• Fill all prescribed medication at least 24 hours prior to surgery. If you have misplaced your prescriptions contact the office immediately. Please allow 24 hours for prescriptions to be called in to your pharmacy.
• Please remember to take your antibiotic – 4 pills of Amoxicillin / Clindamycin 1 hour prior to surgery (if instructed to do so). Follow the instructions on the label. If you have any questions, please contact the office.
• Routine medications can be taken, but please confirm this with the doctor prior to your surgery day. If you are taking medications, please bring the prescription bottles with you.
• If your health changes or you develop a cold, flu, or any other ailment during the week before surgery, please notify us immediately.
• Please do not wear contact lenses, make up or nail polish on the day of surgery. Wear loose fitting clothes, short sleeve shirt with an open neck.
• Please notify us immediately if you suspect that you are pregnant.
• Please, use StellaLife Vega Recovery Kit as instructed on the package of the product (drops, gel and rinse) as instructed (see below for specific instructions).

• For IV Sedation Patients ONLY: Please DO NOT eat or drink anything 6 hours before your scheduled surgery time. You may take your prescribed antibiotics with up to ½ glass of water.
• For Oral Sedation Patients ONLY: Please bring the prescribed sedative in the prescription bottle. DO NOT take the medication until instructed by the clinical staff.
• You must have someone drive you to and from the office. Please have your driver remain in the office while you are undergoing treatment.
• Your judgment and reflexes may be impaired following sedation or anesthetic. Although you may feel fully alert, you should not operate a vehicle, power tools, or any machinery for 24 hours following your procedure.
• Make arrangements for an adult to be present with you the remainder of the day.

Diet

Drink plenty of fluids. The first 6-8 weeks you will need to be on a liquid diet. The bone around implants will be undergoing remodeling during that time and premature function may compromise implants’ integration. After 8 weeks, you may start chewing soft food. The appropriate time for you to start chewing will be determined by your surgeon.

Pain

You should begin taking pain medication before you feel the local anesthetic wearing off, approximately 60 minutes after the procedure. For pain, take Motrin (Ibuprofen) and prescribed pain medications as directed. DO NOT exceed 4,000mg of Tylenol and 2,400mg of Motrin/Ibuprofen within a 24 hour period.

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 often as possible, for the first 24 hours.
HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

Your surgeon may recommend Orion natural products designed to decrease post-operative swelling and bruising. Please, refer to specific instructions on use of Orion products.

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 day after surgery, Orion oral rinse should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then expectorate. Warm salt-water rinses (one teaspoon of salt in a cup of warm water) should be used at least four to five times a day, as well, especially after meals.
Water pik should be purchased before surgery. You may start using it 3-5 days post-surgery.
You may brush your prosthesis with a regular toothbrush without any toothpaste.

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.

Smoking

Do not smoke at all. As discussed at your consultation, smoking dramatically (two to three times) increases the risks of bone graft and implant failure.

• 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.
• Contact lenses, jewelry, and dentures must be removed at the time of surgery.
• Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
• 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 our doctors prior to your surgical date for instructions.

• 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.
• Contact lenses, jewelry, and dentures must be removed at the time of surgery.
• Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
• 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 our doctors prior to your surgical date for instructions.

• Fill all prescribed medication at least 24 hours prior to surgery. If you have misplaced your prescriptions contact the office immediately. Please allow 24 hours for prescriptions to be called in to your pharmacy.
• Please remember to take your antibiotic 1 hour prior to surgery (if instructed to do so). Follow the instructions on the label. If you have any questions, please contact the office.
• Routine medications can be taken, but please confirm this with the doctor prior to your surgery day. If you are taking medications, please bring the prescription bottles with you.
• If your health changes or you develop a cold, flu, or any other ailment during the week before surgery, please notify us immediately.
• Please do not wear contact lenses, make up or nail polish on the day of surgery. Wear loose fitting clothes, short sleeve shirt with an open neck.
• Please notify us immediately if you suspect that you are pregnant.
• Consult with your medication specialist for more instructions. Click here for medication instructions.

• For IV Sedation Patients ONLY: Please DO NOT eat or drink anything 6 hours before your scheduled surgery time. You may take your prescribed antibiotics with up to ½ glass of water.
• For Oral Sedation Patients ONLY: Please bring the prescribed sedative in the prescription bottle. DO NOT take the medication until instructed by the clinical staff.
• You must have someone drive you to and from the office. Please have your driver remain in the office while you are undergoing treatment.
• Your judgment and reflexes may be impaired following sedation or anesthetic. Although you may feel fully alert, you should not operate a vehicle, power tools, or any machinery for 24 hours following your procedure.
• Make arrangements for an adult to be present with you the remainder of the day.

The following information applies when upper back jawbone 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.

This procedure regains lost bone height in the back portion of your upper jaw. 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 OR SNEEZE HOLDING YOUR NOSE FOR THE NEXT FOUR (4) WEEKS.

