Surgical Instructions

It's important to review these pre-operative instructions before undergoing any oral surgery to ensure you are properly prepared for your procedure. We will review all of your options for anesthesia during your initial consulation, and help you select the option that is best and safest for you.

Local Anesthesia

Your mouth and teeth should be well cleansed immediately before your appointment.

General Anesthesia

Have additional questions based on these pre-operative instructions? Contact us today!

How long with the bleeding last?

Active bleeding may continue 4 - 5 hours; light bleeding may continue off and on for several days and is considered normal. It is recommended to bite firmly and continuously on gauze for 30 minutes without opening the mouth.

Talking or frequently changing the gauze will cause bleeding to continue. While actively bleeding, it is recommended to keep your head elevated on several pillows. If active bleeding does not slow down within 3 - 4 hours, fold gauze and bite firmly for 30 minutes without letting up. Repeat this procedure several times. Tea bags can be used if necessary as a last attempt to control bleeding. You may dampen a regular tea bag, wrap with gauze, and bite firmly for 20 minutes. Drinking hot liquids can aggravate bleeding and needs to be avoided for the first 24 hours.

Will I have any swelling?

Swelling usually begins the evening of surgery. Swelling is normal for the first 2 days and peaks on the third day. After the third day, it should gradually decrease. If it doesn't decrease, or it begins to increase, please contact our office. Three days of swelling is not an indication of infection.

How can I prevent nausea?

Make sure you have food in your stomach before taking any pain medications. Stomach irritation is not uncommon postoperatively. You may take Maalox® or Mylanta® to help. If you experience vomiting for longer than 3 - 4 hours, call our office.

What if I have an allergic reaction to my medication?

If you begin itching or break out in a rash, don't take any future doses of medication, and call our office.

Do I need to use Ice packs?

Apply ice starting on the first day of surgery. Rotate ice packs 30 minutes on, then 30 minutes off. This procedure should continue for the first 48 hours. After 48 hours, switch to warm, moist heat.

Do I need to return for my sutures to be taken out?

Sutures usually dissolve within 7 - 10 days. They may come out early (next day possibly), and this is normal. Always remember to keep the area clean.

What if I need a prescription refilled?

If pain medications are needed, you will need to call the office and schedule an appointment. Pain medications cannot be called in.

What types of foods can I eat?

Consume cool liquids and soft foods on the day of surgery. Examples of foods are soups, broths, Jell-O®, pudding, and yogurts. Avoid hot foods, as they will increase bleeding. After bleeding has stopped, the patient may advance their diet as tolerated.

Can I smoke?

Smoking is discouraged until healing is well established. Smoking severely delays the healing process and causes dry socket. Total cessation of smoking is highly recommended to ensure proper healing.

When can I start rinsing my mouth?

No rinsing, spitting, or drinking through a straw is recommended within the first 24 hours. After 24 hours, we recommend warm salt water rinses periodically throughout the day for the next 7 days. Peridex™ rinse may be prescribed to use in the morning and before bedtime. Do not use for more than 7 days postoperatively.

Are headaches and jaw pain normal?

Headaches and jaw pain are normal postoperatively (especially after extractions) and may be due to grinding teeth. Pain is usually worse in the morning due to grinding teeth at night. If you have any questions or concerns, feel free to contact our office.

You have just completed the first step of your implant treatment. If you look inside your mouth, you may be able to see the implant. The implant does require a clean environment to heal properly. Proper care of your mouth will aid in the healing process and reduce the possibility of complications. The following instructions will assist you in this healing process.

General Instructions

Avoid strenuous physical activity for the first 48–72 hours following the procedure. Usually, the fewer implants placed, the sooner you will feel comfortable returning to the normal activities.

Start the prescribed medication immediately. You may have some discomfort after the procedure. Over-the-counter anti-inflammatory medicines (Advil®, Aleve®, or ibuprofen) are often helpful in controlling this type of discomfort. You may supplement the anti-inflammatory medication with pain medication if needed.

The pain medication prescribed for you may cause drowsiness and impair your ability to drive and perform delicate tasks. You do not have to take or finish the pain medication. We may also prescribe an antibiotic. Unlike the pain medication, it is important that you finish this medication unless otherwise directed.

Swelling

You may experience some swelling and/or bruising following the procedure, which usually reaches a peak 2–3 days later. Ice packs will reduce the swelling and/or bruising. Apply ice to the cheek area for a maximum of 30 minutes at a time with a 30-minute break. After 48 hours, gentle heat is more beneficial. Sleeping with your head propped up slightly may also help.

Diet

We would like you to eat soft, nutritious foods. Care should be taken to avoid hard or crunchy foods that might cause trauma to the implant area. Gently rinse with warm water after every meal.

Bleeding

Some minor bleeding after surgery is common. We suggest that you bite on the gauze packing in your mouth for at least 30 minutes. If you notice bleeding from the area after the first 30 minutes, place another gauze pad over the area. Some oozing may occur for a few days after surgery. If implants are placed in the upper jaw, you may experience a nosebleed within the first few days after surgery.

Avoid smoking for at least 2 weeks following surgery. Smoking has been shown to affect the healing process negatively.

