Pre & Post Operative
Care Instructions

INSTRUCTIONS FOLLOWING IMPLANT PLACEMENT

• Avoid strenuous work or exercise for two to three days after treatment.
• Do not smoke. Avoid straws, sucking and spitting.
• Do not look at the treatment site or pull on the lip.
• A slight amount of bleeding from the area is normal.
• Apply an ice pack 15 minutes on, 15 minutes off, to the outside of the face the day of treatment.
• Take 600 mg ibuprofen every six hours for two to three days to reduce swelling, if you are able to take it.
• Take antibiotic until gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Consult your physician or pharmacist.
• Take pain medication as needed.
• A soft diet is advised for the first few days.
• The day following treatment, begin using the prescribed rinse three times a day for 30 seconds. If you run out of the prescribed rinse, use warm salt water.
• Do not brush the treatment site for two weeks.

IMMEDIATELY FOLLOWING TREATMENT: Do not eat, drink or smoke for at least one hour to allow a blood clot to form in the treatment site. Avoid hot food or cold liquid for the first three to four hours. Refrain from excess speaking as it may aggravate the treatment area.

BLEEDING: A slight amount of bleeding from the treatment site is normal. Do not use mouth rinses the day of treatment because this can prevent clotting and prolong the bleeding. If oozing persists, direct pressure should be applied to the affected area with a folded gauze pad for 10-15 minutes. Use steady pressure, do not dab.

SWELLING: Some swelling may be expected following periodontal treatment procedures. You can minimize the swelling by applying an ice pack to the outside of the face over the treatment site. Take ibuprofen 600 mg every six hours the day of treatment to help with swelling, if you are able to take it. Progressive swelling or signs of fever and infection should be reported.

DISCOMFORT: A certain amount of discomfort can be expected. If a pain medication is prescribed, take as directed. Do not take the pain medication on an empty stomach.

DIET: A soft diet is advised for the first few days. Avoid biting into foods that may disrupt the treated area.

ORAL HYGIENE: Do not brush the treatment site for two weeks unless instructed. The day following treatment, you should begin using the prescribed rinse three times a day for 30 seconds. Do not rinse vigorously. Brushing, flossing and using an interproximal brush should be done in the non-treated areas.

IF COMPLICATIONS ARISE WHICH YOU FEEL ARE AN EMERGENCY, CONTACT THE OFFICE AT (715) 832-5396.

INSTRUCTIONS FOLLOWING PERIODONTAL TREATMENT

• Avoid strenuous work or exercise for two to three days after treatment.
• Do not smoke. Avoid straws, sucking and spitting.
• Do not look at the treatment site or pull on the lip.
• A slight amount of bleeding from the area is normal.
• Apply an ice pack 15 minutes on, 15 minutes off, to the outside of the face the day of treatment.
• Take 600 mg ibuprofen every six hours for two to three days to reduce swelling, if you are able to take it.
• If any antibiotic is prescribed, please take as prescribed until gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Consult your physician or pharmacist for more information.
• Take pain medication as needed.
• A soft diet is advised for the first few days.
• Starting tomorrow, begin using the prescribed rinse three times a day for 30 seconds. If you
run out of the prescribed rinse, use warm salt water.
• Do not brush the treatment site for one week.

IMMEDIATELY FOLLOWING TREATMENT: Do not eat, drink or smoke for at least one hour to allow a blood clot to form in the treatment site. Avoid hot food or cold liquid for the first three to four hours. Refrain from excess speaking as it may aggravate the treatment area. BLEEDING: A slight amount of bleeding from the treatment site is normal. Do not use mouth rinses the day of treatment because this can prevent clotting and prolong the bleeding. If oozing persists, direct pressure should be applied to the affected area with a folded gauze pad for 10-15 minutes. Use steady pressure, do not dab.

SWELLING: Some swelling may be expected following periodontal treatment procedures. You can minimize the swelling by applying an ice pack to the outside of the face over the treatment site. Take ibuprofen 600 mg every six hours the day of treatment to help with swelling, if you are able to take it. Progressive swelling or signs of fever and infection should be reported.

