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Surgical Instructions

Our surgeons and staff at MIC are committed to assisting our patients through every stage of their procedure. Please find our helpful information regarding instructions for surgery. If you have any further queries, please phone our team who will be able to assist with all your queries.

General preparation for surgery

  • You may not have anything to eat or drink (including water) for six (6) hours prior to the appointment;
  • No smoking for at least 24 hours before the surgery. Ideally, cut down or stop smoking as soon as possible;
  • A responsible adult must accompany the patient to the hospital and drive the patient home;
  • The patient should not drive a vehicle or operate any machinery for 48 hours following general anaesthesia;
  • Please wear loose fitting clothing;
  • Contact lenses, jewellery, facial piercings and dentures must be removed at the time of surgery;
  • Do not wear lipstick, excessive makeup, or nail polish on the day of surgery;
  • If you have an illness such as a cold, cold sore, stomach or bowel upset, please notify the office;
  • If you take routine medications, please check with our doctors prior to your surgical date for instructions;
  • If your medical history is complex or if you are particularly concerned about undergoing a general anaesthetic, it is usually possible for you to be seen by the anaesthetist for a consultation prior to your admission. Please let the MIC doctors know if you would like to do this.

Anaesthesia

Most of the procedures performed at MIC require anaesthesia. No one looks forward to oral surgery procedures, but MIC provides a range of techniques to relieve the pain and anxiety associated with wisdom tooth removal, implant placement, jaw surgery, facial reconstruction, tooth extraction, and biopsies.

During your initial consultation, your surgeon will take a comprehensive history designed to help recommend the safest and most effective anesthesia for your procedure.

Your anesthesia plan will involve a combination of agents that target pain, both during and after the operation. General anesthesia is only used in a hospital and is administered intravenously. Local anesthesia is used at MIC and is injected into the site to provide pain relief, both during and following the procedure.

Oral medications provide post-operative pain control and can be taken in the days following the procedure.

It is important to understand what form of anesthesia is planned for any procedure and to follow pre-operative instructions precisely. Some types of anesthesia require that food or fluid not be consumed for at least eight hours prior to surgery. In addition, the patient will require transportation and supervision after the procedure.

Instructions for minor oral surgery

At your consultation, one of our doctors will speak with you about any preparation needed before your procedure under a local anaesthetic. This usually relates to medication you may need to cease before undergoing treatment.

Post Surgery:

In the event that you go home with gauze packs in the mouth, these are to be removed one hour after surgery.

You may apply Ice packs to the cheeks to decrease pain and swelling.

Swelling is quite a normal response and usually reaches its peak 24-48 hours following surgery, gradually decreasing after 4-5 days. It often varies from one side of the face to the other, depending on the degree of difficulty of surgery.

Bruising may occur as the swelling starts to subside.

Post-operative bleeding responds well to direct pressure, so use a rolled-up handkerchief to apply direct firm pressure to the bleeding site for one hour. If bleeding persists, please contact the MIC office.

Initially, it is important to take painkillers regularly. The discomfort should decrease significantly after 2-3 days, with a decrease in the need for pain killers.

There may be limitations in mouth opening, but this is completely normal and it will pass as the swelling lessens.

If you experience nausea and/or vomiting following oral surgery, it may relate to medication or swallowed blood. It is wise to have plenty of clear fluids for the first 12 hours. If nausea is a problem, use a bicarbonate elixir, ie DEXSAL. If vomiting persists, please contact us as it may relate to your prescribed pain killers.

Infection is uncommon following removal of wisdom teeth and, if it does occur, it will show itself by a late increase (3-4 days) in swelling, and/or discomfort or the onset of a discharge.

Occasionally antibiotics will have already been prescribed post-operatively to prevent infection and it is essential to finish the course, even if there are no problems.

Dissolving sutures will be used in almost all cases of minor oral surgery. These will fall out or dissolve in approximately 7-10 days following surgery.

With regards to oral hygiene, DO NOT RINSE YOUR MOUTH UNTIL THE NEXT DAY after surgery as it will cause bleeding.

Rinsing with a mouthwash is suggested (a teaspoon of salt in a glass of warm water is recommended) and this should be done after food intake. Tooth brushing should be recommenced as soon as possible.
Your diet may need to be restricted to fluids and soft foods initially, but you will be able to gradually return to a normal diet.

We advise that you refrain from smoking for at least 3 days after the surgery, as this increases the risk of infection.

If problems arise, please phone MIC (not your dentist or doctor) on (07) 5437 9888.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner

Instruction after placement of dental implants

Following your dental implant surgery, you’ll be given some Panadeine Forte and possibly some antibiotics if required.