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 and flying in pressurized aircraft may also increase sinus pressure and should be avoided. Decongestants such as Dimetapp or Sudafed 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 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. For the first 3-4 nights, sleep with at least 2 pillows (20-30 degree elevation) under your head.

Oral Hygiene
Keeping your mouth clean after surgery is essential to reduce the risk of infection. Start salt water rinses the day of surgery. Use one-half 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 four to five times daily and always after eating for the next five days.
When brushing, be very gentle. When expectorating, also be gentle. Do not use an electric toothbrush during the healing process.
We may prescribe an antibiotic rinse (Peridex) for certain procedures. This rinse should be used in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse. Using this rinse more than two times a day will cause staining of your teeth.

Smoking
Do not smoke for at least three 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
Do not wear anything that may put any kind of pressure on the surgical site.

You notice the unexpected flow of air or liquids between your mouth and nose.
You experience sinus or nasal congestion 1-2 weeks post-op on the side your surgery was performed.
There is an increase in swelling in your mouth, cheek or under your eye after 3-4 days from the surgery date.

Swelling
Swelling is often associated with 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. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

Hot Applications
You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, 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 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 don’t 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 the office.

• Fill all prescribed medication at least 24 hours prior to surgery. If you have misplaced your prescriptions contact the office immediately. Please allow 24 hours for prescriptions to be called in to your pharmacy.
• Please remember to take your antibiotic 1 hour prior to surgery. Follow the instructions on the label. If you have any questions, please contact the office.
• Routine medications can be taken, but please confirm this with the doctor prior to your surgery day. If you are taking medications, please bring the prescription bottles with you.
• If your health changes or you develop a cold, flu, or any other ailment during the week before surgery, please notify us immediately.
• Please do not wear contact lenses, make up or nail polish on the day of surgery. Wear loose fitting clothes, short sleeve shirt with an open neck.
• Please notify us immediately if you suspect that you are pregnant
• Consult with your medication specialist for more instructions. Click here for medication instructions.

• Fill all prescribed medication at least 24 hours prior to surgery. If you have misplaced your prescriptions contact the office immediately. Please allow 24 hours for prescriptions to be called in to your pharmacy.
• Please remember to take your antibiotic 1 hour prior to surgery. Follow the instructions on the label. If you have any questions, please contact the office.
• Routine medications can be taken, but please confirm this with the doctor prior to your surgery day. If you are taking medications, please bring the prescription bottles with you.
• If your health changes or you develop a cold, flu, or any other ailment during the week before surgery, please notify us immediately.
• Please do not wear contact lenses, make up or nail polish on the day of surgery. Wear loose fitting clothes, short sleeve shirt with an open neck.
• Please notify us immediately if you suspect that you are pregnant
• Consult with your medication specialist for more instructions. Click here for medication instructions.

Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully

• The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and replaced with a new moist gauze pad, if there is any bleeding.
• There will be a hole where the tooth was removed. The hole will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.
• Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
• Before the local anesthetic subsides (about 60 minutes), take the pain medication prescribed as directed along with Motrin (they work well together). The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around heavy machinery. Avoid alcoholic beverages.
• Place ice packs to the sides of your face where surgery was performed. Refer to the section on Swelling for an explanation.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by, placing a moist gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Twenty-four hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. If your post-operative swelling worsens on post-operative day 4-5 or unusual symptoms occur, call the office for instructions.

Diet
Drink cold liquids after the procedure. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat. Avoid eating hot (temperature), acidic, and spicy foods.

Keep Your Mouth Clean
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a teaspoon of salt especially after eating.

Discoloration/Bruising
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration. The use of Traumeel (see Traumeel sheet) will aid in reducing post-operative bruising and swelling.

Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call the office.

Nausea
Nausea and/or vomiting are 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 with a large volume of water. You can also sip on Coke, tea, or ginger ale.

Activity
Restrict your activities the day of surgery and resume normal activity when you feel comfortable. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you become light headed, stop exercising.

Smoking
Do not smoke for at least two weeks following surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of dry sockets.

Pain
For moderate pain, you may take 1 Motrin every three to four hours. If you are unable to take Ibuprofen then take one or two tablets of Tylenol or Extra Strength Tylenol every three to four hours. DO NOT exceed 4,000mg of Tylenol and 2,400mg of Motrin/Ibuprofen within a 24 hour period. Please Note: Vicodin and other narcotics have Tylenol in them. Use the exact dosages when calculating your pain medication daily intake. For severe pain, take the tablets prescribed as directed along with Motrin (they work well together). The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Be careful. Call our office if you have any questions.
• A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
  Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which support the tooth. These projections usually smooth out spontaneously. If not, they can be removed by the doctor.
• Sore throats and pain when swallowing are not uncommon. The muscles get swollen. This will subside in two to three days.
• Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
• Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve anywhere between a few days and a week after surgery.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problems with Drs and staff of NSCOFS.