Pre & Post Operative Instructions

The doctors at Lighthouse Oral and Maxillofacial Surgery aim to make oral surgery as comfortable an experience as possible for Houston and Katy patients. Following the provided pre- and post-operative instructions will help promote healing and reduce complications. Contact us today to schedule a consultation before considering surgery.

Pre-Operative Instructions: Before Surgery

First and foremost, try to relax before surgery. Make sure that all of your questions are answered, and you understand what to expect so that you can feel calmer and more confident. Remember that the doctors at Lighthouse Oral and Maxillofacial Surgery strive to keep you as comfortable as possible so that you have a positive experience.

Please follow these instructions to prepare for oral surgery with IV Sedation.

• You may not have anything to eat or drink (including water) for eight hours prior to the appointment. If you have a history of difficulty with IV access, please contact the office so we can discuss options to optimize your experience.
• No smoking for 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 anesthesia.
• Please wear dark, 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 upset bowels, please notify the office.
• If you take routine oral medications, please check with us prior to your surgical date for specific instructions.
• If you suffer from asthma, please bring your rescue inhaler with you to your appointment.
• If you are diabetic please bring your glucometer with you to your appointment.

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Post-Operative Instructions: After Surgery

Discomfort

Discomfort is best controlled with multiple medications. It is best to start before the numbness has worn off so that you are not in any discomfort. It is recommended to take 600mg of ibuprofen (3 over-the-counter 200mg liquid gels) every 6 hours and 500-1000mg of acetaminophen every 6 hours. You may take them together but it is best to alternate between the two medications so that you are taking something every 3 hours. For example, ibuprofen 600mg at noon, acetaminophen at 3 pm, ibuprofen at 6pm, acetaminophen at 9pm, ibuprofen 600mg at midnight. If you were given a prescription for Medrol Dose Pack or Decadron, please take it as directed.
During the first 24 hours after surgery, be generous with the discomfort medication, but follow the instructions. Do not exceed the recommended limits of 3200mg of ibuprofen and 4000mg of acetaminophen daily.

Remember that when people say “stay ahead of the pain” they truly mean stay ahead of the inflammation, which is best accomplished with ONE form of NSAIDs(ibuprofen, naproxen, ketorolac, meloxicam) and a form of steroids (methylprednisolone, decadron).

The combination of NSAIDs and steroids will help keep inflammation to a minimum after surgery, which is responsible for all of the undesired issues (discomfort, swelling, sensitivity).

Antibiotics

Not everyone needs an antibiotic after surgery. If you are given an antibiotic, Please take the antibiotic as directed until you are finished with it. If you are a female on birth control pills, be aware that antibiotics can decrease the effectiveness of birth control pills. Please consider a second form of contraception.

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 first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. It is important that the gauze is positioned properly on the soft tissue and not between the teeth. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag wrapped in gauze for thirty minutes. The tannic acid in the tea bag helps to form a clot. 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 a normal part of the healing process. Most swelling does not become apparent until the day following surgery and does not reach its maximum until 2-3 days after surgery. However, the swelling may be minimized by the immediate use of ice packs and keeping your surgical site elevated. Try resting in a recliner or using several pillows to prop yourself up in bed if needed. The ice packs should be rotated every 15 minutes from one side to the other continuously while you are awake. After 24 to 36 hours, ice has no beneficial effect. At 36 hours, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.

Diet

After general anesthetic or IV sedation, liquids should be initially taken. Drink plenty of fluids, please remember you started the day dehydrated from the pre-op fasting. While the local anesthesia is still working and the tissue feels numb, please avoid hot liquids or food. Soft foods (oatmeal, mashed potatoes, scrambled eggs consistency) and plentiful liquids should be consumed on the day of surgery. Advance your diet in firmness as you can tolerate. Some individuals have no issue going back to a normal diet quickly while others may require a gentler and slower approach. Everyone is slightly different in tolerance and as long as your recovery is heading in the right direction, please do not become concerned.

A good measure of hydration is the color of your urine, if it is not clear, please drink more water. Dehydration may cause you to feel nauseated, tired, and overall ill. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat. 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.

Keep the mouth clean

Only very gentle rinsing should be performed on the day of surgery. You should gently brush your teeth the night of surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Discoloration

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. Moist heat applied to the area may speed up the removal of the discoloration.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. Some find that deep slow breathing helps decrease or resolve nausea and vomiting. Try sipping on tea, ginger ale, or a coke. OTC Benadryl has been helpful for many with nausea.

Reactions to medications

After taking any medication, if you experience any itching, rash, or abnormal body reaction, please stop taking the medication immediately. Many symptoms can be relieved with Benadryl. If symptoms persist or worsen, please call.

It is our desire that your recovery is as smooth and pleasant as possible. Following these instructions will assist you. If you have any questions or concerns about your progress, please contact us.

Special instructions for Implant placement

After dental implant surgery, do not disturb the wound. Avoid vigorous rinsing, spitting, or touching the wound on the day of surgery. In some cases there will be a metal healing abutment protruding through the gingival (gum) tissue, which should be gently cleaned with Q-tip dipped in Peridex rinse until it is shiny. If the metal abutment is not shiny, it could have a biofilm building up on it which is home to bacteria and can cause the surrounding tissue to become infected.

Special instructions for bone grafting/membrane placement, guided tissue regeneration.

After grafting surgery, please do not disturb the wound. Avoid vigorous rinsing, spitting, or touching the wound on the day of surgery. Keeping the wound gently and properly cleansed is critical for optimal results. Soaking a gauze in Peridex and placing it on the wound (five-minute duration) two to three times daily significantly lowers the bacterial burden on the wound and allows for ideal tissue healing. Gentle cleansing with a Peridex saturated Q-tip for the first 5 days can be replaced with gentle brushing with an extra soft bristle toothbrush dipped in Peridex.