What are signs of an emergency?

Call 9-11 immediately if you experience any of the following:

  • Difficulty Breathing
  • Difficulty Swallowing
  • Severe Rash
  • Loss of Consciousness
  • Chest or Arm Pain
  • Pressure in Chest
  • Difficulty Speaking
  • Drooping Eyelid
  • Weakness on One Side

when should I call your office?

  • Significant or excessive bleeding
  • Persistent granules in nose or mouth that do not go away
  • Persistent earache or sore throat that do not go away
  • Warmth near surgical area after 3 days
  •  Increased swelling after 3 days
  • A fever of 101.5 degrees or higher
  • Unusual rashes, blotches, or itchiness
  • Vomiting or diarrhea

Will I be PRESCRIBED any medication?

You may be prescribed medication such as antibiotics, anti-inflammatory medication, or narcotics. Use of these medications do have the potential for side effects that include drowsiness and impaired judgement. Caution should be used when participating in physical activity or operating machinery. Please note that antibiotics may interfere with birth control’s effectiveness, so use additional birth control methods until your next menstruation, if applicable. Medications prescribed will be explained by the doctor and our staff.


How should I dispose of medications when I am finished?

Unused medications that remain in your medicine cabinet are susceptible to theft and misuse. To prevent medications from getting into the wrong hands, New Jersey’s Office of the Attorney General urges you to properly dispose of your expired and unwanted prescription medicine at a nearby Project Medicine Drop location. Drop off is simple, anonymous, available 24 hours a day, no questions asked. Always scratch out identifying information on any discarded containers. For a list of locations, please visit: NJConsumerAffairs.gov/meddrop


Is there a summary of instructions?

• If you were sent home with guaze in your mouth, remove it in about 30 minutes. (See full guaze instructions to follow)
• Do not rinse your mouth for 24 hours.
• Do not brush your teeth for 24 hours.
• Continue ice packs (20 minutes on, 2o minutes off) for 48 hours
• Start clear, cold liquids with sugar and ice (ie. iced tea or
smoothies)
• No straws, rinsing, spitting, or smoking.
• Lie on the couch, head elevated 30 degrees ( 2 or 3 pillows)
• Seek assistance when going to/from the bathroom
• Seek assistance when going up/down stairs.
• Sit on the edge of the couch, and then stand up slowly.
• Eat soft foods. Cool or cold foods are better.
• Soups should be warm, not hot.
• Be sure to get plenty of rest, and continue to drink plenty of fluids.
• No alcoholic beverages.
• Do not drive for 24 hours.
• Avoid strenuous activity.
• Avoid prolonged exposure to sun and heat.
• Use all of medication unless instructed otherwise by a doctor.


What are the more detailed instructions?

The First Hour If gauze was placed, it should remain in place, with gentle biting pressure applied, for 1/2 an hour. Do not touch the gauze during this time with your tongue or fingers. After 1/2 an hour, wash your hands and remove the gauze. If there is oozing from the surgical site, fold a new piece of gauze and place it over the site and apply pressure for another half hour. Repeat as necessary.

The First 24 Hours Apply ice packs for the first 24 hours . Use ice in alternating cycle (20 minutes on, 20 minutes off). Do not rinse, spit, smoke,, drink from a straw, or do anything that creates suction for the first 24 hours as it will interfere with healing. You may drink liquids and eat soft, fork-cut foods. Small amounts of bleeding and oozing are normal after surgery. When you sleep, this blood may mix with saliva and appear as if there is more blood than there really is. This may appear on your pillowcase. Do not be alarmed, this is normal.

The Next Day (after surgery) Continue your prescriptions. It is normal to have increased swelling, as well as an increase in discomfort and soreness when opening your mouth. You may continue soft foods and increase the consistency as you see fit, but avoid spicy or hard foods.

The Second Day (after surgery) Begin brushing, but gently. Avoid whitening toothpaste containing peroxide, as this may cause your stitches to dissolve prematurely. If you’ve been prescribed chlorhexidine mouthwash, begin it today. Gently rinse two (2) times a day until sutures are removed or dissolved, being sure to swish well over the surgical sites.

The Next Week (after surgery) Return to our office for your post-operative visits. This will allow the doctor to assess healing and advise you of further instructions. You should be able to fully resume your normal activities and diet.


What can I expect after surgery?

Pain
Unfortunately, pain and discomfort are associated with surgical procedures. If you were prescribed pain medication, take it as prescribed. Be sure not to drink alcoholic beverages, drive, or make important decisions with narcotic pain medication or muscle relaxant. If the pain is mild, you may take “Tylenol” or “Advil” as needed.

Bleeding
Small amounts of bleeding are normal. The gauze helps control bleeding and may need to be replaced if light bleeding continues. Roll or fold gauze so it is about an inch thick and place it over the surgical site. Close the mouth and apply light pressure. This should remain in place for one hour. You should not talk, eat, rinse, or spit during this time. If bleed continues, wet the outside of a fresh teabag with cold water and place over the surgical site and bite down. Place an ice bag over your cheek and lie down with your head elevated on three pillows. If bleeding continues, call the office.

Swelling
Swelling and jaw stiffness are normal. If you have an abscess, especially one that was drained, do not apply heat to your face. If it is more than 24 hours after surgery and you do not have an infection, you may apply a warm compress to the swollen area and sore jaw muscles in cycles, 20 minutes on, 20 minutes of. It should take about a week for most of the swelling to clear, but it may take longer for the final traces to resolve.

