surgical instructions
Questions? We are here for you.
Please call us at (630) 230-1166
Pre-Operative Instructions
Instructions for patients desiring IV sedation:
- Nothing to eat or drink for 6 hours prior to appointment
- Small sip of water to take regular medications is permitted
- Must have a responsible driver present for entire appointment
- Remove artificial nails and nail polish for anesthetic monitoring
- Wear comfortable, loose clothing with short sleeves
- Hair pulled back in bun or ponytail
Please follow these instructions as closely as possible. They are designed to help you heal quickly, and comfortably, with minimal side effects. Sometimes the after-effects of oral surgery are quite minimal, so not all the instructions may apply. However, when in doubt follow these guidelines. If you experience any complications from the procedure, please call our office.
FIRST HOUR
Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough gauze to obtain pressure over the surgical site for another 30 minutes. Tip: It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.
FOR THE REMAINDER OF THE DAY
- Do NOT rinse vigorously or probe the area with any objects
- Do not spit. Tip: Use a tissue to wipe your mouth as needed, or swallow your saliva
- Do not use a drinking straw. Tip: Drink straight from the cup.
- PLEASE DO NOT SMOKE for at least 48 hours. This is very detrimental to healing and may cause dry socket. Tip: Use a nicotine patch if you need it.
- Exercise Care: Do not disturb the surgical area today. 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.
BLEEDING
- Bite firmly for 30 to 45 minutes on the gauze placed in your mouth.
- Remove the gauze after 30 to 45 minutes and replace it with a new one if you are still bleeding.
- Place the new gauze directly over the surgical area. Tip: Firm pressure for another hour should stop the bleeding.
Persistent Bleeding: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding continues after the third attempt, place a tea bag instead of gauze (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office. Tip: The tannic acid in the tea will help to form a clot and stop the bleeding.
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.
SWELLING
Swelling is often associated with oral surgery. 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 surgical area
- Apply for 20 minutes on and 20 minutes off during the first 24 hours after surgery.
- If you have been prescribed medication for the control of swelling, be sure to take it as directed.
- Sleep with your head slightly elevated, above the heart. Tip: This will keep the swelling down.
- On the third day, change to moist heat instead of ice packs.
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.
PAIN
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Pain may last 2-3 weeks, and is most intense 3-5 days after surgery. 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 better manage any discomfort. Some patients find that stronger pain medication 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. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. 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, you must call for a refill during weekday business hours.
NAUSEA
Nausea is not uncommon after surgery. Sometimes 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 help with nausea.
EATING
You might eat soft foods as soon as the anesthetic wears off. Eat any nourishing food that can be taken with comfort. Try not to chew directly on the extraction side. You will heal faster if you are well nourished and hydrated. Avoid extremely hot foods. 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.)
It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas.
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 surgical 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.
BRUSHING
Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. 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. Keeping your mouth clean after surgery is essential.
- Use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.
- Repeat as often as you like, but at least two or three times daily.
- Do not rinse or spit if you are still having trouble with bleeding.
Tip: Do not use mouth rinses containing alcohol for a few days.
HOT APPLICATIONS
You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, or heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
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.
Antibiotics: Take exactly as prescribed.
Pain Medication: Continue as necessary.
Remember that narcotics can make you drowsy, so do not drive or operate machinery. Also, do not drink any alcoholic beverages while you are taking medications.
HEALING
Normal healing after tooth extraction should be as follows: 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-operative course should be gradual, steady improvement. If you do not 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 where you had surgery. Calling during office hours will afford a faster response to your question or concern.
FIRST HOUR
Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough gauze to obtain pressure over the surgical site for another 30 minutes. Tip: It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.
FOR THE REMAINDER OF THE DAY
- Do NOT rinse vigorously or probe the area with any objects
- Do not spit. Tip: Use a tissue to wipe your mouth as needed, or swallow your saliva
- Do not use a drinking straw. Tip: Drink straight from the cup.
- PLEASE DO NOT SMOKE for at least 48 hours. This is very detrimental to healing and may cause dry socket. Tip: Use a nicotine patch if you need it.
- Exercise Care: Do not disturb the surgical area today. 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.
BLEEDING
- Bite firmly for 30 to 45 minutes on the gauze placed in your mouth.
- Remove the gauze after 30 to 45 minutes and replace it with a new one if you are still bleeding.
- Place the new gauze directly over the surgical area. Tip: Firm pressure for another hour should stop the bleeding.
Persistent Bleeding: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding continues after the third attempt, place a tea bag instead of gauze (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office. Tip: The tannic acid in the tea will help to form a clot and stop the bleeding.
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.
SWELLING
Swelling is often associated with oral surgery. 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 surgical area
- Apply for 20 minutes on and 20 minutes off during the first 24 hours after surgery.
- If you have been prescribed medication for the control of swelling, be sure to take it as directed.
- Sleep with your head slightly elevated, above the heart. Tip: This will keep the swelling down.
