Surgical Treatment Instructions

Pre-Surgical Instructions

  • This procedure will be performed using local anesthesia - there are usually no restrictions concerning driving to and from your procedure or returning to work.
  • Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician.
  • If you have been advised, by your physician or dentist to use an antibiotic pre-medication, please make sure you are on the appropriate antibiotic on the day of your appointment.
  • Please eat breakfast or lunch, as applicable.
  • If there is a question, please call our office prior to your appointment.

Post-Surgical Instructions

  • The superficial site will be tender and sore. For this reason you should follow the regimen recommended by your doctor following surgery. Discomfort may be alleviated by taking ibuprofen (Advil, Motrin, etc) and/or acetaminophen (Tylenol) as directed. Following treatment, Dr. McRay or Dr. Cohen will discuss with you the most appropriate and effective pain management regimen, based on your medical history. Additional prescription medication may be required as well.
  • Some oozing of blood from the superficial site is normal during the day and evening of surgery. Slight swelling and bruising may also be experienced. This is temporary and will resolve on its own in a few days.
  • Apply an ice pack with firm pressure to the face directly over the surgical site. You should apply the ice pack alternately 20 minutes on, 20 minutes off, for 6-8 hours following surgery. After 8 hours, the ice pack should not be applied. 
  • Avoid strenuous activity for the remainder of the day. Routine, non-strenuous activity is not harmful, unless otherwise directed. 
  • 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).
  • Careful tooth brushing is desirable and promotes healing. Your doctor will instruct you on the best way to modify your routine. 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.
  • It is essential that you maintain an adequate diet with proper solid and fluid intake during the first 3 days following surgery.
  • Smoking and alcohol consumption delay the wound healing process and should be avoided or minimized for 3 days following surgery.
  • 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.
  • Recall visits are necessary to monitor the progress of healing.
  • 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 Surgery?

  • Post- surgical infection is unusual, but possible. Signs of infection include 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. 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.
  • 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 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.