Instructions – Collins Oral & Facial Surgery https://facesurgeon.com Oral Surgery in Conway, AZ Fri, 15 Dec 2017 17:14:22 +0000 en-US hourly 1 https://wordpress.org/?v=4.5.12 https://facesurgeon.com/wp-content/uploads/cropped-Favicon-32x32.png Instructions – Collins Oral & Facial Surgery https://facesurgeon.com 32 32 Pre-Operative Instructions https://facesurgeon.com/instructions/pre-operative-instructions/ Tue, 09 Feb 2016 00:21:59 +0000 http://facesurgeon.com/instructions/pre-operative-instructions/ This only applies to patients who are scheduled to be sedated for surgery. Nothing to eat or drink after midnight the night before surgery. This includes water, gum, candy, breath mints, smokeless tobacco, etc. If surgery is to be performed in the afternoon, then the patient should have nothing to eat or drink for at least 6 hours before the…

The post Pre-Operative Instructions appeared first on Collins Oral & Facial Surgery.

]]>
This only applies to patients who are scheduled to be sedated for surgery.
  1. Nothing to eat or drink after midnight the night before surgery. This includes water, gum, candy, breath mints, smokeless tobacco, etc. If surgery is to be performed in the afternoon, then the patient should have nothing to eat or drink for at least 6 hours before the surgery. If you do not follow these instructions, your surgery will be canceled. If you fail to tell us that you have not followed these instructions, you are putting your life at risk!
  2. A responsible adult must accompany the patient and remain in the waiting room for the entire time of the planned surgical procedure. If you are a patient under the age of 18, you must be accompanied by a parent or legal guardian. This person must be able to drive since the patient will be unable to drive for at least 24 hours after the anesthesia or sedation. The patient must have an adult stay with them at all times for the first 24 hours after surgery.
  3. Please arrive 15 minutes before the scheduled surgery time. Some procedures may warrant you arriving up to one hour early.
  4. Prior arrangements should be made so that the patient may refrain from any work, travel, or physical activity for at least a 24-hour period following surgery. Many surgeries will require a longer recovery period than 24 hours.
  5. Any medications that are normally taken should be taken with a sip of water unless otherwise instructed by the doctor, preferably at least 2 hours before surgery time. It is very important that certain heart and blood pressure medications be taken before surgery. Not taking these types of medications can sometimes increase your risk for surgical complications and can result in your surgery needing to be postponed.
  6. Loose clothes should be worn to facilitate the starting of an intravenous line to administer the sedation or anesthetic and also facilitate the placement of monitoring equipment. Flat, comfortable shoes should be worn. Short-sleeved shirts are preferable.
  7. Contacts should not be worn on the day of surgery. Jewelry and makeup should also not be worn on the day of surgery.
  8. IV sedation may need to be postponed if you have a severe head cold, significant sinus infection with drainage, or high fever. If you feel really “sick,” sometimes you will not heal as well after surgery. Please call our office to discuss any illness you may develop close to your scheduled surgery date.
  9. While taking antibiotics, birth control pills may become ineffective. Extra precautions should be taken while you are on antibiotics.
  10. We ask you to please leave all personal belongings, including cell phones, in the waiting area during your surgery. Also please note, cell phones are not allowed to be used in the operating room after surgery as this disrupts the discharge process and can compromise patient care.
  11. DENTAL IMPLANTS PATIENTS ONLY: You will need to cleanse using the antibacterial soap Hibiclens before surgery. Please wash your face the night before and the morning of surgery. Please clean around behind your ears and down your neck. Please also use the Hibiclens to shampoo your hair the morning of surgery. Do not get the soap in your eyes.

The post Pre-Operative Instructions appeared first on Collins Oral & Facial Surgery.

]]>
General Post-Operative Instructions https://facesurgeon.com/instructions/general-post-operative-instructions/ Tue, 09 Feb 2016 00:21:59 +0000 http://facesurgeon.com/instructions/general-post-operative-instructions/ BLEEDING Some bleeding and oozing are to be expected. Please keep the gauze pack firmly over the surgery site for about one hour. The gauze pack can usually be changed out upon your arrival home. If no bleeding occurs upon removal, the gauze does not need to be replaced. If bleeding continues (which is more typical), a new gauze pack…

The post General Post-Operative Instructions appeared first on Collins Oral & Facial Surgery.

