Please follow these instructions as closely as possible. They are designed to help you heal quickly, and comfortably, with minimal side effects. If you-experience any complications, please call our office. We have a 24 hour answering service that can always reach one of the doctors by pager, and we will return your call as soon as possible, usually within thirty minutes.

FOR THE REMAINDER OF THE DAY:
1) Do not spit. Use a tissue to wipe your mouth as needed, or swallow your saliva.
2) Do not use a drinking straw. Drink straight from the cup.
3) Do not smoke.
4) Keep fingers and tongue away from the surgical area.
Spitting, the use of a straw, smoking, and poking can dislodge the blood clot that is forming, and will cause bleeding from the area. Also, smoking can increase the chances of an infection.

FOR BLEEDING:
Some minor bleeding is expected after implant surgery. It will usually subside quickly, and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours, Upper implants may occasionally trigger some bleeding from the nose, This is normal and will stop quickly.
1) Keep gauze on the surgical area with some pressure for 30 to 45 minutes.
2) Remove the gauze after 30 to 45 minutes, and replace it with a new piece of gauze if you are still bleeding. It is important to make sure the gauze is directly on the surgical site. Firm pressure for another hour should stop the bleeding.
3) If you find that this is not working after your third attempt, use a moistened tea bag instead of the gauze. The tannic acid in tea will help to form a clot, and stop the bleeding.
4) If all else fails, call the office.

FOR SWELLING:
Most patients will experience some swelling after surgery in the mouth. It may be mild or severe, and is different for every patient. The swelling will get bigger for the first 24 to 48 hours before it starts to go away. It may last for several days to one week. Some bruising may also develop on the face.
1) Use an ice pack on the cheek or face next to the surgical site. Keep it on for 15 to 20 minutes, then off for 10 minutes, and repeat until you go to sleep. Start again the next day.
2) Sleep with you head elevated slightly, above the heart. This will keep swelling down.
3) On the third day, change to moist heat instead of ice packs. This will bring the swelling down quicker.

EATING:
You may eat soft foods as soon as the anesthetic wears off. Try not to chew directly on the surgical site. You may resume a regular diet as soon as you feel up to it. Please stay well nourished, and well hydrated, you will heal faster.

BRUSHING:
You may brush your teeth, avoiding the surgical area, either tonight, or tomorrow morning. Be gentle, and do not spit or rinse forcefully. Start brushing the surgical area on the second day, and be very gentle on the stitches.

RINSING:
You may start rinsing today, gently, with some warm salty water every few hours. Do not use alcohol-containing mouth rinses for a few days.

MEDICATIONS:
You were probably given one or more prescriptions for medications. Take all medications with a full glass of water, and as directed on the bottle. Call us if you experience severe nausea, or diarrhea, or cannot swallow your pills.
1) Antibiotics: Continue until the bottle is empty. Do not quit halfway.
2) Pain Medicine: Continue as necessary. Remember that narcotics can make you drowsy, so no driving, operating machinery, or alcoholic beverages while you are taking them.
3) Mouth rinse: Peridex or Periogard. Swish with one-half ounce for thirty seconds, and spit it out, two times per day.

At Exclusive Oral Surgery, we realize that having any surgery can be stressful. Our desire is to have your post-operative course progress as smoothly as possible. These instructions provide some general guidelines with regard to post-operative care; your doctor may give you additional instructions as well. Thank you for choosing Exclusive Oral Surgery.

Try not to disturb the area where your Biopsy was performed. To avoid irritation, keep your tongue away from the surgical site. You may have stitches; don’t be alarmed if they loosen or fall out before your post op visit.
Pathology results from a biopsy may take one to two weeks. Your doctor will inform you of your results. This is usually done at the time of your follow up appointment.

Bleeding

Some minor bleeding may occur after the procedure. This can last up to 24 hours. If bleeding is rapid and doesn’t slow down when pressure is applied it is best to call the office to speak with a Surgical Assistant for further instructions.

Swelling

Swelling can be a normal occurrence after surgery. In some instances swelling can be worse or peak on the third to fourth day after surgery. Should the swelling increase beyond this time period or be accompanied by severe pain or an elevated temperature, then please notify your doctor. If applicable, apply an ice pack to the outside of the face corresponding to the surgical site. Place the ice pack for 20 minutes at a time then rest for 20 minutes. Please apply ice packs for 48 hours starting the day of surgery. If the biopsy was taken from the tongue or roof of mouth then direct application ice chips will be most beneficial.

Pain Medications

You may have been given prescriptions for one or more pain medications to help manage severe discomfort following your surgery. However, in some cases moderate discomfort can be controlled with Tylenol or an anti-inflammatory medication (Advil/Motrin/Ibuprofen; Aleve/Naprosyn; Lodine/Etodolac). Anti-inflammatory medications can be alternated with a narcotic medication in most cases. Take these and all medications as prescribed and in the manner indicated by your doctor. It is a good idea to begin taking your pain medications while you are still numb.

