Post-Operative Instructions

1. Keep firm, gentle, constant pressure on your gauze for 45-60 minutes. If the bleeding has not stopped, gently clean mouth and place a moist gauze pad over the surgical area for 30-45 minutes longer. Keep in mind that you will have slight bleeding over the first 24 hours. You do not need a gauze pad in place because of oozing, use a damp paper towel to blot this out. Do not spit or use a straw during the first 24 hours, violent motions may disturb the forming blood clot.

2. If active bleeding persists, you may moisten a tea bag wrapped in gauze, squeeze out excess water, and place directly over the cleaned surgical site. Keep constant, gentle pressure on the bag for at least 60 minutes. You should clean the mouth with cool water or a moist paper towel, then immediately place the pack. If bleeding is still not controlled, call the office.

3. Use an ice pack on the outside of the face over the surgical site for 24-72 hours after surgery. This will help relieve discomfort and minimize swelling.

4. Use your pain medication and all the other prescribed medications as directed. Do not take pain medications on an empty stomach. There is no need to take these medications unless you have pain.

5. Eating and drinking: During the first 24 hours avoid extremely hot, crunchy, or hard foods. While you are still numb, nothing with chunks in it-smooth and creamy foods. Early diet suggestions include: Yogurt, pudding, instant breakfast, and milkshakes. When the feeling has returned, you may have normal soft foods: casseroles, stews, cooked vegetables, rice, and noodles.  No sharp, crispy, or crunchy foods until we evaluate healing.  Proper nutrition is important for healing.

6. Oral hygiene: For the first 24 hours use cool water for rinsing. After 24 hours, you may start rinsing with Peridex (chlorhexidine) twice a day and warm salt water (1/2 teaspoon salt in 8 ounces of water) several times a day. When the numbness is gone, you may gently brush up to, but not on the surgical site(s).

7. The first 72 hours: Do not sip through a straw; minimal alcohol; no commercial mouthwashes; no use of tobacco products. All of these can disturb healing with increased risk of bleeding and discomfort.

8. If you have any questions or problems, please call the office, 940-696-2002.

Post-Operative Pain Control

Pain can be controlled at the site and in the brain.  Combinations of medicines work better.

Site Control

NSAIDs (nonsteroidal anti-inflammatory drugs)-Advil, Motrin (ibuprofen); Aleve, Naprosyn (naproxen); Celebrex (celecoxib), Voltaren (diclofenac); Mobic (meloxicam); Toradol(ketorolac); and Aspirin are examples.

Work against both pain and swelling.

Can cause kidney damage and stomach ulcers.  They can also increase bleeding. This is usually not an issue with oral surgery; local measures can be used to control this.

Brand names are better than generic.

Dosages:  Advil 200mg x 3, 3x a day; max 800mg 4x a day.  Aleve 220mg 2x a day; max 1500mg a day.  Max doses are for short periods of time only.

Central Control

Tylenol  500mg x2 up to 4x a day, max 4g (8 extra strength 500mg or 12 regular 325mg tablets).  Tylenol in large quantities can cause massive liver damage.

Ultram (tramadol) is a synthetic narcotic that works well by itself.  Typical dosage is 50mg every 4 hours.  Maximum is 8 per day.  Advil (or another NSAID) and/or Tylenol can be taken with this.

Tylenol with codeine is a preparation that works well for dental pain.  Advil or another NSAID can be taken with this.  Tylenol with codeine, take 1-2 every 4 hours.  Rate limiting factor is the Tylenol.  These have 300mg of Tylenol each.

Strategy for Pain Control

Combinations of medicines are safer, you have less chance of side effects.   They frequently help one another work better.

If not contraindicated, use your NSAID of choice plus Tylenol, may add Ultram.    OR    Take NSAID plus Tylenol with codeine.

Take Advil (or other NSAID) first regularly, add Tylenol regularly or as needed, add Ultram as needed.  Remove in reverse order when feeling better:  Stop narcotic first, then stop Tylenol, then stop NSAID.

Advil 600mg + Tylenol 500-650mg 3x a day works very well for dental pain.  Max dose is Advil 800mg + Tylenol 1000mg 4x a day.

Advil 600 mg 3x a day + Tylenol with codeine 1-2 every 4 hrs ONLY WHEN NEEDED.

Do not use any of these medications if you have allergies or reactions to them.  Talk to us if you have questions.

Implant Home Care Instructions

1. Bone fusion (osseointegration) to your implant(s) depends in part on how you take care of your mouth. The ideal conditions for this have been created; you must maintain them.

2. Throughout the healing phase (3-6 months). NO PRESSURE must be placed on the implant(s). Movement is the enemy of bony healing. If you are wearing a removable prosthesis (denture, partial, flipper), it has been relieved or removed to avoid excess pressure. During your healing phase, if you notice any pressure from the prosthesis on a area, notify us

3. IMMEDIATELY AFTER SURGERY— For 72 hours you should minimize your activity. Increased blood pressure will cause more circulation to the area and more pain, swelling, and bleeding. Implant placement is usually less painful than having teeth removed; however, this is not the time to test the limits of the body. The following will also help.
– Use moist gauze packs as needed for bleeding
– Keep your head elevated above your heart
– Ice the area(s) as much as possible
– Keep everything (food, tongue, toothbrush) away
– Take your medications as prescribed, especially antibiotics
– Instead of brushing the area around the implant(s), use the prescribed antimicrobial mouth rinse. You may brush other areas.

4. EARLY HEALING PHASE— The gums will take 2-4 weeks to be normal again. During this time, any irritation to them might compromise the healing. Eat soft foods on the other side.

First Week – Relay on the antimicrobial mouth rinse to clean the area. First, rinse with warm water, then Peridex for 30-60 seconds.

Second Week – If your case was complex (bone grafts, significant gum manipulation), the above may still apply. Otherwise, you may gently swab the areas with Q-tips dipped in Peridex after you rinse the area clean. You may continue the Peridex swabs to keep the gums healthy. We will schedule regular follow up appointments to personalize your home care.

5. LATE HEALING PHASE— Once the gums are healed, you may resume normal hygieneactivities. There must still be no pressure of any kind of the implants(s). If you have any questions please call.

Treatment of Dry/ Burning Mouth

– Take a daily multiple vitamin
– Take CoQ10 supplement
– Use Biotene toothpaste
– Sleep with a humidifier in your room
– Use OraMoist dry mouth patch-can find on
– Drinks lots of water
– A trial of anti-fungal therapy may be beneficial

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