DISCOMFORT: A certain amount of discomfort can be expected. If a pain medication is prescribed, take as directed. Do not take the pain medication on an empty stomach. DIET: A soft diet is advised for the first few days. Avoid biting into foods that may disrupt the treated area.

ORAL HYGIENE: Do not brush the treatment site for one week unless instructed. Starting tomorrow, you should begin using the prescribed rinse three times a day for 30 seconds. Do not rinse vigorously. Brushing, flossing and using an interproximal brush should be done in the non-treated areas.

IF COMPLICATIONS ARISE WHICH YOU FEEL ARE AN EMERGENCY, CONTACT THE OFFICE AT (715) 832-5396.

INSTRUCTIONS FOLLOWING INITIAL PERIODONTAL THERAPY (SCALING AND ROOT PLANING)

1. When anesthesia has been used, your lips, teeth, and tongue may be numb for several hours after the appointment. Avoid any chewing until the numbness has completely worn off. It is easy to bite or burn your tongue or lip while numb. It is recommended that you take two ibuprofen or acetaminophen tabs before the anesthetic completely wears off. This will help with any swelling or discomfort.
2. It is not unusual for the teeth to be more sensitive to hot or cold temperatures, and/or sweets. This occurs as the gum tissue heals and shrinks in size. Brushing two or three times daily with sensitivity toothpaste or using fluoride rinses may help alleviate this over time. If sensitivity continues or is severe, professional application of a desensitizing agent may be required.
3. Rinse with warm salt water several times daily.
4. Smoking should be avoided for a minimum of 24-48 hours because it deters healing. In addition, smoking will stop the progress of healing from the initial periodontal therapy and make stable maintenance of periodontal disease difficult. Complete smoking cessation is highly recommended.
5. A slight amount of bleeding following initial periodontal therapy is not unusual, and should gradually subside.
6. Following initial periodontal therapy, you can expect to notice less redness, less bleeding, and less swelling of your gum tissues. Your teeth may feel smoother, and your mouth will taste and feel better. Your gum health must be maintained with proper homecare, as instructed, and regular professional care.
7. In most cases, only one half of the mouth is treated per visit. Please remember to keep all appointments to complete the treatment on the opposite side as well as follow-up appointments thereafter.
8. Daily oral hygiene is essential to the proper healing of your tissues. Brushing, flossing, and rinsing with recommended products are critical.
9. Maintenance appointments are essential for adequate healing and proper maintenance. When maintenance appointments are not kept, it is possible that patients will require another sequence of initial periodontal therapy.

If you have any questions, please feel free to contact our office at (715)832-5396.

INSTRUCTIONS FOLLOWING TISSUE GRAFTING/GINGIVAL GRAFTING

• Avoid strenuous work or exercise for two to three days after treatment.
• Do not smoke. Avoid straws, sucking and spitting.
• Do not look at the treatment site or pull on the lip.
• Wear the protective cover for a minimum of two days following treatment.
• A slight amount of bleeding from the area is normal.
• Apply an ice pack 15 minutes on, 15 minutes off, to the outside of the face the day of treatment.
• Take 600 mg ibuprofen every six hours for two to three days to reduce swelling, if you are able to take it. Do not exceed the daily maximum dosage listed.
• Take antibiotic until gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Consult your physician or pharmacist.
• Take pain medication as needed.
• A soft diet is advised for the first few days.
• The day following treatment, begin using the prescribed rinse three times a day for 30 seconds. If you run out of the prescribed rinse, use warm salt water.
• Do not brush the treatment site until after your next appointment.

IMMEDIATELY FOLLOWING TREATMENT: Do not eat, drink or smoke for at least one hour to allow a blood clot to form in the treatment site. Avoid hot food or cold liquid for the first three to four hours. Refrain from excess speaking as it may aggravate the treatment area.

BLEEDING: A slight amount of bleeding from the treatment site is normal. Do not use mouth rinses the day of treatment because this can prevent clotting and prolong the bleeding. If oozing persists, direct pressure should be applied to the affected area with a folded gauze pad for 10-15 minutes. Use steady pressure, do not dab.

