PREOPERATIVE INSTRUCTIONS
ARRIVAL
- Please arrive 15 minutes prior to your scheduled procedure time.
- This allows time for check-in and final preparations before surgery.
FASTING REQUIREMENTS
- Do NOT eat or drink anything (including water) for at least 6–8 hours prior to your surgery.
- Failure to follow fasting instructions may result in your surgery being canceled, delayed, or rescheduled.
MEDICATIONS
- You may take essential oral medications (for conditions such as high blood pressure or seizures) with a small sip of water the morning of surgery.
- If you are taking blood thinners (including baby aspirin), please stop 5 days before surgery unless otherwise instructed by your physician.
TRANSPORTATION
- If you are receiving general anesthesia, you must have a responsible driver accompany you.
- Your driver should remain on-site for the entire duration of your procedure.
WHAT TO WEAR
- Please wear loose-fitting, comfortable clothing and a short-sleeve shirt on the day of your surgery.
NAIL POLISH
- Remove all nail polish before your procedure.
- This allows the doctor to properly check your circulation during surgery.
FOR IMPLANT SURGERY PATIENTS
- Begin your prescribed antibiotics 2 days before surgery.
- Also take your dose the morning of surgery with a small sip of water.
POST OPERATIVE INSTRUCTIONS
IMPLANTS
DAY OF SURGERY
- Do not rinse on day of surgery, it may prolong your bleeding. Avoid rinsing, spitting, brushing, or using a straw for the first 24 hours as this keeps the blood clots from dislodging which prevents dry sockets. (Dry socket: a loss of a blood clot resulting in exposed bone within the socket which can be painful, usually presenting itself as a sudden increase in pain 3-4 days after surgery.) Call the office if you think you may have developed a dry socket.
- Remove gauze when eating & replace as needed.
- Numbness may last for up to 12 hours.
- Headaches are not uncommon after surgery (especially with general anesthesia). Possible causes include stress from surgery, dehydration, the effects of anesthetic drugs, pain medication, or caffeine withdrawal. Expect it to subside within a couple of days.
- Sore throat is also not uncommon. A suction tip is often used to suction your throat free of irrigation, blood & secretions which may cause your throat to feel irritated. Expect this to subside within a couple of days.
STARTING THE NEXT DAY
- Starting the day after surgery, begin lukewarm salt water rinses (dissolve 1tsp salt in 8 oz of warm water). Rinse 3-4 times a day (after meals & before bedtime) for 2 weeks.
- Rinse with the prescribed antibacterial rinse beginning 24 hours after your surgery, twice a day, for 2 weeks. The prescription rinses should be continued thereafter, once-a-day, before bedtime. Warm saltwater rinses are also recommended after meals, starting the evening after surgery.
- Brush your teeth twice daily, being gentle initially around the surgical sites.
- If given an irrigating syringe, do NOT use the syringe until 1 week after surgery. Using the syringe too early may displace the blood clot & cause a dry socket.
- You may start to experience a slight earache, low grade fever, or flu-like symptoms on the day after surgery, as well as throughout the first week. All such symptoms are expected to resolve within 24-48 hours. Please call the office if these symptoms persist.
- After two weeks, while brushing your teeth, we encourage brushing directly on the metal stump (Healing Abutment) to keep the abutment clean. Be sure to use a manual toothbrush and NOT an electronic or ultrasonic toothbrush while doing so. Brush twice daily, being gentle initially around the surgical site.
BLEEDING
- You will go home with gauze packs in your mouth, but you will need to change them, once you get home, every 20-40 minutes until the bleeding subsides.
- Place the gauze packs directly over the surgical sites. Fold the gauze into a small square, place on top of the surgical site keeping constant pressure.
- If bleeding continues or is excessive, apply a moist tea bag (provided) over the surgical sites, place the gauze over the tea bag, & bite firmly for 45 minutes to 1 hour with constant pressure.
- When less than half of the gauze is saturated with blood, having the gauze in your mouth is no longer necessary. Slight oozing of blood is normal for up to 24 hours.
- Some oozing or pink saliva may occur over the next several days.
SWELLING
- Swelling is normal after surgery & can be a cause of post-surgical discomfort.