]]>
BLEEDING

Some bleeding and oozing are to be expected. Please keep the gauze pack firmly over the surgery site for about one hour. The gauze pack can usually be changed out upon your arrival home. If no bleeding occurs upon removal, the gauze does not need to be replaced. If bleeding continues (which is more typical), a new gauze pack should be placed, and firm pressure should be applied for about 45 minutes to one hour. Repeat as necessary. A tea bag can be used if your gauze supply runs low. A thick washcloth dipped in ice water can also help control bleeding. It is not uncommon to have oozing of blood for several hours. Most bleeding problems are related to not placing firm, uninterrupted pressure on the bleeding sites.

SWELLING

Swelling will be at a maximum about 2 or 3 days after surgery. Often early in the morning, swelling is at a maximum. Keeping your head elevated (in a recliner or on several pillows) for approximately 3 days will reduce swelling. Ice packs are helpful for the first day or so.

CARE OF YOUR MOUTH

Do not rinse for the first 24 hours. It is best not to spit, use a straw, or brush your teeth with toothpaste the first day after surgery. You may brush your teeth gently with warm water; however, avoid rinsing. The following day, please begin rinsing your mouth with warm saltwater rinses (1 teaspoon of salt in a glass of warm water) approximately 3 or 4 times per day. Starting on the second or third day after surgery, you can resume normal oral hygiene as before surgery. You may have to be a little gentle around the wisdom teeth sites, but please remember that a clean surgical site is less likely to get infected.

For Wisdom Teeth Patients: The lower sockets tend to accumulate food debris during the healing process, mostly because the socket has to heal from below and gravity will allow the food to collect in these areas. Starting on day 5 after your surgery, it is important to take the syringe that we give you in your post-op supplies and start irrigating the food debris out of your socket once per day. It is probably best to do this at night before going to bed. Most infections related to wisdom teeth removal are the lower wisdom teeth sites that have not been irrigated out thoroughly. These infections usually occur at about 2–3 weeks after surgery. If you are having difficulty irrigating your sockets, please contact our office.

A dry socket is a relatively rare occurrence in our practice; however, it is a situation that can be painful and usually does not respond fully to pain medication. Most patients that think they have a dry socket are not irrigating the sockets properly to remove food debris and/or they are coming off the steroid dose pack and now need to be taking ibuprofen on a scheduled basis. Taking ibuprofen as described below (if medically permitted) takes care of most potential dry socket patients. If you have not responded well to the ibuprofen regimen on or around day 4 or 5, please give our office a call. If you have any questions as to if you have a dry socket or not, we welcome your phone call and will be glad to see you during the post-op time frame.

If you are a smoker, there will already be a chance of slow healing and the potential for more post-operative problems. Pre-operative smoking and smoking during the healing phase are both detrimental to oral healing. Ideally, you should quit smoking for at least 2 weeks before having oral surgery. Many patients do not feel like they can quit smoking, but cessation of smoking during the immediate time after surgery may also be beneficial to oral healing.

Please remember that if you have had a bone graft placed in a socket, the use of the syringe is contraindicated. There should be more detailed instructions in the Dental Implant Post-Operative Instructions that we will discuss verbally with you. Please remember that we do not recommend flushing out a socket that has had bone graft material placed.

NAUSEA

Nausea can occur after general anesthesia or with the use of pain medication. Remember, do not take the pain medication on an empty stomach. If you were given medicine for nausea, you will find this very helpful. Nausea is rare and usually does not last very long.

ITCHING & RASH

Narcotics (pain medicine) can cause itching in certain circumstances. Without a rash developing, the itching is likely a side effect of the pain medicine. Benadryl (25 mg) can often lessen this side effect. If itching persists, we can get you different pain medicine. If you develop a rash, this could be a sign of an allergy, and we need to be notified.

PAIN

Pain levels are relatively difficult to predict after oral surgery. Some patients experience very little pain, and others tend to have more discomfort. Our goal is to be sure you are comfortable during the post-operative time frame until you have healed properly. We will typically prescribe you a narcotic pain medicine, which is usually required the day of surgery. It is best to have a little something in your stomach before taking your first narcotic medication. Please remember that pain medicine can take 30–45 minutes to take effect; therefore, be sure you are planning ahead if you start experiencing any pain. Frequently, a steroid dose pack is prescribed after surgery, and this will reduce inflammation and pain. If you are prescribed a steroid dose pack, we will have you start this the day after surgery because we will have given you one steroid dose through the IV during surgery.

