Surgical Instructions

Pre-surgical Instructions

This procedure will be performed using local anesthesia. There are usually few restrictions after the procedure concerning driving or returning to work. A doctor is available at all times should a problem arise after your treatment.

Avoid aspirin or aspirin-based products, including NSAIDs (non-steroidal anti-inflammatory drugs) one week before surgery.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.

Please eat breakfast or lunch as applicable.

If you have been advised, by your physician or dentist to use antibiotic pre-medication, please make sure you are on the appropriate antibiotic on the day your appointment.

Post-surgical Instructions

1. Avoid strenuous activity for the remainder of the day. Routine, nonstrenuous activity is not harmful, unless otherwise directed. Smoking and alcohol consumption delay the wound healing process and should be avoided or minimized for 3 days following surgery.
2. It is essential that you maintain an adequate diet with proper solid and fluid intake during the first 3 days following surgery.
3. Avoid manipulation of the facial tissues as much as possible. Do not raise the lip or pull back the cheeks to inspect the surgical site as you may dislodge the sutures (stitches).
4. Some oozing of blood from the superficial site is normal during the day and evening of surgery. Slight swelling and facial skin discoloration (bruising) may be experienced. This is temporary and will resolve on its own in a few days.
5. Apply as ice bag with firm pressure to the face directly over the surgical site. You should apply the ice bag alternately 20 minutes on, 20 minutes off, for 6-8 hours following surgery. After 8 hours, the ice bag should not be applied. Frequent moist heat applications to the face are recommended after the third post surgical day. Maximum swelling may occur 48 hours after surgery.
6. Post surgical infection is unusual, but possible. Signs of infection may cause increased pain, increased swelling and tenderness, elevated body temperature, chills, and other flu like symptoms. An objectionable odor and taste may also be experienced. If these conditions exist, please call our office.
7. The superficial site will be tender and sore. For this reason you should follow the analgesic regimen recommended by our office following surgery. Additional prescription medication may be required as well.
8. Careful tooth brushing is desirable and promotes healing. Brush only the teeth and make every effort to avoid the gums. Twenty-four hours after surgery, you may begin rinsing with Peridex if prescribed or a mild saltwater solution of ½ tsp. of table salt and ½ glass of warm water.
9. The sutures (stitches) that have been placed must be removed to ensure proper healing. It is important that you return at the appointed time for suture removal.
10. Recall visits are necessary to monitor the progress of healing.
11. Should any complications arise, please do not hesitate to call. If you feel that your symptoms warrant a physician and you are unable to reach us, go to the closest emergency room immediately.

Are There Any Potential Problems After Treatment?

• Lower teeth and nerve injury. There is a slight possibility that nerve injury can occur during root canal surgery to the lower posterior teeth. Your endodontist is trained to assess this possibility prior to treatment and will advise you accordingly. For lower posterior teeth, the root tips may be near a nerve that supplies feeling to the lip, chin and gums. Your endodontist is trained to design your surgery to minimize the chances of damaging this nerve. Rarely, this nerve can become irritated during the process of surgery. In these cases, when the local anesthesia wears off, you may experience tingling, altered sensation or, in rare cases a complete lack of feeling in the affected tissues. Should this occur, it is usually temporary and will resolve over a period of days, weeks or months. In rare cases, these changes can be permanent and/or painful.
• Upper teeth and sinus communication. The upper teeth are situated near your sinuses, and root canal surgery can result in a communication between your mouth and the adjacent sinus. Should this complication occur, it will usually heal spontaneously. We will give you special instructions if this is apparent at the time of surgery. We prefer that you don’t blow your nose for two to three days after surgery. If you have to sneeze, you should sneeze with an open mouth into a tissue. You should not create any pressure in the sinus area. If you sense a complication after surgery, please contact us.

• Post-operative infections. Post-operative infections occasionally occur. This usually requires just an office visit and examination. Many times placing you on an antibiotic for one week will take care of the infection. Occasionally, other follow-up procedures will be needed.