- Apply ice packs to your face for the first 48 hours to minimize swelling (20 minutes on, & 20 minutes off). Do NOT freeze the skin!
- After 48 hours, warm compresses (instead of ice) works best. You may use whichever feels best to you.
- Swelling, discomfort, & possibly bruising typically peak on the 3rd day after surgery & will gradually improve.
- Sleeping elevated or reclined is not necessary, but may help minimize the swelling.
- Jaw muscle stiffness may cause limited opening of your mouth. It is important to begin chewing food to exercise these muscles. If stiffness of your jaw muscles persists past 1 week, jaw-opening exercises are recommended by stretching your mouth open assisted by your fingers. Your mouth opening will gradually increase.
SUTURES (STITCHES) + BONE FRAGMENTS
- Sutures are dissolvable unless otherwise specified. Call to schedule removal if needed.
- During the healing process, you may feel sharp edges in the surgical areas with your tongue. It is likely the bony walls, which originally supported the teeth. Occasionally, small slivers of the bone will work themselves out during the first week or two after surgery. These are not pieces of teeth, & if necessary, we will remove them. Call the office if you are concerned about this.
DRIVING / EXERCISE / SMOKING / ALCOHOL
- You should not drive, operate heavy or dangerous equipment, or sign any legal documents for at least 24 hours following anesthesia.
- Narcotic pain medication can impair your judgement & reflexes. Extended use (for more than 3-5 days) of narcotics is discouraged to avoid dependence & gastric issues.
- Avoid vigorous physical activity for 1 week following surgery. Physical activity increases your blood pressure, which may cause an increase in your swelling, pain, & bleeding.
- It is very important that you avoid smoking for a minimum of 7 days. Smoking will increase your bleeding; the nicotine and tar in tobacco impair healing. In fact, avoiding smoking for the duration of healing will significantly increase the likelihood of a successful implant integration.
- No smoking for at least 1 week. Smoking will increase your bleeding, the nicotine & tar in tobacco impairs healing & may cause dry sockets & infections.
- No alcohol intake while you are recovering from anesthesia, or while taking prescription medications.
MEDICATIONS
- Recommended initial regimen: 2 Tylenols (OTC) + 1 Ibuprofen (Rx).
- This combination can be taken every 6 hours as needed for pain. Make sure you have eaten beforehand to prevent nausea.
- If your pain is not controlled by the above regimen, take your prescribed narcotic. It is safe to be taken together.
- If you develop hives or a rash from any of the mediations, discontinue them & call our office for further instructions.
- Antibiotics: Start the day after surgery (unless recommended otherwise) & finish the entire course until gone.
- If you feel nauseated, drink small portions of a carbonated drink such as 7UP® or ginger ale every hour for 3 – 4 hours. Prescription anti nausea medication can be prescribed for you as well. Avoid all milk & dairy products as long as nausea is present. If you are taking a narcotic, you may also half the dose or break the pill in half.
FOOD SUGGESTIONS:
To help with medication tolerance, we recommend that you eat right away after your surgery.
- DAY 1 (Non-Chew Foods)
- Start with clear liquids, such as broth, milkshakes/smoothies (no straw!), ice cream, yogurt, pudding, applesauce, Jell-O, soups (warm, not hot), mashed potatoes & gravy, oatmeal, cream of wheat, congee/rice porridge
- DAY 2-3 (Soft Foods)
- Pasta, mac & cheese, rice, scrambled eggs, soft/flaky fish, meatloaf, cottage cheese, bananas, avocados
- DAY 4 (Regular Food as tolerated)
Do NOT chew on the implant site for 4 weeks. After 4 weeks, you may chew soft foods only. Avoid eating anything hard, crunchy, and/or chewy foods along the implant site for the entire duration of healing, which is usually between 2-4 months, as determined by your surgeon at the time of surgery.
Do not skip meals as this is not a time to diet! If you take nourishment regularly, you will feel better, gain strength, & have less discomfort. Nutrition & high caloric intake is KEY to proper healing.
