We
are committed to providing the same quality of care following procedures
that began during your initial visit. To that end, please refer
to some general postoperative guidelines below, and by all means,
CALL at any hour of any day to report any continuing problem.
(718) 398-1969
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Please select from the list of post-operative instructions...
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THE
DAY OF SURGERY
1.
Some degree of discomfort and pain arises as numbness subsides.
At the first sign of pain or discomfort, take the pain medication
prescribed. Please make sure you read the directions carefully before
taking the medication. Any pain medication can cause nausea and
vomiting. It is very important that you have some food in your stomach
before you take them.
2.
DO NOT DISTURB
THE AREA OF SURGERY.
The first stages of healing are aided by placing tissues at rest.
Avoid vigorous chewing, excessive spitting, or rinsing as initial
healing may be delayed, active bleeding restarted, or infection
introduced.
3.
Expect minor bleeding or oozing from the operative site. This bleeding
may continue throughout the first day. For the first hour, keep
firm pressure on the area of surgery by biting on the gauze sponge
placed in your mouth at the office. If bleeding persists, continue
pressure on a fresh sponge for an additional 30 minutes to an hour.
Biting on a moist tea bag wrapped in gauze may help control persistent
oozing from the surgical site. Tea has an ingredient that promotes
blood clotting.
If active bleeding should recur at any time,
carefully rinse your mouth with cold water and apply a fresh gauze
sponge to the bleeding site. Firm pressure for 15-30 minutes usually
controls the problem. Should active bleeding persist, please call
the office.
4.
LIMIT PHYSICAL ACTIVITY during the first 24-48 hours after
surgery. Overexertion may lead to postoperative bleeding and discomfort.
When you lie down, keep your head elevated on a pillow.
5.
PAIN FOLLOWING ORAL SURGERY will be most severe
within the first 6-8 hours after the operation. If you have to take
the prescribed severe pain medication, remember to have some food
intake prior to that and to start slowly. Please do not drink alcoholic
beverages while taking prescription pain medication. Do not wait
for the pain to become unbearable before using some form of pain
medication, as then it will be more difficult to control. Moderate
to severe pain usually does not last longer than 24-48 hours, and
there should be no more than the slight pain or discomfort after
the third day. Persistent or increasing pain 3-4 days following
oral surgery may be caused by early loss of the blood clot (dry
socket) or infection. If you feel that this may be happening to
you, please contact us so that we can help make you more comfortable.
6.
SWELLING RELATED TO THE SURGICAL PROCEDURE usually
develops during the first 12-24 hours following surgery, often increasing
on the second day. It should begin to subside by the third day.
Swelling can be minimized a great deal by wearing an ice pack on
the side of your face for 30-45 minutes every hour while you are
awake during the first 24 hours following the surgery, unless you
receive special instructions. Anti-inflammatory medications, such
as Motrin or Advil, also help decrease swelling.
7.
FLUID INTAKE
IS IMPORTANT.
We suggest you start with clear carbonated beverages, such as ginger
ale, Seven-Up, or Sprite. Once your stomach has settled, you can
advance to other fluids such as water, teas, soda, broth, soups,
or juices. We suggest avoiding dairy products initially, such as
milk, milk shakes, and egg nogs. Also avoid hot liquids until the
numbness has worn off, and the bleeding has stopped. It is important
to drink plenty of fluids.
8.
AVOID USING A STRAW FOR SEVERAL DAYS as it may
cause the blood clot to dislodge and delay healing.
9.
FOOD SELECTION is largely a matter of your choice.
Soft, cool foods that require little or no chewing are most easily
tolerated at this time. A nutritious diet throughout your healing
process is most important to your comfort and temperament. Hungry
people become irritable and less able to deal with discomfort which
can follow surgery. Since you will be taking medication, it is important
to remember that eating can prevent nausea sometimes associated
with certain medications. Once your stomach is settled, soups, broiled
fish, stewed chicken, mashed potatoes, macaroni and cheese, and
cooked vegetables can be added to your diet as your comfort indicates.