While taking narcotic pain medications, do not drink alcoholic beverages, drive, or operate any machinery for 24 hours after the last dose of narcotic pain medicine. Some patients experience nausea and or vomiting as a result of narcotic pain medications. The risk of nausea can be minimized by taking medications with some food. If you have a persistent problem with nausea or vomiting, please notify your doctor.
Antibiotics

If you have been placed on antibiotics, take them as directed. If you have an unfavorable reaction such as a rash, please discontinue the medication and call the office for further instructions.

Oral Hygiene

Mouth cleanliness is essential to good healing. Start rinsing 24 hours after your surgery. Rinse with warm salt water (1/2 teaspoon of salt to an 8 oz cup of warm water) three to four times a day. Use the saltwater rinse in addition to any other rinses prescribed by your doctor. You may begin to brush your teeth 24 hours after surgery. Of course be gentle in the region(s) of the surgery.
Diet

Drink plenty of fluids; however avoid hot liquids and foods. Soft food and cool liquids should be eaten on the day of surgery. You may return to a normal diet, as tolerated, beginning the day after surgery but avoid crunchy food (popcorn, pretzels, and potato chips) for a week after surgery, as these could become lodged and irritate the surgical area.

Activities

Resume normal activities a day or so after surgery, or as directed by doctor. Please keep physical activities to a minimum immediately following surgery.

Avoid smoking for as long as possible following surgery. The use of tobacco products slows down the healing process and may lead to developing other complications. We strongly recommend avoiding tobacco products for one full week.

Some pain, bleeding, swelling and seeping are normal following oral surgery.  A cold compress placed on the face near the extraction site for 30 minutes every five to ten minutes on the day of your surgery can be helpful. This will help reduce pain and swelling. Do not miss your follow up appointment(s) with your dentist and do not probe the area with your tongue or fingers.  Please do not touch your lips to see or feel the area treated. Avoid brushing your teeth near the surgery site but brush and floss the rest of your mouth as instructed by the office.  You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by your doctor as needed.  A warm salt water rinse, approximately ½ teaspoon in an eight ounce glass of water, three times a day can be helpful.

For the first 24 hours you may experience some cold and heat sensitivity.  Do not eat, drink, chew or consume foods and beverages that are extremely hot or spicy until the numbness has worn off following the anesthetic.  Avoid vigorous physical exercise for the first 24 hours and do not consume alcoholic beverages or smoke for at least 48 hours.  Do not brush, rinse or spit. Do not use a straw for drinking.  During the first few days after surgery a diet of liquids and soft foods such as soups, yogurt, juice and smoothies are recommended.  If you experience excessive bleeding or discomfort after 48-72 hours, please call our office immediately.

Follow any other instructions provided by the office on your visit.  Please take all medications as prescribed including your prescribed antibiotics to help prevent infection.

A certain amount of swelling, pain and bleeding is normal.
The following instructions are provided to make your postoperative recovery period as short and pleasant as possible.
You will be having a Sinus Lift if the area in the upper jaw that you are to have an implant(s) currently has insufficient bone because of an enlarged sinus. This procedure will augment the deficient area in the maxillary sinus. The bone that is being grafted will most commonly be coming from freeze dried bone and artificial synthetic bone. Other sites may be used for donation of your own bone as previously discussed with you by our doctors. Because of this you may have two post-surgical wounds: The donor site and the recipient site.
DO NOT UNDER ANY CIRCUMSTANCES. BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS. This may be longer if indicated. You may sniff all you like but NO BLOWING.
Bite down and maintain firm pressure on the gauze pack that was placed at the end of your surgery. There may be two areas of gauze in your mouth. Do this for at least 30 minutes. At that time remove the pack and replace it with another gauze sponge as provided. Repeat this as necessary. There should not be excessive bleeding. Bright red blood rapidly pooling in the area is not normal. If this occurs and does not decrease with pressure please call the office immediately. There may be a small amount of nasal discharge. It may be clear or lightly bloody. Excessive bleeding from the nose should be reported immediately.
If you were asleep for the surgery be sure to eat a soft nutritious food prior to taking any medications. This will decrease the chances of post-surgical nausea. You were prescribed an antibiotic prior to surgery this should be continued until all the pills have been taken. You were prescribed a decongestant; take this until it is all gone. Take your pain medications as needed in accordance with the directions. Codeine, hydrocodone or Demerol can be supplemented with Advil or ibuprofen type medications. Be sure you have no allergies that the doctor does no know about.
Do not rinse or spit for a minimum of 72 hours and longer if possible. This tends to disturb the blood clot and can prolong bleeding, open the wound and slow healing. There should be no blood in your mouth.
Saliva can be swallowed. Do not brush your teeth next to the surgery site for 48 hours or only brush in areas away from your graft surgery. When expectorating, BE GENTLE. If you used a prescribed mouthwash prior to surgery, it should be continued starting 24 hours after your surgery. Place the mouthwash in the area of the surgery and let it sit 30-60 seconds. Do not rinse with it until after you have returned for suture removal.
Apply ice immediately in the areas where the surgery was done. Since your graft was in the upper jaw you can expect swelling and discomfort up into the nose and even under the eyes and cheeks. Bruising and discoloration is not unusual. Crushed ice or equivalent should be placed in a plastic bag then in a washcloth and placed on the face. Apply for 30 minutes, then off for 20-30 minutes. This should be done on a near continuous basis (or as much as possible) for the first 48 hours and longer if possible or if this helps reduce your pain.
Avoid excess activity. In addition, DO NOT SMOKE. Do not drink with a straw or drink carbonated liquids (minimum 3 days). Do not consume alcoholic beverages while taking your pain medication. SMOKING CAN CAUSE THIS PROCEDURE TO FAIL.
You will notice that you cannot see any new bone in your mouth as the gums covers the area. The area of the graft placement will feel full and tight. This is normal. Do not stretch your lip daily to inspect the area. This can cause wound breakdown.
If you have a temporary flipper or denture to wear do not place it until the numbness in the area is gone. You very likely may need to wait until the stitches are removed until your denture can be worn. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. If you have questions about the fit of your flipper or denture, do not wear it until our doctors or your referring dentist can see you.

