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Surgery

Frenectomy – What and Why

Occasionally, a thick piece of soft tissue grows between the front surfaces of the upper central incisor teeth up to the maxilla (upper jaw). This tissue is attached strongly to the bone. The result of this excessive frenum attachment is the inability for the upper front teeth to come together. The resulting space is unsightly and causes the back teeth to come together in an improper position (malocclusion).

Treatment for this excessive frenum is a simple surgical procedure called a frenectomy. The excess tissue attachment is gently trimmed away and the gingival site heals rapidly (few days), allowing the two front teeth to eventually come together and the remainder of the teeth to meet (occlude) in a proper relationship.

Do not wait. As soon as an excessive frenum is diagnosed, have it removed.

Post-Op Instructions

After Tooth Extraction

After an extraction, it’s important for a blood clot to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30 to 45 minutes after the extraction. If bleeding or oozing continues after you remove the gauze pad, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important to protect it, especially for the next 24 hours. Do not smoke, suck through a straw, rinse your mouth vigorously, or clean the teeth next to the extraction site.

These activities will dislodge the clot and slow down healing. Limit yourself to calm activities for the first 24 hours. This keeps your blood pressure lower, reduces bleeding and helps the healing process.

After the tooth is extracted, you may feel some pain and have some swelling. You can use an ice bag to keep this to a minimum. The swelling usually starts to go down after 48 hours.

Use pain medication only as directed, and call if it doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. Drink lots of fluids and eat only soft nutritious foods on the day of extraction. Don’t use alcoholic beverages and avoid hot and spicy foods. You can begin eating normally the next day, or as soon as it is comfortable.

Gently rinse your mouth with salt water three times a day (a tsp. of salt in a cup of warm water, rinse-swish-spit). Also, rinse gently after meals- it helps keep food out of the extraction site. It is very important to resume your normal dental routine after 24 hours, which should include brushing your teeth, and tongue and flossing at least once a day. This speeds healing and helps keep your breath and mouth fresh.

Call us right away if you have heavy bleeding, severe pain, continued swelling after two or three days, or a reaction to the medication. After a few days you will be feeling fine and can resume your normal activities.

Implant Placement

This instruction sheet will help you to understand the dental implant placement procedure.

Please have a good nights rest before the day of implant placement, and eat a moderate breakfast or lunch.
A local anesthetic will be used to block sensation in the area where the implant is to be placed.
Sterile covers will be placed over your clothing and hair, and our work station to reduce the presence of bacteria.
We will wear sterile outer clothing to eliminate any contamination.
A small incision will be made in your gums to obtain access to the location where the implant will be placed.
Sereal sizes of small drills will be used to make precise and painless preparations in the locations where the implants will be placed.
Implants will be placed into the prepared sites.
Your gum tissue will be stitched together to isolate the newly placed implants from oral fluids and foods. The stiches will dissolve, or come out by themselves, unless we advise you differently.
You will be asked to bite on gauze sponges far at least 30 minutes to stabilize the site and stop any slight blood flow.
You will be given at least (2) prescriptions which you should have filled and begin to use immediately:
1. An antibiotic to control any potential infection. Please take this medication as directed until the tablets are gone.
2. A pain medication to control discomfort. Take this medication only until you do not need it anymore.
Anesthesia should remain in your mouth for at least 1 hour after we are finished.
As soon as possible after treatment, place ice in a plastic bag and put it on the outside of your face for a few hours over the sites where the implants were placed. This reduces the potential swelling and bruising. However, you may still have some swelling and bruising for a few days.
1. There may be a feeling of numbness caused by the surgery that lingers for a time. Usually this goes away within a few days. In a very few cases, it does not go away totally.
2. Eat and drink only soft foods for a few days. The less force you put on the implants at this time, the better the chance of their optimum healing. Over 95% of implants are accepted well by the body, but about one in 20 is rejected and must be replaced.

Periodontal Surgery Post-Op Instructions

To insure your comfort and the success of treatment, we strongly suggest that the following instructions be carried out.

Work And Exercise

Return Home Immediately And Relax. The sedative medicine takes some time to completely wear off, possibly as much as 24 hours. It is normal to sleep a good deal during this period. Do not try to drive or operate any machinery for 12 hours as your reaction time is slowed. Work can be resumed tomorrow, but you may choose to wait several days. DO NOT UNDERTAKE ANY STRENUOUS EXERCISE FOR SEVERAL DAYS.

