Before & After Surgical Instructions

Before Surgical Instructions



ON THE DAY OF SURGERY, AN I.V. WILL BE STARTED IN YOUR ARM OR HAND. MEDICATIONS WILL THEN BE GIVEN THROUGH THE I.V. AND WILL CAUSE TOTAL RELAXATION AND VERY LITTLE RECALL (IF ANY) OF THE EVENTS SURROUNDING SURGERY. YOU WILL NOT BE COMPLETELY UNCONSCIOUS, BUT INSTEAD BE IN A VERY DEEP AND COMFORTABLE SLEEP.

TO HELP US GIVE YOU A SAFE AND SUCCESSFUL SURGERY, IT IS VERY IMPORTANT THAT YOU FOLLOW THE INSTRUCTIONS LISTED BELOW. IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CALL US.

 

>> Do NOT eat or drink anything (including water) for eight (8) hours prior to surgery. However, it is important that you take any regular medications (high blood pressure medication, thyroid medicine, etc.) and your antibiotic, using only a small sip of water. Do NOT take any type of sedative (anti-anxiety medication), pain medication or aspirin on the morning of surgery.

>> Do NOT wear lotion, perfume or cologne (our vital signs monitor will not read as accurately otherwise).

>> Remove polish from both index fingers so that we can obtain an accurate oxygen saturation reading.

>> Leave all jewelry at home.

>> You MUST have someone drive you home.

>> Do not drive; operate power tools or machinery, etc., for the remainder of the day.

 

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After Surgical Instructions

    • Oral Surgery

    • Implant

    • All On Four

    • Expose and Bond

    • Frenectomy

    • Biopsy

 


Oral Surgery

Sometimes the after-effects of dental procedures are quite minimal, so not all of the instructions may apply.  Common sense will often dictate what you should do.  However, when in doubt follow these guidelines or call our office for clarification.  (713) 665-9200

DAY OF PROCEDURE

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the extraction areas, making sure they remain in place.  The packs may be gently removed after 30 minutes.  If active bleeding persists, place enough new gauze to obtain pressure over the extraction site for another 30 minutes.  The gauze may then be changed as necessary (typically every 30 to 45 minutes), but often no additional gauze packs are required.   

EXERCISE CARE:  Do not disturb the procedure area today.  Do NOT rinse vigorously or probe the area with any objects.  You may brush your teeth gently.  PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.

OOZING:  Intermittent bleeding or oozing is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.  The "ooze" may look more impressive than it really is because it is mixed with your saliva. Do not be alarmed.  This is normal.

PERSISTENT BLEEDING:  Bleeding should never be severe.  Try repositioning the packs.  If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes.  Ice water rinses can also help. If bleeding remains uncontrolled, please call our office.

SWELLING:  Swelling is often associated with oral dental procedures.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the extraction area.  This should be applied twenty minutes on and twenty minutes off during the first 24 hours after the extraction.  The swelling usually begins on the day after surgery and is at its maximum at 3-4 days.  The swelling with then subside over the next 2-3 days. 

PAIN:  Unfortunately dental procedures can be accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.  Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced.  The effects of pain medications vary widely among individuals.  Some patients may even require two of the pain pills at one time.  Remember that the most severe pain is usually within the first 12 hours after the local anesthetic wears off.   After that, your need for medicine should lessen.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, we appreciate your making every effort to call for a refill during weekday business hours.  In the unlikely situation that you need a prescription over the weekend, please call our regular office number and the answering service can get you in touch with Dr. Iero or the nurse on-call.


NAUSEA:  Nausea is not uncommon after an extraction.  In most cases, the pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may also help with nausea.  If you routinely become nauseated, let Dr. Iero know so he can prescribe an antiemetic for you. 

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods while your lips and tongue are numb to prevent an accidental burn.   It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.)   Over the next several days you may gradually progress to solid foods.  It is important not to skip meals!  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES:  If you feel something hard or sharp edges in the extraction areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office so we can remove them for you.

 

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES:  Keeping your mouth clean after extractions is essential.  Use the prescribed Peridex Rinse at least three times a day.  Gently swish a capful of solution for approximately one minute. 

BRUSHING:  Begin your normal oral hygiene routine as soon as possible after the procedure.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS:  You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, and heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will also help decrease swelling and stiffness. 

HEALING:  Normal healing after tooth extraction should be as followed:  The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-procedure course should be gradual, steady improvement.  If you don't see continued improvement, please call our office.  If you are given a plastic irrigating syringe, DO NOT use it for the first five days.  Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call the office.  A 24-hour answering service is available to contact the doctor on call after hours.  Calling during office hours will afford a faster response to your question or concern.      713.665.9200

 

>>> DOWNLOAD "AFTER ORAL SURGERY INSTRUCTIONS"



Implant

It is our desire that your recovery be a smooth and pleasant one.  Please follow these instructions to assist in giving you the best result possible. If you have an emergency and need to get in contact with Dr. Iero after business hours, a 24-hour answering service is available.  Please note that calling during office hours will afford a faster response. (713) 665-9200

>> Start your antibiotic and rinse two days prior to surgery.  If you did not receive your prescriptions on the day of your consultation, please call our office with your pharmacy information. Take your antibiotics until they are gone. Use the rinse 3 times a day until you complete your antibiotics.

