Patient Information
FIRST VISIT
Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.
Please assist us by providing the following information at the time of your consultation:
• X-Rays or CT Scans
• A list of medications you are presently taking
IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.
A pre-operative consultation and physical examination is mandatory for patients undergoing IV Sedation for surgery. Please have nothing to eat or drink 8 hours prior to your surgery. You will also need an adult to drive you home.
Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)
PREOPERATIVE
Before IV Sedation
• You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
• No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
• A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
• The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
• Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
• If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office. If you take routine oral medications, please check with Dr. Luciano prior to your surgical date for instructions.
POSTOPERATIVE
Implants
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.
Swelling
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours. . The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post- operatively.
Diet
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
Pain
Unfortunately, most oral surgery is accompanied by some degree of discomfort. If you take your first dose of pain medication before the anesthetic has worn off, you will be able to better manage your discomfort. Avoid taking aspirin for pain. Antibiotics may be prescribed to reduce the small risk of infection, it is important that you take ALL of
the prescription as directed.
Antibiotics
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Oral Hygiene
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed CLOREXIL or PERIOGARD Oral Rinse before bed. The day after surgery, the oral rinse should be used three or four times a day. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.
Activity
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days. This was discussed in the pre-operative consultation.
Bone Grafts
The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant replacement of the extracted tooth.
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 disturb or touch the wound. • Avoid rinsing or spitting for 2 days to allow blood clot and graft
material stabilization.
• 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.
• Do not smoke. 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.
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 do not hesitate to contact Dr. Luciano.
SINUS PRECAUTION
The following information applies when upper jaw bone height or width have been lost. The graft is placed to help restore your jawbone in preparation for possible implant replacement of the missing tooth or teeth. You have had a Sinus Lift Augmentation procedure in your upper jaw. This procedure regains lost bone height in the area of your first and second molar and occasionally second premolar. It is an important procedure as it allows implant placement in an area that could not be implanted otherwise because of insufficient bone height due to an enlarged sinus.
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.
Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open. Do not drink with straws and do not spit. Scuba diving may also increase sinus pressure and should be avoided. Decongestants will help reduce pressure in the sinuses. You may also be given a prescription for antibiotics. Please take these as directed. Anything that causes pressure in your nasal cavity must be avoided. Avoid “bearing down”—as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. Smoking must be stopped.
Antibiotics
Be sure to take the prescribed antibiotics as directed to help prevent infection
Oral Hygiene
Do not rinse or spit on the day of your surgery. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. You should not have a significant amount of blood in your mouth. Saliva can be swallowed, even if slightly blood tinged.
Keeping your mouth clean after surgery is essential to reduce the risk of infection.
Do not brush the teeth in the area of surgery for 48 hours. When brushing, be very gentle. When expectorating, also be gentle.
Smoking
Do not smoke for at least two weeks after surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of bone graft and sinus augmentation failure.
Wearing Your Prosthesis or Nightguards
Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary “flipper” to wear do not place it until the numbness in the area is gone. 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. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or our office can see you.
Post-Operative Problems or Complications
As with any procedure, unexpected post-operative healing can occur. If you notice the unexpected flow of air or liquids between your mouth and nose, please let us know immediately.
If you are aware of several small particles of graft material being discharged from your nose, let us know as well.
If you experience sinus or nasal congestion on the side your surgery was performed, let us know.
If there is an increase in swelling in your mouth, cheek or under your eye after 5 days, let us know.
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 do not hesitate to contact Dr. Luciano.