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Craig M. Misch, DDS, MDS
Specialist in Oral & Maxillofacial INSTRUCTIONS FOR LOCAL ANESTHESIA SURGERY PATIENTS
1. Increase your fluid intake following surgery and maintain a soft diet. If
you have difficulty drinking fluids or swallowing contact the office.
2. Do not wear your dentures unless otherwise told by your doctor.
Pressure from the denture can cause the sutures to loosen and disturb
the healing implants.
3. Do not pull on your lip to examine the surgical site. The incision may
open which can jeopardize the bone graft or implant and delay healing.
4. Do not smoke for at least two weeks after surgery. Smoking will delay
healing and contribute to a greater risk of graft and/or implant failure.
Use the nicotine patch as directed if needed. You may also receive a
prescription for Zyban (bupropion) to help prevent smoking. Ask the
doctor if you need these anti-smoking medications.
6. Do not brush your teeth in the operated area until the sutures are removed
(one to two weeks). Starting the day after surgery you may gently brush your teeth in areas distant from the surgical site. Rinse your toothbrush under hot water to soften the bristles and avoid vigorous rinsing. Gentle rinsing with Peridex (chlorhexadine) will help to clean the treated area. To make the salt water rinse, mix one teaspoon of salt with half a glass of warm tap water. 7. Please limit your physical activity following surgery. You should be able to resume light activity in a day or two. Avoid physical exercise or strenuous activity for at least one week. Sinus graft surgery 8. Avoid rinsing vigorously (ballooning your cheeks) or spitting until the sutures are removed. 9. Do not blow your nose and sneeze with your mouth open if you have to. You may experience some bleeding from the nose. If you feel congested, the doctor may recommend an over the counter nasal spray such as Afrin and decongestants such as Sudafed tablets. Do not use the nasal spray for more than 3 days.
Bleeding

Slight bleeding for a number of hours following surgery is not unusual. The blood will mix with your saliva and look like you are bleeding more than you really are. Your saliva may be tinged with blood for up to 48 hours. If heavy bleeding is still present a few hours after surgery, moisten a wash cloth or wrap a tea bag in moist gauze and place it over the area applying pressure for one-half hour. Repeat this if necessary. Holding small amounts of ice water in your mouth will usually stop any slight oozing. If there is excessive bleeding the day of or continual bleeding the day after surgery, call for instructions. You will probably have pain in the area the day of and the day following surgery and possibly longer. Take your prescribed pain medication after surgery even if you do not feel pain. It is easier to prevent pain than decrease it. Take pain medication when you arrive home and every 6 hours for the next 24 hours, then as needed. Do not drive or operate machinery when taking narcotic medications such as Vicodin (hydrocodone), Percocet (oxycodone), or Tylenol #3. Limit your activity the first few days after surgery. Trying to do too much too fast increases the swelling which increases your pain.
Swelling
To minimize swelling, a cold pack should be intermittently applied to the face next to the operated area (use crushed ice in zip-loc bags or a bag of frozen peas and wrapped in paper towel). Keep the cold pack on for 10 minutes, then off for 10 minutes. Repeat this sequence throughout the day of surgery. Bed rest immediately after surgery with your head elevated by a pillow is also recommended. By limiting your activity the day of surgery, you will significantly limit the degree of swelling. Swelling usually peaks three days after surgery and may persist for several days. There may be numbness associated with the swelling. Fair skinned patients or those who bruise easily may anticipate some discoloration of the skin over the area. If the swelling is severe and/or you feel feverish as well, please call. It may be helpful to apply Vaseline to your lips to keep them moist.
Instructions for diet following bone graft or implant surgery
Drink plenty of cool fluids after surgery such as water and fruit juice. Avoid
carbonated beverages (soda) and very hot foods or drinks for at least two days.
A soft non-chewing diet is recommended for two weeks after surgery to allow the
gum tissue to heal. It is also advisable to avoid acidic foods such as tomatoes,
peppers, or citrus fruits and highly seasoned foods that may irritate the mouth.
You may resume eating these foods in a few weeks after the mouth sutures are
removed.
After the sutures are removed from your mouth it is still important not to disturb
the area so that the bone graft or implants may fuse to your jawbone. Do not eat
with your dentures or removable teeth. We realize that you may occasionally be
in social situations that you will want to wear your dentures. If you occasionally
need to eat a meal with the denture in place, choose a diet that is soft and does
not require much chewing. If you need to use your denture for eating more that
once a week please discuss this with Dr. Misch.
Patients that maintain a good diet of soft foods generally feel better, have less
discomfort, and heal better. A nutritious diet throughout the healing period is
important to your comfort, temperament and healing. Chop food in smaller pieces
or use a blender to puree. A daily multiple vitamin and calcium supplements (ie.
Citrical) are also recommended. Food supplements such as Metrecal, Nutrament,
Ensure, Enrich, Sego, Instant Breakfast, etc. may be helpful. Also avoid foods
that may cause trauma to the gums such as popcorn, chips, nuts or shells.
Breakfast Apple juice, water, milk, coffee, tea. Yogurt, cooked cereals such as oatmeal or cream of wheat. Scrambled eggs, cottage cheese, milk, toast, applesauce. Lunch and Dinner Home cooked broth, bouillon, soups. Ground beef, baked or broiled fish, broiled or stewed chicken (finely chopped). Macaroni and cheese, scrambled eggs, bread softened with gravy. Baked or mashed potatoes. Asparagus, peas, carrots, lima beans, string beans (all mashed). Cottage cheese, canned bartlett pears. Jell-O, puddings, pound cake. Milkshakes and ice cream.
NOTIFY THE DOCTOR IF ANY OF THE FOLLOWING OCCUR:
1. If pain or swelling increases after 3 days (it should be decreasing).
2. If the sutures become loose or dislodged before 3 days.
3. If you have any signs which may indicate a drug reaction or allergy
such as itching, hives, rash or difficulty swallowing or breathing.
4. You develop a fever or body temperature becomes higher than 100
degrees F taken orally.
5. Numbness persists three days after surgery.
6. Pain in your jaws is not relieved by the prescribed pain medication.
7. If you have persistent nausea or pain that prevents drinking

8. If you are having difficulty not smoking after surgery.
Telephone Number
Doctor’s Office: (941) 957-6444
Doctor’s E-Mail Address: [email protected]

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