>> To control minor bleeding after surgery, apply moderate pressure over the surgery site(s) with gauze packs.

>> Do not smoke or use any tobacco products.  Using tobacco increases the risk that your body will reject the implant(s).

>> Avoid eating or drinking extremely hot food or drinks until the numbness has completely worn off.

>> If possible, chew on the opposite side from the implant.  If implants were placed on both sides, limit your diet to soft foods.  Do not chew hard or crusty foods for the first two weeks.

>> To reduce swelling, apply ice packs, on-and-off every 10-15 minutes.  This is only beneficial during the first 12 hours after surgery.  After 12 hours, change to using warm moist heat packs.

>> Do not brush directly on the implant site for two weeks.  Continue brushing your other teeth as usual. 

>> It is normal for gums to be sore or swollen for a few weeks after surgery.

>> If you will be wearing a removable appliance during the healing process (denture, partial denture or flipper), we may advise you to wear the appliance 24/7 for the first two weeks.  The appliance will give the implant site(s) added protection during the healing period.

>> If persistent numbness, bleeding or discomfort occurs, please call the office.

 

 

>>> DOWNLOAD "AFTER IMPLANT INSTRUCTIONS"



All On Four

It is our desire that your recovery be a smooth and pleasant one. Please follow these instructions to assist in giving you the best result possible. If you have an emergency and need to get in contact with Dr. Iero after business hours, a 24-hour answering service is available. Please note that calling during office hours will afford a faster response.     713.665.9200

>> Start your antibiotic and rinse two days prior to surgery. Use the rinse three times a day until you are done with antibiotics.   If you did not receive your prescriptions on the day of your consultation, please call our office with your pharmacy information.

>> Limit your diet to soft foods for the first 3 months. Do not chew hard or crunchy foods. If you cannot mash it with the back of a fork, do not eat it. For the first two weeks, the diet is pureed. From 2-6 weeks, the diet should be anything you can easily cut with a fork.  This is a very soft diet.

>> Do not smoke or use any tobacco products.  Using tobacco increases the risk that your body will reject the implant(s).

>> Limit your physical activity, including heavy lifting and exercise for 72 hours after surgery. 

>> To reduce swelling, apply ice packs, on-and-off every 10-15 minutes.  This is only beneficial during the first 12 hours after surgery. After 12 hours, a heat pack may be beneficial.

>> For the first 24 hours, use a very soft toothbrush dipped in salt water (1/4 teaspoon of salt to 8 oz. of warm water)

>> Do not use a WaterPik or an electric toothbrush for two months after surgery. 

>> It is normal for gums to be sore or swollen for a few weeks after surgery. 

>> If you have persistent numbness, bleeding or discomfort please call the office.

 

>>> DOWNLOAD "AFTER ALL ON FOUR INSTRUCTIONS"



Expose and Bond

Sometimes the after-effects of an expose and bond procedure are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. (713) 665-9200

Day of Procedure

First Hour: All depending where the incision has been made, keep gauze in place to control any bleeding that may occur.  The gauze pack may be changed as needed.

Exercise Care: Do not disturb the procedure area today.  Do NOT rinse vigorously or probe the area with any objects.  PLEASE DO NOT SMOKE for at least 48 hours since this may slow down the healing process.

Oozing: Intermittent bleeding or oozing is normal.  Bleeding may be controlled by placing fresh gauze at the site for 30-45 minutes at a time.  The “ooze” may look more impressive than it really is because it is mixed with saliva.  Do not be alarmed.  This is normal. 

Swelling: Swelling is often associated with oral procedures.  It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the area where the compress can be placed directly over site.  You can apply compress on and off for the first 24 hours. 

Pain: Unfortunately oral procedures can be accompanied by some degree of discomfort.  Depending on the severity of the procedure, you may be given a prescription for pain medication or be instructed to use over the counter medications to manage the discomfort.  It is best to take the pain medication before the anesthetic has worn off.  Make sure and bring with you the medication that has been prescribed on the day of the expose and bond. 

Diet: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  It is best to avoid foods that may irritate the expose and bond site.  Steer clear of hard crunchy foods for the first few days.

Sutures: These are placed at the expose and bond site and will fall apart on their own with in 7 to 10 days. 

** It is important to not bite down on anything that may compromise the chain or the bond that has been placed on the exposed tooth.

Instructions for Second and Third Days

Mouth Rinses: Keeping your mouth clean after extractions is essential.  Use the prescribed Peridex Rinse at least three times daily.  Gently roll a capful of solutions for approximately one minute and spit.

Brushing: Begin your normal oral hygiene routine as soon as possible after the procedure.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

Healing: Normal healing after an expose and bond should be as follows:  The first couple of days are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although possibly still swollen, can usually begin a more substantial diet.  Expose and Bone procedures can be associated with moderate bleeding and swelling. Swelling will peak 3-4 days after surgery and quickly resolve over the next few days. If you do not see continued improvement, please call our office.