ETC:
If you had an IV and notice redness, pain, a red streak, swelling or bruising, heat to the touch, or a hardened area where the IV was removed, you should apply a heating pad or a warm moist towel to the area. If you do not notice improvement within 24 hours, please call our office.
POST OPERATIVE INSTRUCTIONS:
EXTRACTIONS
DAY OF SURGERY
- Do not rinse on day of surgery, it may prolong your bleeding. Avoid rinsing, spitting, brushing, or using a straw for the first 24 hours as this keeps the blood clots from dislodging which prevents dry sockets. (Dry socket: a loss of a blood clot resulting in exposed bone within the socket which can be painful, usually presenting itself as a sudden increase in pain 3-4 days after surgery.) Call the office if you think you may have developed a dry socket.
- Remove gauze when eating & replace as needed.
- Numbness may last for up to 12 hours.
- Headaches are not uncommon after surgery (especially with general anesthesia). Possible causes include stress from surgery, dehydration, the effects of anesthetic drugs, pain medication, or caffeine withdrawal. Expect it to subside within a couple of days.
- Sore throat is also not uncommon. A suction tip is often used to suction your throat free of irrigation, blood & secretions which may cause your throat to feel irritated. Expect this to subside within a couple of days.
STARTING THE NEXT DAY
- Starting the day after surgery, begin lukewarm salt water rinses (dissolve 1 tsp salt in 8 oz of warm water). Rinse 3-4 times a day (after meals & before bedtime) for 2 weeks.
- Brush your teeth twice daily, being gentle initially around the surgical sites.
- If given an irrigating syringe, do NOT use the syringe until 1 week after surgery. Using the syringe too early may displace the blood clot & cause a dry socket.
- You may start to experience a slight earache, low grade fever, or flu-like symptoms on the day after surgery, as well as throughout the first week. All such symptoms are expected to resolve within 24-48 hours. Please call the office if these symptoms persist.
BLEEDING
- You will go home with gauze packs in your mouth, but you will need to change them, once you get home, every 20-40 mins. until the bleeding subsides.
- You should place the gauze packs directly over the surgical sites. Fold the gauze into a small square, place on top of the surgical site keeping constant pressure.
- If bleeding continues or is excessive, apply a moist tea bag (provided) over the surgical sites, place the gauze over the tea bag, & bite firmly for 45 mins. to 1 hour with constant pressure. Repeat if necessary.
- When less than half of the gauze is saturated with blood, having the gauze in your mouth is no longer necessary. Slight oozing of blood is normal for up to 24 hours.
- Some oozing or pink saliva may occur over the next several days.
SWELLING
- Swelling is normal after surgery & can be a cause of post-surgical discomfort.
- Apply ice packs to your face for the first 48 hours to minimize swelling (20 mins on, & 20 mins off). Do NOT freeze the skin!
- After 48 hours, warm compresses (instead of ice) works best. You may use whichever feels best to you.
- Swelling, discomfort, & possibly bruising typically peak on the 3rd day after surgery & will gradually improve.
- Sleeping elevated or reclined is not necessary, but may help minimize the swelling.
- Jaw muscle stiffness may cause limited opening of your mouth. It is important to begin chewing food to exercise these muscles. If stiffness of your jaw muscles persists past 1 week, jaw-opening exercises are recommended by stretching your mouth open assisted by your fingers. Your mouth opening will gradually increase.
IRRIGATION SYRINGE (Wisdom Teeth Only)
- Start use of the irrigation syringe (provided) 1 week after surgery. Draw up warm salt water into the syringe, place the tip of the syringe deep into the healing socket & flush hard. This keeps the areas clean displacing all food & debris, & promotes healthy healing of the surgical sites. Do this after meals & before bedtime, for 2 weeks or until the sockets are closed.
SUTURES (STITCHES) + BONE FRAGMENTS
- Sutures are dissolvable unless otherwise specified. Call to schedule removal if needed.
- During the healing process, you may feel sharp edges in the surgical areas with your tongue. It is likely the bony walls, which originally supported the teeth. Occasionally, small slivers of the bone will work themselves out during the first week or two after surgery. These are not pieces of teeth, & if necessary, we will remove them. Call the office if you are concerned about this.