Ensure, Carnation Instant Breakfast and/or yogurt supply excellent
added nutrition.
10.
Take any special medication such as ANTIBIOTICS we have prescribed
on the specified dosing schedule. Yogurt with active cultures or
acidophilus should be taken while on antibiotics to prevent diarrhea.
It is important to take the antibiotics to completion. If you are
given antibiotics and take birth control pills, you should be aware
that the birth control pill may become ineffective, therefore take
appropriate precautions.
11. Take any regularly scheduled medication (for
diabetes, high blood pressure, etc.) on your regular schedule unless
advised to do otherwise.
12.
TRY TO AVOID SMOKING COMPLETELY, as it tends to slow the
healing process and may also contribute to development of a dry
socket.
13.
DO NOT DRIVE AN AUTOMOBILE for 24 hours following surgery
if you have had intravenous sedation, or if you are taking prescription
pain medication.
14.
IF YOU WERE INFORMED THAT A SINUS COMMUNICATION OCCURRED DURING
SURGERY, as a result of the close relationship between
the roots of your upper teeth and your sinuses, or if you have had
some surgery that involved work near your sinuses or in your sinuses,
please follow these instructions:
DO NOT blow your nose.
DO NOT sneeze through your nose. If the urge to
sneeze arises, sneeze with your mouth open.
DO NOT smoke or use a straw.
AVOID swimming and strenuous exercise for at least
one week.
It is not uncommon to have a slight amount of bleeding from the
nose for several days.
Please remember that occasionally a second procedure may be required
if there is a persistent sinus communication.
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THE
DAY FOLLOWING SURGERY AND THEREAFTER
1. On the morning of the day following surgery,
rinse your mouth carefully with the solution made by adding 1/2
teaspoon of salt to a large glass of warm water. Repeat three times
a day until remaining soreness subsides. Resume brushing any remaining
teeth and your regular oral hygiene as soon as possible. Do not
avoid brushing the area as this will cause more inflammation in
the area. Please do not use a syringe or Water Pik® to aggressively
rinse during the first week. This can dislodge the blood clot.
2.
DO NOT WORRY ABOUT STITCHES. Stitches (also known as sutures)
are usually placed to control bleeding, aid healing and help prevent
food from collecting in the surgical site - - especially for lower
teeth. The sutures we use dissolve in 3 to 5 days and DO NOT HAVE
TO BE REMOVED.
3.
ANY SWELLING, SORENESS, OR STIFFNESS IN THE JAW MUSCLES
can be relieved by applying a warm moist towel to the affected side
of the face several times a day. Moist heat should be used after
the first 24 hours. If swelling, tenderness, or pain should increase
after the first few days, call the office.
4.
Sometimes a soft diet may be necessary for the first few days following
surgery. Most patients are able to resume regular food intake within
a short time.
5.
Bruising marks may appear on the skin of the face during the first
few days after surgery. Moist heat application will help relieve
this condition once again.
WHAT
ARE DRY SOCKETS? Dry sockets continue to be the most common
problem people experience following dental surgery. They arise due
to premature loss of a blood clot in the empty tooth socket and
affect approximately one out of five patients. This seems to occur
with greater frequency in people who smoke or are taking birth control
pills. While both jaws can be affected, they usually occur in the
lower jaw on the third to fifth day. They cause a deep, dull, continuous
aching on the affected side(s). Patients may first notice the pain
starting in the ear radiating down towards the chin. It frequently
begins in the middle of the night, and the Motrin medication usually
doesn’t help. Treatment involves placing a medicated dressing
in the "empty" tooth socket. This will help decrease the
pain and protect the socket from food particles. The effectiveness
in alleviating the pain lasts for 24-48 hours and usually will require
dressing changes every day or two for five to seven days. Dressings
usually are removed when you have been pain free for 2-3 days. The
dressing doesn’t aid in healing. The only reason to place
a dressing is for pain control. If Motrin is controlling the pain,
the socket will heal without a dressing. An irrigation device will
be given to you to help keep food particles from lodging in the
extraction site following removal of the dressing.