- On the third day, change to moist heat instead of ice packs.
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.
PAIN
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Pain may last 2-3 weeks, and is most intense 3-5 days after surgery. 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 better manage any discomfort. Some patients find that stronger pain medication 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. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. 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, you must call for a refill during weekday business hours.
NAUSEA
Nausea is not uncommon after surgery. Sometimes 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 help with nausea.
EATING
You might eat soft foods as soon as the anesthetic wears off. Eat any nourishing food that can be taken with comfort. Try not to chew directly on the extraction side. You will heal faster if you are well nourished and hydrated.
Avoid extremely hot foods. 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.)
It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas.
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 surgical 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.
BRUSHING
Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. 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. Keeping your mouth clean after surgery is essential.
Use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.
Repeat as often as you like, but at least two or three times daily.
Do not rinse or spit if you are still having trouble with bleeding.
Tip: Do not use mouth rinses containing alcohol for a few days.
HOT APPLICATIONS
You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, or heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
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.
Antibiotics: Take exactly as prescribed.
Pain Medication: Continue as necessary.
Remember that narcotics can make you drowsy, so do not drive or operate machinery. Also, do not drink any alcoholic beverages while you are taking medications.
HEALING
Normal healing after tooth extraction should be as follows: 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-operative course should be gradual, steady improvement. If you do not 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.
FIRST HOUR
Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough gauze to obtain pressure over the surgical site for another 30 minutes.
FOR THE REMAINDER OF THE DAY
(1) Do not spit. Tip: Use a tissue to wipe your mouth as needed, or swallow your saliva
(2) Do not use a drinking straw. Tip: Drink straight from the cup
(3) PLEASE DO NOT SMOKE for at least 48 hours. This is very detrimental to healing and may cause dry socket. Tip: Use a nicotine patch if you need it.
(4) Exercise Care: Do not disturb the surgical area today. Keep fingers and tongue away from the surgical area.
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
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.
(3) Place the new gauze directly over the surgical area. Tip: Firm pressure for another hour should stop the bleeding.
Some minor bleeding is expected after dental 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.
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 may increase for the first 24-48 hours before it starts to go away. It may last for several days. Some bruising may also develop on the face.
DIET
You may start with non abrasive foods such as mashed potatoes, pasta, cottage cheese, soup, or scrambled eggs as soon as the local anesthetic wears off. You may resume a regular diet as soon as you feel up to it; however, please try not to chew directly on the implant sites.
ORAL HYGIENE
You may start rinsing tomorrow, very gently, with some warm salt water (1 tsp of salt in 8 ounces of warm water). You may brush your teeth per usual, though be very careful near the surgical sites.
BONE GRAFT MATERIAL
If your surgeon placed bone graft material at the time the dental implant was placed, you might notice some gritty material in your mouth. This is nothing to worry about and should subside within a day or two.
WILL I BE ABLE TO SEE THE IMPLANT?
Depending on the location and stability of the implant being placed, your surgeon may opt to bury the implant under the gum tissue. In time, you will return and have the implant uncovered so the implant can be restored.
If stability is optimal, the second stage procedure can be bypassed, and an attachment is placed that protrudes through the gum tissue, which will be visible. Once the bone has healed, the restoring dentist will be able to access the implant without the need for further surgery.
WHEN CAN THE CROWN BE PLACED?
A dental crown can be attached to a dental implant once the implant has fused to the bone This is a process called osseointegration. The length of time the bone must heal varies from case to case and will be discussed with your surgeon The length of time needed for osseointegration is a function of the bone quality, quantity, and implant stability at the time of placement.
MEDICATIONS
You were probably given one or more prescriptions for medications. Take all as directed on the bottle. Call us if you experience severe nausea or diarrhea, or cannot swallow your pills.
• Antibiotics: Continue until the bottle is empty. Do not quit halfway.
• Pain Medicine: Usually it is necessary to take narcotic pain medication in a scheduled fashion (every 4-6 hours) for the first 24 hours and as needed thereafter. Remember that narcotics can make you drowsy, so no driving, swimming, operating machinery, or drinking alcoholic beverages while you are taking them.
• You may wean yourself off of the narcotic medication and substitute 500 mg of acetaminophen (Tylenol®).
• If directed to do so, you may use ibuprofen, 600 mg, every 6 hours while awake, for the first 4 or 5 days.
ACTIVITY
Once you are no longer taking narcotic pain medication, you may resume your normal activities as you feel up to it. Go easy at first with exercise and recreation, and increase your activity slowly over several days back to your normal routine.
CARE OF THE MOUTH: Brushing and flossing- Begin brushing and flossing the following day. Avoid surgical site for two days. Mouthwash- If prescribed, use the prescribed mouthwash two to three times daily beginning the morning after surgery until instructed to discontinue. Please avoid using electronic toothbrushes or a waterpik for four weeks on the surgical site following surgery.
