Before Surgery and Anesthesia

In preparation for your surgery and IV sedation, please ensure that you DO NOT EAT OR DRINK ANYTHING for at least six hours prior to your appointment time.  You may drink half a small glass of water, and only water, up to 2 hours before the procedure.

For morning appointments, your last meal should be at midnight.  If your surgery is scheduled for the afternoon, you may have a small, light and easily digestible meal at least six hours prior to your appointment.  Please avoid fried or greasy foods.  It is best to avoid all dairy products.

Please do not consume any alcohol for at least 24 hours prior to your intravenous sedation and surgery.

Please make arrangements for a responsible adult to receive home care instructions following completion of the surgery and to drive the patient home.

The patient must not drive a motor vehicle for 24 hours following anesthesia or sedation; the patient should avoid tasks requiring skill, concentration, or judgment during this time.

Wear loose clothing, preferably short sleeves, since we will need easy access to your arms for IV placement.


General Care After Surgery

Swelling, Bruising and Discomfort

Swelling, bruising and discomfort may occur after surgery and are completely normal.  Swelling of the face and neck may result from the surgical removal of teeth.  Swelling peaks after 48 hours, and then gradually subsides.  It is normal for bruising to appear on the jaw and upper neck.  Most problems will subside within a week.  An ice bag may be applied outside the face next to the site of surgery, 20 minutes on and 20 minutes off for the first 24 hours.

Bleeding

It is normal for the saliva to be lightly streaked with blood for one or two days.  If frank bleeding is present, fold gauze into a firm thick wad and place directly onto the socket or against the operative site and maintain steady pressure for twenty minutes or longer.  The less frequently the gauze is changed the better.  Do not spit out.  Do not chew gauze.  A tea bag moistened in luke warm water may be substituted for the gauze pad.

Nausea

Nausea is quite common and may occur after an anesthetic or from some medicines especially narcotic pain medicines.  The use of Gravol can be very useful.  Flat carbonated drinks, such as cola or ginger ale also relieve nausea. 

Limited Mouth Opening

This is a normal protective mechanism and is due to fluid in the jaw muscles.  It will gradually disappear after a few weeks.  Massage the area and apply heat.  Mouth opening exercises can also help.

Temperature Elevation

A temperature increase of up to about 102 F or 39 C is common for up to 48 hours following surgery.  If your temperature exceeds this, please call our office.

Stitches

Dissolving stitches are used to control bleeding in the area of the surgery.  These stitches gradually come out on their own (3 - 10 days).

Oral Hygiene

DO NOT rinse your mouth on the day of surgery as this can disturb the healing process.  Gently rinse on the day following surgery.  Rinse hourly and especially right after eating.  Rinse with ½ tsp of salt in a glass of warm water and any diluted mouth rinse.  Begin brushing your teeth when comfortable.  SMOKING IS BEST AVOIDED FOR AT LEAST 3 DAYS.

Diet

Avoid hot drinks until the local anesthetic has worn off.  Your jaw may be stiff or your throat sore.  You will be able to drink and may be able to eat pureed and soft foods.  Drinking should begin immediately upon arriving home from surgery.  Drink water, soups, fruit and vegetable juices.  Drink as much as you are able.  Resume a regular diet as soon as you are able.

Medications

Pain - for simple types of surgery, two regular strength Advil or Tylenol tablets may be used as necessary to relieve the pain.  If the pain is more severe, a prescription will be given that is to be taken as directed.  The first tablet should be taken before the anesthetic wears off.  Narcotic pain medicine may cause some dizziness; do not drive.  Ibuprofen can be taken together with narcotics, although this can cause increased stomach upset.

Antibiotics and other medicines should be taken until the prescription is finished.

For nausea or stomach upset, Gravol can be taken with your medication.  If a rash, severe stomach cramps or diarrhea occurs, stop taking your medicine and call our office.

PLEASE FOLLOW DIRECTIONS FOR MEDICATIONS PRESCRIBED.

