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Surgical Instructions

Pre-operative Instructions

The following instructions may be helpful when preparing for your upcoming surgery. Please do not hesitate to call if you have any last minute questions.

You should receive your pre/post-operative prescriptions with this instruction sheet. For your convenience, please have them filled prior to your scheduled surgery, unless they have been previously phoned in to the pharmacy of your choice. Please bring your filled prescriptions with you to your appointment.

It may be important to stop taking Aspirin and non-steroidals such as Motrin or Advil, 7-10 days prior to your surgery. If you are taking Coumadin or another blood thinner, please check with your primary care physician before discontinuing use. We keep the office cool, so dress warmly. You may bring your iPod or MP3 player with you if you would like.

In order to evaluate your progress and healing, we will see you for post-operative checks during the course of your treatment. After surgery, in most cases, we will see you back for a periodontal maintenance cleaning and an examination of surgical area about 10-12 weeks following the surgery.

Antibiotics

Oral Sedation

If you elect to use one of the following oral sedatives you must have a ride to and from the office. Remember, we encourage you to eat prior to your surgery.  If you are diabetic, it is important you maintain your regular diet prior to surgery.  You must be accompanied by an adult who will be responsible for driving you home and caring for you after surgery. YOU CANNOT DRIVE YOURSELF! 

• Lorazepam 2mg, Demerol 50mg, Phenergan 25mg  (Take all 3 pills 1 hour before surgery)
• Halcion 0.25mg (Take 1 hour before your surgery) 

•  DO NOT EAT OR DRINK (this includes WATER, soda, coffee, etc) 8 hours prior to your surgery.  If you take blood pressure medication, please take with minimal water.  It is important that you have an empty stomach at the time of surgery. 
• Please wear short sleeves, to allow us to place the blood pressure cuff and IV.
• DO NOT drink alcoholic beverage 12 hours prior to surgery.
• You need to have a driver. YOU CANNOT DRIVE YOURSELF!

Food Suggestions

When preparing a post-op menu, please consider some of the following choices:

Post-operative Instructions

These instructions apply to the surgical procedure just completed. They are designed to help you minimize post-surgical discomfort and inform you of any situation that may require special attention.

 DIet

Bleeding

It is common to have some bleeding or oozing during the first one to two days following periodontal surgery.  A pink discoloration to your saliva is normal, however, bright red blood is not to be expected. 

 If excessive or continuous bleeding occurs:

• Do not rinse your mouth.
• Elevate your head when lying down.
• Apply moistened gauze to the immediate area with moderate pressure for 20 minutes, repeat if necessary.
• Enclose a moistened tea bag in a gauze square and apply pressure for 20 minutes.
• Call the office if bleeding persists.

  Antibiotic

An antibiotic will be prescribed following your surgical procedure.  Take as directed until gone.  It is advisable not to take these medications on an empty stomach, as nausea may result.  For women taking birth control pills, be advised that antibiotics may interfere with their effectiveness.

Pain Management/ Medications

Some discomfort may be present when the anesthesia wears off.  You have been given a prescription for pain management. Taked the medication within one hour after surgery and always with a full glass of water. DO NOT USE ASPIRIN following surgery. Non-aspitin pain relievers are acceptable. It is not unusual to have discomfort for at least the first week following your surgical procedure. You will be given a prescription for medication to help you tolerate the post-surgical recovery period. Please take your medications as directed. If necessary, you may take your pain medication more frequently than every 4-6 hours to stay ahead of the soreness. It is advisable to not take pain medication on an empty stomach, as nausea may result.

As an alternative to prescription medications, some patients have found taking a combination of over the counter Ibuprofen and Tylenol to be effective. You may take the combination in either of the following dosages: 3 Advil Liqui-Gels and 2 Regular Strength Tylenol or 3 Advil Liqui-Gels and 1 Extra Strength Tylenol, every 4-6 hours as needed.

Note: When taking any prescribed medication containing Acetaminophen (Tylenol), i.e.; Percocet, Hydrocodone, Vicoden or Tylenol with Codeine, you should not take additional Tylenol so as not to exceed the safety level of Acetaminophen. Please contact the office with any questions you may have.

Swelling

Swelling may occur following your surgical procedure. To minimize the swelling, place an ice pack over the outside cheek area for 20 minutes on and 20 minutes off. Continue using ice for 24 hours following procedure as often as possible.  Please keep your head elevated on several pillows or by sitting in a recliner for the first 24 hours.  The amount and the duration of swelling differ from person to person.

Care of the Dressing

Please do not smoke during the post surgucal period, as it may interfere with the healing process,  Healing results are significantly worse in smokers than in non-smokers.  Smoking is a major factor in tissue grafting and implant failure.

Alcohol

Do not drink alcohol while taking prescription pain medications.

Oral Hygiene

Continue to brush and floss the teeth which were NOT involved in the surgery, avoiding the area covered by the surgical dressing.  Rinsing: You may rinse gently with a prescribed mouth rinse or warm salt water to cleanse the surgical areas beginning 24 hours after surgery.  Be gentle, do not disturb the blood clots that have formed at the surgery site.  You may notice a white film over the surgical sites.  This is completely normal.  If tissue grafting was done you may have a plastic mouthpiece (stent) covering your palate.  This needs to stay in place for the first 48 hours.  You may then remove the stent and rinse gently, then immediately place back over the palatal donor site.  After 1 week, leave the stent out at night this helps the surgical site to heal faster.  However, please continue to use the stent during the day for 2 weeks.

Suture Removal

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