Operative Instructions


PRE-OPERATIVE INSTRUCTIONS


Your optimal response to dental surgery is dependent on prior preparation and your confidence that this procedure is of value to you. Part of your comfort level is based on addressing your concerns or questions. It is very important to follow these instructions for your safety and comfort during the procedure.
1.  Medications: Take prescribed medications (such as blood pressure) as directed. Please let us know if anything has changed with your medical history. Blood thinner (such as Aspirin, Plavix, and Coumadin) users should discuss the use of these medications with Dr. Yu or Dr. Litizzette before your surgery to be determined by your physician if you can discontinue them. If you are diabetic then please bring your medications & monitor with you to your appointment.
2.  Smoking: Make every effort to minimize smoking for 12 hours before the start of your procedure.
3.  Prescriptions: We will call in your surgery prescriptions a few days prior to your surgery. Please pick them up prior to your surgery date. Please start your antibiotic 2 days prior to surgery date.
4.  Clothing: Wear clothing that is not restrictive to the neck, arms or stomach. Wear loose-fitting tops, so that the sleeves can be rolled up to the shoulders and please avoid dresses.

Sedated Patients

If you are having conscious IV or oral sedation please follow these instructions before your scheduled appointment:
•  Designated Driver: If you are having sedation you must have a responsible adult, over 18 years old, drive you to and from your appointment (you will not be able to drive the remainder of the day). If your designated driver chooses to leave during your procedure then make sure he/she provides a contact number with our front desk staff. Following the procedure, the designated driver should escort you home in a vehicle and remain with you until you are fully awake.
•  Food: No food or opaque liquids (ie. milk, OJ, soda, etc.) for six (6) hours before the start of the procedure. (i.e. if you are not scheduled for your procedure until after 11:30am, try to eat something in the early morning, then abstain from eating until after your procedure). If you are diabetic and required to eat something in the morning then follow the guidelines that have been given to you by your physician.
•  Liquids: Clear liquids are allowed up to two (2) hours before the start of procedure (ie. water, black coffee, cranberry juice, etc.)

If you are taking oral sedation in addition to the above instructions:
•  Prescription: You will be prescribed two (2) Halcion pills at your local pharmacy. You will be taking one (1) pill one hour prior to your surgery time and bring the second pill with you to your appointment.
•  Consents: You will need to sign your consent(s) before oral sedation. Either arrive 1 hour early, or we can e-mail them to you.
•  Finances: You will need to complete the finances before taking oral sedation, unless your escort will do this on your behalf.




POST-SURGICAL CARE INSTRUCTIONS

BLEEDING

- Bleeding after surgery may continue for several hours up to 24hrs. Pink or blood-tinged saliva may be seen for 2-3 days following the surgery and does not indicate a problem. Rest with your head elevated for up to 1 week. The best way to stop profuse bleeding is to place moist gauze over the surgical site with firm pressure for 30-60 minutes. If bleeding continues, place pressure using a cold, moist tea bag for an additional 30 minutes. Bleeding should always be evaluated by looking directly at the surgical site. Place a towel on your pillowcase the evening of your surgery to avoid staining linens.

SWELLING

- Swelling is the body's normal reaction to surgery and healing. The swelling may not become apparent until the day following surgery and may not reach its peak until 2-3 days. After this time, the swelling should decrease but may persist for 7-10 days.

Swelling may be minimized by the immediate use of ice packs. Apply the ice packs to the outside of the face 15 minutes on and then 15 minutes off while awake for the first 24 hours. If swelling is present after 2 days you may alternate with warm compresses. Sleeping with the head elevated will also help minimize swelling for up to 1 week.

PAIN

- Oral surgery can be accompanied by some degree of discomfort. The following regimen of medication should provide adequate pain control, more than if you were taking narcotic medication alone.

If you are able to take non-steroidal anti-inflammatory medications like Ibuprofen (Advil or Motrin) we recommend taking this prior to the local anesthetic wearing off. More severe pain may require a prescribed pain medication. You may alternate Ibuprofen and your prescribed pain medication. To alternate, begin by taking 600mg (3 tablets of 200mg each) of Ibuprofen. Then, in 3-4 hours take the prescribed pain medication. In another 3-4hours take another dose of 600mg Ibuprofen. Continue alternating as needed. The prescribed pain medication may make you drowsy; therefore, do not drive while taking it. Once you feel like you can stop the pain medication, use Ibuprofen or Tylenol. All medications should not exceed the recommended dosage. Ibuprofen has the added advantage of reducing inflammation and swelling much better than the pain medication. Please do not take any medication if you are allergic or if you have been instructed by your doctor not to take it. After its peak in 2-3 days, discomfort should decrease daily. If not, please call our office. Do NOT take hydrocodone at the same time as Tylenol products. Also avoid aspirin products unless directed by physician.

PERIOSCIENCES™ AO ProVantage GEL

- Starting the day after surgery, apply gel 5 times a day for the first 3 days & then 3 times a day for 5 days & then 2 times a day until gone. Don’t rinse or eat for 30 minutes after you apply it. PerioSciences gel plays a very important role in healing and helps prevent post-operative infection.

