Post Operative Instructions

POST-OP INSTRUCTIONS FOR FRENECTOMY

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Lingual Frenectomy (tongue-tie):

Your goal is to have the frenum heal and re-form as far back as possible.

1. With a clean or gloved finger, lift the tongue at the top of the diamond in the middle of the tongue. Your goal is to see the whole diamond open up and lengthen. It may bleed slightly when it is stretched or re-opened. This is not a concern. Begin doing this the morning after treatment. Try to make a game of it if possible and keep it playful.
2. Repeat this 3 times a day, at various times during the day for 3 weeks.
3. Encourage the child to move the tongue as much as possible by sticking it out and holding for 10 sec, out to the left, right, open wide and lift up, make clicking noises, and clean off the teeth. Do these exercises as often as possible, but try for 4 times a day.
4. The released area will form a wet scab after the first day. It will appear white or yellow and soft because it is wet. This area is what you will be pressing against. The healing will be happening under the scab, just like a scrape anywhere else on your body. The white area will get smaller each day, but healing is still happening! So even though the white scab will heal you MUST continue the stretching or the new frenum will not be as long as possible and the surgery may need to be repeated.

Labial Frenum (lip-tie):

The goal is for the frenum to heal and re-form as high as possible.

1. Pull the lip up as high as possible, high enough to press against the nose. You want to see the whole white diamond open up. Press gently but firmly against the wound to massage it and keep the diamond open. It may bleed slightly when this is done, but this is not a concern. Try to make a game of it if possible and keep it playful.
2. Repeat 3 times a day, at various times during the day for 3 weeks.
3. The released area will form a wet scab after the first day. It will appear white or yellow and soft because it is wet. This area is what you will be pressing against. The healing will be happening under the scab, just like a scrape anywhere else on your body. The white area will get smaller each day, but healing is still happening! So even though the white scab will heal you MUST continue the stretching or the new frenum will not be as long as possible and the surgery may need to be repeated.

The child can eat whatever foods he or she can tolerate. Pain relief is needed the first few days. Give Motrin (ibuprofen) or Tylenol as directed on the package based on weight. If the lip-tie was released, the child’s lip may swell up slightly that evening or the next day. It is normal and will go down after a day or two. The wound will be sore for a few days, at one week look much better, and at two weeks look almost normal. A slight fever is normal the first day. They should eat and sleep normally. If you’re concerned it is growing back together, come back for a visit or email a picture. Follow-up with a myofunctional therapist and bodyworker (Chiropractor, CST) is recommended for full rehabilitation.

If you have any questions, please call us at .

POST-OP INSTRUCTIONS FOR FUNCTIONAL FRENULOPLASTY IN CHILDREN

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POST-OP INSTRUCTIONS FOR INFANT TONGUE-TIE RELEASE

Your goal is to have the frenum heal and re-form as far back as possible. You should do the stretches with the baby laying down on a bed or couch facing away from you like during the exam. There is a video on our website at www.TongueTieAL.com. Please follow-up within 7-10 days. Begin doing the stretches the DAY AFTER the procedure. Gloves (preferred) or clean hands with nails trimmed should be used for stretches.

1. If the lip was revised also, first put your fingers all the way in the fold of the lip and pull the lip up and out as high as possible, so you can see the white diamond and cover the nostrils. It may bleed slightly the first day or two, this is not a concern.
2. With one or two fingers, lift the tongue up and back just above the white diamond to put tension on the wound and hold for 10 seconds. It may bleed slightly the first day or two, this is not a concern.
3. The main issue is to open the “diamond” all the way up on the lip and especially the tongue. If you notice it is becoming tight, then stretch a little more to open it back up.
4. Repeat this ideally 6 times a day (4 minimum) (change up the time during the day).
5. Repeat this for 3 weeks.
6. At other times, play in your child’s mouth a few times a day with clean fingers to avoid causing an oral aversion. Tickle the lips, the gums, or allow your child to suck your finger.
7. Tummy-Time as much as possible. Visit www.TummyTimeMethod.com for helpful tips.
8. The released area will form a wet scab after the first day. It will appear white and soft. It may change color to yellow or even green. This is not infection, but is just a scab in the mouth. The white / yellow area will get smaller each day lengthwise, but HEALING IS STILL HAPPENING! So even though the white scab will heal you must continue stretching or the new frenum will not be as long as possible and the surgery may need to be repeated. If you have any concerns, please contact our office.