EATING: Adequate nutrition is essential for normal healing. Following surgery, your diet should be restricted to COLD LIQUIDS OR ROOM TEMPERATURE for the first 24 hours. A high protein, soft diet is desirable with plenty of fluids. AVOID peroxide, alcohol, hot or carbonated beverages, hot food and drinking through a straw for the first 24 hours. After 24 hours, you may resume your normal diet. DO NOT SKIP MEALS. If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster.
ACTIVITIES: Plan to rest at home the remainder of the day of surgery. You may read, watch TV or work at your desk at home. When sleeping, elevate your head to decrease swelling. Do not exercise for the first 48 hours after surgery as the heart rate will increase and thus bleeding will increase.
SWELLING: It is not unusual for swelling to occur after surgery. To minimize swelling, you will be advised to use an ice pack. Place the ice pack on the outside of your face, over the treated area for 20 minutes, and then take it off for 20 minutes. Continue to apply ice packs as much as possible for the first 24 hours after surgery. If swelling and/or bruising occurs after the day of surgery, apply a warm moist compress to the area.
BLEEDING: Slight bleeding or oozing is normal during the first 1-2 days following surgery. You will leave our office with a piece of gauze over the surgical site. This piece of gauze should remain over the site for 20 minutes. If the surgical site is bleeding or oozing once the initial piece of gauze has been removed then the gauze should be replaced with a new, moist gauze. You will apply firm pressure to the site for 5 minutes or until the bleeding/oozing stops. Avoid spitting and the use of a straw to drink as the suction action disrupts the natural clotting process. If bleeding is excessive or continuous, do not rinse. Recline at a 45-degree angle and rest for 15 minutes. Often, physical activity can stimulate bleeding. If excessive bleeding occurs after the first 24 hours, please call our office.
SMOKING: Please do not smoke for at least 3 days after surgery. Smoking is the number one factor in causing pain and delayed healing.
MEDICATIONS: Take all medications as directed. Drink plenty of fluids and eat soft foods prior to taking any pain medications. This will help prevent nausea, upset stomach, and expedite the medication’s effects. Avoid drinking alcohol, using heavy machinery, and driving while on medication.
Post-Operative Instructions for Expose and Bond
Sometimes the after-effects of surgery are quite minimal, so not all the instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office.
Care of your mouth after surgery has an important effect on healing. Swelling, discomfort, and restricted jaw function are expected and should not cause alarm. These may be minimized by following the instructions below. Please read them carefully.
Bleeding: Remove the gauze pack after 1 hour. Slight bleeding is expected. If bleeding is excessive, place a moistened, folded gauze pad or a moistened tea bag over the wound and bite firmly for 30 minutes with constant pressure. Assume a semi-upright position using a couple of pillows. Do not spit, use straws, smoke, or brush your teeth for the first 24 hours. Spitting or sucking causes bleeding to continue.
Pain: Take your medications as directed on the package. Do not drive or operate mechanical equipment after taking prescription pain medication.
Swelling: Apply an ice pack on the face near the area where surgery was done upon returning home. Continue this on and off for 24–48 hours. Peak swelling should occur between the second and third day after surgery and then diminish slowly.
Stitches/Sutures: Sutures are placed to help facilitate closure of the gums, reduce bleeding and swelling, and prevent food from seeping into the extraction sockets. Most stitches are dissolvable and supposed to unravel or fall out on their own (typically around 5 days after surgery).
The Chain: Please avoid touching or playing with the chain, to minimize the chances of it falling off. Keep in mind that this does happen from time to time, especially after the orthodontist puts it into use. If the chain/bracket falls off, it’s ok. This is not an emergency, but we will need to re-cement it for you; give us a call during normal hours and we can set up a time to be seen.
Diet: A liquid to soft food diet is recommended on the day of surgery. Avoid using straws, chewing over the surgical area, and extremely hot foods and foods with sharp edges (chips, pretzels, etc.) for a few days. Gradually resume your normal diet as tolerated.
Oral Hygiene: The day following surgery, the mouth may be rinsed gently with a lukewarm saltwater solution (a ½ teaspoon of salt per half glass of lukewarm water) or prescribed mouthwash after each meal and at bedtime. The teeth should be brushed but avoid the site of surgery for several days. Do not use hydrogen peroxide rinses or an irrigation device like a Waterpik® for at least 1 week.
Smoking: Smokers are advised not to smoke for 3 days following surgery.
Rest: Avoid overfatigue and get adequate rest. Avoiding sports, exercise, and strenuous activity for at least 2–3 days is generally recommended.
Dental Care: It is usually best to avoid routine or elective dental care for approximately 2 weeks after surgery unless your doctor has advised otherwise.
Post-Op Visits: If you have been given an appointment for post-operative surgical care, please return to our office as scheduled. Generally, an appointment with your orthodontic treatment provider should be arranged within the next 2 weeks. If you are experiencing problems or have questions, we can usually arrange a post-operative visit on short notice.