SURGICAL INSTRUCTIONS for "your confidence, safety & comfort" PRE-SURGICAL INSTRUCTIONS Preparing for your oral surgery: If your first visit is for CONSULTATION, bring in the yellow or purple 'referral' slip that your dentist gave you, a list of any medications you are taking and appropriate insurance information & referrals as indicated by your insurance carrier. If you have any questions about the insurance, call the office and speak to Hugo or Kristen. We will call your carrier at the time of service to confirm coverage and amounts. Take all your medications as you normally do. Bring in any questions you or your family members may have. If you plan on having LOCAL ANESTHESIA: Take your medications as you normally do, you may also eat and drink before your appointment. Again, bring your yellow or purple referral slip and any insurance information. Call the office anytime if you have any questions. If you plan on having GENERAL ANESTHESIA or SEDATION: Take your medications as you normally do, with a SMALL sip of water. YOU MAY NOT EAT OR DRINK FOR 6 HOURS PRIOR TO YOUR APPOINTMENT! This is very important for your SAFETY while under anesthesia and during your recovery. You MUST bring a responsible adult to escort you home and to understand the post-operative instructions that we will review with you after the surgery is complete (written instructions will also be provided). This escort will also be responsible for helping you to have your prescriptions 'filled' on your way home from the office.  Patients' should wear loose clothing.  A Tee Shirt is ideal to allow for comfort and safety during your anesthesia and surgical procedure.  IF YOU HAVE ANY QUESTIONS AT ANY TIME DO NOT HESITATE TO CALL US - WE ARE HAPPY TO ANSWER YOUR QUESTIONS AND INVOLVE YOU IN YOUR SURGICAL PLANNING AND DECISIONS. POST-OPERATIVE INSTRUCTIONS AFTER YOUR DENTAL EXTRACTIONS: DO NOT RINSE OR SPIT FOR 24 HOURS AFTER YOUR EXTRACTION! Bite on the gauze you were given to control any bleeding or oozing of blood. SWELLING: The swelling usually reaches a maximum at 48 hours after the procedure. In rare instances you may notice an increase in the amount of swelling after leaving the hospital/office; generally, this is swelling from the procedure, NOT from the infection. Ice packs should be applied to the affected area(s) of the face and jaws, 15 minutes on and 15 minutes off (repeating), for the first 48 hours after the procedure. The head should be maintained elevated for the duration of the post-operative swelling period. If you have any questions at any time, call Dr. Matos. PAIN: Take the prescribed medication as directed. Depending on your procedure and diet, the medication will be in tablet or liquid form (tablet/Elixir). If you have been prescribed a medication with a narcotic (codeine/hydrocodone/oxycodone) and do not desire the narcotic, you may take Tylenol Tablets/ Tylenol Children’s Elixir or Advil/Children’s Motrin Elixir as directed. Call Dr. Matos with any questions. MEDICATION: You may have been prescribed other medications for management of an infection or for sinus precations. Take all the medications as prescribed, except for the analgesic (pain killer), this may be taken as needed. BLEEDING: A small amount of oozing or bleeding is common for the first 48 hours after the surgery and may continue for up to two weeks. Very often the saliva or salt water from rinsing will be pink when expelled from the mouth. If there is question about the amount of bleeding or if the expelled saliva/salt water is bright red, contact Dr. Matos immediately (or go to the nearest emergency room). You may also try using a tea bag, moistened with warm water, placed over the surgical site and bite down hard for 20-30 minutes. Then do not rinse or spit for 24 hours... ORAL HYGIENE: You CAN brush, be gentle in the area where you had surgery. Rinse the mouth with salt water as instructed, very gently and DO NOT SPIT out the water, lean forward abd let the rinse water fall out of your mouth. Oral Mouthwashes are NOT recommended immediately post-operatively because they may burn due to their alcohol contents. DIET: For the first two days after the procedure a puree/mechanical soft diet is recommended. Remember to rinse your mouth with salt water before and after meals. The salt water solution can be made by adding one teaspoon of table salt to an 8 oz glass of warm tap water. The third day after the procedure you may begin to eat a normal diet with supplement such as milk shakes and nutrient drinks (SustaCal/Ensure). Remember to rinse after every meal! If your jaws are NOT wired closed you should maintain a SOFT DIET until your Dr. Matos tells you otherwise (this means food that does NOT require CHEWING!) You may experience some bruising of the cheeks, around the eyes, down the neck and even to the level of the chest. This is a result of the venous drainage system of the head and neck, do not be alarmed. There is a small amount of discomfort that may not be relieved with the analgesic. Ice packs, head elevation and rest are sufficient to accommodate the low level of discomfort. If you feel that the discomfort is unbearable or have frank pain, call Dr. Matos. NOTE: If you do not have an open surgical site (an extraction socket) you can rinse more aggressively since you are less likely to dislodge any bloodclots. IMPLANT SURGERY CARE: the above pertains and... if you had surgery in the upper jaw, around or near the sinus, DO NOT BLOW YOUR NOSE UNTIL FURTHER NOTICE! You may have been prescribed medication to keep you from getting congested. Take the medication as directed. Blowing your nose can cause significant bleeding & swelling and should be avoided. Call Dr. Matos if you have any questions, anytime. CORRECTIVE JAW SURGERY CARE & FACIAL FRACTURE REPAIRS: The above pertains and... You may have been prescribed a medication for prophylaxis against infection, an analgesic, a decongestant and a nasal spray (or any combination). Take all the medications as prescribed except for the analgesic, this may be taken as needed. BLEEDING: A small amount of oozing or bleeding is common for the first 48 hours after the surgery and may continue for up to two weeks. Very often the saliva or salt water from rinsing will be pink when expelled from the mouth. If there is question about the amount of bleeding or if the expelled saliva/salt water is bright red, contact Dr. Matos immediately or go to the nearest emergency room. NOSE BLEEDING: DO NOT BLOW YOUR NOSE UNTIL FURTHER NOTICE! You have been prescribed medication to keep you from getting congested. Take the medication as directed. Blowing your nose can cause significant bleeding and should be avoided. BEING WIRED CLOSED: Very often it is required to have the jaws maintained closed with the use of wires, elastics or both. This is called Maxillomandibular Fixation (MMF). The jaws cannot heal without being maintained closed. THE MMF MAY ONLY BE REMOVED IN AN EMERGENT SITUATION!! The MMF is released by cutting the wires/elastics located on both sides and in front with heavy scissors. If you feel nauseous you do not need to cut the MMF, as long as you have only eaten liquids you are not in danger. Do not eat until the nausea subsides; call Dr. Matos with any questions. DIET: If your jaws are wired closed you MUST maintain a liquid diet ONLY. For the first two days after the procedure a clear fluid diet is recommended. Remember to rinse your mouth with salt water before and after meals. The salt water solution can be made by adding one teaspoon of table salt to an 8 oz glass of warm tap water. The third day after the procedure you may begin to eat a full liquid diet with supplement such as milk shakes and nutrient drinks ( SustaCal/Ensure). Remember to rinse after every meal! NOTE: These "Instructions" are general instructions and do not replace the instructions given to you at the surgical visit and reviewed with you prior to your discharge from the office. We hope this helps to clarify any questions or for reference purposes... Again, call Dr. Matos at 908-282-6998 or 1-888-MATOS OS anytime with any questions about your surgery and care...