Several days after surgery, lower wisdom teeth sites in particular often require inflammation reduction to heal up completely. The steroid dose pack is prescribed for anti-inflammatory purposes, and it helps with swelling and post-operative pain. As the steroid dose pack is running out on about post-operative day 5 or 6, you may feel some increased discomfort in the lower wisdom teeth sites. One main reason for this can be food debris buildup in the sockets, and this is why we recommend starting the syringe on day 5. A second reason for this increased pain is that you are coming off of the steroid dose pack, and elevated inflammation is starting to occur at the surgery sites. This is a good time to begin ibuprofen (600–800 mg) every 6–8 hours for the next 2–3 days if medically tolerated. Most dry sockets are not truly dry sockets but can be managed with the above regimen. Please call our office if you have any questions or concerns about pain lasting longer than you feel like it should.

DIET

The day of surgery you should only consume liquids or very soft foods. It is usually best not to consume anything until 2 or 3 hours after surgery with general anesthesia. Antibiotics and pain medicine can be taken after a small amount has been consumed. It is very important to maintain good nutrition. If you had surgery on one side of your mouth only, regular food can be consumed with caution after you feel like the surgical sites have mostly healed (usually 2–5 days).

POST-OPERATIVE CONDITIONS

The following post-operative conditions may occur in some patients while healing is progressing normally:

  1. Swelling on one or both sides of the jaw.
  2. Numbness around the corner of the mouth or tongue. Please notify us if this persists for longer than 5–7 days.
  3. Mild, occasional bleeding from a healing socket.
  4. Bruising can occur; however, it is rare.
  5. Difficulty opening your jaw for a few days.
  6. Some tenderness around the IV site in your arm. If this should occur, elevate your arm (on pillows) and apply warm, moist heat. Call our office if this persists for greater than 24 hours.
  7. After anesthesia, the risk of fainting is higher. Please stand up slowly and ask for assistance immediately following surgery.
  8. Infections are rare after oral surgery. Usually, swelling within the first week is not related to an infection. The mouth will develop a yellow scab over a healing extraction site. This should not be confused with an infection.
  9. Small bone fragments can work their way to the surface during the healing process. Generally, these will resolve with time.

Please keep in mind that it is reasonable to expect your normal activities to be disrupted following a surgical procedure.

If any problems arise or if you have any questions, please call. We really do care!

Clinic Phone Number: (501) 336-8888
Dr. Collins’ Cell Phone: (501) 730-5180
Dr. Collins’ Email: mitch.collins@conwaycorp.net

The post General Post-Operative Instructions appeared first on Collins Oral & Facial Surgery.

]]>
Post-Operative Instructions: Dental Implant https://facesurgeon.com/instructions/post-operative-instructions-dental-implants/ Tue, 09 Feb 2016 00:21:59 +0000 http://facesurgeon.com/instructions/dental-implant-post-operative-instructions/ DISCUSSION: Dental implant surgeries all have one thing in common: a dental implant is placed in the jaw for one reason or another. However, the situation for each patient and the purpose and position of the implant varies widely depending on what is trying to be accomplished. Therefore, our dental implant instructions will discuss a specific set of general dental…

The post Post-Operative Instructions: Dental Implant appeared first on Collins Oral & Facial Surgery.

]]>
DISCUSSION:

Dental implant surgeries all have one thing in common: a dental implant is placed in the jaw for one reason or another. However, the situation for each patient and the purpose and position of the implant varies widely depending on what is trying to be accomplished. Therefore, our dental implant instructions will discuss a specific set of general dental implant instructions and then break down each clinical scenario. This should help you know how to care for your specific situation and minimize any confusion.

GENERAL INSTRUCTIONS:

PAIN

Typically, pain is not too severe in dental implant patients. Front upper jaw implants typically hurt very little; however, lower jaw implants sometimes hurt worse in the molar area. Occasionally, the pain will persist in lower implants longer than a week, and additional treatment such as steroids might be needed. If you have pain that is severe and persists longer than a week, please contact our office. The good news is that many patients require very little pain medicine after surgery, and they find the procedure to be less painful than they expected.

BLEEDING

Many implant patients report very little bleeding after surgery because the implant will help close off a socket, or the gums will be tightly closed around the implant. Bleeding can occur and should be managed with gauze pressure as shown to you before and after surgery. If bleeding is more severe than expected, please apply firm pressure on the area by biting down on the gauze for a straight 45 minutes without removing the gauze. If the bleeding continues, then reapply the gauze with firm pressure. Ice packs are also helpful with bleeding and keeping your head elevated will benefit you as well. Most cases of severe bleeding will subside if these instructions are followed. Being sure that you are taking enough pain medicine and keeping your blood pressure under control can be very important as well. If you are on a blood thinner and bleeding persists after 24–48 hours, then you may want to contact Dr. Collins for further discussion. Severe bleeding is very atypical after dental implant surgery.