Following your surgery, please note that the pain will be most severe within the first 6-8 hours after the operation. Moderate to severe pain usually does not last longer than 48 hours. Mild discomfort usually diminishes after the third day and you may also experience a little discomfort around the area that can last for several weeks. An over-the-counter pain relief such as Panadol or Nurofen will be sufficient.

In order to minimise swelling and bleeding after the placement of dental implants, you may wish to keep your head elevated for the first 24 hours and relax as much as possible.

Avoid all strenuous activities for at least three days following the implant surgery and use ice packs on the area to reduce swelling.

Our staff at MIC will ask you to rinse your mouth with warm salty water – one teaspoon of salt in a cup of water – about three times a day to keep the area clean. Clean your implant(s) twice daily using a soft toothbrush and use floss if you wish.

We advise that you care for your dental implant in the same way that you would your natural teeth. Professional cleaning is important too, so regular check ups and cleans with your dentist are advised.

If problems arise, please phone MIC (not your dentist or doctor) on (07) 5437 9888.

Instructions after an apicectomy

When the local anaesthetic wears off a few hours after your apicectomy surgery, there will be some discomfort. Your surgeon will arrange painkillers for you and they may also prescribe a course of antibiotics.

The discomfort is usually worse for the first few days, although it may take a couple of weeks to completely disappear. You may require a day or two off work, during which time you should avoid strenuous exercise.

After an apicectomy, swelling can occur both inside and outside the mouth. This is usually most noticeable for about two days. It is important to keep the site of surgery as clean as possible for the first few weeks after surgery.

If you are finding it difficult to use a toothbrush, you can keep the area clean by gently rinsing with a mouth wash or warm salt water (dissolve a teaspoon of kitchen salt in a cup of warm water) commencing the day after surgery.

It is unusual for the area to bleed after surgery, but bleeding can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled up handkerchief or swab. If the bleeding does not stop, please contact MIC.

Lifting the gum to uncover the root of the tooth can occasionally lead to a numb feeling in the gum, which will last a few months. Because the gum is cut, it can occasionally shrink back a few months after surgery as scar tissue forms. This is not normally a problem but if the tooth has been crowned, the edge of the crown may become exposed.

If you have any concerns about your dental implant surgery, please contact MIC.

Instruction after genioplasty or orthognathic surgery

Discomfort after genioplasty or orthognathic surgery is usually worse for the first few days, although it may take a couple of weeks to completely disappear.

You will be given intravenous antibiotics while you are in hospital so the area can heal without any infection. You will be sent home with painkillers and a course of antibiotics.

Immediately after the surgery, the jaw and chin area will feel swollen and tight. Swelling and bruising is generally worse on the second or third day after the operation.

The swelling can be reduced by using the ice packs and sleeping propped upright for a few days. Most of the swelling should disappear after a fortnight but there is often some subtle swelling that can take several months to disappear although only you and your family are likely to notice this.

Complications:

While complications are rare with genioplasty or orthognathic (jaw) surgery, it is important that you are aware of the possible warning signs:

Bleeding: some oozing from the cuts inside your mouth on the night of operation is normal and to be expected. Significant bleeding is very unusual but should it occur it can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled up handkerchief or swab.

Numbness: your bottom lip will be numb and tingly after the operation, similar to the sensation after having an injection at the dentist. This numbness may take several months to disappear and in a minority of patients may last forever.

Infection: the small plates and screws that hold your jaw in its new position are usually left in place permanently. Occasionally they can become infected and need to be removed, but if this happens, it is not normally a problem until several months after surgery. The metal that is used is titanium. A review appointment will be arranged to see your surgeon one week after the procedure.

In the weeks following an osteotomy, it is often necessary to put elastic bands on your orthodontic braces to guide your bite into its new position.

A review appointment at MIC will be made for you approximately one week after surgery.

Post operative pain relief information

Our standard pain relief regime at MIC is for patients to take two paracetamol tablets and one Nurofen tablet every four hours if awake (ie Panadol, Herron paracetamol, Panamax) for 48 hours after the procedure — and then as required.

If the paracetamol and Nurofen combination is insufficient, use the Panadeine Forte we provide, instead of the paracetamol. Keep taking the Nurofen.

Panadeine Forte contains a standard dose of paracetamol, plus a large dose of codeine. Take half to one Panadeine Forte tablet and repeat in half an hour if necessary. Only use Panadeine Forte for severe pain.

Your anaesthetist will notify you of any restrictions to this regime.

Ice Packs

You will need to purchase ice packs to help reduce pain and swelling, and frozen peas are the best option on the market. Purchase one packet for each cheek and keep one spare for each cheek.

Apply the first pack to each cheek and put the spares in the freezer as soon as you arrive home. To avoid frostbite of the cheek, place a layer of towel between your cheek and the bag of peas. Use a “20 minutes on, 20 minutes off” regime.

By having two bags for each side, you can rotate the bags to allow them to refreeze.

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