Follow up with a lactation consultant is critical if nursing. Bottle-feeding babies will benefit from visiting a feeding therapist. A bodyworker (chiropractor, CST, etc.) is also very helpful. You should expect one better feed a day (two better feeds the second day, etc.). Sometimes there’s an immediate difference in feeding, and sometimes it takes a few days. Skin to skin, warm baths, and soothing music can be very beneficial to calm the baby.

For pain make sure to give CHILDREN’S TYLENOL (160mg / 5mL) starting WHEN YOU GET HOME and for the next 2-3 days every 4-6 hours. For babies who weigh 6lbs give 40mg or 1.25mL, 7lb give 1.5mL, 8lb give 1.75mL, 9lb give 2mL, 10lb give 2.25 and 11lb give 2.25mL. Babies 12-14lb can have 80mg or 2.5mL, 15-17lb give 3mL. If your child is 6mo old and 12-17lbs, you can give Infant’s Motrin (ibuprofen) at 1.25mL (50mg). If your baby is refusing to nurse or seems to be in pain, please make sure the Tylenol dose is correct. Your child’s lip will swell up slightly that evening or the next day. It is normal and will go down after a day or two. The area will be sore for a few days, at one week look much better, and at two weeks look much better and almost normal.

POST-OP INSTRUCTIONS FOR POST SURGERY

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INSTRUCTIONS FOR PATIENTS FOLLOWING SURGERY

YOU ARE LEGALLY IMPAIRED FOR 25 HOURS FOLLOWING A GENERAL ANESTHETIC OR IV SEDATION. DO NOT DRIVE OR OPERATE HAZARDOUS MACHINERY

1. Bleeding

   Some bleeding is normal following your surgery. To control bleeding, place tightly rolled gauze over the surgical site and apply firm, constant biting pressure for one hour after your procedure.

   Excessive bleeding can be controlled by place a cool moisturized tea bag over the surgical site for one hour while applying pressure. Replace gauze every hour or when eating or taking medication. Rest with your head elevated on two or more pillows for the first day.

   If bleeding does not stop or suddenly starts again, is it usually due to irritation of the wound by mouth or gauze movement, frequent gauze changes or failure to limit your activity and rest.

2. Bruising

   Bruising may be present to varying degrees but is usually not severe. It will subside within five to ten days.

3. Swelling

   Some Swelling is almost always present following dental surgery and is caused by bleeding in the tissues. Ice packs will help reduce the swelling, but should not be placed directly on the exposed skin. Rather, wrap an ice pack in a damp towel and place on the sides of your face for 20 minutes on, 20mins off while awake. Swelling typically reaches its maximum in 48 hours.

4. Limited Mouth Opening

   This is a normal protective mechanism caused by accumulation of fluid in the jaw muscles to help healing. Limited opening usually subsides in two weeks.

5. Pain

   Pain may vary from non-existent to severe, depending on the extent of your procedure, but some discomfort should be expected. Painkillers are meant to reduce discomfort. But will not always eliminate it.

   Dental Anesthesia/ freezing will last about 4 hours on the top jaw and atleast 8 hours on the bottom. Do not wait for discomfort or pain before taking medication. Start taking your recommended painkillers before freezing wears off. Approximate time of surgical dose ____________________________________.

   Avoid smoking, spitting or sucking through a straw for 3 days. These activities may dislodge or dissolve blood clots, increasing both your discomfort and healing time.

