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. We can be reached at 281-394-9340 during regular business hours.

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 into 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 and Advil, 7-10 days prior to your surgery. If you are taking Coumadin or another blood thinner, remember to discontinue them as directed. If you take antibiotic premed, please take it as directed before your surgery. You will feel better if you have eaten prior to surgery. We keep the office cool, so dress warmly. You may bring your iPod or MP3 player with you if you like.

In order to evaluate your progress and healing, we will see you for weekly post-operative checks during the first 1-3 weeks. In most cases, after surgery we will also look forward to seeing you back for a periodontal maintenance cleaning and an examination of tissue maturation about 10-12 weeks following the surgery.

POST OPERATIVE INSTRUCTIONS FOR PERIODONTAL SURGERY

CARE OF THE MOUTH: Bandages are often used for protection. In many cases, the bandage will come off before your post-operative appointment. If loss of the bandage causes bleeding, discomfort, or concern please call our office. The bandage is temperature sensitive. AVOID very hot beverages as they may soften and loosen the bandages .

ICE PACKS: Can be applied to the face over the surgical area to reduce swelling and bleeding. Apply the ice pack to the area off and on for at least the first 4-6 hours following surgery. Eating and chewing of normal food can be done in areas that did not have surgery. After 48 hours you are encouraged to return to a normal balanced diet. You can chew in the area of surgery as soon as you feel comfortable doing so.

ORAL HYGIENE: Cleaning of the area should be avoided so as not to disturb the healing process for the first week of surgery. The remainder of your mouth should be cleaned using your usual oral hygiene techniques.

BLEEDlNG: A slight amount of bleeding is not unusual. Avoid rinsing, spitting or sucking actions the day of surgery as this will cause additional bleeding by disturbing the blood clot that has formed. In case of excessive or continuous bleeding, moisten a teabag and apply it with pressure to the site for 15 minutes. Repeat if necessary. In addition, apply ice to the outside of our face and keep your head elevated. If after the 2nd application of ice and teabag, the bleeding continues please call our office.

ANTIOBOTICS: Will be prescribed for the first week after your surgery to prevent infection. Have the prescription filled immediately and begin taking it as instructed.

DISCOMFORT: Some discomfort is to be expected. The level will vary depending on the extent of the surgery. Use Advil/Tylenol regularly to control most discomfort. You will begin a prescription for pain before you leave today. If the pain is more moderate to severe, please have the prescription filled and take as instructed.

*YOUR POST OPERATIVE VISITS ARE VERY IMPORTANT*

We will see you in 2 weeks to check the area and remove remaining bandages and sutures. Please don’t hesitate to call if you have any questions or concerns.

POST-OP INSTRUCTIONS FOR 6 WEEKS – SOFT TISSUE GRAFTING AND PINHOLE TECHNIQUE

1. NO BRUSHING OVER SURGICAL SITE(S). Do not use cotton swabs, cloth or any soft or hard object to clean area. 
2. NO FLOSSING (Water-Pik ONLY from tongue-side or inside on low)
3. NO TOUCHING: with finger or any other device or object.
4. Do not lick surgical area.
5. Do not sleep on the side where surgery was done. If you have both sides done, sleep on back.
6. No facial massages for 3 weeks or massage that area of the face for any reason.
7. NO LOOKING: Do not obsess over or question Doctor about appearance of gums for 6 weeks. You cannot look without pulling cheek.
8. RINSE ONLY WITH LIPS APART: SLOSHING ONLY (NO Chipmunk cheeks when you rinse.)
9. Do not play wind instruments for 3 weeks. Do not blow balloons.
10. Do not suck on foods/straws or spitting.
11. No mints, chewing gum over surgical area. 
12. DO NOT EAT crunchy or sticky food (like bread) that can get stuck on or in between your teeth.
13. NO scalding hot drinks (tea, coffee, water or hot soups).
14. NO alcohol for at least 1 week.
15. No smoking, no electric cigarettes, chewing tobacco, cigar, pipe or smoking marijuana for at least 6 months. Please consult doctor if you need to use marijuana or inhalants.
16. Wear 24-hour appliance or night guard as prescribed (if recommended by the doctor). Failure to wear appliance may cause relapse. Check with your doctor if you wear any other appliances (e.g., retainers, lnvisalign, Peria-Protect, etc.)
17. No triclosan, hydrogen peroxide, bleach or any mouth rinse not approved by Doctor. (Coconut oil, holistic mouth rinses, or homeopathic remedy used only with permission of doctor). 
18. No Clenching or grinding go the teeth (No heavy lifting that require clenching of the teeth).
19. No heavy aerobics or vigorous exercising/dancing or physical activity for 3 weeks. (walking or non-strenuous activities are ok).
20. No facial device such as snorkeling or CPAP for 2 months. Consult with doctor in case of CPAP.
21. ICE OVER AREA at 10 minute intervals for the first 48 hours to minimize swelling.
22. DO NOT BE ALARMED ABOUT SOFT TISSUE SWELLING OR BRUISING FOR THE FIRST WEEK.
23. EXPECT cold sensitivity for 6 weeks or longer. DO REPORT sensitivity during check-up appointments.
24. PAIN CONTROL- take one each of acetaminophen (Tylenol) and NSAID (Motrin or Advil) at the same time, subject to other instructions by doctor.
25. CALL DOCTOR IMMEDIATELY IF YOU HAVE UNEXPECTED PAIN, CONTINUOUS BLEEDING, HEAT, OR ABNORMAL SENSATION AT SURGICAL SITE.
26. Patient MUST return to our office 24 hours after surgery, 1 week after surgery, 3 weeks after surgery, and 6 weeks after surgery.
27. After the 6th week you may brush surgical area with special extra soft brush dispensed or ordered by this office for 6 MONTHS.
28. Don’t press phone against face.

 Hygiene Care 6 Weeks After Pinhole (ON SURGICAL SITE)

1. Brush surgical site using soft toothbrush. PHB brand tooth brush is one option.
2. Use roll technique when brushing surgical site (from vestibule down). Ten strokes for each area, at least.
3. Waterpik using lowest mode. Direct the Waterpik from the lingual ( the tongue-side of your teeth), not from the facial side.
4. Do not use electric toothbrush for 6 months.
5. After 6 months, electric toothbrush can be used but only held by the fingers, never in the palm of your hand.
6. Floss if necessary, but only through the contact point. Don’t touch the gums with the floss.
7. If you see a different doctor for regular cleaning, remind hygienist or doctor not to measure or clean under the gum for 6 months. No crowns or veneers should be done on those teeth before 6 months.

Antibiotics

Please alert the office to any allergies or sensitivities that you might have to antibiotics. You will be prescribed an antibiotic if our doctor determines it to be necessary. 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.

Food Suggestions

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