Pre-operative Instructions
What to Expect from Surgery
Years ago periodontal surgery was considered an ordeal. Today, there should be no pain involved during surgery and the postoperative discomfort is usually minimal. New sophisticated medications ensure you a smooth procedure.
For surgeries that last an hour or longer, most patients prefer a light sedation. The medication we use is Versed, which is similar to Valium and is administered intravenously. We often use Nembutal and Demerol for longer procedures. This is not general anesthesia, which we don’t do in the office and is extremely safe. We have done thousands of sedations without incident. Your blood pressure and blood oxygen levels are monitored during the procedure to ensure your safety. With sedation, an hour procedure seems like 5 minutes and you are not even aware of the local anesthetic when it is given. Of all the additions to modern periodontics, this is the most significant for patient comfort. If sedation is used, you must have a driver. If your driver does not stay for the surgery, he or she will need to be back 15 minutes before the end of the appointment.
Postoperative discomfort has been dramatically reduced with the use of NSAIDS (non-steroidal anti-inflammatory drugs). These drugs, such as Ibuprofen, stop the formation of the chemicals the body normally produces that will cause heightened pain. NSAIDS are not narcotics, so you can function normally when taking them. Generally, NSAIDS are started the morning before surgery and are taken for three days. After this time no prescription medications are normally needed. In addition to the NSAIDS, a narcotic is often recommended for the first day. It is used along with the NSAID and will eliminate and breakthrough discomfort.
Some patients especially implant and regeneration cases are given antibiotics to take starting the day of the surgery. It is important to take the prescriptions as directed to optimize healing.
A prescription mouthwash is often prescribed after surgery and may be used for 3 weeks. It is much more effective that nay over the counter alternatives and kills bacteria throughout the mouth.
At 3 weeks any dressing is removed, along with sutures that have been placed. Most sutures will dissolve and will not need to be removed. The area is cleaned and postoperative care of the area reviewed. This appointment generally lasts 15 minutes and should not cause discomfort.
Instructions
The following instructions may be helpful when preparing for your upcoming surgery. Please do not hesitate to call if you have any last minute questions. We can be reached at 954-522-3228 during regular business hours.
You should receive your pre/post-operative prescriptions with a post-operative instruction sheet. For your convenience, please have your medication filled prior to your scheduled surgery, unless they have been previously phoned into the pharmacy of your choice. Please bring your filled prescriptions with you to your appointment.
If you are taking Coumadin or another blood thinner, remember to discontinue them as directed. If you take antibiotic premed, please take it as directed before your surgery. You will feel better if you have eaten prior to surgery. The office may be cold, so dress warmly. We offer iPods to listen to music during your treatment but if you prefer your own you may bring your iPod or MP3 player with you if you like. In order to evaluate your progress and healing, we will see you for weekly post-operative checks during the first 1 to 3 weeks.
Antibiotics
Please alert the office to any allergies or sensitivities that you might have to antibiotics. You will be prescribed an antibiotic if our doctor determines it to be necessary. Take as directed until gone. It is advisable not to take these medications on an empty stomach, as nausea may result (unless you are going to be sedated for your procedure).
Sedation
Sedation patients, please do not have any food or drink for 6 hours prior to your surgery visit. Also, you will need someone to drive you to and from your visit. If you have any questions regarding sedation please contact our office. For IV sedation patients, it is beneficial to hydrate the night before you procedure.