6. Oral Hygiene

   Do not rinse your mouth or attempt to clean around the surgical site for the first 24 hours. Rinsing should start the day following your surgery. Use 1 tsp. of salt in 8 ounces (250ml) of warm water or you may be provided with a prescription of anti bacterial mouth rinse (Chlorhexidine).

   If you have been provided with a mouth rinse prescription, rinse lightly after every meal for 7 days. Use cleaning syringe provided no sooner than 7 days after your procedure with the salt solution after every meal.

7. Diet & Nutrition

   Begin drinking cool clear fluids as soon as possible to prevent dehydration. It is important that you drink ample fluids in small frequent amounts (i.e water, fruit and vegetable juices and soups such as broth) Avoid hot liquids for 2 days.

   Increase soft diet as tolerated (i.e eggs mashed potatoes, well cooked pasta and yogurt)

   Do not eat foods with husks or seeds (i.e popcorn, sesame seeds, strawberries, poppy seeds, etc) as they are easily lodged in the surgical sites and may cause infection and therefore should be avoided.

   Rest and nutrition are important components of healing. You may feel tired and achy after a general anesthetic. This is less common after IV sedation. Avoid Strenuous exercise. A Quiet evening of rest will allow your body to begin to heal.

8. Sutures/Fillings

   Stitches are dissolveable. They take approximately one week to dissolve, but may fall out after a few days. While stitches are in place they will feel like a thread in your mouth.

   If you had fillings placed, your bite may require adjusting. This Procedure takes 5-10 minutes and does not require any anethetic. Please call the office if your bite feels high following your appointment.

   IT IS VERY IMPORTANT THAT OUR OFFICE IS NOTIFIED OF ANY UNEXPECTED ADMISSIONS TO HOSPITAL WITHIN 10 DAYS OF YOUR DENTAL TREATMENT

If you have any questions or concerns,

Please contact the office at 1 (780) 413-0824, toll free 1 (888) 322-2161

After hours:

Dr. Chambers 1 (780) 452- 4957

Dr. Jickling 1 (780) 913-3113

Dr. Young 1 (780) 554-0401

Dr. Choriatis 1 (780) 242-0308

www.dentalservicegroup.ca

POST-OP INSTRUCTIONS FOR SINUS LIFTS

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INSTRUCTIONS FOR PATIENTS FOLLOWING SINUS ELEVATION

1. Do not blow your nose.

2. If you must sneeze, do so with your mouth open to avoid unnecessary pressure in the sinus.

3. Take your medications as directed.

4. Do not suck through a straw when drinking.

5. Do not lift or pull on the lip to look at surgical site. The incision may open which can lead to bleeding, infection, and delayed healing.

6. No rinsing or spitting for three days.

7. Do not apply pressure to the area with your tongue or fingers.

8. No smoking for at least three days. The incision may open which can lead to bleeding, infection, and delayed healing.

9. Maintain a soft, high protein diet until you are comfortable enough to return to a normal diet.

10. Sensitivity to cold on natural teeth may occur - avoid ice and cold drinks.

11. You may expect to find some small granules in your mouth for several days. This is normal and more material has been added in anticipation of this. Notify the office if a large amount of material is lost from the surgical site.

12. If a denture is worn over the surgical site, limit its use as much as possible.

13. Nose bleeds may occur. This is not uncommon with a sinus elevation procedure.

14. No strenuous activity for 3 days, no swimming for 7 days.

If you have any questions or concerns, please contact Dr. Wing at .

POST-OP INSTRUCTIONS FOR DENTAL IMPLANTS

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1. Take 2 Advil tabs with 1 Tylenol tab every 6 hours for the first 2-3 days. This will reduce inflammation and soreness.
2. Use ice packs (or frozen peas) to control inflammation
3. Take antibiotic as prescribed
4. DO NOT chew or eat hard foods. Stay with a soft diet for one week. Cut food into small pieces.
5. DO NOT rinse, spit, or drink through a straw for 24 hours after the procedure.
6. After 24 hours, rinse often (at least 5-10 times per day) with warm salt water.
7. DO NOT smoke for 72 hours. Smoking can decrease success for the healing of the implant and tissue.

