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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Post-Surgery Care Instructions from Wing Dental

Thank you for choosing Wing Dental for your dental surgery. Below are important post-surgery care instructions to help ensure a smooth recovery. Please don't hesitate to contact us at (780) 624-9464 if you have any questions or concerns.

Impairment

You will be legally impaired for 25 hours following general anesthesia or IV sedation. During this time:

• Do not drive.
• Avoid operating any hazardous machinery.

Bleeding

It's normal to experience some bleeding after your surgery. To manage it:

• Place tightly rolled gauze over the surgical site and apply firm biting pressure for one hour after your procedure.
• For excessive bleeding, use a cool, damp tea bag over the surgical site for one hour while applying pressure.
• Change the 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, it’s often due to irritation from mouth movement, frequent gauze changes, or not resting enough.

Bruising

Bruising may occur but usually isn’t severe. It should subside within 5 to 10 days.

Swelling

Swelling is common and caused by bleeding in the tissues. To reduce swelling:

• Use ice packs wrapped in a damp towel.
• Apply the ice pack on the sides of your face for 20 minutes on and 20 minutes off while awake.
• Swelling typically peaks at 48 hours.

Limited Mouth Opening

This is a normal protective response due to fluid accumulation in the jaw muscles and should subside within two weeks.

Pain

Pain levels can range from minimal to severe. Here’s how to manage it:

• Start taking your recommended painkillers before the anesthesia wears off.
• Dental anesthesia lasts about 4 hours for the top jaw and at least 8 hours for the bottom jaw.
• Avoid smoking, spitting, or using straws for 3 days to prevent dislodging blood clots.

Oral Hygiene

Do not rinse or clean around the surgical site for the first 24 hours. Starting the day after surgery:

• Rinse with a solution of 1 tsp. salt in 8 ounces (250ml) of warm water.
• If prescribed, use an antibacterial rinse (Chlorhexidine) lightly after every meal for 7 days.
• Use a cleaning syringe with the salt solution after every meal starting 7 days post-surgery.

Diet & Nutrition

Start with cool, clear fluids to prevent dehydration. Gradually increase your intake of soft foods like eggs, mashed potatoes, well-cooked pasta, and yogurt. Avoid hot liquids for 2 days. Stay away from foods with husks or seeds (e.g., popcorn, sesame seeds) that could get lodged in surgical sites.

Rest and Recovery

Rest and proper nutrition are crucial for healing. You may feel tired and achy, especially after general anesthesia. Avoid strenuous exercise and prioritize a quiet evening of rest.

Sutures/Fillings

• Stitches are dissolvable and will disappear within a week, though they may fall out sooner.
• If you had fillings placed and your bite feels high, please call our office. Adjustments take 5-10 minutes and do not require anesthesia.

Important Notice

Please notify our office immediately if you are unexpectedly admitted to the hospital within 10 days of your dental treatment.

For any questions or concerns, contact us at .

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 ____________________.

POST-OP INSTRUCTIONS FOR BONE GRAFT

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Post-Operative Instructions for Bone Grafting

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 socket is over packed to allow for the loss of a small number of particles. It is normal to have some of them come out of the graft site and into your mouth. There are some things that can be done to minimize the number of particles that become dislodged.

What to expect following surgery:

BLEEDING: Small amounts of blood in the saliva can make your saliva appear quite red/pink the remainder of the day after the procedure.

PAIN: Before the anesthetic wears off, it is recommended you take 600-800mg of Ibuprofen every 6 hours to relieve any post op discomfort. If you are allergic or cannot take Ibuprofen, you can take 1000mg of Acetaminophen every 6 hours. Alternating Ibuprofen and Acetaminophen every 3 hours will help with pain control. If more severe discomfort occurs, please contact the office.

SWELLING: Some swelling of the lip or cheek may occur.

Antibiotics will be prescribed, be sure to finish full prescription as directed.

What to do following surgery:

After leaving the office, rest and avoid strenuous activities for the remainder of the day. This will help reduce bleeding and aid in the healing process.

Eat soft foods for the first 2-4 days. Drink plenty of water. Avoid chewing hard foods on the graft sites. Do not use a straw. Avoid alcohol for 48 hours.

For the first day, it is advisable to let the blood clot stabilize by not rinsing your mouth. Following the first day, gentle rinsing would be advised; avoid vigorous rinsing. Do not rinse vigorously because you can disturb some of the bone graft granules. Do not use any mouthwash. Use only water or warm salt water if desired.

Smoking should be avoided for a minimum of 1 week as it slows down the healing process.

Do not apply pressure with your tongue or fingers to the grafted area. Avoid poking the site with your tongue or toothbrush.

Return to the office as scheduled for a 1 week or 2 week follow up. Return to the office as directed for removal of the sutures.