SWELLING

Swelling usually peaks about 3 days after surgery. We encourage you to keep your head elevated (in a recliner or on several pillows) for 3–5 days to reduce swelling. Using the cool jaw ice packs are very important and can minimize swelling as well. Make sure you change out the cool jaw ice packs about every 2 hours and watch for excessive redness where the ice is applied. If this is the case, you may need to take periodic breaks using the ice. Many patients will receive a steroid dose pack after surgery for swelling; however, this is not routine for all implant patients. Most of the time, it is the patients that end up having more extensive surgery. If you develop a late swelling (after a week or two), this could be a sign of an infection, and you will need to contact our office.

GENERAL CARE OF YOUR MOUTH

Every implant situation is slightly different. However, it is best not to rinse for the first 24 hours. Unless your specific instructions say otherwise, rinsing with warm, lightly salted water usually starts on the second day after surgery. We recommend saltwater rinses at least 3 times per day. In all situations, the important objective is to keep the implant brushed and as clean as possible to reduce plaque buildup. In some situations, the implant parts are not visible; however, the implant area should still be kept clean with gentle brushing and saltwater rinses. We recommend the universal use of long-term Peridex™ (chlorhexidine) brushing starting 2 weeks after implant surgery. Peridex is not meant to be used as a rinse! Typically, you will use this about every third day with normal hygiene tooth brushing occurring 2–3 times per day otherwise. Specific instructions may be given to you regarding Peridex, and we will discuss these with you during the pre-operative and post-operative time frame. Additional mouth care instructions will be given to you that are specific to the procedure you had done.

DETAILED HYGIENE INSTRUCTIONS

To prolong the life of your new dental implants, maintaining oral hygiene is of utmost importance. Here are some important tips to follow to keep them in tip-top shape!

  • Twenty-four (24) hours after surgery, begin using warm, diluted saltwater rinses to promote healing. These should be done at least 3 times per day.
  • Starting on the second day after surgery, the implant sites should be brushed with a small, soft (child’s) toothbrush. At first, you can use just warm salt water if desired and eventually advance to toothpaste. Peridex brushing for a new implant or a recently uncovered implant usually is not necessary until around 2 weeks post-surgery or post-uncovering. Peridex brushing should be reviewed with you, and it is just to be performed around every second or third day in most implant cases.
  • If good brushing techniques are used, no electric brush is needed. For some patients, a Sonicare toothbrush can be helpful.
  • Non-metal proxy brush attachments or soft picks are available for cleaning between teeth.
  • We recommend a Waterpik in many situations. For our fixed detachable implant appliances (All-on-4® appliances), we will go over Waterpik instructions in detail. It is very important that it is done properly, and we typically recommend a combination of Peridex and tap water to use under these appliances to keep the areas clean.

SMOKING

Some surgeons will not place implants in people who smoke. We have found that smokers tend to do fairly well early on but will often lose more bone quicker, which can result in the implant failing. There is also a slightly increased risk of early failure in smokers. We encourage you to stop smoking at least 2 weeks before surgery, but stopping a few months before is preferable. If you are a smoker, we will ask you to sign a smoker’s consent, which indicates you understand that you are at an increased risk of implant failure and that our office is not financially responsible for any implant failures in patients that smoke.

IMPLANT PROBLEMS/FAILURES

A dental implant is a foreign body placed in the jaw. Many years ago, this would be in no way considered possible, but now we know that dental implants are highly successful and have a great track record. Nonetheless, implant problems and/or failures do occur. We want you to understand that implants fail for many reasons. Sometimes, it can have nothing to do with the surgical technique. Experience plays a large role in the success of your implants. Most implant failures occur for unknown reasons. However, in the vast majority of the population, implants work exceptionally well. The location in the mouth affects implant success as well as bone quality. Other medical conditions, such as Vitamin D deficiency, diabetes, chronic steroid use, and many other medical conditions can contribute to implant failure. Following instructions and attending all of your post-operative appointments are very important to your long-term implant success. Even with all our greatest efforts, occasionally we will have unexplained failures and problems that arise. We have a policy of trying to replace failed implants at minimal or no costs to patients. There is not a specific warranty, and there is no time frame as to when this elapses. We stand behind our work and try our best to minimize any expenses if you have any problems in the future. There are some costs that are somewhat out of our control, which includes a need for future bone grafting, facility fees, and anesthesia. We do our best to take care of you and make a commitment to your long-term implant success. Certain situations are unavoidable and not predictable. Unfortunately, we cannot incur the costs of highly unexpected events and certain unexpected situations such as the need for a hospitalization, long-term antibiotics, etc. These types of complications are rare, but we want you to realize this is a cooperative effort, and maximum compliance is important for both parties.