SWELLING: Some swelling may be expected following periodontal treatment procedures. You can minimize the swelling by applying an ice pack to the outside of the face over the treatment site. Take ibuprofen 600 mg every six hours the day of treatment to help with swelling, if you are able to take it. Progressive swelling or signs of fever and infection should be reported.

DISCOMFORT: A certain amount of discomfort can be expected. If a pain medication is prescribed, take as directed. Do not take the pain medication on an empty stomach.

DIET: A soft diet is advised for the first few days. Avoid biting into foods that may disrupt the treated area.

ORAL HYGIENE: Do not brush the treatment site for two weeks unless instructed. The day following treatment, you should begin using the prescribed rinse three times a day for 30 seconds. Do not rinse vigorously. Brushing, flossing and using an interproximal brush should be done in the non-treated areas.

IF COMPLICATIONS ARISE WHICH YOU FEEL ARE AN EMERGENCY, CONTACT THE OFFICE AT (715) 832-5396.

INSTRUCTIONS FOLLOWING SINUS LIFT PROCEDURE

What to expect following treatment:

Bleeding: Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.

Discomfort: Moderate discomfort may be noticed when the anesthetic first wears off and may continue for several days.

Swelling: Some swelling and discoloration of the lip and/or cheek may occur and may last for a few days.

Sensation: There may be a temporary loss of feeling in the gums in the operated area. The teeth may also feel loose for a time. The teeth may be sensitive to hot and cold temperatures.


What to do following the procedure:

• After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.
• Read all instructions for each medication carefully.
• Take two Tylenol, Advil, or similar non-aspirin pain reliever as directed not to exceed daily maximum dosage listed. Take it before the anesthesia wears off.
• If pain medication is prescribed, take it as you need it. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications. Note that many pain medications contain Acetaminophen (Tylenol).
• Nausea is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food and taking the pill with a large glass of water.
• Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.
• Eat soft foods for the first 2-4 days. Maintain a good, balanced diet. Drink plenty of water. Do not drink through a straw. Avoid alcohol for 48 hours.
• Avoid chewing directly over the operated area until the sutures are removed.
• Brush all of your teeth after each meal. Avoid the treated area for the first day. Take care to avoid pulling the sutures.
• Do not rinse vigorously; do not use a Waterpik®.
• A saltwater solution (½ teaspoon salt + ½ teaspoon soda + 8 ounces warm water) held in your mouth for 2 to 3 minutes every hour may make your mouth more comfortable.
• Avoid blowing your nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended.
• Avoid lifting the lip with your fingers to look at the area. It is possible to accidentally tear the sutures, open the incision, and delay healing.
• Smoking should be stopped following treatment. Healing and success of the treatment will be substantially reduced by the cigarette smoke chemicals in your body.
• If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills, consult your physician or pharmacist.
• You may be instructed to use a prescription antimicrobial mouth rinse.
• Return to your dentist’s office for removal of the sutures or follow-up appointments as directed.

Please call our office at (715) 832-5396 if you have:

• Uncontrollable discomfort
• Excessive or severe bleeding
• Marked fever
• Excessive warm swelling occurring a few days after the procedure
• Reactions to medications, especially rash, itching, or breathing problems

Following these instructions very closely will greatly help your comfort and promote uneventful healing of the area. If any of the instructions are not followed, you might have significantly more discomfort, and the success of the treatment may be affected.

ORAL CONSCIOUS SEDATION INSTRUCTIONS

For your safety, ALL of these instructions must be strictly followed prior to commencing sedation. Neglecting any of these items may be cause to cancel that day’s treatment.

EATING AND DRINKING: It is imperative that the patient undergoing sedation has an empty stomach. Patients should not have anything to eat or drink for 8 hours prior to the appointment. Patients should have no caffeine for 8 hours prior to appointment.

CHANGE IN HEALTH: A change in health, especially the development of a cold or fever with congestion of the nose and/or chest is very important – these may compromise the airway. Please notify the staff of any change in your health. It may be necessary to reschedule the appointment.

