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After Sinus Lift Graft

These instructions may be provided as a supplement to other post-operative instructions.  Be sure to read and follow all post-operative instructions.  Elevation of the maxillary sinus membrane and placement of bone graft material is a delicate and sometimes tedious operation. The success rate of this surgical procedure is very high, but your cooperation in following these instructions is important. One of the purposes of the following instructions is to avoid any maneuvers that significantly change the pressure differential between your mouth and your sinuses.

PHYSICAL ACTIVITY:  Do not blow your nose.  Absorb any nasal drainage with a tissue. Do not suck through a straw. Do not smoke.Do not suppress sneezes.  If you must sneeze, do so with your MOUTH OPEN.  Do not play with the wound and stitches with your tongue, this takes commitment, as the tongue is an inquisitive organ!  DO NOT, place your fingers into your mouth or retract your cheek in an effort to see the wound. If you make an effort to see the wound, you are jeopardizing the healing process.  Do not engage in any activity that will significantly raise your heart rate or blood pressure for 24 hours after your surgery.  You should avoid contact sports for 2 weeks minimum.  Depending on your occupation, you may return to work within 24 to 48 hours.

WOUND CARE & HYGIENE: Wait until 24 hours have passed since your surgery then rinse your mouth with a mixture of 50% warm salt water (1/2 teaspoon per 6 oz. glass) and 50% Hydrogen Peroxide at least four times a day, ideally after eating and before going to bed.  If you were given a prescription antibacterial rinse, use this twice a day in addition to the salt water. Beginning on the evening of your surgery day, you may gently brush your front teeth and the top of your tongue.  However, do NOT allow your toothbrush to venture past your canines (Eye teeth) towards the back of your mouth.  You may resume brushing your back teeth (top only) after one week has passed since your surgery. Treat your wounds delicately.

MEDICATIONS: Take an over-the-counter decongestant like Pseudoephedrine (Sudafed) as directed on the package until your next appointment. The adult dose will be two 30 milligram pills (60 mg) every six hours. In most cases a NSAID (like prescription Flurbiprofen or OTC Ibuprofen or Advil) or even Tylenol (if your doctor has advised you to avoid NSAIDs) will relieve a significant amount of your discomfort, if not all of it.  It can be helpful (but not required) to start taking the NSAID (or Tylenol) several hours before your surgery if this is possible. Then continue to take the NSAID or Tylenol on a schedule for 5 days after the procedure.  This is your BASELINE pain-preventive medication. Depending upon your specific procedure, you may also receive a prescription for a narcotic analgesic (likeDarvocet or Lorcet); if so, then use this only if pain persists in spite of your taking the BASELINE medication. If your BASELINE medication is Tylenol, then you should stop taking this while you are using the Prescription narcotic medication (as it contains some Tylenol).  If your BASELINE is an NSAID medicine, then continue taking and use the narcotic prescription in addition for break-through discomfort.

SWELLING & BRUISING:  This develops within the first 24 hours, peaks at 48 to 72 hours, rapidly resolves, and is negligible by the seventh day. You may use an ice pack during the first 24 hours (no heat) for comfort and to reduce swelling.  Keep your head elevated at 45 to 60 degrees from the horizontal for the first 48 to 72 hours.  Discoloration of the face sometimes normally occurs as a result of bleeding into the tissues (bruise or hematoma) and will resolve in 5 to 7 days. 

BLEEDING/FEVER: Bleeding is usually minimal if present at all, since the gums have been sutured together.  You may experience some mild oozing from the suture line for the first 24 hours.  If it seems persistent and is bothersome, please call the office. Fever can occur within 48 to 72 hours, and usually is associated with a decrease in fluid intake, vomiting, or dehydration.  An oral temperature under 101 degrees usually responds to good fluid intake and TYLENOL every four hours.  If you note a fever of 103 degrees or greater, please call the office.

EATING & NUTRITION:  If you were asleep during surgery, begin with clear liquids like 7-UP to avoid nausea.  Then rapidly advance to milkshakes, soups, and then solid food as tolerated.  Be careful not to chew until the numbness has worn off.  Let the severity of your discomfort guide you in the selection & placement of food.  Take smaller bites & keep the food in an area remote from the wound(s) if possible.  After 3 or 4 days you should be able to chew a soft or even regular consistency diet, depending on your level of discomfort. A normal intake of calories is important, as your body now has a higher than usual metabolic requirement in order to heal your wounds.

NAUSEA:  This may occur as a side effect of the prescribed medications or (rarely) from the anesthetic drugs.  If you received intravenous anesthesia, a dose of nausea-preventive medicine was given. Try not to take your pills on an empty stomach.  Antacids (Maalox, Pepto-Bismol, etc.) may help to alleviate nausea.  If vomiting occurs and is persistent, call the office.  A prescription will be called in for a suppository medication.

IF QUESTIONS ARISE, PLEASE DO NOT HESITATE TO CALL US AT 770-218-9135