DIET

The day of surgery, you should only consume liquids or very soft foods. It is usually best not to consume anything until 2 or 3 hours after surgery with general anesthesia. Pain medication and antibiotics, if needed, can be taken after a small amount of liquid or very soft food has been consumed. It is very important to maintain good nutrition for proper healing.

Newly placed implants have a vulnerable time frame for a few weeks, so extensive chewing forces placed on the implant itself can result in implant failures. If you have had implants placed on one side of your mouth and the other side is normal, then we recommend chewing on the non-surgical side of your mouth until healing is complete. If you have a temporary crown placed on an implant, it should not be in the bite when we finish the procedure. It is very important that you chew in other areas of your mouth and be very conscious of avoiding this tooth when you chew. If you have implants underneath a regular denture, it is very important to be cautious with your chewing for several weeks. If you have a fixed All-on-4® type of appliance, we recommend staying on a very soft, no-chew diet for approximately 4 weeks and then an extremely soft diet for about 3 months after this.

Our long-term goal is to have you chewing normally and functioning better than you were before implant surgery! Please bear with us during the healing phase and understand that excessive forces placed on healing implants can result in problems.

NAUSEA

Nausea can occur after general anesthesia or with the use of pain medication. Remember, do not take the pain medication on an empty stomach. If you were given medicine for nausea, you will find this very helpful. Nausea is rare and usually does not last very long.

SUPPLEMENTAL PROCEDURES

Occasionally, implant placement or the preparation for implant placement requires supplemental procedures. These procedures require special instructions which may or may not apply to your clinical scenario. If they do apply, we will review these instructions with you. If they do not, you can ignore them. They are as follows:

SINUS LIFT SURGERY

The upper jaw has a very large sinus in it on both sides called the maxillary sinus. Frequently, the sinus dips down relatively low in the back part of the upper jaw and limits the amount of bone available to place implants. Occasionally, a sinus lift is performed to lift the sinus membrane up out of the way so that bone and implants can be placed in this area. When we do a sinus lift, it is important to follow what we call sinus precautions. They are as follows:

  1. Do not blow your nose for 1–2 weeks after surgery. We recommend using a saline nasal spray to sniff back several times per day to keep your sinuses draining properly and to prevent the need to blow your nose. This is very important and should be strictly followed for approximately 2 weeks.
  2. If you feel the need to sneeze, please be sure to keep your mouth open so that air can flow out of your mouth and not build up a lot of pressure inside your sinus. We will often suggest that you use Afrin Nasal Spray after a sinus lift. This is a decongestant that can be used twice daily. It is mostly designed to keep the sinus passages open and the nasal cavity open for air transfer. Long-term use of Afrin can be addictive, so we recommend it be used only for the first 2–3 days and longer than this if severe nasal congestion is present. Do not use longer than one week.
  3. We typically prescribe an antibiotic to be taken for a week following surgery. Please remember to take your probiotic as instructed while you are taking the antibiotic to minimize antibiotic complications.
  4. It is possible to have a small amount of blood come out of your nose the night of your surgery on the side where the sinus lift was performed. This should not be concerning unless the bleeding persists and is more than a few drops.

All of these instructions are essentially designed to prevent the movement of the bone graft and allow for proper healing from your sinus lift.

If you experience a sinus infection, where you have pain on the side we operated on at any time during the post-operative period (even a few months down the road), please notify us.

BONE GRAFTING

Bone grafting can come in many forms when done in association with dental implants. The most common form of bone grafting involves grafting a tooth socket that has experienced bone loss, with or without implant placement. If a tooth has extensive bone loss around it and a dental implant is needed, frequently all the bad tissue in the socket has to be removed and new bone placed. Many times, this can be done at the time of implant placement. But other times, it is done as a separate procedure, and the implant is placed later. The most important thing to remember about the placement of bone graft material is that we want the bone graft material to stay in place. Excessive rinsing in the first 2–4 days after surgery could potentially displace the bone graft material, and use of the syringe to flush out a specific socket that has bone graft material in it would be contraindicated because it could flush out the graft material as well.

Other examples of grafting could be larger bone grafts harvested from the jaw and/or hip area. These types of grafts are placed with screws, and the bone is covered very well by gum tissue. It is important to use saltwater rinses in these situations. Please let us know if you feel like the graft is exposed in your mouth or if any of the screws become exposed as well.