DESIGNATE A DRIVER: A responsible adult must accompany and provide the transportation home after the procedure. It is recommended that they remain in the office during the procedures. Arrange to have a responsible adult with you for at least 4-6 hours after the procedure, to provide care as needed.

STREET DRUGS: The use of ‘street drugs’ (marijuana, cocaine, heroin, etc.) is strictly forbidden for several weeks prior to anesthesia and until a full recovery is achieved. No smoking or drinking is allowed for 8 hours prior to the procedure time. Literature has reported serious and potentially lethal complications when street drugs and anesthetic agents are mixed.

MEDICATIONS: Sedative medications must be taken according to the doctor’s instructions. Patient must have NO CHANCE OF PREGNANCY.


THE DAY OF SURGERY

CLOTHING: Wear comfortable clothing. Do not wear contact lenses. Please leave any valuable items at home.

MEDICATION: Take any of your regular prescription medications as directed, unless otherwise instructed by your dentist or physician.

ARRIVAL: Please arrive at our office at least 10 minutes prior to the appointment time. This will allow you to use the restroom prior to sedation and treatment. There are times when we will instruct you to arrive an hour prior to your appointment if we are having you take your initial sedative medication at the office where we can monitor you closely. Bring a book or magazine for this waiting period if you like.

AT THE OFFICE: After a brief examination in the office we may decide to give additional medications and/or start you on nitrous oxide inhalation sedation. For optimal safety of all patients, state of the art monitors will be placed to continuously evaluate the status of the heart and lungs from the beginning of treatment until recovery for discharge. Each sedation plan is individualized for the specific patient, so the medications to be administered, dosages, and recovery times vary.

LEAVING THE OFFICE: Due to the lingering effects of the sedation medications, patients must have a responsible adult accompany them to their overnight destination. A patient will not be allowed to leave the office by taxi or bus without a responsible adult


AT HOME / POST-SEDATION INSTRUCTIONS

EATING, DRINKING, and SMOKING: As soon as the patient is able, encourage fluid intake beginning with clear liquids (water, Gatorade, soda, fruit juice and popsicles) and advance as tolerated to a regular diet. Encourage as much liquid intake as tolerated to reduce the occurrence of nausea and/or vomiting, a common side effect of sedation medications. If vomiting occurs, do not become alarmed, this is normal. Wait 1 hour to let the stomach calm down before trying again with water. Keep all liquids and food at room temperature. Hot liquid and food may cause bleeding of treatment sites and cold items may not be tolerated due to pain, but will be helpful if swelling is expected. The patient should not be allowed to sleep for prolonged periods of time without urinating. For adults: NO ALCOHOL and NO SMOKING for the first 12 hours.

ACTIVITY: The patient must not drive or engage in moderate to high physical activity for 12 hours or until the effects of the medication have subsided completely. Do not plan to drive a vehicle or operate potentially dangerous equipment for 12 hours after sedation. Since judgment may be impaired during this time as well, the patient should not be allowed to make any critical decisions until fully recovered from the anesthesia.

SLEEPINESS: The patient may be sleepy for a time after sedation. The duration of drowsiness varies with the depth of the sedation and duration of the treatment. To avoid falling off a bed or sofa, you may want to place a blanket on the floor and allow the patient to sleep there. All post operative patients should ride home in the car in a reclined position and at home sleep on their side supported by a pillow behind their back. This will help to maintain an adequate airway during sleep and if vomiting occurs. The patient’s chin should be in an extended position away from the chest. This will also aid in keeping the airway open and facilitate effortless breathing. A responsible adult should arouse the patient every 1-2 hours for the first 4-6 hours after anesthesia to ensure a smooth recovery.

PAIN or FEVER: Supplemental oral pain relievers may be provided by your dentist. Muscle aches, tired jaw muscles and nausea are common after anesthesia and usually resolve by themselves within 24-36 hours. Encourage deep breathing and coughing to clear the lungs of any accumulated secretions.

EVENING PHONE NUMBER: Be sure to provide Dr. Jason Johnson or Dr. Russell Dylla with a phone number where they can reach the patient and care provider later that day to check on the progress of recovery and to answer any questions you may have.