Antibiotics
Not all patients will receive antibiotics. If you are given one, have it filled and follow the instructions on the label. If the surgical site has increased pain, redness, warmth, swelling, or if you have a fever three or more days after surgery, return to the office to be examined. There signs may indicate a post-operative infection. If you are on birth control pills, use additional birth control until your next menstruation, as antibiotics may interfere with
effectiveness.

Functioning
It is normal to have discomfort and limitations opening your jaw. Chewing gum at intervals, as well as opening your mouth just beyond where your jaw opens easily, will reduce stiffness.

Diet
A nutrionally-balanced diet is very important, so do not skip meals. During the first several hours of surgery, consume a liquid diet (broth, jello, sherbert, tea, etc). Avoid popcorn and small seeds (ie. sesame, poppy, blackberry) for 4 weeks. If you are diabetic, take your medication as usual, unless instructed otherwise.

Rinsing
Do not rinse for the first 24 hours. Rinsing should be done in the morning upon awaking, after meals, and bedtime. Do not rinse if there is bleeding.

Ice
Use ice packs to the surgical site and over the face for only the first 48-72 hours. Do not leave ice on continuously (2o minutes on, 20 minutes off).

Heat
After the first 72 hours, you may use heat to the surgical site. Use a warm towel or a heating pad. Rinse with warm water. Do not apply heat if you have an infection, had one drained, or have increased swelling after 3 days. Do not leave heat on continuously (2o minutes on, 20 minutes off).

Lips
Your lips and corners of your mouth may become sore or cracked. Keep them lubricated with vaseline or lip balm. You may get a canker or fever blister. If this occurs, keep it lubricated and contact the office. do not use peroxide, Anebsol®, or Listerine®.

Nausea
Nausea may be a result of anesthesia, narcotics, antibiotics, or swallowing some blood. Drink carboned beverages (ie. ginger ale) every hour. Take 1/2 of your pain medication at the next usual time. Call if it persists.

Bruises
A yellow or blue discoloration of the skin may
appear. This should resolve in two weeks.


Are they any specific instructions for implants?

Do not eat on the side of the implant or grafting. Use a Q-tip soaked with Chlorhexadine to cleanse the implant and incisions. Our office will inform you when to return to your dentist and when you can begin to floss and use a proxy brush.

If you were instructed to irrigate:

• Irrigation may need to be performed for 2-6 weeks depending on the healing process. The doctor will let you know at your post-op appointment how long you should continue to irrigate for.

• Irrigate at least twice a day, after breakfast and right before bed. If you feel you must have food in the area after lunch, you can irrigate then as well.

• Massage the area every hour to help reduce swelling. Ice the area for 20 minutes before massaging to reduce discomfort during massage.


How do I irrigate?

Irrigation is performed to clean the area and help the healing process, to help reduce irritation, discomfort, swelling, and even infection.

• Fill the syringe with Peridex/Chlorhexadine (the antibiotic rinse) mixed with water
• Follow your teeth all the way to the back of your mouth where the tooth was removed
• Take he syringe and gently turn it to your cheek and lift your wrist so the tip of the syringe drops into the hole/socket
• Push the liquid into the area, also pumping up/down and back/forth causing any debris to loosen and be flushed out
• Use 1 or 2 filled syringe per area or until the liquid runs clear (no food particles). If you do not see any debris while irrigating, then you are not doing it correctly.
• There may be some bleeding initially. This is normal and there is no need to be alarmed. The bleeding will stop once the area has been kept clean for a day.


What are the care instructions after sinus surgery?

• Use all of your prescribed medication as directed.
• You will be most likely be prescribed three medications: an antibiotic, an inhaled nasal steroid, and an antihistamine.
• Refrain from blowing your nose for at least 7 days. You may wipe nostrils, but blowing can disrupt your sinus membrane. The medicines prescribed should reduce the need to clear your nose.
• Do not smoke, or be exposed to second hand smoke. Smoke has damaging effects on all tissues of the body, including sinus membranes.
• Ocassional blood in the nostrils, or tasting blood, is normal. If bleeding is significant, call the office.
• If you were prescribed Neo-Synephrine® nose drops, do not use them for more than 4 days.
• If you were prescribed normal saline nose drops, you may use them until instructed otherwise by the doctor.
• Refrain from using a straw and from pulling on your lip to look at stitches
• Granules in your nose and mouth are common, but contact the office if they persist.

OVER THE COUNTER
Afrin – 2 sprays to affected side twice per day for 3 days. You must stop after the 3rd day to avoid rebound affect
Ocean Nasal Saline Spray – 2 sprays to affected side at least every hour while awake
Mucinex or Guaifenesin – Follow package instructions
Sudafed – 30 mg every 6 hours while awake. Do not take if you have hypertention or cardiac history. May cause insomnia.
Antihistamines (Allegra/Claritin/Zyrtec) – Follow package instructions
Humidifier/Vaporizer – Use especially at night before bed.
Steam – Inhale steam 2-4 times per day for 10 minutes by leaning over a bowl of hot water with a towel over your head. You can add Vicks Vapo-Rub.
Fluids – Increase fluid intake, 12 recommended glasses daily

PRESCRIPTION
Nasal Steroid Spray – 2 sprays to the affected side daily