If a partial denture or complete denture is worn on top of a bone grafted area, this should be done very cautiously, and close follow-up is needed. Abnormal pressure placed on a graft can cause graft failure; therefore, we ask that you follow all of our instructions very carefully if you are wearing a partial or complete denture over a bone grafted area. At times, the denture will have to be left out after surgery, but we will discuss these instructions in detail with you if this is your case.

POST-OPERATIVE CONDITIONS

The following post-operative conditions may occur in some patients while healing is progressing normally:

  1. There may be swelling on one or both sides of the jaw.
  2. Numbness around the corner of the mouth or tongue may develop. Please notify us if this persists for longer than 5–7 days.
  3. Mild, occasional bleeding from a healing socket may occur.
  4. Bruising can occur; however, it is rare.
  5. You may have difficulty opening your jaw for a few days.
  6. There may be some tenderness around the IV site in your arm. If this should occur, elevate your arm (on pillows) and apply warm, moist heat. Call our office if this persists for greater than 24 hours.
  7. After anesthesia, the risk of fainting is higher. Please stand up slowly and ask for assistance immediately following surgery.
  8. Infections are rare after oral surgery. Usually, swelling within the first week is not related to an infection. The mouth will develop a yellow scab over a healing extraction site. This should not be confused with an infection.
  9. Small bone fragments can work their way to the surface during the healing process. Generally, these will resolve with time.

IMPLANT UNCOVERING

Implants that are buried under the gum tissue when placed are typically uncovered in a minor surgical procedure 2 months later in the lower jaw and 4 months later in the upper jaw. After the implants are uncovered, a small healing abutment will be placed on the implant. This healing abutment is left in place while the tissue heals and gets ready for the final crown. During this process, it is very important that the healing abutment be cleaned regularly by brushing and flossing. The tissue is susceptible to inflammation and infection during this time frame, and meticulous hygiene is very important.

Please keep in mind that it is reasonable to expect your normal activities to be disrupted following a surgical procedure.

If any problems arise or if you have any questions, please call. We really do care!

Most importantly, don’t forget to come back for follow-up visits!

Clinic Phone Number: (501) 336-8888
Dr. Collins’ Cell Phone: (501) 730-5180
Dr. Collins’ Email: mitch.collins@conwaycorp.net

The post Post-Operative Instructions: Dental Implant appeared first on Collins Oral & Facial Surgery.

]]>
Post-Operative Instructions: Jaw Surgery https://facesurgeon.com/instructions/post-operative-instructions-jaw-surgery/ Tue, 09 Feb 2016 00:21:59 +0000 http://facesurgeon.com/instructions/jaw-surgery-post-operative-instructions/ SURGERY/HOSPITALIZATIONS Most jaw surgeries are performed in the convenience of our office surgical facility. Typically, you will be asked to arrive one hour before your scheduled surgery time. We will have you change into a hospital type gown with tight stockings to minimize the chance of blood clots in your legs. After your surgery, you will be allowed to recover…

The post Post-Operative Instructions: Jaw Surgery appeared first on Collins Oral & Facial Surgery.

]]>
SURGERY/HOSPITALIZATIONS
  • Most jaw surgeries are performed in the convenience of our office surgical facility. Typically, you will be asked to arrive one hour before your scheduled surgery time.
  • We will have you change into a hospital type gown with tight stockings to minimize the chance of blood clots in your legs.
  • After your surgery, you will be allowed to recover in our office most of the day, and at that point, you will either be discharged to go home or prior arrangements will have been made to transport you to the Conway Regional Medical Center. Most patients that are transported to the hospital will only need to stay one night; however, each case is handled on an individual basis.
  • If you live out of town, we may have you come by our office after you are discharged from the hospital so that we can review final instructions and get a post-operative X-ray.
  • There will also be a dressing around your head and jaw area that has a cooling pad inserted within the head wrap. There is an ice chest connected to this cooling pad that must be plugged in at all times and must have fresh ice maintained so that the cooling pad is working properly. It is important to make sure the cooling pad is working properly so that swelling can be kept to a minimum. We will instruct you on how to do this. The head wrap and dressing will typically be removed the day after surgery; however, in some cases, the dressing will be left in place for 2 days. The ice chest is property of our office, so we ask that you please return this after your recovery time frame.

