Operative Instructions

Pre-Operative Instructions

PLEASE LET THE DOCTOR OR STAFF KNOW IMMEDIATELY IF YOU HAVE ANY OF THE FOLLOWING CONDITIONS:

You are or think there is any possibility of being pregnant.
If you are allergic to or have any adverse reactions to any medications.
If you are taking blood thinners or require a pre-medication prior to a dental appointment due to an artificial joint replacement, etc.

The following instructions may be helpful when preparing for your upcoming surgery. Please do not hesitate to call the dentist if you have any last-minute questions. We can be reached at 804.272.9079 during regular business hours.

We will make every attempt necessary to give you your prescriptions required for pre- and post-surgery. Please make sure that the office has your correct pharmacy information, so that your prescriptions can be sent in for you to pick up prior to your procedure. Please bring your filled prescriptions with you to your appointment.

It may be important to stop taking aspirin and non-steroidal 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.

In order to evaluate your progress and healing, we will see you for periodic post-operative checks in the two-month period following your procedure. The first visit will typically be two weeks after your procedure, but please give the office a call if you feel like you need to be seen sooner than your scheduled appointment. 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.

Antibiotics
Please alert the office to any allergies or sensitivities that you might have to antibiotics. You will be prescribed an antibiotic, which you should begin taking up to 48 hours prior to your procedure, as directed and until it is 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.

Sedatives
If you elect for the nitrous oxide option, you will be able to drive yourself home. The effects of the laughing gas wear off within minutes of removal of the mask that provides the gas.
If you elect to use conscious oral sedation, you must have a responsible adult to drive you home after the procedure. You will be unable to leave the office alone. For a procedure scheduled in the morning, DO NOT EAT AFTER MIDNIGHT (12:00AM) of the morning in which the procedure is scheduled. You may ingest a small amount of water along with any medications you are required to take.

Please wear a shirt with short sleeves and loose-fitting, comfortable garments and plan to arrive approximately 30 minutes before the scheduled appointment. We will have you take any prescribed medications exactly as directed when you arrive to the office.

If you should develop a cold, flu, sore throat, respiratory infection, or any other illness, please notify our office as soon as any symptoms develop. We will need to reschedule your appointment when you are more physically fit. At least 48 hours' notice is greatly appreciated when rescheduling appointments.

Post-Operative Instructions

DISCOMFORT AND MEDICATIONS

Periodontal surgery, like other surgical procedures, may be associated with varying degrees of discomfort. This depends on the procedure involved and individual differences. All medications should be taken strictly as prescribed. The interval between taking the medication and the total length of time that you are to remain on your medications has been carefully determined to give you the maximum benefit with the minimum use of drugs. Variation from the prescribed regimen can affect healing and the success of your procedure. Reduced efficacies of oral contraceptives (birth control) have been associated with range antibiotics. Therefore, we advise consideration of this when antibiotics are prescribed during your therapy.

Remember all prescription medications should be taken on a FULL stomach and/or after a meal!
Take the FIRST dose of antibiotics the night before the procedure.
If analgesics (pain medications) have been prescribed, it is usually best to take the first dose while the surgical site is still anesthetized (“numb”).
Please start using the Peridex Mouthwash the day after the procedure, and ONLY use for 4 DAYS after procedure, then STOP! This can stain your teeth & tongue and can cause bacteria to build up in the mouth.
If still in significant pain, you may alternate Acetaminophen (Tylenol) 500mg and Ibuprofen (Advil, Motrin) 800mg, AS NEEDED. Do not take both at the same time, they should be taken 4-6 hours apart.

BLEEDING

You may notice slight bleeding from the surgical site. This type of minor bleeding for one to two days is not unusual and is not a major concern. If at any time you notice the formation of large blood clots or an obvious flow of blood which is more than a slight ooze, notify your doctor at once.

If you experience heavy bleeding from the surgical site, place a damp BLACK TEA BAG (no green tea, or with any additives) and apply pressure to the surgical area until the bleeding has stopped. If you still are experiencing heavy bleeding, please notify Dr. Amin, who may advise you to go to your nearest emergency room.

