«fname» «lname»: monday, august 09, 2010

Pre treatment guidelines for patients scheduled for periodontal or dental implant surgery.
The following guidelines are intended to facilitate the surgical process. Please follow these guidelines closely
and call our office if you need additional help.
Medications: Firstly, advise our office of any changes in your medical history, including any
changes in your medication history, on a timely basis. Begin all prescribed medications 1 hour
before your scheduled appointment. If we have prescribed a steroid dose pack, take two
(usually of 6) prescribed tablets, 1 hour beforehand. Flip the packet over for prescribing
guidelines. (This should not be done if you are having an IV sedation). Also, take two extra
strength (over the counter) Tylenol. Extra Strength Tylenol is currently difficult to find. Use either
Tylenol Geltabs or store brand equivalents. Tylenol substantially boosts the effect of Ibuprofen
(Motrin). This protocol will facilitate an uneventful and more comfortable post-treatment
outcome).
If you take a daily aspirin, or if you are any anti-coagulative medications, these must be stopped
5 days prior to the appointment.
Make-up: Please remove all make-up before coming to the office. Make-up will contaminate the
surgical site.
Shaving: Unless you normally wear a beard or moustache, please shave cleanly (for hygienic
reasons), prior to your appointment.
Smoking: Try to cut back on the amount of smoking (if possible). This would include taking a
lesser number of puffs on each cigarette.
Bruising/swelling: Anticipate modest bruising and swelling. This is normal and routine
following oral surgery. It will be controlled both by your medications, as well as ice packs on the
outside of your face following treatment, and sucking on ice cubes, all at the same time.
Clothing: Wear loose fitting clothing to the surgery appointment. Do not wear finest finery, and
try not to wear white or other light colored items.
Music: If you want to bring your own music, or IPOD, please do so. We will be providing you
with a wide range of musical choices and a headset during your procedure.
Cell phones: Please turn off your cell phones when you enter our office. PLEASE!!!

Rescheduling: This time has been specifically reserved for you. We need a minimum of 48
working hours notification, if you cannot make the appointment. A fee, for the full amount of the
procedure is charged for broken appointments, or appointments cancelled without adequate
notification
Post treatment guidelines:

Contacting Dr. Richman: (C) 404/784-7272 (Poor cell phone reception at home)
(H) 404/252-4052.
Personal Email: richmancs@gmail.com

MEDICATIONS: Take and finish ALL medications – No Exceptions. Printed guidelines on each
medication container override all verbal instructions from our office. Start all prescribed medications as
soon as you get home, with a full glass of room temperature water. What you took earlier today does
not count. All medications, including the pain medications must be taken until gone. Analgesics (pain
tablets): Motrin /Ibuprofen), Take one 600 mg tablet every six hours. Two Tylenol Geltabs must be
taken in between the Motrin (Ibuprofen). Tylenol doubles the efficacy of the Motrin/Ibuprofen. The
Motrin and Tylenol will therefore be staggered every 3 hours, so that you end up taking each one every
6th hour. If this combination is not keeping you comfortable, call Dr. Richman at 404/784-7272.
Discomfort may be expected during the first few days but the medication should keep you comfortable.
Pain medication requiring a prescription, e.g. Tylenol III or Lorcet makes you drowsy. Do not drive a
motor car or operate any machinery if you take prescription-type pain medication. This does not apply
to Motrin/Ibuprofen.
For females, certain medications, particularly antibiotics, (example Penicillin, Tetracycline, Doxycycline
and others) are known to inhibit the effects of birth control medications. If you are on any form of birth
control medication, please take appropriate precautions.
Patients taking Tetracycline (Doxycycline) should not be exposed to the sun or tan with tanning lamps.
If you experience severe nausea/ diarrhea/vomiting or dehydration, contact Dr. Richman.

Exercise: No exercise that raises blood pressure for a minimum of 4 full days.

Precautions: Observation of surgical area: Do not pull your lips or cheeks back to view the surgical
site, especially if you have had any grafting done. This will pull the gum flap away from the area,
resulting in a failure. Do not allow your tongue to play with the edges of the gum or the sutures.
Rinsing, Brushing and Flossing: Do not brush the surgical area, but brushing the teeth and
gently flossing is appropriate starting tomorrow. Periogard, Peridex or Chlorhexidine, gently bathe
the area (do not swish) with 15cc’s for 15 seconds, three times per day, start 1 hour before the surgery.
Continue until contents of bottle are completed.
Eating and Drinking: Do not eat or drink anything hot, until you get your feeling back. This will
prevent burning and biting your lip or cheeks. Once you get your feeling back there are no
restrictions relative to eating or drinking. Drink large quantities of orange juice (for Vitamin C) during
the healing period. It is also important to eat a normal balanced diet.
Swelling, bleeding and bruising: are normal post surgical features and will occur, please do not be
concerned. Swelling and bruising may be extreme and extensive, do not be alarmed! All swelling
should begin to decrease in 5-7 days. Swelling may be extreme – not a problem. Place ice packs over
the surgery site for 30-40 minutes, 4 times a day for 4 days. However, if swelling and bruising is
substantially worsening, please contact Dr. Richman. Expect some bleeding during the first 12 hours.
If bleeding is excessive, this may be controlled by bathing (not rinsing) the area with a strong solution
of cold tea and/or by placing a moist tea bag over the area and applying pressure over the tea bag for
five minutes at a time.
Dressing: Certain surgical procedures require a dressing over the operated area. If you have a
dressing, it might be lost within the first 12 hours. This is normal. All the treated teeth (including those
covered with a dressing, where applicable) should not be brushed for 1 week. Continue to brush and
floss the remainder of your mouth thoroughly.

Source: http://www.roswellperiodontics.com/wp-content/uploads/Pre-Post-Adult-Website-Jan-2012.pdf