PAIN MANAGEMENT/MEDICATIONS

  • We find that our level of experience at dealing with jaw surgery patients provides a better situation for our patients in an office setting versus in the hospital recovery room. You will spend most of the day in our office waking up and recovering after surgery.
  • You will be given IV medications the day of surgery, and your pain will be managed up until the time of discharge. If you are transported to the hospital, you will typically be on a pain pump that will allow you to manage the pain at your own pace. If you are discharged to go home, you will need to take pain medicine by mouth, which typically comes in the form of a liquid.
  • You will also have an antibiotic to take for about one week.
  • If you have upper jaw or nasal surgery, we will typically prescribe a decongestant nasal spray as well as a saltwater nasal spray. It is important not to blow your nose for approximately 2 weeks if you have had upper jaw or nasal surgery. Judicious use of the saline nasal spray is recommended. This will be reviewed with you before and after surgery.
  • We may ask that you take a steroid dose pack after surgery; however, this is less likely if you are hospitalized because more time will be allowed for us to give steroids through the IV route.
  • We require our patients to take probiotics while taking antibiotics to minimize some of the complications associated with antibiotics.
  • You will likely be given a prescription for an anti-nausea medication. Please remember that adequate hydration is a very important factor in minimizing nausea for the first several days of recovery. Pain medicine can also make some patients nauseated, so it is best taken with something in your stomach to minimize this risk. It can also cause itching, but typically this will not be in the form of an allergy but as a side effect of the medication. If you experience itching without the development of a rash, then you may want to decrease the dose of pain medicine and consider taking some Benadryl.

DIET

  • Nutrition is a very important part of your recovery from jaw surgery. We ask that you maintain a no-chew diet for approximately 6 weeks.
  • We will provide you with a copy of “Dinner Through a Straw,” which will provide you with nutritional recipe ideas for after surgery. Soups, puddings, broths, and shakes can be consumed for the first few days after surgery. After a couple of weeks, you may find it possible to consume mashed potatoes, scrambled eggs, etc. Ensure Plus, Carnation Instant Breakfast, and products high in protein are very important to maintaining your nutritional status. Dr. Collins will let you know when you can advance to a normal diet.
  • It is possible that you may lose several pounds after surgery (10–15 pounds); however, eating frequently, taking in plenty of protein supplements and increasing calorie intake can minimize weight loss and improve your ability to recover quicker. We recommend experimenting with shakes and nutritional protein supplement intake before surgery. Patients that know what they like and can put together high-calorie/high-protein shakes tend to do better than people who experiment post-operatively.

CARE OF YOUR MOUTH

  • Typically, we will clean your mouth when you come in for your follow-up, usually 1–2 days after surgery. After this initial cleaning, it is mostly your responsibility to keep your mouth clean.
  • It is important to get a soft child’s toothbrush and begin brushing the outside of your teeth as soon as feasibly possible. We will give you instructions on how to do this. Brushing the inside of your teeth may be more difficult until you are a little further out from surgery.
  • It is important to start doing warm saltwater rinses as often as possible after surgery. We recommend doing this at least 3 times per day as soon as you can. This should consist of 1 teaspoon of salt in 8 ounces of warm water.
  • We advise avoiding harsh mouthwashes such as Listerine; however, dilution of Listerine and/or Scope can be used after a week or two of recovery.
  • You may have rubber bands on your braces after surgery, and we will instruct you regarding these.
  • In rare cases, your teeth may be wired together after surgery. If this is the case, you will need to always carry your wire cutters with you in case of an emergency. We will give you wire cutters to use after surgery if this is anticipated. After a week or two, it may be possible for you to remove your rubber bands on your own and brush your teeth and then reapply the rubber bands afterward. We will instruct you on how to do this if this is the case.

SWELLING

Swelling can be minimized by keeping the cooling pad in place for 1–2 days after surgery. Swelling usually peaks on or about day 3 or 4. The swelling can be fairly dramatic after some jaw surgeries. We recommend that you keep your head elevated (on 2–3 pillows or in a recliner) for up to a week or so after surgery. Swelling may take several weeks to resolve completely. The majority of swelling will go away in the first week or two after surgery, but a small amount will remain and may take several weeks or months to slowly go away and totally resolve. During the first few weeks after surgery, it is common to be more swollen in the morning, especially if you are not sleeping elevated and end up sleeping on one side or on your stomach. If this persists during the latter part of the day with increased pain, this could be a sign of infection, and you would need to contact our office.

EMPLOYMENT/SCHOOL/EXERCISE

You may need to take at least 2–3 weeks off work/school for your surgery. Most patients feel fairly good after about 2 weeks of recovery, but because of the dietary changes, it may be as long as 6 weeks before you have most of your energy back. Strenuous exercise should be avoided until you have all of your strength back. Since a normal diet is not typically resumed until about 6 weeks after surgery, we advise caution in doing too much strenuous activity until you are back consuming a normal diet and have normal energy reserve. Certain contact sports, which could result in trauma to the face, such as football, basketball, etc., should be avoided for 3 months. Non-contact versions of these sports can begin at 4–6 weeks post-surgery, but trauma to the jaw must be avoided. Patients that participate in the band and use their mouth to play certain instruments may have to avoid practicing for up to 6 weeks. Most patients can return to part-time work after 2 weeks of recovery, but this depends on the individual. We would advise not working or driving a vehicle while you are taking pain medicine.