ANTIBIOTICS

- Take the entire prescription as directed until gone. Antibiotics are given to help prevent infection. Make sure to call the office if a rash or other unfavorable reaction occurs. If your throat feels swollen, go to the Emergency Room. Please be advised that antibiotics may reduce the effectiveness of some medications, such as birth control pills. We recommend taking probiotics to help maintain proper digestive health.

ORAL HYGIENE

- The best way to prevent infection and ensure healing is to keep your mouth clean. Starting the day after surgery brush and floss as normal, avoiding any surgical sites until your post-op visit. On the second day, gentle rinse by moving water in your mouth and dribbling it out. No spitting. You must continue your recommended cleanings as directed.

ACTIVITY

- For the first 72 hours you should rest with no physical activity or heavy lifting. After 72 hours, you may resume activity as tolerated, unless otherwise directed. Air travel out of town should be avoided for 7-10 days after surgery. If you are having IV sedation you are not allowed to drive for the remainder of that day.

SUTURES / STITCHES

- Most sutures are resorbable or fall out on their own. If non-resorbable sutures are used you will be given instructions on when they will be removed. DO NOT remove or pull on sutures on your own. If a suture becomes bothersome, call our office to schedule a suture trim. If bleeding occurs because the sutures have fallen out, use moist gauze to apply pressure as described above.

ALCOHOL / SMOKING

- Do NOT smoke for at least seven days, and then limit smoking to half. Smoking delays healing and increases the failure rate of surgical therapy (including implants and grafts). Avoid alcoholic drinks for 5-7 days. Alcohol may interfere with antibiotics, pain medication and healing.

SINUS LIFT PROCEDURES

- Expect swelling and some bruising for several days after surgery. For the first week, do NOT blow your nose. If you sneeze, try and open your mouth and make it into a cough. Sneezing and blowing your nose may place additional pressure on the sinus membrane and introduce bacteria in the surgery site. For allergy and congestion relief, you can use over the counter medications such as Sudafed, Zyrtec or Claritin. Afrin Nasal spray can also be used by lying on your back and placing nose drops in without inhaling. Avoid: suction, spitting, straws, smoking and heavy exercising for 5-7 days after procedure.

DRY SOCKETS (TOOTH EXTRACTION)

- If a dry socket occurs (loss of blood clot from socket) there is constant pain that may radiate to other areas including ear, jaw and teeth. Symptoms of a dry socket may occur starting the 3rd to 4th post-operative day. If you do not have improvement during the first few days following the procedure, call the office. To help prevent a dry socket avoid vigorous rinsing, spitting, using a straw, smoking and, exercising for 5-7 days after procedure.

If bone graft material is placed, you may find some small granules in your mouth throughout healing process. This is normal and expected. Complete closure of an extraction site may take 6-8 weeks.

PALATAL STENT (For Soft Tissue grafting)

- If tissue was taken from the palate, a stent may be placed that covers the roof of the mouth. This is to be worn continuously for the first 24 hours after surgery. After that day, the stent is to be worn as little as possible to promote healing. It is not unusual for the healing graft to turn white or gray, so don’t be alarmed. If front teeth have been grafted do not bite into anything for 2 weeks, cut food up and place in mouth. Do not disturb the sutures, some sutures may wrap around the teeth. Avoid playing with sutures with your tongue. The surgical site must remain undisturbed for 10 days, do not pull on lip to look at the area.

OSSEOUS PROCEDURES

- Most surgeries involve repositioning of the gum tissues and recontouring the bone around the teeth. In regenerative procedures, bone materials and barrier membranes may be used to “rebuild” tissues lost to disease. Patients can expect increased sensitivity, gum recession, and food impaction between teeth following surgery.

DENTAL APPLIANCES

- If you wear any dental appliance please bring it to your surgical appointment or post-op visit. This may include Invisalign-Type Tray, Night Guard, Retainer, etc. It may need to be adjusted to avoid pressure against the surgical site.

TEMPORARY IMPLANT CROWN

– If temporary crown is placed on an implant you are to avoid biting/chewing on it until a permanent crown is placed by your restorative dentist.

DIET

- For the first 2 days following procedure, you should avoid hot liquids or foods. Cold liquid type/soft foods are most easily tolerated. 3 to 4 days after procedure, you can progress to soft solid foods, chewing away from the surgical site(s). You should avoid foods that are hard, sticky or chewy, including nuts, sunflower seeds, popcorn, etc., which can get lodged in the surgical areas.

Do NOT use a straw and avoid carbonated beverages for 5-7 days after surgery. They can cause more bleeding and loosening of the sutures.

FOODS TO EAT AND DRINK DAYS POST PROCEDURE


(See Our Diet Suggestion Sheet)
Soft Foods starting day three


A soft diet is anything you can cut with a fork and chew with less than three bites (ground meat dishes, pasta, cooked vegetables, fish, scrambled eggs, etc). Increase diet as tolerated or instructed.


512-306-8822
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Dr. Yu and Associates

Dr. David Yu
Dr. Nicole Litizzette

4201 Bee Caves Road Suite C-211
Austin, TX 78746

Fax: (512) 306-8848


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