 

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.  A 24-hour answering service is available to contact the doctor on call after hours.  Calling during office hours will afford a faster response to your question or concern.  713.665.9200

 

 

>>> DOWNLOAD "AFTER EXPOSE & BOND INSTRUCTIONS"



Frenectomy

Sometimes the after-effects of a frenectomy procedure are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. (713) 665-9200

Day of Procedure

First Hour: All depending where the incision has been made, keep gauze in place to control any bleeding that may occur.  The gauze pack may be changed as needed.

Exercise Care: Do not disturb the procedure area today.  Do NOT rinse vigorously or probe the area with any objects.  PLEASE DO NOT SMOKE for at least 48 hours since this may slow down the healing process.

Oozing: Intermittent bleeding or oozing is normal.  Bleeding may be controlled by placing fresh gauze at the site for 30-45 minutes at a time.  The “ooze” may look more impressive than it really is because it is mixed with saliva.  Do not be alarmed.  This is normal. 

Swelling: Swelling is often associated with oral procedures.  It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the area where the compress can be placed directly over site.  You can apply compress on and off for the first 24 hours. 

Pain: Unfortunately oral procedures can be accompanied by some degree of discomfort.  Depending on the severity of the procedure, you may be given a prescription for pain medication or be instructed to use over the counter medications to manage the discomfort.  It is best to take the pain medication before the anesthetic has worn off.  Make sure and bring with you the medication that has been prescribed on the day of the procedure.
Diet: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  It is best to avoid foods that may irritate the frenectomy site. Softer foods may be a better choice for the first few days.

Sutures: These are placed at the frenectomy site and will fall apart on their own with in 7 to 10 days. 


Instructions for Second and Third Days

Mouth Rinses: Keeping your mouth clean after extractions is essential.  Use the prescribed Peridex Rinse at least three times daily.  Gently roll a capful of solutions for approximately one minute and spit.

Brushing: Begin your normal oral hygiene routine as soon as possible after the procedure.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

Healing: Normal healing after a frenectomy should be as follows:  The first couple of days are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although possibly still swollen, can usually begin a more substantial diet.  If you do not see continued improvement, please call our office. 

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.  A 24-hour answering service is available to contact the doctor on call after hours.  Calling during office hours will afford a faster response to your question or concern.  713.665.9200

Frenectomies are associated with a fair amount of (upper) lip or under the tongue (lower) swelling. Swelling is at its maximum at 3-4 days after surgery. After day 4, the swelling will rapidly resolve.

 

 

>>> DOWNLOAD "AFTER FRENECTOMY INSTRUCTIONS"



Biopsy

Sometimes the after-effects of a biopsy procedure are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. (713) 665-9200

Day of Procedure

First Hour: All depending where the incision has been made, keep gauze in place to control any bleeding that may occur.  The gauze pack may be changed as needed.

Exercise Care: Do not disturb the procedure area today.  Do NOT rinse vigorously or probe the area with any objects.  PLEASE DO NOT SMOKE for at least 48 hours since this may slow down the healing process.

Oozing: Intermittent bleeding or oozing is normal.  Bleeding may be controlled by placing fresh gauze at the site for 30-45 minutes at a time.  The “ooze” may look more impressive than it really is because it is mixed with saliva.  Do not be alarmed.  This is normal. 

Swelling: Swelling is often associated with oral procedures.  It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly if procedure area is on a cheek or area where the compress can be placed directly over site.  You can apply compress on and off for the first 24 hours. 

Pain: Unfortunately oral procedures can be accompanied by some degree of discomfort.  Depending on the severity of the procedure, you may be given a prescription for pain medication or be instructed to use over the counter medications to manage the discomfort.  It is best to take the pain medication before the anesthetic has worn off.  Make sure and bring with you the medication that has been prescribed on the day of the procedure. 

Nausea: Nausea is not uncommon after a procedure.  Sometimes the medications may be the cause.  This can be reduced by preceding the pain medication with a small amount of food and taking the medication with a large volume of water.  Classic Coca Cola may help with any nausea that may be experienced.

Diet: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods. You may need to stick to soft foods for the first few days after the procedure.

Sutures: These are placed at the site of the biopsy and will fall apart on their own with in 7 to 10 days. 

 

Instructions for Second and Third Days

Mouth Rinses: Keeping your mouth clean after extractions is essential.  Use the prescribed Peridex Rinse at least three times daily.  Gently roll a capful of solutions for approximately one minute and spit.

Brushing: Begin your normal oral hygiene routine as soon as possible after the procedure.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

Healing: Normal healing after biopsy should be as follows:  The first couple of days are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although possibly still swollen, can usually begin a more substantial diet. If you do not see continued improvement, please call our office. Peak swelling is at day 3-4 after surgery. Do not be worried, this is normal.
Note: Tongue biopsies can be very painful for 1-2 weeks after surgery. There is usually a good amount of swelling as well. This swelling usually resolves over the next three to four days.

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.  A 24-hour answering service is available to contact the doctor on call after hours.  Calling during office hours will afford a faster response to your question or concern.  713.665.9200

 

 

>>> DOWNLOAD "AFTER BIOPSY INSTRUCTIONS"

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