PATIENT INFORMATION

• Introduction
• First Visit
• Scheduling
• Financial Policy
• Insurance
• Patient Registration
• Surgical Instructions

Surgical Instructions

Pre-operative Instructions

The following instructions may be helpful when preparing for your upcoming surgical correction. Please do not hesitate to call if you have any last minute questions. We can be reached at (281) 363-2009 (The Woodlands) & (936) 756-1669 (Conroe) during regular business hours.

You should receive your pre/post-operative prescriptions with this instruction sheet. For your convenience, please have them filled prior to your scheduled surgery, unless they have been previously phoned in to the pharmacy of your choice. Please bring your filled prescriptions with you to your appointment.

It is mandatory to stop taking Aspirin, non-steroidals such as Motrin/Advil, Coumadin, Plavix, Persantine, Aggrenox, Aspirin, Garlic, Ginseng, Ginkgo, Vitamin E or other blood thinners or certain herbal medications 5 days prior to your surgery.   

Antibiotics

If you take an antibiotic premedication please take it 2 hours prior to your surgery.

Please alert the office to any allergies or sensitivities that you might have to antibiotics. You will be prescribed an antibiotic if Dr. Dwyer determines it to be necessary for your safety and healing.

Sedatives

Dr. Dwyer uses the following oral sedative; you must have a ride to and from the office. Please bring your pre-operative medication with you to the office.

• Triazolam (Halcion)

Sutures

In order to evaluate your progress and healing, we will see you in 7 days to remove sutures, then 14 and 30 days for post-operative checks during the first month. To insure excellent post-operative healing, we will also schedule you for a periodontal maintenance prophylaxis and an examination of tissue maturation at 10-12 weeks following the surgery.

Post-operative Instructions

These instructions apply to the surgical procedure just completed. They are designed to help you minimize post-surgical discomfort, swelling, possible tissue discoloration, and inform you of any situation that may require special attention.

Medications

Continue the antibiotics as directed. Before taking any medication, slowly sip something cool like clear apple or cranapple juice, tea, broth, or Jell-O to coat your stomach and avoid nausea. As a certain amount of discomfort can be expected, we usually provide analgesics (pain pills) to take at home. After your stomach is coated, take 2 of the pain pills, then take 1-2 every 3-4 hours if discomfort persists. Fifteen minutes after taking the first analgesic, take 1 Ketoprofen. Continue to take 1 Ketoprofen every 8 hours to control inflammation as needed. Do not use aspirin as it promotes bleeding.

Note: When taking any prescribed medication containing Acetaminophen (Tylenol), i.e.; Percocet, Hydrocodone, Vicodin or Tylenol with Codeine, you should not take additional Tylenol so as not to exceed the safety level of Acetaminophen. Please contact the office with any questions you may have.

Food Suggestions

When preparing a post-op menu, please consider some of the soft-diet choices:

Swelling

A slight amount of swelling is usual but may be most evident on the third day. To minimize the swelling, place an ice pack over the outside cheek area for 20 minutes on and 10 minutes off for the first 6 hours. Continue using ice for the first 24 hours following the procedure as often as possible.

Bleeding

A slight amount of bleeding is normal within the first 24 hours.. If excessive or continuous bleeding occurs:

• Avoid vigorous rinsing or spitting of any kind.
• Elevate your head 20 degrees when lying down.
• Apply moistened gauze to the immediate area with moderate pressure for 20 minutes-repeat if necessary.
• Gentle pressure with a tea bag moistened with cool water for 20 minutes will help control oozing.
• Please call the office if bleeding persists.

Dressing

A "pack" or surgical dressing (which acts as a bandage) may be placed around areas of your sutures to provide protection, assist healing, and enable comfortable chewing. Care must be taken not to dislodge the dressing in the several hours required for it to harden, and it usually remains in place until you return to the office. Do not worry if small pieces dislodge, but should a large piece become loose or break off within 3 days, call the office if you are uncomfortable. After 3 days, should this happen, remove the dressing very carefully so as not to pull the sutures loose. Remember the surgical dressing is there for your comfort and to promote healing. Some sutures may begin to dissolve after 5 days; the others will be removed in the office at the prescribed time.

Diet

Wait until all numbness is gone before chewing any food. For the first 24 hours after surgery, drink cold (non-carbonated) fluids and eat soft foods, but do not chew solid foods on areas guarded by a protective dressing. After 24 hours, with caution and as tolerated, a normal diet may be resumed. Do not use a straw as it can create suction and promote bleeding. Remember, adequate nutrition is essential for maximum healing and tissue maturation.

Smoking

Do not smoke for at least 2 weeks following your surgical procedure. Nicotine will significantly slow healing by 50% and will compromise success.

Alcohol

Do not drink alcohol while taking prescription pain medications.

Rinsing and Brushing

Frequent but gentle rinsing (6-8 times a day) with a warm salt water solution (1 teaspoon salt and 1 tablespoon hydrogen peroxide in 8 ounces of warm water) will aid healing and soothe and cleanse your mouth. For convenience, this solution can be prepared ahead, put in a closed container and taken with you during the day. Be sure to rinse after each meal and before bed.

Toothbrushing and Fluoride application should be instituted on the areas that required surgery. Brush only the biting surfaces of teeth and do not floss those areas for the first week. Gently brush and floss the areas which did not require surgery. Care must be taken not to dislodge the dressing material so do not use toothpicks or a Proxabrush or a waterpik device on the operated areas until the sutures are removed. Beginning the day after surgery and throughout the first week, gently brush the entire mouth after each meal using a manual or electric toothbrush. Continue fluoride use especially before bed each night as it controls tooth and root sensitivity.

You may notice increased discomfort and swelling 3-4 days after the surgical procedure. As the tissues begin to heal, they may pull against the sutures and protective dressing.

If you have any questions, please call our office at (281) 363-2009 (The Woodlands) & (936) 756-1669 (Conroe)