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Surgical Instructions

Pre-operative Instructions
The following instructions should be helpful to you when preparing for your upcoming surgery.  Please call our office if you have any additional questions.

     Adjustment of medications

It may be important to stop taking Aspirin (including baby Aspirin), fish oil supplements, herbal remedies such as garlic, green tea, and ginseng, and NSAIDs such as Motrin and Advil 10 days prior to surgery.  This helps to control bleeding during your procedure and aids in prevention of post-operative bruising.  You may substitute Tylenol if you need a pain reliever.  

If you take a prescription blood thinner such as Coumadin, Warfarin, or Xeralto, remember to discontinue or adjust your dosage as directed by your medical doctor. 

If you take antibiotic premed, please take it as directed prior to your surgery.

     The morning of your surgery

Please eat normally prior to your surgery.  As you will be taking prescription medications after your surgery, you will feel better if you have eaten. 

Please dress comfortably and bring a lightweight sweater or jacket that is removable.  We keep the office cool and you may want to wrap up.  Alternately, large, bulky sweaters that cannot be removed make it difficult to monitor your blood pressure so please leave those for another day.

You may bring your iPod or MP3 player with ear buds or headphones if you desire.  Also, if you feel the bright lights in the operatory may bother you,  you may want to bring a pair of sunglasses.

     Antibiotics and prescription medications

Please alert the office to any allergies or sensitivities you may have to antibiotics and pain medications.  You will likely be prescribed an antibiotic and pain medication to take after your surgery.  If you would like to have your prescriptions called in, please bring the name and phone number of your preferred pharmacy.  


If you have elected to use oral sedation you must have a ride to and from our office.  Please be sure that you have eaten a light meal (a slice of toast is perfect) prior to surgery and have removed any acrylics and/or nail polish from at least one finger on your right hand. 



Post-operative Instructions
These instructions are designed to help minimize post-surgical discomfort.  If you have additional questions we are always happy to answer them so please don't hesitate to call the office.  This is routine for us but probably not for you so don't worry that you might have a silly question - we don't mind at all and are here to help.


It is not unusual to have discomfort for several days to a week following your procedure.  Please take your medications as directed.  Taking pain medication promptly and regularly helps to manage the discomfort.  Take prescribed medications with food.  Failure to do so may result in nausea. 

After the first few days or if you cannot tolerate prescription pain medications, you may want to control the discomfort with a regimen of over the counter Ibuprofen and Tylenol.  Some patients find that 600mg of Ibuprofen or 650mg of Acetaminophen taken with food every six hours works well.  Please do not exceed this dosage of OTC pain medications and call our office if you have any questions. 

Do not take additional Tylenol with prescribed medications such as Vicodin or Tylenol with Codeine so as not to exceed the safety level of Acetaminophen.

Take antibiotics until gone unless otherwise instructed. 

You may be given an antimicrobial mouth rinse to use after surgery.  This acts to clean the surgical site where brushing is not recommended.  Please use this rinse at least twice per day starting the day following treatment.  After several days and if your surgical area is small, you may saturate a cotton ball or gauze with the rinse and hold it gently over the area for 30 seconds to one minute.  Please call the office to double check if you are unsure if this method is appropriate for you.  The cotton ball method is not recommended with soft tissue grafts. 

     Swelling and bleeding

Swelling may occur following your procedure and will typically persist for two to three days following surgery.  Please utilize your ice pack for the first day following surgery and longer if necessary.  Place the ice pack over the outside of your cheek area for twenty minutes on and twenty minutes off.

Avoid exercise, activities that require bending over repeatedly or for long periods of time, diving, and travel by air for the first week following surgery.  It may be helpful to sleep with your head elevated, either in a recliner or with an extra pillow.  If you have persistent swelling that is not relieved within a few days or seems excessive, please call the office for additional instructions.

A small amount of bleeding or oozing is normal.  Saliva may appear pink and there may be a lingering taste of blood.  This is not unusual.  Please do not rinse you mouth or forcibly spit which will exacerbate the problem.  Taking small sips of cold water or applying pressure with moistened gauze or a moistened tea bag may be helpful if light bleeding is a problem.


Please follow these common sense instructions following surgery.  Avoid very hot, very cold, spicy, crunchy, and acidic foods for at least the first week following treatment.  A soft diet is recommended.  Foods such as pasta, yogurt, steamed or baked fish, cottage cheese, oatmeal, soup, mashed potatoes, and soft peeled fruits are most easily eaten.  Unless you have had a soft tissue graft, you may resume a normal diet as soon as you feel comfortable and many people have no problems chewing on the opposite side of the mouth from the surgical site.   Soft tissue grafts are very delicate and extreme caution should be used when eating not to disturb the graft site.  

     Smoking and alcohol

Please don't smoke for at least two weeks after surgery.  Smoking significantly slows healing and can compromise the results of your surgery. 

Do not drink alcohol while taking pain medications.  Alcohol can cause dizziness, drowsiness, and nausea when taken with some antibiotics so exercise caution.

     Brushing and flossing

Do not brush the surgical site.  You may resume normal brushing and flossing in other areas the day following surgery.  Do not use a water flosser until advised to resume by the doctor.  If a bone graft or membrane has been placed, you may be advised not to resume flossing in the area of treatment for several weeks after surgery.

     Soft tissue grafts

If your procedure has included a soft tissue graft you will need to exercise extreme caution after surgery.  Soft tissue grafts are very delicate and proper post-surgical care is critical in the success of the procedure.  Avoid strenuous activity for at least two weeks following treatment.  Do not brush or floss the graft for several weeks or until advised to do so by the doctor.  Do not bump, poke, or prod the graft either directly or through the lip or cheek.  Avoid pulling on your lip or cheek to look at the grafted area.  Eat soft foods and cut up larger pieces into small bites so as to avoid disturbing the graft by biting pieces off of larger foods.  Please try to avoid vomiting (we know you will) or consuming strongly acidic foods and drinks.  Smoking is guaranteed to retard the healing of the graft so please don't do it.  

If you have any additional questions, please call the office. For after-hours emergencies, please call the number given on our answering machine.

1100 Nw Loop 410 Ste 505
San Antonio, TX 78213
(210) 341-6023