Surgical Instructions

Pre-Surgical & Post-Surgical Instructions

Pre-Surgical Instructions:

All implant patients should start their antibiotic regiment 1 day prior to surgery. Antibiotics are important in preventing infection. Your antibiotic will be called in to your preferred pharmacy 2 days prior to your surgery. Once you have picked up your antibiotic prescription, please take the first three doses on the day before your surgery. (1 dose with breakfast, 1 dose with lunch, and 1 dose with dinner) Take another dose on the morning of your surgery.

Please take 600mg of ibuprofen (Advil) the night before surgery AND the morning of surgery.

Patients receiving IV sedation need to comply with the following guidelines:
  • Take all prescribed medications as normal unless specifically told differently
  • You will need to arrange for an escort to pick you from your appointment and drive you home.
  • Do not eat or drink anything for at least 8 hours prior to your appointment time. The ONLY exception is when taking medication.
  • Please drink a minimal amount of water for taking medications.
  • Please wear loose and comfortable clothing.
  • Post-Surgical Instructions:

    Continue taking the prescribed antibiotic until it is completely gone.

    Pre-made envelopes, containing 400 mg ibuprofen (Advil) and 500 mg acetaminophen (Tylenol), have been made with the date and time they should be taken. Please follow these guidelines BY THE CLOCK. This often requires setting an alarm during the night to ensure pills are taken at the proper time. These two drugs make a powerful cocktail to combat inflammatory and pain mediators.

    Swelling is a common response to surgery as the body works to heal properly. Typically swelling does not start until hours after surgery and reaches its peak 2-3 days post-surgery. To help minimize swelling please wear the ice pack for 4 hours immediately after surgery and 4 hours the next day.

    Some minor bleeding is normal for the first 1-2 days after surgery. Excessive bleeding (mouth fills rapidly with blood) should not occur. Excessive bleeding is no normal and could be a medical emergency, call 911 or report to an ER if uncontrolled bleeding occurs.

    Drink plenty of fluids. Avoid hot foods and hot liquids for 48 hours. Only very soft foods should be eaten for the next 3-5 days.

    Good home care is essential for good healing. Brush teeth as normal, however, avoid brushing the surgical site. Use any prescribed mouth rinse (gently) in the morning, after every meal and in the evening the first week after surgery.

    When sinus augmentation (grafting) is done the following precautions should be taken:
    • Wipe nasal secretions, try not to blow nose
    • Do not suck through a straw
    • Sleep with your head elevated above your heart (try using an extra pillow or two)
    • Take any other medications prescribed by the doctor
    • Call the office and report any nose bleeds

    Lastly, we promote the acronym “R.I.C.E”.

    • Rest; take the next few days easy.
    • Ice; wear the ice pack.
    • Compression; the ice pack also helps compress the surgery area which promotes effective healing.
    • Elevation; sleep with your head elevated the first night after surgery.

    Please don’t hesitate to call with any additional questions or concerns. The better these guidelines are followed the faster and smoother the healing process will be. 

    Download and Sign the Pre and Post Surgical instructions below:

    Pre-Sedation Instructions

    We ask that our patients follow these instructions strictly so that the sedation can go as planned and in the safest of conditions. Any neglect or disregard of these instructions may result in the cancellation of the treatment.

    If your doctor has requested a pre-treatment evaluation by your physician please make sure the physician faxes the Medical Evaluation form to the office. Please bring the original document on the day of treatment. This allows us to review the medical findings prior to your appointment.

    Nothing should be ingested after midnight the night before treatment, unless instructed otherwise by the doctor. The patient may drink clear liquids (water, Pedialyte, apple juice or sports drink) up to eight (8) hours prior to the procedure. ABSOLUTELY no milk, soup, juice with pulp or other non-clear liquids. Patients not following these instructions may have their treatment cancelled.

    Please continue prescribed medications at their normal schedule, unless you are instructed otherwise by the doctor. Medications must be taken with only a small sip of water. We ask patients to refrain from taking vitamins, herbal medicines, or non-prescribed medications.

    We are aware that there may be changes in our patient’s health, and it is important to inform our staff if you have a cold or fever. Prior to sedation, patients should be in optimal health and treatment may be re-scheduled if there are changes in health.

    All patients must be accompanied to and from the appointment by a responsible adult. ALL patients should be in an appropriate seat belt and should be sitting in an upright position on their way home. Do not plan to drive a vehicle or operate potentially dangerous equipment for 24 hours after your treatment. Do not take a bus or a taxi home.

    Please wear casual and comfortable clothing, preferably with short sleeves. Comfortable pants or sweat pants should also be worn as well as comfortable flat shoes. Leave all valuables at home.

    These instructions must be adhered to before commencing with sedation. Neglecting any of the following may compel the doctor to cancel the start of treatment.

    Post-Sedation Instructions

    The patient should be in an appropriate seat belt, sitting in an upright position. Although the patient met criteria for discharge, the medication can have lasting effects. The patient should not be left alone for next six hours and should continue to rest for the remainder of the day.

    It is common for the patient to be sleepy, dizzy or off balance after sedation. For the first few hours, the patient should not be permitted to walk unassisted. Patients may be nauseous, which may be increased by the automobile ride home. The patient should not make any business decisions for at least 24 hours.