Periodontal Dressing

A periodontal dressing (pack) may have been placed over the surgical site. If so, this dressing will harden to form a plastic like consistency and must not be disturbed until healing is nearly complete. It contains medication which helps prevent infection and which will make the healing period more comfortable. If, by chance, the dressing should come loose or be broken before your next appointment, do not be alarmed, but contact our office at your convenience. Exaggerated movement of the jaws (talking laughing, yawning, and vigorous chewing, ect.) must be avoided during the first 24 hours after surgery, so that a strong blood clot is permitted to form, insuring better healing, and so that the periodontal dressing is not displaced before it has hardened. Occasional blood stains in the saliva may be expected. If some bleeding continues, rinse with ice water and then take a piece of gauze or a cold, wet tea bag and cover the area under pressure for 30 minutes. Approximately 10 days after your surgical appointment, the dressing as well as any sutures will be removed. Another dressing may be applied for a second period of time.

Diet

Soft And Cool diet for the first 24 hours after surgery. We encourage you to restrict your diet to soft, nourishing foods while sutures or the dressing is in place. This will help to prevent breaking the dressing. For the same reason, it is advisable to chew only on the side furthest away from the site of the surgery. Bland foods lacking high seasoning are less irritating and are encouraged during the healing phase as well. For 24 hours after surgery, hot foods and drinks should be avoided since heat can cause swelling around the surgical site. An ICE BAG held on the lip or cheek over the surgical site for 10 minutes on and 5 minutes off will help reduce swelling during the initial 4 to 5 hours.

For persistent swelling after the first 24 hours, heat is encouraged (warm water rinses, hot water bottle, heating pad, ect) since this will increase circulation to the surgical site and healing will be promoted. NO ALCOHOLIC BEVERAGES WHILE TAKING ANY MEDICATIONS, NO FRUIT, NO FRUIT JUICES, AND NO CARBONATED BEVERAGES UNTIL DIRECTED.

Home Care

As already mentioned, plaque control procedures must not be neglected, even during this post-operative phase of your treatment. Beginning the day after surgery, all the teeth not covered by a periodontal dressing must be brushed and flossed as you normally do. We encourage you not to use toothpaste, since many are irritating to healing tissues. NOT TOOTHPASTE, BAKING SODA, SALT WATER, OR MOUTHWASHES UNLESS OTHERWISE DIRECTED.

Medication

Pain medication may or may not be prescribed depending on the severity of your surgical procedure. If it is not prescribed, Tylenol or Motrin tablets will keep you comfortable. Do not take pain medication if it is not needed.

In some cases, an antibiotic may be prescribed to eliminate any chance of infection. It is imperative that you follow the directions on the label when taking antibiotic medication. Be certain that you take this medication as prescribed until finished. Prescription pain medications are quite strong and consequently, to avoid mild symptoms of nausea, the medication should be taken with food. You should also avoid operating any mechanical devices or vehicles while taking the prescribed medication.

General Information

Problems which arise during your post-operative period, such as continued bleeding, persistent pain, abnormal swelling, ect should be discussed with us. We also suggest that you elevate your head by using two pillows during sleep for the first 36 to 48 hours after surgery. This will help reduce swelling. DO NOT USE STRAWS DURING THE FIRST THREE POST OPERATIVE DAYS. Such activity can cause bleeding. Due to its adverse effect upon healing, it is advisable that you NOT SMOKE OR USE ANY TOBACCO PRODUCTS.

While this type of dental therapy is not enjoyable for anyone, following the instructions listed above is the best way we know to make the healing phase as pleasant as possible. Remember, our goal, as well as yours, is to retain your natural teeth in health and comfort. This surgical procedure is one important way which will help us both to achieve this goal.

Suggested Food Items For Day Of Surgery

NO HOT FOODS OR HOT BEVERAGES

Beverages:

Water
Iced Tea
Milk

Miscellaneous:

Slim Fast Milk Shake – no straw
Jello
Pudding
Pasta – cold
Yogurt

Do Not Eat/ Drink The Following Items For 2 Weeks After Surgery

No spicy foods
No juices
Chips
Popcorn
Carbonated drinks

Suggested Food Items Following Day After Surgery

Canned Foods:

Chopped Mixed Greens
Various Beans
Various Peas
Green Beans
Soup
Cream Corn

Bread:

Rolls
Honey/Wheat with crust broken off
Soft Bread

Meats:

Sliced Smoked Turkey Breast
Sliced Baked Ham
Fish Fillets - baked
Hamburger
Meatloaf

Breakfast foods:

Eggs
Oatmeal
Cereals

No Carbonated Drinks – No Straw