Please follow these instructions as closely as possible. They are designed to help you heal quickly, and comfortably, with minimal side effects. If you experience any complications from the procedure, please call our office. We have a 24 hour answering service that can always reach one of the doctors by pager, and we will return your call as soon as possible (usually within thirty minutes).

FOR THE REMAINDER OF THE DAY:
(1) Do not rinse your mouth.
(2) Do not spit. Tip: Use a tissue to wipe your mouth as needed, or swallow your saliva.
(3) Do not use a drinking straw. Tip: Drink straight from the cup.
(4) Do not smoke. Tip: Use a nicotine patch if you need it.
(5) Keep fingers and tongue away from the surgical area.
Rinsing, spitting, the use of a drinking straw, smoking and poking can dislodge the blood clot that is forming, and will cause bleeding from the surgical area. In addition, smoking can increase the risk of an infection.

FOR BLEEDING:
1. Bite firmly for 30 to 45 minutes on the gauze placed in your mouth.
2. Remove the gauze after 30 to 45 minutes and replace it with a new one if you are still bleeding. Tip: If the gauze is soaked, replace it earlier than 30 Minutes.
3. Place the new gauze directly over the surgical area. Tip: Firm pressure for another hour should stop the bleeding.
4. If bleeding still continues after third attempt place a tea bag instead of gauze. Tip: The tannic acid in the tea will help to form a clot and stop the bleeding.
5. IF BLEEDING IS NOT CONTROLLED, CALL OUR OFFICE IMMEDIATELY.
Some bleeding is normal and expected after a tooth extraction. It will usually subside quickly, and stop within a few hours after surgery. A little oozing is also normal and may persist for several hours or even overnight.

FOR SWELLING:
1. Use an ice pack over the cheek or face directly over the surgical area.
2. Keep it on 15-20 Min then off 10 Min and repeat until you go to sleep. Then repeat the cycle the next day. Tip: The ice pack is reusable, just place in the freezer until cold before using it.
3. Sleep with your head slightly elevated, above the heart. Tip: This will keep the swelling down.
4. On the third day, change to moist heat instead of ice packs. This will bring the swelling down quicker.
Most patients will experience some swelling after surgery in the mouth. It might be mild or severe, and it is different for every patient. The swelling will increase during the first 24 to 48 hours before it will begin to subside. It might last from several days to a week.

EATING:
You might eat soft foods as soon as the anesthetic wears off. Try not to chew directly on the extraction side. You might resume a regular diet as soon as you feel up to. You will heal faster if you are well nourished and hydrated.

BRUSHING:
You may brush your teeth, avoiding the surgical area, either tonight or tomorrow morning. Be gentle and do not spit or rinse forcefully.
Tip: You may use an extra soft toothbrush during this period.

RINSING:
Tomorrow you might start rinsing gently with some warm salty water every few hours. Tip: Do not use mouth rinses containing alcohol for a few days.

MEDICATIONS:
You were probably given one or more prescription medications. Take all medications with a full glass of water as directed on the bottle instructions — Call our office if you experience severe nausea or diarrhea, or cannot swallow the pills.
1. Antibiotics: Take exactly as prescribed.
2. Pain Medication: Continue as necessary.
Remember that narcotics can make you drowsy, so no driving, no operating machinery and no alcoholic beverages while you are taking medications.

In addition to the general postoperative instructions, we would like to emphasize a few points.
Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. It’s normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:
Do not vigorously rinse or spit for 3-5 days.
Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
For the first 2 days, we would suggest letting the blood clot stabilize and not even rinse your mouth. Following the second day, gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules. If a partial denture or a flipper was placed in your mouth, you may have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.