SUTURES

Sutures (stitches) are placed to hold the gingival tissues in the proper position for ideal healing. If sutures were placed, your doctor will usually want you to return for a follow up and to remove them once sufficient healing has occurred. DO NOT disturb the stitches with your tongue, toothbrush, or in any manner since displacement will impair healing.

ORAL HYGIENE

Continue to brush and floss the tongue and any teeth which were not involved in the surgery (or are covered by the periodontal dressing). The surgical area should not be disturbed for the first week post operatively, meaning no brushing or touching with your fingers or tongue. However, you will need to begin gently cleaning around the surgical site with a cotton swab soaked in hydrogen peroxide. After your sutures have dissolved or been removed, generally 7-10 days after the procedure, you may begin gently rinsing with warm salt-water or a mouthwash and should lightly clean the teeth using a soft toothbrush, or as instructed by your doctor.

DIET

For the first 24-48 hours eat and drink everything cold (such as ice cream, cold yogurt, cold soups). For your comfort and to protect the surgical area, a soft diet (such as fish, eggs, hamburger meat, pasta, etc.) is recommended. Avoid chewing in the area of surgery. Avoid hard, fibrous, “sharp,” and anything foods with small seeds (such as chips, apples, popcorn) as these may be uncomfortable and dislodge the periodontal dressing. Avoid hot food/beverages the DAY OF the surgery. Drink plenty of fluids. It is important to maintain a diet with a normal calorie level that is high in protein, minerals, and vitamins to support the post-operative healing. Post-surgery is not the time to start a diet – this could have detrimental effects on healing and lessen the chances of success of the surgical therapy.

DO EAT

Ice Cream and everything cold for 24-48 hrs.
Mashed Potatoes
Ground meats (Ground Turkey, Chicken, Beef)
Pasta
Jell-o
Pudding
Oatmeal
Eggs (any style)
Soup
Flaky Fish (halibut, tilapia, salmon
Pancakes
Smoothies
Protein drinks
Yogurt

DO NOT EAT

Pizza
Bread
English Muffins
Bagels
Sandwiches
Steak
Meat/Poultry with bones
Caramel
Popcorn
Nuts
Jerky
Chewing gum
Chips
Raw vegetables

PHYSICAL ACTIVITY

Avoid strenuous physical activity during your immediate recovery period, usually the first 48-72 hours.

PERIODONTAL DRESSING

A periodontal dressing (pink, resembling silly-putty) is often used to cover the surgical site for 7-10 days after surgery. The dressing is placed around your teeth to protect the surgical area and should not be disturbed. If small pieces break off or the entire packing falls off and you do not have any discomfort, there is no cause for concern.

SWELLING

Some swelling of the operated area is not unusual and may begin after the surgery. An ice pack may be used to minimize swelling in the first 24 hours. If an ice pack is not available, ice should be placed in a plastic bag and wrapped in a thin cloth towel and applied directly over the surgical area. You should apply the ice pack as much as possible for the first 24 hours after surgery (remember- never expose ice directly to the skin) - 15 minutes on, 15 minutes off. You should also keep your head elevated above the heart for the first 24 hours after surgery. This may necessitate the use of several pillows to support your head and upper body while sleeping. After 4 days of using the Peridex Mouthwash have passed, start gently rinsing with warm salt-water rinses 3-4 times per day.

SMOKING

All smoking should be stopped until after your sutures have dissolved or been removed to ensure the best healing and success of your surgical procedure. Healing results are significantly worse in smokers than in non-smokers.

ALCOHOL

All intake of alcohol should be stopped until after the removal of your non-absorbable sutures, and then minimized for the next several weeks to enhance healing. The combination of alcohol and certain pain medications is not recommended.

DO NOT’s

For the next 7 days following your procedure, DO NOT spit, smoke, rinse hard, drink through a straw causing a “sucking” action in your mouth, use commercial mouthwash, drink carbonated soda, or use an irrigating device.

It is normal to experience sensitivity to hot and cold foods/drinks for at least 6 to 8 weeks after surgery. It also takes your gum tissue 6 to 8 weeks to heal completely after surgery. Please contact us should you have questions or concerns not listed in these instructions.