If you need assistance over the weekend,
it is helpful if you call around 9:00 AM, so that we can arrange
to see you in one of our offices. We appreciate your patience as
we do our best to keep you comfortable during the healing process.
Faithful compliance with these instructions
will add to your comfort and hasten your recovery. Be sure to follow
these instructions carefully. Only in this way will you avoid the
complications which lead to unnecessary discomfort and delayed recovery.
Should any undue reaction or complications arise, notify the office
immediately.
If
you need to contact us after office hours, please call the office
at (718) 398-1969.
We
make every attempt to answer my emergency pager as promptly as possible.
Occasionally, your messages do not reach our pagers. If you do not
hear from the doctor on call within one-half hour, please call back
and ask them to page the doctor again. Do this until your page has
been answered by the doctor.
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POSTOPERATIVE
INSTRUCTIONS FOR SOCKET BONE GRAFTING
In addition to the general postoperative instructions, we would
like to emphasize a few points.
Your
bone graft is made up of many particles. You may find some small
granules in your mouth for the first several days. Do not be alarmed
by this. It isnormal to have some of them come out of the graft
site and into your mouth. There are some things you could do to
minimize the amount of particles that become dislodged:
Do not vigorously rinse or spit for 3-5 days.
Do not apply pressure with your tongue or fingers to the grafted
area, as the material is movable during the initial healing.
Do not lift or pull on the lip to look at the sutures. This can
actually cause damage to the wound site and tear the sutures.
For the first day, we would suggest letting the blood clot stabilize
and not even rinse your mouth. Following the first day, gentle rinsing
would be advised but not too vigorously as you can again disturb
some of the bone graft granules. If a partial denture or a flipper
is placed in your mouth, you will probably have to see your restorative
dentist to have it adjusted and learn how to remove and replace
it appropriately.
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POSTOPERATIVE
INSTRUCTIONS FOLLOWING SINUS GRAFTING
If you had a sinus grafting procedure performed the general postoperative
instructions still apply, but we would like to emphasize a few important
points about your particular procedure and remind you of some instructions:
1. Do not blow your nose.
2. If you must sneeze, do so with your mouth
open to avoid any unnecessary pressure on the sinus area.
3. Do not smoke or use smokeless tobacco.
Smoking greatly inhibits the healing, especially in the sinus graft.
4. Do not take liquids in through a straw.
5. Do not lift or pull up on your lip to
look at the stitches, as this may actually create damage and tear
the stitches.
6. Take your antibiotics as directed and
until finished.
7. You may have some bleeding from the nose.
This is not uncommon and should pass quickly.
8. You may be aware of small granules in
your mouth for the next few days. This is not unusual, as your graft
is mainly made of particles and not all of them are accepted by
the body.
9.
If you feel congested, you may need to use antihistamines or decongestants.
If you do, use over-the-counter products such as Tavist-D or Dimetapp.
We would also suggest that you avoid nasal sprays unless they are
saline. Most of the time, patients do fine without any nasal sprays,
antihistamines, or decongestants.
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POSTOPERATIVE INSTRUCTIONS
FOR ENDOSTEAL IMPLANTS
If you had endosteal implants placed, general postoperative instructions
apply, but we would like to emphasize a few things:
1. Placement of endosteal implants usually
do not create a great deal of pain. Once again, start with Advil
first.
2. You need to brush the area after the first
24 hours with a very soft toothbrush. Do not avoid brushing the
area. Most times the sutures that are placed are dissolvable sutures
which will dissolve on their own in 8-12 days.
3. If a one-stage implant was placed so that
you can actually see the metal part protruding from the gum tissue,
it is very important for you to keep this area clean. You may start
with a Q-tip dipped in Listerine or even warm salt water. Just clean
the metal part protruding from the tissue. Then you can proceed
to a soft toothbrush.
4.
Avoid chewing hard foods on the implant sites. Chewing forces during
the healing phase can decrease the body’s ability to heal
around the implant.
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