DRIVING / EXERCISE / SMOKING / ALCOHOL
- You should not drive, operate heavy or dangerous equipment, or sign any legal documents for at least 24 hours following anesthesia.
- Narcotic pain medication can impair your judgement & reflexes. Extended use (for more than 3-5 days) of narcotics is discouraged to avoid dependence & gastric issues.
- Avoid vigorous physical activity for 1 week following surgery. Physical activity increases your blood pressure, which may cause an increase in your swelling, pain, & bleeding.
- No smoking for at least 1 week. Smoking will increase your bleeding, the nicotine & tar in tobacco impairs healing & may cause dry sockets & infections.
- No alcohol intake while you are recovering from anesthesia, or while taking prescription medications.
MEDICATIONS
- Recommended initial regimen: 2 Tylenols (OTC) + 1 Ibuprofen (Rx).
- This combination can be taken every 6 hours as needed for pain. Make sure you have eaten beforehand to prevent nausea.
- If your pain is not controlled by the above regimen, take your prescribed narcotic. It is safe to be taken together.
- If you develop hives or a rash from any of the mediations, discontinue them & call our office for further instructions.
- Antibiotics: Start the day after surgery (unless recommended otherwise) & finish the entire course until gone.
- If you feel nauseated, drink small portions of a carbonated drink such as 7UP® or ginger ale every hour for 3 – 4 hours. Prescription anti nausea medication can be prescribed for you as well. Avoid all milk & dairy products as long as nausea is present. If you are taking a narcotic, you may also half the dose or break the pill in half.
FOOD SUGGESTIONS:
To help with medication tolerance, we recommend that you eat right away after your surgery.
- DAY 1 (Non-Chew Foods)
- Start with clear liquids, such as broth, milkshakes/smoothies (no straw!), ice cream, yogurt, pudding, applesauce, Jell-O, soups (warm, not hot), mashed potatoes & gravy, oatmeal, cream of wheat, congee/rice porridge
- DAY 2-3 (Soft Foods)
- Pasta, mac & cheese, rice, scrambled eggs, soft/flaky fish, meatloaf, cottage cheese, bananas, avocados
- DAY 4 (Regular Food as tolerated)
Do not skip meals as this is not a time to diet! If you take nourishment regularly, you will feel better, gain strength, & have less discomfort. Nutrition & high caloric intake is KEY to proper healing.
ETC:
If you had an IV and notice redness, pain, a red streak, swelling or bruising, heat to the touch, or a hardened area where the IV was removed, you should apply a heating pad or a warm moist towel to the area. If you do not notice improvement within 24 hours, please call our office.
POST OPERATIVE INSTRUCTIONS:
EXPOSE AND BOND
DAY OF SURGERY
No rinsing, spitting, brushing or using a straw for the first 24 hours after surgery. This is to prevent the blood clot from dislodging.
NEXT DAY
You can brush your teeth the day after surgery but please keep the bristles away from sites until it begins to heal. Begin with gentle warm salt water rinses (1/2 tsp of salt in 8 oz of water) 3 times a day. Continue for one (1) week. Do not use hydrogen peroxide or mouthwash.
FOLLOW UP
Please schedule a follow up appointment if there was a packing placed. Otherwise, please schedule with your orthodontist for continued care.
BLEEDING
Change the gauze every 45 min to 1 hour until bleeding slows down.It’s normal to have some bleeding (oozing around extraction site for up to 24 hours following surgery). Do not leave gauze in all day.
SWELLING
It is normal to have swelling the day of and up to 5 days after surgery. The day of your surgery you will want to use ice packs on the outside of the face to minimize early swelling. Do this for 30 minute periods, separated by 10-15 min. intervals. Use ice for the first 48 hours. Warm compress can be used as needed for swelling and discomfort after 48 hours.
SUTURES
If sutures were used, they are dissolvable. You will need to make an appointment for a suture removal if you were advised that they were NOT dissolvable.
PRESCRIPTIONS
If you were given prescriptions, follow the directions on the bottle. If you received antibiotics, please start the next day after surgery and take the full amount until finished even though symptoms have disappeared. Be sure to eat before taking pain medication to avoid nausea (make sure it is enough food to coat your stomach). If nausea persists, you can try to take half of your pain medication. Refills will only be given during office hours when patient’s medical records are available.