Please DO NOT hesitate to call me at the office , if you have any concerns whatsoever.

Sincerely,

Dr. Winston Wing BSc, DDS

POST-OP INSTRUCTIONS FOR FUNCTIONAL FRENULOPLASTY

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After the surgery:

Expect some mild swelling, pain, and/or discomfort as a normal process of wound healing. Generally, this is fairly mild and can be controlled with over-the-counter pain medications. Possible (but very rare) complications of frenuloplasty may include anesthesia complications, bleeding, pain, numbness, failure of procedure, voice and swallowing changes, infection, injury to adjacent structures, and scarring.

Immediately after surgery:

It is normal to experience some bloody oozing during the first 1-2 days. If steady bleeding occurs, place gauze under the tongue to hold pressure and call the office. If heavy bleeding persists, please go to your local emergency department.

We recommend using Tylenol and/or ibuprofen as needed for pain.

We use absorbable sutures that will fall off on their own within a week after surgery. If this does not happen, we will remove them for you at your 1-week post-op visit. After the sutures come out, we then encourage you to brush the surgical site with a soft toothbrush.

We recommend rinsing with salt water and/or alcohol-free mouthwash several times a day to keep the wound clean and reduce the risk of infection.

It is extremely important to perform the stretches and exercises as prescribed by your myofunctional therapist to obtain optimal results. Be gentle with exercises for the first 3-5 days. Stretching exercises are better than straining.

If you experience severe pain that does not improve with medication, brisk bleeding, severe swelling at the site of surgery, or difficulty breathing please call the office right away.

POST-OP INSTRUCTIONS FOR BOTULINUM TOXIN

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1. Try to exercise your treated muscles for 1-2 hours after treatment (e.g. practice frowning, raising your eyebrows or squinting). This helps to work Botulinum Toxin into your muscles. Although this is thought to help, it will NOT impact your treatment negatively if you forget to do this.

2. Do NOT rub or massage the treated areas for 4 hours after your treatment. Do NOT do strenuous exercise for 4 hours after treatment. Also avoid facials or saunas for 4 hours after your treatment. This will minimize the risk of raising your blood pressure and therefore minimize the risk of temporary bruising. Feel free to shower and go about most other regular daily activities.

3. Do NOT lie down for 4 hours after treatment. This is to avoid the risk of pressure on the treated areas (from your pillow) and to avoid the risk of having the area rubbed accidentally.

4. Be assured that any tiny bumps or marks will go away within a few hours to avoid rubbing the treated area.

5. Results of your treatment may take up to 14 days to take full effect. Please wait until the 14 days has passed before assessing if you are pleased with the result.

6. Dr. Wing needs to see you for a 2 week follow up assessment appointment. This will ensure Dr. Wing is able to see how YOUR facial muscles reacted to your treatment. If you require more product to fine tune/adjust your treatment results, it will be applied during this appointment at an additional cost.

7. Because BOTOX requires a special technique in order to customize the injections to your individual muscular structure, it is important that your muscle actively recovers BUT that your skin is not creasing to the point from where you started.

8. BOTOX is a temporary procedure and at first, you may find that your treatment results will last approximately 3-4 months. If you maintain your treatment appointments with the frequency recommended by Dr. Wing, the duration of each treatment result may last longer than 4 months.

9. Initially Dr. Wing sees his patients between the 3 months to 4 months’ time period, to create the best clinical results for you during this period. If you allow BOTOX to completely wear off, it is difficult for Dr. Wing to be able to see how your individual muscles reacted and therefore optimal results for your face can be more difficult to achieve.

10. Dr. Wing will need to see you again in 3 - 4 month. Please ensure you book this appointment before you leave our office today. We will contact you to remind you of your booked appointment. If the date/time is not suitable, we will be more than happy to reschedule your appointment. If you have any questions or concerns please feel free to call us at

Your 2 week assessment is booked for ___________________.

Your 3 – 4 month appointment is scheduled for ____________________.