SEEK ADVICE: If vomiting persists beyond 4 hours, or temperature remains over 101° for more than 24 hours contact Eau Claire Periodontics at 715-832-5396.

IF THE PATIENT BECOMES UNRESPONSIVE OR HAS DIFFICULTY BREATHING CALL 911 IMMEDIATELY!
IF YOU HAVE ANY QUESTIONS, PLEASE CALL THE OFFICE AT 715.832.5396

IV Conscious Pre-Sedation Instructions

For your safety, ALL of these instructions must be strictly followed prior to commencing sedation. Neglecting any of these items may be cause to cancel that day’s treatment.

EATING AND DRINKING: You should not drink grapefruit juice or eat any grapefruit products for seven (7) days prior to your appointment. It is imperative the patient undergoing sedation has an empty stomach. Patients should not have anything to eat or drink for eight (8) hours prior to the appointment. Patients should have no caffeinated beverages (coffee or pop) for eight (8) hours prior to appointment.

CHANGE IN HEALTH: A change in health, especially the development of a cold or fever with congestion of the nose and/or chest is very important – these may compromise the airway. Please notify the staff of any change in your health. It may be necessary to reschedule the appointment.

DESIGNATE A DRIVER: A responsible adult must accompany and provide the transportation home after the procedure. Arrange to have a responsible adult with you for at least six (6) hours after the procedure, to provide care as needed.

STREET DRUGS: The use of ‘street drugs’ (marijuana, cocaine, heroin, etc.) is strictly forbidden for several weeks prior to anesthesia and until a full recovery is achieved. No smoking or drinking is allowed for 48 hours prior to the procedure time. Literature has reported serious and potentially lethal complications when street drugs and anesthetic agents are mixed.

MEDICATIONS: Sedative medications, if prescribed, must be taken according to the doctor’s instructions. Patient must have NO CHANCE OF PREGNANCY.


THE DAY OF TREATMENT

CLOTHING: Wear comfortable clothing and, preferably, a short sleeve shirt. Do not wear contact lenses. Please remove nail polish and/or artificial nails prior to your appointment. Please leave jewelry and any valuable items at home.

MEDICATION: Take any of your regular prescription medications as directed, unless otherwise instructed by your dentist or physician.

ARRIVAL: Please arrive at our office at least 10 minutes prior to the appointment time. This will allow you to use the restroom prior to sedation and treatment. Cell phones are not allowed in the treatment room.

AT THE OFFICE: For optimal safety of all patients, state of the art monitors will be placed to continuously evaluate the status of the heart and lungs from the beginning of treatment until recovery for discharge. Each sedation plan is individualized for the specific patient, so the medications to be administered, dosages, and recovery times vary.

LEAVING THE OFFICE: Due to the lingering effects of the sedation medications, patients must have a responsible adult accompany them to their overnight destination. A patient will not be allowed to leave the office by taxi or bus without a responsible adult.


AT HOME / POST-SEDATION INSTRUCTIONS

EATING, DRINKING, and SMOKING: As soon as the patient is able, encourage fluid intake beginning with clear liquids (water, Gatorade, soda, fruit juice and popsicles) and advance as tolerated to a regular diet. Encourage as much liquid intake as tolerated to reduce the occurrence of nausea and/or vomiting, a common side effect of sedation medications. If vomiting occurs, do not become alarmed, this is normal. Wait one hour to let the stomach calm down before trying again with water. Keep all liquids and food at room temperature. Hot liquid and food may cause bleeding of treatment sites and cold items may not be tolerated due to pain, but will be helpful if swelling is expected. The patient should not be allowed to sleep for prolonged periods of time without urinating. For adults: NO ALCOHOL and NO SMOKING for the first 24 hours.

ACTIVITY: The patient must not drive or engage in moderate to high physical activity for 24 hours or until the effects of the medication have subsided completely. Do not plan to drive a vehicle or operate potentially dangerous equipment for 24 hours after sedation. Since judgment may be impaired during this time as well, the patient should not be allowed to make any critical decisions until fully recovered from the anesthesia.