DRIVING
Do not drive a car for 12 hours after a general anesthetic or with certain medications that were prescribed.
EATING
The patient is welcome to eat right away after surgery. We suggest the patient to be on a soft food diet for 2-3 days following surgery. We recommend a colder diet the first day. This will decrease any chance of excess bleeding. The patient is not to have hot food the first day of surgery.
SMOKING & ALCOHOL
Please refrain from smoking for at least 2 weeks to prevent the blood clot from dislodging, infection, and delay in healing. Please do not consume alcohol with medication.
EXERCISE
Limit vigorous exercise to up to a week as this will increase your blood pressure which may cause more bleeding from the surgical site or dislodge the blood clot.
POST OPERATIVE INSTRUCTIONS
GRAFTING/SINUS LIFT
Care of your mouth is very important for proper healing. The following instructions will maximize your healing and improve the long-term outcome of your dental implants, or to simply maintain the architecture & integrity of your bone.
Bone grafting is performed to increase the height and/or width of bone in preparation for your implant(s). Usually, the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. Similar procedures can result in varying outcomes between people.
If you had a Sinus lift/augmentation, we advise you follow Sinus Precautions (provided) for 4 weeks. Do NOT blow your nose! Decongestants such as Afrin® Nasal Spray, Claritin or Allegra may be used to help with sinus drainage. A nosebleed can be expected for the first several days.
DAY OF SURGERY
- Do not rinse on day of surgery, it may prolong your bleeding. Avoid rinsing, spitting, brushing, or using a straw for the first 24 hours.
- Remove gauze when eating & replace as needed. Do not chew on the site until the sutures are removed.
- Numbness may last for up to 12 hours.
- Headaches are not uncommon after surgery (especially with general anesthesia). Possible causes include stress from surgery, dehydration, the effects of anesthetic drugs, pain medication, or caffeine withdrawal. Expect it to subside within a couple of days.
- Sore throat is also not uncommon. A suction tip is often used to suction your throat free of irrigation, blood & secretions which may cause your throat to feel irritated. Expect this to subside within a couple of days.
STARTING THE NEXT DAY
- Starting the day after surgery, begin lukewarm salt water rinses (dissolve 1tsp salt in 8 oz of warm water). Rinse 3-4 times a day (after meals & before bedtime) for 2 weeks.
- Brush your teeth twice daily, being gentle initially around the surgical sites.
- You may start to experience a slight earache, low grade fever, or flu-like symptoms on the day after surgery, as well as throughout the first week. All such symptoms are expected to resolve within 24-48 hours. Please call the office if these symptoms persist.
BLEEDING
- You will go home with gauze packs in your mouth, but you will need to change them, once you get home, every 20-40 minutes until the bleeding subsides.
- Place the gauze packs directly over the surgical sites. Fold the gauze into a small square, place on top of the surgical site keeping constant pressure.
- If bleeding continues or is excessive, apply a moist tea bag (provided) over the surgical sites, place the gauze over the tea bag, & bite firmly for 45 minutes to 1 hour with constant pressure.
- When less than half of the gauze is saturated with blood, having the gauze in your mouth is no longer necessary. Slight oozing of blood is normal for up to 24 hours.
- Some oozing or pink saliva may occur over the next several days.
SWELLING
- Swelling is normal after surgery & can be a cause of post-surgical discomfort.
- Apply ice packs to your face for the first 48 hours to minimize swelling (20 minutes on, & 20 minutes off). Do NOT freeze the skin!
- After 48 hours, warm compresses (instead of ice) works best. You may use whichever feels best to you.
- Swelling, discomfort, & possibly bruising typically peak on the 3rd day after surgery & will gradually improve.
- Sleeping elevated or reclined is not necessary, but may help minimize the swelling.
- Jaw muscle stiffness may cause limited opening of your mouth. It is important to begin chewing food to exercise these muscles. If stiffness of your jaw muscles persists past 1 week, jaw-opening exercises are recommended by stretching your mouth open assisted by your fingers. Your mouth opening will gradually increase.
