exposed operated tissues. Please refrain from drinking alcoholic beverages the day of surgery. The following nutritional supplements have been found to aid in surgical healing. Taking the following dosages for at least 4-6 weeks following your surgery can enhance healing:
Multi-vitamins with minerals (1/day) Vitamin C (1000mg 1/day) Vitamin E (400 iu 1/day)
Implants post-op

Do not disturb the wound. Avoid rinsing, spitting or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.

Swelling

Swelling is a normal o\ccurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours.

Diet

Drink plenty of fluids. Avoid hot liquids, spicy, fat and hot food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain and Antibiotics

Be sure to take the prescribed pain medication and antibiotics as directed to help prevent infections.

Oral hygiene

Good oral hygiene is essential to good healing. After breakfast and before sleep. Be sure to rinse for at least 30 seconds then spit it out, and do not eat, drink or rinse in the next 30 minutes. You have to buy  a extra soft brush teeth, do not touch where the stitches are.

Activity

Keep physical activities to a minimum immediately following surgery, if you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise. Do not expose to high temperatures (oven, machines, iron, stove) etc.

Wearing your prosthesis

Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days. This was discussed in the pre-operative consultation.

Extractions post-op
Discomfort and swelling of the affected side may occur for 24-48 hours. Tenderness when chewing may persist for up to a week.
  • A small amount of bleeding for a few hours is not unusual and can be controlled by biting on a piece of gauze or a wet tea bag. A lot of saliva mixed with a little blood can look deceiving. Seepage may occur 3-4 days after the extraction. If you are concerned about the amount of bleeding, DO NOT hesitate to call.

  • Ibuprofen (ie. Advil. Motrin) 400-800 mg every 6 hours usually will provide sufficient pain relief. Be sure to take this medication with food. Additional medications will be prescribed if needed.

  • Antibiotics may be prescribed for infection. All of this medication should be taken as directed unless an allergic reaction develops. If there are signs of an allergic reaction
    (ie. Rash, itching, unusual swelling), stop taking the medication immediately and call us. If the reaction is severe (ie. difficulty breathing), go to the nearest Emergency Room.
  • NO ALCOHOLIC beverages should be consumed while taking these medications.
  • To keep swelling to a minimum, apply an ice pack to the affected side for 20 minutes on, 20 minutes off. Do this as often as possible for the first day and as needed on subsequent days. Avoid heat to the outside of the affected side.
  • Brush your teeth as usual but brush gently around the surgical site. You may use salt water rinses after 24 hours (dissolve 1 tsp salt in 1 cup warm water).
  • Do not smoke or drink through a straw for at least 24 hours; these can cause delayed healing and/ or dry a socket. When you do resume smoking, take small puffs rather than deep drags to keep from loosening the clot.

Until the site is not tender, eat a soft diet (ie. pasta, fish, potatoes). Be sure to drink plenty of water (8 glasses/day). Adequate nutrition aids in healing.

  • sleep works wonders for the body, so take it easy for the rest of the day. Go to bed earlier than usual with your head slightly elevated.

  • Upper back-teeth are close to your sinuses. If you have had these teeth extracted, you may have a slight opening between your mouth and sinus. As a precaution, you should blow your nose very gently. Do not stifle or suppress sneezes. Avoid excessive blowing or sucking pressure with either your nose or mouth. Keep cotton gauze in the extraction site for the first few days, changing it frequently

Sinus Lift

The following information applies when upper jaw bone height or width have been lost. The graft is placed to help restore your jawbone in preparation for possible implant replacement of the missing tooth or teeth.
You have had a Sinus Lift Augmentation procedure in your upper jaw. This procedure regains lost bone height in the area of your first and second molar and occasionally second premolar. It is an important procedure as it allows implant placement in an area that could not be implanted otherwise because of insufficient bone height due to an enlarged sinus.


The bone that has been grafted is most commonly a combination freeze-dried bone, artificial synthetic bone and your own bone. Because of this you may have two post-surgical wounds: the donor site and the recipient site.


DO NOT UNDER ANY CIRCUMSTANCES. BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS.

This may be longer if indicated. You may sniff all you like but NO BLOWING.
Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open. Do not drink with straws and do not spit. Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided. Decongestants such as Drixoral, Dimetapp, or Sudafed will help reduce pressure in the sinuses. You may also be given a prescription for antibiotics. Please take these as directed. Anything that causes pressure in your nasal cavity must be avoided. Avoid “bearing down”—as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. Smoking must be stopped. If necessary Dr. Hohl or Dr. Kelly can prescribe Nicoderm patches.


Antibiotics


Be sure to take the prescribed antibiotics as directed to help prevent infection


Oral Hygiene


Do not rinse or spit on the day of your surgery. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. You should not have a significant amount of blood in your mouth. Saliva can be swallowed, even if slightly blood tinged.

Keeping your mouth clean after surgery is essential to reduce the risk of infection. Start salt water rinses the day following your procedure. Use one-half teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least four to five times daily and always after eating for the next five days.

Do not brush the teeth in the area of surgery for 48 hours. When brushing, be very gentle. When expectorating, also be gentle.

We may prescribe an antibiotic rinse (Chlorhexadine, Periogard, Peridex) for certain procedures. This rinse should be used in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse. Using this rinse more than two times a day will cause staining of your teeth.


Smoking


Do not smoke for at least two weeks after surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of bone graft and sinus augmentation failure. Dr. Thomas Hohl or Dr. Patricia Kelly can prescribe a Nicoderm patch if you feel you need it.


Wearing your Prosthesis or Nightguards


Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary “flipper” to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or our office can see you.


Post-Operative Problems or Complications


As with any procedure, unexpected post-operative healing can occur. If you notice the unexpected flow of air or liquids between your mouth and nose, please let us know immediately.

If you are aware of several small particles of graft material being discharged from your nose, let us know as well.

If you experience sinus or nasal congestion on the side your surgery was performed, let us know.

If there is an increase in swelling in your mouth, cheek or under your eye after 3 days, let us know.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. Please try to call during office hours; however a 24-hour answering service is available for after hours contact with a doctor. The after hours telephone 520 980 5298

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