All procedures will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. Unless
you are being sedated, you must have a ride to and from the office.

Continue taking all medications for blood pressure, diabetes and any other conditions as recommended by your physician. If you have any questions,
please contact Dr. Kashlan prior to your appointment.

Please Eat A Full Breakfast Or Lunch As Applicable.

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.

If you have been advised by your physician or dentist to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, hip,
knee, cardiac or other prosthesis, or if you have had rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your
appointment. You only need to premedicate for the treatment appointment. If there is a question, please call us prior to your appointment. If you can take ibuprofen (Advil) or naproxen sodium (Aleve), it does help reduce inflammation when taken pre-operatively. We recommend 2 tablets of either medication 2-4 hours before endodontic therapy.

Proper wound healing is dependent on good home care after your surgery. Please read the following instructions carefully (they may or may not all apply to you):

ACTIVITY: Please restrict physical activity, excessive speaking, and rest as much as possible on the day of surgery. Avoid exercise such as working out or vigorous sports activities for at least 2 days.

PAIN CONTROL: Unfortunately most oral surgery procedures are accompanied by some degree of discomfort, usually peaking on the third day. In addition to the pain medication prescribed, you may alternate with Advil 800mg (Ibuprofen), as instructed by your doctor. Take the first prescribed pill before the anesthetic (“numbness”) has worn off, so you can better manage the pain. Please follow pain medication instructions exactly as prescribed.

IMPORTANT: Driving or operating heavy machinery while taking narcotic pain medication can be very dangerous and must be avoided. Also, you should not consume alcohol while taking narcotics.

NAUSEA: Nausea may be present after surgery and is usually caused by the pain medications prescribed. Preceding each pain pill with a small amount of soft food can reduce nausea.

INFECTION: If you are prescribed an antibiotic, please take it as prescribed until it is all finished (Even if you feel better).

MOUTH RINSES: You may be given a prescription for an antimicrobial rinse (Chlorhexidine, PerioGard or Peridex). This is a rinse that kills bacteria in your mouth and will help maintain the cleanliness of the surgical site during healing. Starting tomorrow, rinse gently with one-half (1/2) a cap-full twice a day for 1 minute then spit it out. Do not eat or drink anything for 30 minutes following the rinse. Do NOT use an over- the-counter mouthwash for 2 weeks. Beginning the evening of the surgery, you may gently rinse with warm salt water (1/2 teaspoon salt in a tall glass of water) 3-4 times per day for the first week after surgery help with keeping the surgical site clean. Do NOT rinse vigorously or spit excessively for the first 24 hours following surgery. Do not use an oral irrigating device.

BLEEDING: Some pinkness in saliva is normal for the first 24-48 hours. If active bleeding persists, place enough moistened gauze to obtain pressure over the surgical site for another 30-45 minutes. The gauze may then be changed as necessary. Position the patient with the head elevated above the heart for the first day (i.e. the lounge chair, lazy boy position or 1-2 pillows behind your head when lying down. If bleeding still persists or becomes heavy you may substitute a caffeinated tea bag (brewed, squeezed damp-dry and adequately cooled before applying) for 30-45 minutes. Do NOT use a straw for the first few days after surgery, as suction can start bleeding from the surgical site. If heavy bleeding persists and cannot be controlled, please call Dr. Kashlan.

SWELLING: Some degree of swelling and bruising is normal and is often associated with oral surgery (this maybe seen in the area of surgery, throat, cheek and even part of your neck), is expected and may increase over the first three days and then will take 4 to 5 additional days to go away. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied thirty minutes
on and ten minutes off, while awake during the first 3 days after surgery. If swelling is excessive, spreading, impeding your breathing or continuing to enlarge after 3 days, please call the office or Dr. Kashlan. Applying moist heat to the swollen area may help resolving swelling, but heat should NOT be applied until the 4th day after surgery. Use of Advil 800mg (Ibuprofen) as prescribed by your surgeon can minimize post-operative swelling in addition to ice. Any unusual or excessive swelling should be reported to our office.

SUTURES: You may have several sutures (“stitches”) placed to hold the gingival tissues in the proper position for ideal healing. The loss of one during healing is usually not a problem. Do NOT disturb the sutures with your tongue, toothbrush or in any other manner since displacement will impair healing. Your sutures will dissolve or will be removed between 1-2 weeks after surgery.

ORAL HYGIENE: Keeping your mouth clean after surgery is essential! Continue gentle brushing in the non-surgical areas after the third day using a soft toothbrush. The surgical area should not be disturbed for the first 10 days postoperatively.

DIET: Good nutrition is paramount to good healing. Drink plenty of liquids. It is advisable, to limit the first day’s intake to liquids or pureed foods as chewing maybe uncomfortable. Over the next several days you may gradually progress to soft foods for the next 10 days while chewing slowly on the opposite side of the mouth. If you are a diabetic, maintain your normal eating habits.

Example of foods you can have: Protein shakes, malts, milkshakes, yogurt, ice cream, apple-sauce, cottage cheese, custard, oatmeal, fish, eggs, overcooked vegetables and warm soup. Cold food and liquids can help keep the surgical area comfortable

Example of foods you cannot have: Hard, fibrous, “sharp” or sticky foods as they may get lodged in the surgical site. These include popcorn, pretzels, nuts, sesame seeds, pizza, candy, gum, dried fruits, peanut butter, crackers, rice, pastries, potato/corn chips, apple, carrots and all breads. Avoid spicy or temperature hot food or liquids during the week after surgery

SMOKING: PLEASE DO NOT SMOKE for as long as possible after surgery (for at least 48 hours). If you smoke you will have pain even when taking the pain medicine. The cigarette smoke has chemicals in it and can cause pain. Sucking on the cigarette will dislodge the blood clots and make you bleed even more. Healing results are significantly worse in smokers than in non-smokers.

ALCOHOL: All intake of alcohol should be stopped until after your sutures have been removed and minimized for the next several weeks after suture removal to enhance healing. The combination of alcohol and certain pain medications is not recommended.

Implant Surgery Procedures: Avoid any contact or chewing directly in the area of the implant(s) surgery for 5 weeks following the surgery as this can cause the implant to fail. If you experience persistent numbness the morning following implant surgery call the office immediately.

Bone Grafting Procedures: Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. The grafted area is over packed to allow for the loss of a small amount of particles. It is normal to have some of them come out of the graft site and into your mouth (or into your nose if you had a sinus augmentation procedure.) To minimize the amount of particles being dislodged: -Do not apply pressure with your tongue or fingers to the grafted area because the material is movable during the initial healing and this can allow failure of the grafting.

Do not lift or pull the lip to look at the sutures; this can actually cause damage to the wound site and tear the sutures.

Dry Sockets Following Tooth Extractions: This is the most common post extraction complication A dry socket is very painful. Avoid smoking or suction through a straw for at least 3 days after surgery to help prevent dry socket. If you are given a plastic irrigating syringe, do NOT use it for the first five days.

Other Precautions:
-If you have a denture, plate, partial or any removeable prosthesis, ask Dr. Kashlan if you can wear it following your surgery.
-You may experience sensitivity to sweets and extremely hot or cold foods or beverages for the first 4-6 weeks. This is normal and should not alarm you.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will help your recovery, but if you have questions about your progress, please Dr. Kashlan at (470)-851-6355.

CONTACT EMERGENCY MEDICAL SERVICES (“EMS”) OR CALL “911” IF:
-You have severe uncontrolled bleeding (and cannot reach our office)
-Patient loses or has lost consciousness
-There is swelling in your mouth or throat which blocks your ability to breath properly