    We understand that patients are typically hungry following their treatment, but we ask you to follow these guidelines. Start with clear liquids in small amounts upon arriving home. After 20-30 minutes, advance to some soft simple carbohydrates. If the patient rejects food, do not force it. A regular (soft) diet may be resumed three hours after arriving home. No alcohol for 48 hours.

    Most patients will receive intravenous pain medication at the conclusion of treatment. Additional pain control strategies will be discussed prior to discharge.

    A bandage will be placed at the IV site and may come off at any time. No further care should be required other than to observe it once per day for redness, swelling or discomfort. Call if:
    ▪ Vomiting persists beyond four hours.
    ▪ Temperature remains elevated beyond 24 hours.
    ▪ Persistent or excessive bleeding.
    ▪ Patient unable to drink liquids at home.
    ▪ Pain not relieved by OTC medication.
    ▪ Any other matter that causes concern

    Post-Operative Instructions

    Please read the information below to help the healing process start out as successful as possible.

    Implant Placement:
    Implants are placed with either tissue completely covering the surgical area or with a healing abutment that may stick above the gums slightly. It is important not to disturb or chew on this extension (healing abutment) of the implant during the initial healing. It can be gently brushed after the first few days of healing. In some cases, a temporary tooth or teeth may be placed on the implants at the time of implant placement. These teeth are temporary teeth. They are intended to be more cosmetic than functional. Please refrain from chewing on these teeth to allow for proper healing, unless told otherwise by your doctor. If these teeth ever break or feel loose, please call the office immediately.
    Bone grafting:
    Bone grafting may be accompanied by swelling, and some pain. These symptoms usually only last for 2-5 days. If they last longer, please contact the office. Be sure to avoid chewing around the surgical site. Do not touch or press the surgical area with your tongue or fingers. During the first 3 weeks of healing, it is extremely important that the area be undisturbed. Avoid brushing or using a Waterpik around the area for the first week of healing.
    Extractions:
    Extraction sites may lightly bleed for 1-2 days after surgery. Pain and swelling may be present for 2-5 days. If they last longer, please contact the office. Avoid brushing or using a Waterpik around the area for the first week of healing.
    Sutures:
    Sutures were placed to help the soft tissue heal faster. It is important to not “play” with the sutures, especially during the first week of healing. Do not pull or tug on your sutures. Your sutures are resorbable / non-resorbable. Resorbable sutures will come out on their own in 5-10 days. Non-resorbable sutures will be removed by the office at your post-op visit, usually 2 or 3 after surgery. If you have any concerns regarding your sutures, please call the office.
    • Do not eat or drink anything spicy, hot (temperature), no carbonated drinks, no alcohol consumption or anything with citrus for 2 days.
    • Eat soft, cold foods for the next 3-5 days.
    • Drink plenty of fluids.
    •  Do not suck through a straw until you are seen for you post op appointment.
    • Soft recommended foods: apple sauce, mashed potatoes, broth soup, pudding, soft noodles, protein shakes, ice cream, yogurt.
    • Foods to avoid: chips, rice, chia seeds, strawberries, raspberries, hard nuts, crunchy foods, and citrus.
    • Cut food into small pieces to make food easier to chew.
    • No chewing for __(amount of time the doctor chooses)_______.
    •  Do not drive, make important decisions, sign legal documents, or do any activities that require alertness, balance or coordination for the next 24 hours.
    • You must be under the care of a mature adult for the next 24 hours.
    • Sleep at a 45 degree angle for the first night. (Sleep in a comfy arm chair, or sleep upright in your bed, using several pillows to keep your head elevated.)
    • Do not do any vigorous activities for the next 24 hours.
    • Take packets of 400 mg of Ibuprofen and 500 mg of Tylenol every 4 hours for the next 24 hours BY THE CLOCK, set an alarm for the middle of the night dosages. (for the first 24 hours, take pain medications as advised above even if you do not feel any pain.) After 24 hours, take pain medication as needed for pain.
    • If prescribed, take packets of 10 mg Phenylephrine HCI and 25 mg Diphenhydramine at times written on packets until gone.
    • Take over the counter probiotics. (This will help prevent or reduce any side effects from antibiotic use such as diarrhea, nausea, or indigestion.)
    • Continue taking antibiotic until it is gone.

    * Start your normal daily medication when you go home or when your doctor tells you to

    •  Some bleeding is normal for the first 24 hours after surgery. Excessive bleeding (mouth fills rapidly with blood) should not occur. If you experience excessive bleeding, please call 911 or go to the emergency room.
    •  Swelling and bruising are common and may not start for hours after the surgery. Use an ice pack (standard ice pack or bag of frozen peas, for example) for 4 continuous hours immediately after surgery and for 4 continuous hours the following day before noon.
    • Do not brush directly around site for first few days.
    • If prescribed, lightly rinse and soak area with Peridex.
    • No vigorous swishing or spitting.
    • Do not blow nose. Sneeze with mouth open with hands supporting cheek bones. Cough with your mouth open.
    • Call our office to report any nose bleeds, following surgery.
    • Wipe nasal secretions.
    • Rest; for the next few days.
    • Ice; use the ice pack.
    • Compression; the ice pack helps compress the surgery area and promote effective healing.
    • Elevation; sleep with your head elevated the first night after surgery.
    * If you are a smoker, DO NOT smoke for 72 HOURS after your surgery

    Download and Sign the Pre and Post Surgical instructions below:

    For surgical instructions concerning sedatives and operations, please click on the links below. If you have any questions, please give us a call!

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