Dr. Bela Shah

PRE-TREATMENT SURGERY INSTRUCTIONS

OUR PREPARATION:

We are committed to reserve ample time for your procedure while minimizing your time in the office. Should it be impossible for you to keep your appointment, rescheduling FOUR DAYS in advance will allow us to help someone else in need. THANK YOU IN ADVANCE FOR YOUR CONSIDERATION.

HOW TO HELP:

Please let us know of any change in your health or medication. Eat a high protein meal. Hypoglycemic patients should eat two hours before surgery. Please have prescriptions filled before your appointment. Avoid taking aspirin (Tylenol is okay) for 1 week prior to your appointment. Aspirin can cause bleeding. Avoid alcohol and caffeine 48 hours before surgery. They can interfere with anesthetic. If you wear partial dentures, retainers, night guards or other removable appliances, please bring them with you. Please wear comfortable clothing. Layers are preferred. Get a good night sleep. We will too!

SPECIAL INSTRUCTIONS:

When having IV sedation, DO NOT eat or drink anything after midnight, the night before your surgery. If prescribed, take Valium as directed the night before and day of your procedure. All diabetic patients are expected to follow their normal medications and diet unless modification has been specifically discussed with your physician. Be sure to take all prescribed medications as usual. Stop all “Blood Thinner” medications three days prior to surgery and resume them the day after.

POST OPERATIVE INSTRUCTIONS

1 DISCOMFORT/ MEDICATIONS. Periodontal surgery, like other surgical procedures, may be accompanied by varying amounts of discomfort. In order to best manage any discomfort, the following is recommended: Continue taking all prescription medications unless otherwise directed For the first 36 hours after surgery, take 600mg of Ibuprophen (Advil) every 6 hrs. This will minimize inflammation, which minimizes discomfort. If an 800mg dose is used, take every 8 hours. Take Ibuprophen along with food to avoid stomach upset. Do not take Ibuprophen if your physician has advised you to not take Ibuprophen or NSAIDS (non-steroidal anti-inflammatories). Depending on the procedure performed, you may have been given a prescription for a pain medication. To insure proper healing, take exactly as directed. If you were prescribed antibiotics for your procedure, it is very important to take as directed, and until gone. Not complying with antibiotic instructions can dramatically affect the results of your performed procedure.

2 BLEEDING. Slight bleeding or “oozing” from the surgical site is expected for the first 2 days If sudden profuse bleeding occurs, contact your doctor immediately or seek immediate care via Emergency Room.

3 SWELLING AND BRUSING. Minor swelling after periodontal surgical procedures is common. Depending on the procedure performed, swelling may continue to increase for up to 36 hrs. If swelling continues to increase after 36 hours and is accompanied by severe pain, contact your doctor. This may be a sign of infection. Any unusual or large swelling should be reported to your doctor immediately. If swelling intrudes upon airway, seek immediate care via Emergency Room. To minimize swelling, apply ice to the outside of the cheek over the surgical site. For the first two days, apply ice as much as possible. This greatly reduces post-operative swelling, which in turn decreases any discomfort. Do not apply heat to the surgical area for the first two days. After two days, warm compresses may be applied on the cheek. Facial or neck bruising after surgery may occur in some individuals. If this occurs, it is not a negative sign of healing nor will it affect the result of the procedure.

4 ORAL HYGIENE. Normal oral hygiene in every area of the mouth, except for at the surgical site, should be resumed the evening of surgery. Brushing, flossing, irrigating devices, interproximal brushes, and any other oral hygiene practice should be discontinued at the surgical site for the first week following surgery. You will be given an anti-plaque mouthwash that will help clean and disinfect the surgical site without brushing and flossing at the site. This mouthwash should be used by gently rinsing twice daily (and no more) for 30 seconds. Use for one week (unless otherwise directed). Avoid use of any commercial mouthwashes. At your post-operative appointment, you will be instructed on when and how to resume oral hygiene at the surgical site.

5. DIET For the first week after surgery, as soft diet is important to avoid any disturbances to the surgical site. Completely avoid anything hard, crunchy or small that may disturb or get caught in the surgical site (seeds, nuts, popcorn, chips). If this occurs, an infection of the surgical site may occur. To assure proper healing of the surgical site, it is imperative that you receive adequate nutrients, vitamins and minerals, even when on a soft diet Chew any soft foods on the side opposite the surgical procedure for the first week. If both sides of the mouth had surgery performed, a complete liquid diet is recommended for the first week. Plenty of fluids should be consumed in order to achieve optimal healing. Avoid any carbonated beverages the first week following surgery.

6. SUTURES. Sutures are in place to help keep the gum tissue in place during the initial healing period. Avoid allowing your tongue to feel or disturb sutures. This often causes sutures to fall out prematurely. Do not pick, pull or cut sutures on your own. If a lose suture is irritating to you, please call our office, and we will see you immediately for a suture trim. Most or all of your sutures will be removed at your post-operative appointment.

7. IMPLANT AND GRAFTING SITES. It is very important to avoid any trauma (chewing) in this area for the first week after surgery. The area should be protected if possible for the first four weeks following surgery in order to achieve the best results (no hard or crunchy foods on that side of the mouth).

8. PHYSICAL ACTIVITY Avoid any strenuous activity or heavy lifting for the first 2-3 days after surgery.

9. SMOKING. Smoking dramatically affects proper healing following periodontal surgery. All smoking should be stopped until suture removal. Following implant surgery, smoking cessation is recommended eight weeks following surgery. Smoking negatively affects implant success rates, but smoking cessation 8 weeks following surgery has been shown to decrease failure rates.

10. ALCOHOL Alcohol should not be consumed during the initial healing process. Depending on the antibiotic or pain medication being taken post-operatively, the consumption of alcohol is often prohibited.