Constipation

Codeine in pain medicine is constipating.  If this occurs, a mild laxative such as Milk of Magnesia may be taken.  Increase your fluids.

After IV Sedation

After Intravenous Sedation

It is important to rest quietly for the remainder of the day and up to 24 hours following your appointment.  The medications that you were given will make you feel drowsy and your responses will be slow.  Therefore you will require someone to drive you home and remain with you for the rest of the day.  You must not drive, operate machinery, or consume alcohol, for 24 hours following surgery.  You may not remember activities immediately after the procedure.

Occasionally the intravenous site will be irritated due to the medication used.  If the site is sore, apply a warm compress (face-cloth with warm water).  If the intravenous site becomes painful, red, or swollen, please call the clinic or the surgeon.  Bruising may occur at the intravenous site.  This will resolve itself.

You may experience some nausea and mild vomiting after the sedation.

You may start off with sips of clear fluids (clear broth, apple juice, ginger ale) or full fluids (cream soups, pudding) for the first day.  A soft diet can begin in 2-3 days (pasta, eggs), then a regular diet as tolerated.  It is important that you drink fluids to prevent dehydration and to promote optimal healing.

If you have any unusual problems, please call our office.  We appreciate receiving routine phone calls, such as prescription renewals or questions, between the hours of 9am-5pm, Monday to Friday.

After Extractions

After Extractions

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately.    

For mild discomfort use Ibuprofen, Tylenol or any similar medication; two tablets every 3-4 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 3-4 hours.

For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.

Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water).

After Dental Implant Surgery

After Dental Implant Surgery

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

Diet

Drink plenty of fluids. Avoid hot liquids or 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. Try to avoid chewing directly on the area or areas where the implant was placed until at least your post-operative appointment.

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 following surgery.  As discussed at your consultation, smoking significantly increases the risk of implant failure.  If you’re planning on quitting, this would be the time.

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. 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.

Other Post-operative Considerations

You will notice that you cannot see the actual implants in your mouth as the gums cover the area. This is good. Do not stretch your lip daily to inspect the area. This can cause wound breakdown. In many instances a healing cap or abutment was placed over the implant. This will look silver and will be emerging through the gums. Again, do not stretch your lip daily to inspect the area. This can cause wound breakdown. Be very cautious not to eat or chew on these temporary implant covers as it will place undue movement on the implants below and can cause implant failure.

After Socket Bone Grafting

Smoking

DO NOT SMOKE for at least two weeks following surgery.  As discussed at your consultation, smoking significantly increases the risk of implant failure.  If you’re planning on quitting, this would be the time.

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. 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.

Other Post-operative Considerations

You will notice that you cannot see the actual implants in your mouth as the gums cover the area. This is good. Do not stretch your lip daily to inspect the area. This can cause wound breakdown. In many instances a healing cap or abutment was placed over the implant. This will look silver and will be emerging through the gums. Again, do not stretch your lip daily to inspect the area. This can cause wound breakdown. Be very cautious not to eat or chew on these temporary implant covers as it will place undue movement on the implants below and can cause implant failure.

After Onlay Bone Grafting

After Onlay Grafting

You have had a Cortical Bone Graft if the area where your jawbone was deficient. This procedure will augment the deficient area in preparation for implant replacement of missing teeth.

Because of this you may have two post-surgical wounds: the donor site and the recipient site.

Try to avoid chewing directly on the area or areas where the bone graft was placed until at least your post-operative appointment.

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.  Do not use the rinse more than three times a day.

Smoking

DO NOT SMOKE for at least two weeks following surgery.  As discussed at your consultation, smoking dramatically increases the risk of bone graft failure.

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.

After Sinus Lift

After Sinus Lift

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, 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.

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.



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.

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.

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.



Monday to Friday | Tel: 416.221.6656 | Fax: 416.221.4579 | Email: info@dryarmand.com

interior full-size photo