Patient Instructions

Instructions for patients undergoing local anesthesia, nitrous oxide (laughing gas) sedation, oral (children and adult) anesthesia:  You may have a light meal   (oatmeal, cereal, toast with a small glass of juice) 2-4 hours before your scheduled appointment.  For patients undergoing oral sedation, a friend or family member should accompany the patient to their appointment, stay in the doctor’s office during the procedure, escort the patient home and observe the patient for 24 hours.

Instructions for intravenous (IV) sedation:  Patients undergoing Intravenous (IV) Sedation should have nothing to eat or drink for 6-8 hours prior to their appointment.  If your appointment is in the morning, please refrain from all meals and beverages after midnight.  If your appointment is in the afternoon, please eat a light breakfast (cereal, oatmeal, toast with a glass of juice/coffee) 6 hours prior to your scheduled appointment.  Patients should wear loose, comfortable clothing (workout pants/sweats pants/shorts, a short sleeved t-shirt and shoes without a heel) to your appointment and should get plenty of sleep the night before.  Minors should always have a parent or legal guardian accompany them to their appointment.  A friend or family member should accompany the patient to their appointment, stay in the doctor’s office during the procedure, escort the patient home and observe the patient for 24 hours.

Special Considerations:

Daily/Routine Medications:  Patients taking daily medications may take their medications at their normal times with a few small sips of water.

Diabetic Patients undergoing Intravenous (IV) Sedation:  Patients with Diabetes should attempt to schedule their appointments in the morning when possible.                         

For Non-Insulin Dependent Diabetics undergoing Sedation:  All oral agents (Metformin, Glipizide, Glyburide, etc…) should be stopped the morning of surgery and may be resumed at their regular dose and time after surgery.

For Insulin Dependent Diabetics undergoing Sedation:  Take half the daily NPH Insulin dose the morning of surgery and do not take your regular insulin.  After surgery, resume meals and normal NPH and Insulin regimens.

For Patients Taking Coumadin/Warfarin:  Prior to your procedure, a consultation with your regular physician will determine whether there is a need to temporarily stop your Coumadin/Warfarin therapy.  Laboratory studies may be required to determine your current level of anticoagulant activity.  If there is a need to discontinuation your Coumadin/Warfarin, please follow the guidelines set forth by your primary care physician and DO NOT attempt to stop your anticoagulant therapy without your physician consent.

For Patients currently taking or with a history of Bisphosphonate Therapy:  For patients with a history of the following medications Actonel, Boniva, Fosamax, Fosamax Plus D, Skelid, Didronel, Aredia, Zometa and Bonefos please click here.

Other Considerations:  Patients with certain repaired and congenital coronary heart disease (CHD), prosthetic heart valves, cardiac transplantation recipients whom have developed cardiac valvulopathy, previous infective endocarditis, artificial joints within the past 6 months and/or cardiac stents are subject to antibiotic prophylaxis 1 hour prior to your appointment.

**Post-Operative Instructions are Specific to the Procedure Performed**

Post-operative Instructions for extractions, wisdom teeth removal, dental implants and bone grafting:  Following oral procedures, we recommend a soft or liquid (cold) meal upon arriving home.  Adequate nutrition is essential to normal healing, therefore, appropriate nutrition is encouraged.  Remember that you have had nothing to drink for the past 6-8 hours, so please keep your body hydrated by drinking lots of water.  Please refrain from carbonated beverages and fruit juices, as these products may cause delayed healing and/or infection.  For the first 24 hours, please avoid rinsing, hot liquids and using a straw.  Patients are strongly encouraged to refrain from cigarette smoking for as long as possible after extractions, oral bone grafting and dental implants as cigarette usage increases the likelihood of delayed healing, infection and implant/graft failure.

Bleeding, bruising and swelling are NORMAL EVENTS in the healing process and ARE TO BE EXPECTED following surgery.  Bleeding typically subsides a few hours after the procedure and is typically well controlled by biting on a piece of gauze or a wet tea bag.  Although unlikely, bruising may occur several days after surgery and will resolve completely within 7 to 14 days.  Swelling is a natural component of the healing process and typically peaks 72 hours after surgery.  Swelling can be decreased with the use of ice packs and Ibuprofen (Advil, Motrin, Alleive, Naproxen).  Swelling may cause limited movement and/or decreased opening of your mouth, this is a normal phenomenon.  If swelling and/or limited opening continues after 7 days, please call our office for further instructions. 

Beginning 24 hours after surgery healing may be accelerated by performing a warm salt-water oral rinse 2-3 times a day.  Simply mix a teaspoon of table salt with 8 ounces of warm tap water and rinse and spit for 30 seconds.  Continue oral rinses for 1 week or as directed by your doctor.  You may brush your teeth the day after surgery, please make sure to brush only your teeth and not your gums, especially for bone grafting and dental implant patients.

Nausea and Vomiting may occur after surgery.  It is most frequently associated with taking your pain medication on an empty stomach.  If nausea and vomiting occur, discontinue your pain medication and take Ibuprofen (Advil, Motrin, Alleive) for your pain control.   If the nausea continues, please call our office immediately for further instructions.