Resources to Refer a Patient

Evolve OMS is a by-referral practice only. To become a patient at our practice, you must be referred by a dentist, dental specialist, or medical doctor.

Our office will contact patients by phone and/or email within one (1) business day of referral receipt.

Please follow these instructions to prepare for sedation: No smoking for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible before the day of surgery. You will have to withhold from having anything to eat or drink within eight (8) hours before your planned surgery. A responsible adult must accompany you (the patient) to the office, remain in or near the office during the procedure, and drive you home. Wear loose-fitting, comfortable clothing with sleeves that can be rolled past the elbow and low-heeled shoes. Remove contact lenses, jewellery, and dentures before being taken in for your procedure. Do not wear lipstick, excessive makeup, or nail polish on the day of surgery. If you have an illness such as a cold, sore throat, stomach or upset bowel, please inform the office immediately. Most oral medications can be taken. In preparation for anesthesia, you should be aware that after your appointment, you must not operate a motor vehicle or hazardous machinery, make important decisions or consume alcohol and/or other drugs with sedative properties for at least 18 hours or for as long as longer drowsiness or dizziness persists.

Some pain, swelling, bleeding, bruising and jaw muscle tightness are all common post-operative events. See below for an expanded description of each: PAIN MANAGEMENT Some pain is expected following surgery. Take medications as directed, whether prescribed or recommended. Please remove the gauze when taking any medications. Medications are best taken with soft foods. Do not delay taking your prescribed pain medication, as we want the medications to start working before the freezing wears off. SWELLING Swelling will gradually increase during the first three days before improving. To minimize swelling, apply ice to the outside of your face over the treated area. Keep the ice packs in place for 20-minute intervals, followed by a 20-minute break. This is very important during the first 24 hours. Elevate your head when resting. You can do this by placing several pillows behind your back so you are lying at an incline. BLEEDING Expect some bleeding after surgery. This may continue for several hours. Be sure to place the gauze directly over the socket and bite down to apply pressure. Keep the gauze in place until the bleeding stops. Similarly, you can also use a wet tea bag (black tea works best). The tea contains chemicals that can help control the bleeding. BRUISING Slight bruising may occur. It is not necessarily a sign of a complication. Bruising usually resolves over a week. JAW WEAKNESS Some temporary tightness in the jaw muscles may cause difficulty opening your mouth for a few days after surgery. This is a normal post-operative event that will resolve in time. If lip, chin, or tongue numbness occurs, there is no cause for alarm. This is usually temporary in nature. If it is concerning, let us know.

Recovery should include pain medication, cold or ice application, rest, and gently rinsing or cleaning the surgical area. For more information, please see below: GAUZE The gauze pad should be folded to about 2 inches thick and placed over the surgical area while biting down for at least 30 minutes. It should be removed after the initial half hour. If bleeding persists, replace it with a fresh piece of gauze. Remove the gauze when eating, sleeping, or taking any medications. PAIN MEDICATION Medications are ideally taken with soft foods. Do not delay taking your prescribed pain medication, as we want the medications to start working before the freezing wears off. If you have been prescribed antibiotics, you can take them together with your first dose of pain medication. Antibiotics: You have been prescribed an antibiotic (likely Amoxicillin/Doxycycline) to prevent infection. Be sure to finish the entire course of antibiotics. Mouth Rinse: Spitting or vigorous mouth rinsing should be avoided during the first 24 hours. This can dislodge the blood clot and increase bleeding. If you were prescribed a medicated mouth rinse (i.e., chlorhexidine), you may begin gently rinsing after 24 hours. This medication can cause temporary staining of the teeth by sticking to plaque. After eating, brush your teeth with your regular toothbrush before using the rinse. If no mouth rinse prescription was given, you may gently begin to rinse with salt water after 24 hours. Be sure to rinse after eating. The best mixture of salt and water is 1 tsp. of salt in 1 cup of warm water. Non-Prescription (Over The Counter) Pain Medication: Sometimes, if the anti-inflammatory is insufficient, we suggest you add 500mg-1000mg of Tylenol between each dose of Ibuprofen. ICE To minimize swelling, apply the provided ice pack to the outside of your face over the treated area. Keep the ice packs in place for 20-minute intervals, followed by a 20-minute break. This is very important during the first 24 hours. Elevate your head when resting. You can do this by placing several pillows behind your back so you are lying at an incline. REST Restrict your activities on the day of surgery and resume normal activity when you feel comfortable. We recommend avoiding heavy lifting (>10 kilograms) for the first 5-7 days after surgery. SUTURE CARE Dissolvable Sutures: If you have dissolvable stitches, they will loosen or melt away on their own at some point during the next week. If they come loose even on the day of surgery, do not worry. If it’s been more than a week, and your stitches remain intact, you can gently attempt to brush them away. Non-Dissolvable Sutures: If you have non-dissolvable sutures, we intend to remove them in the office during a scheduled follow-up visit 2-3 weeks after your procedure. CLEANING If you’ve had a tooth removed, avoid brushing directly on the surgical site. Use the curved-tip (Monoject) syringe to flush the socket with Chlorhexidine (an antiseptic and disinfectant). Also, use the special soft toothbrush that we have provided for you to brush your teeth safely, especially those near your surgical area. If you’ve had a tooth removed with bone grafting, avoid brushing the grafted site until one week after your procedure. On day eight, it is important to start cleaning the surgical site to prevent infection. Use the special soft toothbrush we provided you and gently brush the area. DO NOT flush or clean the socket.

Your diet and activity level will be most affected. Avoid high temperatures and anything too spicy. Drink plenty of liquids, but do not use a straw. Do not use straws for at least 24 hours following surgery, as this may dislodge the blood clot, increasing the risk of developing a dry socket. Regular food intake will make you feel better and aid in a faster recovery. For work and exercise, avoid any activity that elevates your heart rate (i.e. running, brisk walking, aerobics, sports, weight lifting, heavy lifting) for 5-7 days. You will be limited to soft foods for a brief period after surgery (see the next question for more info).

Any small foods like rice, peas, seeds or nuts that can quickly become trapped in the operative site(s). When “frozen," swallowing liquids or medication may be more difficult. Take small sips of water. When first doing this, consider observing yourself drinking in a mirror. Drink warm or cool drinks/soup until local anesthesia, or “freezing,” has worn off approximately 2 to 6 hours following the procedure.

Below, you will find our safe post-operative meal planning guide: Breakfast Yogurt Scrambled Eggs Banana Protein Shakes Soft, Crustless Bread – can be spread with cream cheese and seedless jelly (avoid bread with grains) Oatmeal Cold Cereal Lunch & Dinner Soup Mashed Potatoes Baked Potatoes Pasta with a smooth sauce (no chunks) Macaroni and Cheese Fish Tuna Salad Egg Salad Sides & Desserts Apple Sauce Cottage Cheese Avocado Pudding Ice Cream Muffins Milkshake Seedless Fruit Smoothies (Mango, Avocado etc) Jello