Stitches will dissolve in 5–7 days and typically do not require removal. Do not worry about the stitches if they start to come out earlier.

Cleaning

Important times to clean are after breakfast and before you go to bed at night. Rinsing is very helpful in keeping your mouth clean. Start rinses the day after surgery. The prescribed mouthwash should be used twice daily — after breakfast and before bed. Be sure to rinse for at least 30 seconds, then spit it out. Warm saltwater rinses (a teaspoon of salt in a cup of warm water) should be used at least 4–5 times a day, as well, especially after meals.

You should also start brushing your other teeth as normal 24 hours after surgery. Avoid flossing or the use of a Waterpik® to the surgical site for the first 2 weeks.

Wearing your prosthesis

Partial dentures, flippers, or full dentures should be used immediately after surgery unless otherwise directed by your doctor. However, wear them with caution. Remember, do not apply undue pressure over the implant surgical site. Excessive pressure can affect the success of your implant.

Long-term dental implant care

To maintain a successful implant, it will require a significant commitment to your oral hygiene practices. A daily program of oral care must be established and maintained in conjunction with your dentist and hygiene visit. Attend professional cleaning appointments every 3–6 months.

Proper aftercare of your dental implants is important for maintaining them for a lifetime without problems. Dental implants require the same care as real teeth, including brushing, flossing, and regular checkups.

Flossing should be done around the implant at least once a day. If you have an irrigation system, you may irrigate each implant on low speed (1.5 water to 2 caps of Listerine®). This method of cleaning is very effective in removing plaque that may form under the gums. Please discuss your irrigation system with your dentist or hygienist before using it with your implant.

If you are wearing your prosthesis, these should be left out at night or at least several hours during each day.

The restoration piece on top of the dental implant is not as strong as natural teeth. Avoid applying excessive pressure or eating hard foods to prevent breaking the restoration and/or irritating the implant area.

Should you notice any swelling, redness, or discomfort in the area of the implant after the healing phase, please notify the office. Your patience and self-care will help make your dental implant successful. If you have any questions or unusual problems, please call the office where you had your implant(s) placed.

Proper care of the mouth following most dental procedures can reduce complications and speed the healing of the surgical area.

Protecting the Blood Clot

Maintain gentle pressure by biting on the gauze sponge that has been placed over the surgical area, or by biting on a moistened tea bag wrapped in a piece of gauze. Keep firm, steady pressure for 30 minutes. If bleeding persists, please feel free to contact the office or answering service. Do not sleep with gauze in your mouth. Report any unusual discomfort, drainage, swelling, redness, or fever above 100° F.

Do not rinse or use mouthwash for at least 24 hours. After 24 hours, we recommend rinsing with warm salt water (a 1/2 teaspoon of salt in 8 ounces of warm water) every 1–2 hours. (The use of commercial mouthwashes during the healing period is not encouraged.)

Discomfort following dental surgery is normal. If medication has been given or prescribed, take as instructed.

Carefully use a toothbrush in the area of the mouth not involved in the surgical procedure. A clean mouth heals faster.

Adequate consumption of nutritious foods and fluids following surgery and/or general extractions is most important. We recommend a liquid or soft diet for 24–48 hours following oral surgery. We also recommend avoiding any extremes in temperatures or spicy foods.

Activity

Rest for the first 2 post-operative days to minimize bleeding and swelling. Elevate your head on a couple of pillows to further minimize swelling. If you have had impacted teeth removed, you should avoid all strenuous activities for 1 week. For routine extractions, 2 days of limited activity is plenty. Don't pick at the surgical area. Don't consume liquids through a straw. Avoid alcoholic beverages, and refrain from smoking until healing is well established.

Control of Swelling

Gently apply ice packs to the area for 30 minutes on, 30 minutes off. Continue application of ice packs for the first 48 hours only.

Sutures will dissolve in 5–7 days and typically do not require removal. Do not worry about the sutures if they start to come out earlier.

Additional Instructions

Stretching the corners of the mouth may result in the lips becoming dry, cracked, or sore. If this occurs, the lips should be kept moist with Vaseline® or a similar ointment. Trismus or difficulty opening the mouth may be present for a few days (this is not unusual). If numbness of the lips, chin, or tongue persists, it will most likely be temporary and will go away on its own in a few days or weeks. If you develop severe throbbing pain down deep in the jaw, back near the ear, 3 or 4 days after the tooth is removed, contact our office.

Medication and Anesthetics

Patients receiving intravenous or nitrous oxide sedation should be accompanied home by a responsible adult after surgery. Medications, drugs, prescriptions, and anesthetics may cause drowsiness and lack of awareness and coordination, which can be increased with the use of alcohol and other drugs. Therefore, we advise that you do not operate any vehicle, automobile, or hazardous device for 24 hours after your release from surgery or until further recovered from the effects of the anesthetic medications or drugs that may have been given to you in the office. Take all medication exactly according to the directions on the bottle.

Allergic Reactions

If you experience a generalized rash, itching, etc., call your oral surgeon at the office or call the answering service immediately.

Do not hesitate to call if any questions arise.