SUTURES (STITCHES) + BONE FRAGMENTS
- Sutures are dissolvable unless otherwise specified. If you had grafting with an extraction, there might be a membrane protecting the bone graft secured with sutures (stitches). Stitches will be removed at your designated follow-up appointment unless a dissolving suture has been used.
- During the healing process, you may feel sharp edges in the surgical areas with your tongue. It is likely the bony walls, which originally supported the teeth. Occasionally, small slivers of the bone will work themselves out during the first week or two after surgery. These are not pieces of teeth, & if necessary, we will remove them.
- If bone grafting has been done, it is not uncommon to feel small bone particles within your mouth during the healing period. If you feel there are excessive amounts of bone grafting material exiting from your surgical site, please call the office to be evaluated.
DRIVING / EXERCISE / SMOKING / ALCOHOL
- You should not drive, operate heavy or dangerous equipment, or sign any legal documents for at least 24 hours following anesthesia.
- Narcotic pain medication can impair your judgement & reflexes. Extended use (for more than 3-5 days) of narcotics is discouraged to avoid dependence & gastric issues.
- Avoid vigorous physical activity for 1 week following surgery. Physical activity increases your blood pressure, which may cause an increase in your swelling, pain, & bleeding.
- No smoking for at least 1 week. Smoking will increase your bleeding, the nicotine & tar in tobacco impairs healing & may cause dry sockets & infections.
- No alcohol intake while you are recovering from anesthesia, or while taking prescription medications.
MEDICATIONS
- Recommended initial regimen: 2 Tylenols (OTC) + 1 Ibuprofen (Rx).
- This combination can be taken every 6 hours as needed for pain. Make sure you have eaten beforehand to prevent nausea.
- If your pain is not controlled by the above regimen, take your prescribed narcotic. It is safe to be taken together.
- If you develop hives or a rash from any of the mediations, discontinue them & call our office for further instructions.
- Antibiotics: Start the day after surgery (unless recommended otherwise) & finish the entire course until gone.
- If you feel nauseated, drink small portions of a carbonated drink such as 7UP® or ginger ale every hour for 3 – 4 hours. Prescription anti nausea medication can be prescribed for you as well. Avoid all milk & dairy products as long as nausea is present. If you are taking a narcotic, you may also half the dose or break the pill in half.
FOOD SUGGESTIONS:
To help with medication tolerance, we recommend that you eat right away after your surgery.
- DAY 1 (Non-Chew Foods)
- Start with clear liquids, such as broth, milkshakes/smoothies (no straw!), ice cream, yogurt, pudding, applesauce, Jell-O, soups (warm, not hot), mashed potatoes & gravy, oatmeal, cream of wheat, congee/rice porridge
- DAY 2-3 (Soft Foods)
- Pasta, mac & cheese, rice, scrambled eggs, soft/flaky fish, meatloaf, cottage cheese, bananas, avocados
- DAY 4 (Regular Food as tolerated)
Do not skip meals as this is not a time to diet! If you take nourishment regularly, you will feel better, gain strength, & have less discomfort. Nutrition & high caloric intake is KEY to proper healing.
ETC:
If you had an IV and notice redness, pain, a red streak, swelling or bruising, heat to the touch, or a hardened area where the IV was removed, you should apply a heating pad or a warm moist towel to the area. If you do not notice improvement within 24 hours, please call our office.
POSTOPERATIVE FOOD SUGGESTIONS
NO STRAWS FOR 24 HOURS POST SURGERY
DAY OF SURGERY
- Milkshakes
- Fruit Smoothies
- Frozen Yogurt
- Pudding
- Cottage Cheese
- Applesauce
- Ice Cream
- Jell-O
- Soup ( Warm not hot)
DAY 2 POST SURGERY
- Cream of Wheat
- Oatmeal
- Eggs
- Rice
- Mac and Cheese
- Mashed Potatoes
- Pasta (Any kind)
- Cream of Rice
BEVERAGE SUGGESTIONS
- Water
- Gatorade
- Milk
- Fruit Juice
- Hot Beverages
- Hot Food
- Spicy Food
- Crispy, Crunchy, Chewy Food