OFFICE VISITS AND LONG-TERM FOLLOW-UP

You may have anywhere from 4–6 office visits after your surgery. Typically, you are seen fairly early after the surgery for review of instructions, assistance with oral hygiene and obtain X-rays to verify that everything is in the proper position. We may take X-rays during your recovery phase to verify that everything is healing well. We will have you return to see your orthodontist to begin completion of your orthodontic care anywhere from 4–6 weeks after surgery. We may ask you to make this appointment with your orthodontist soon after your surgery so that proper planning and time can be allowed for this appointment. Occasionally, patients will have arch bars placed by us instead of braces, and these are typically removed under IV sedation in the office 4–6 weeks following surgery.

We request that you come in for a final evaluation appointment after you have completed your orthodontic care. This appointment can range anywhere from 6 months to 2 years after your surgery. It will consist of a final set of X-rays, photographs, and exam verifying that you have healed properly and have obtained a satisfactory result. This appointment is very important, and we ask that you please plan this into your post-operative visits.

POST-OPERATIVE CONDITIONS

The following post-operative conditions may occur in jaw surgery patients while healing and progressing normally:

  1. SWELLING that may reappear several days after surgery (especially early in the morning).
  2. NUMBNESS of face/lips. This may persist for several months and may take up to one year to resolve. Rarely, patients may have small areas of numbness that do not resolve. If you have significant numbness at 2–3 months after surgery that does not appear to be improving, please notify our office.
  3. SORE THROAT, which will typically occur for 1–3 days after surgery. This soreness in your throat is typically from the breathing tube and is best managed by pain medication and drinking plenty of fluids.
  4. BRUISING can occur and will often last for several weeks. Bruising is not as typical with jaw surgery as it is with other skin-type surgeries. However, if you have bruising, it may drop down and be on the upper part of your chest before it finally goes away.
  5. BLEEDING: Nasal bleeding can occur after upper jaw surgery. It should be treated with Afrin Nasal Spray, elevation of your head, and pressure to that side of your nose/face. Persistent bleeding should be reported.
  6. TENDERNESS around the IV site. If this should occur, elevate your arm (on pillows) and apply warm moist heat. If the tenderness and swelling of the IV site persist after a few days, please notify our office.
  7. PERSISTENT BURNING UPON URINATION can be signs of a bladder infection and should be reported. This is a possible complication of having a Foley catheter placed. However, it is very rare.
  8. SWELLING AND/OR TENDERNESS IN ONE LEG should be reported. One risk of surgery is blood clots that can develop in the leg. We encourage you to get up and walk around during the first few days following surgery to minimize this risk. The stockings that we place on your legs during surgery minimize this risk; however, this can be a serious complication. Tenderness in a calf or swelling in your leg should be reported.
  9. NORMAL JAW FUNCTION: It may be several weeks before you develop normal jaw function again. It is not uncommon for some patients to not be able to eat normally for about 8 weeks. We ask that you maintain a no-chew diet for 6 weeks, but it may take longer than that to be able to eat normally. Difficulty opening your jaw can occur for several weeks but should be back to normal by about 8 weeks after surgery. If you notice pain in your jaw joint (in front of your ear) and/or a new popping or clicking in the jaw joint, please let us know. Restricted opening that lasts longer than 2 months should also be reported to our office.
  10. DRYNESS, CRUSTING OF THE LIPS: This is typical for the first week or so after surgery. A&D Ointment seems to work out best for this condition.
  11. FOLLOW-UP APPOINTMENTS: Please attend all of these appointments because they are very important to your recovery. If you have any questions after your surgery, please feel free to contact our office during clinic hours at (501) 336-8888. If you have questions or concerns during non-clinic hours, you may text or call Dr. Collins on his cell phone at (501) 730-5180. Emailing Dr. Collins is also acceptable at mitch.collins@conwaycorp.net.

Most importantly, don’t forget to come back for follow-up visits!

Clinic Phone Number: (501) 336-8888
Dr. Collins’ Cell Phone: (501) 730-5180
Dr. Collins’ Email: mitch.collins@conwaycorp.net

The post Post-Operative Instructions: Jaw Surgery appeared first on Collins Oral & Facial Surgery.

]]>