SLEEPINESS: The patient may be sleepy for a time after sedation. The duration of drowsiness varies with the depth of the sedation and duration of the treatment. To avoid falling off a bed or sofa, you may want to place a blanket on the floor and allow the patient to sleep there. All post operative patients should ride home in the car in a reclined position and at home sleep on their side supported by a pillow behind their back. This will help to maintain an adequate airway during sleep and if vomiting occurs. The patient’s chin should be in an extended position away from the chest. This will also aid in keeping the airway open and facilitate effortless breathing. A responsible adult should arouse the patient every 1-2 hours for the first 4-6 hours after anesthesia to ensure a smooth recovery.

PAIN or FEVER: Supplemental oral pain relievers may be provided by your dentist. Muscle aches, tired jaw muscles and nausea are common after anesthesia and usually resolve by themselves within 24-36 hours. Encourage deep breathing and coughing to clear the lungs of any accumulated secretions.

SEEK ADVICE: If vomiting persists beyond four (4) hours or temperature remains over 101° for more than 24 hours, contact Eau Claire Periodontics at 715-832-5396.

IF THE PATIENT BECOMES UNRESPONSIVE OR HAS DIFFICULTY BREATHING CALL 911 IMMEDIATELY!
IF YOU HAVE ANY QUESTIONS, PLEASE CALL THE OFFICE AT 715-832-5396

INSTRUCTIONS FOLLOWING A SINUS PERFORATION

The surgery which you just received has left a perforation in the membrane that lines the sinus floor. This sinus is a large hollow space in the upper jaw, usually lying just above the roots of the back teeth. There is a connection between the sinus and the respiratory (breathing) system. This is usually why many people have sinus trouble when they “catch a cold”. A perforation or opening resulting from a tooth extraction results in a direct communication between your mouth and your sinus through the socket from which your tooth was removed. A blood clot should form in this area to close that opening. A perforation or opening resulting from a sinus graft procedure has been covered by a dissolvable barrier. Sometimes additional treatment is necessary.

We have taken certain measures to allow this perforation to heal. It will usually heal with no problems as long as the sinus doesn’t have a previous infection or inflammation.

However, there are some precautions you must take so as not to disturb the healing process.

1. DO NOT disturb the blood clot in the socket from which the tooth was removed. The clot is what closed the perforation.
2. DO NOT blow through your nose. This will cause pressure and force the clot out of the socket.
3. Avoid anything that will cause you to sneeze or cough. Sneezing and coughing cause the same problem as blowing your nose. If you must sneeze or cough, do so with your mouth OPEN.
4. Avoid smoking. If you must smoke, do not blow smoke through your nose, and take light drags on the cigarette.
5. DO NOT be alarmed if you find blood in your nose. This may happen occasionally since the nose in connected directly to the sinus.

If you have any questions or concerns, please do not hesitate to call us at 715-832-5396

INSTRUCTIONS FOLLOWING SUTURE REMOVAL

Excellent hygiene is essential for optimal healing after suture removal. Continue good oral hygiene in untreated areas and begin the following procedures in the treated areas:

TODAY:

Brush your teeth twice a day. Each day gradually increase your pressure with the toothbrush in treated areas.
Begin flossing all treated areas, flossing only the part of the tooth you can see (not under the gumline).
Begin using the rubber tip stimulator twice a day. Use it from both the tongue and cheek side to help flatten the gum between the teeth.

AFTER TWO DAYS

Begin using your Proxabrush.
The tissue may be tender and bleed slightly, but this will improve daily.
Do not use an electric toothbrush yet.

AFTER 7 DAYS:

Discontinue the rubber tip stimulator unless instructed otherwise.
Continue daily use of your Proxabrush.
Return to using an electric toothbrush if applicable. You are now brushing at full pressure.
Begin flossing below the gumline.

We will see you again in three months for a periodontal maintenance appointment. If you have any questions or concerns about your plaque control or healing, please contact our office.

IF COMPLICATIONS ARISE WHICH YOU FEEL ARE AN EMERGENCY, CONTACT THE OFFICE AT 715.832.5396.