Surgical Information

At WisNova Innovative Dental Specialists, we believe that patient care is just as important before and after surgery as it is during surgery.

 

Please select one of the categories below to learn more about the steps you
should take regarding your procedure.

Pre-Operative Information

Important reminders for the day of your surgery if you are being sedated:

  • Fasting
    • Do not eat or drink for 8 hours before your scheduled surgery appointment if you are being sedated.
  • Medications
    • If you use an inhaler, please bring it with you to your appointment.
    • Take your regularly prescribed medications with a small sip of water unless directed differently by your doctor.
    • If you were prescribed an antibiotic, please take this with a small sip of water 1 hour before your appointment.
  • Other items
    • If you wear them, you will need to remove your contact lenses during sedation and should ideally keep them out for the rest of the day. Please wear your glasses, or bring a case for your contact lenses.
    • Do not wear eye makeup or nail polish to your appointment
    • Please contact the office if you are sick so we can discuss whether to postpone your appointment, and for how long.
    • If there is any chance you could be pregnant, please advise your doctor.
    • Please wear loose-fitting, comfortable clothes. Your sleeves should be easily rolled up above the elbows.
  • You must be accompanied by a responsible adult at your appointment. He or she will need to wait at our facility until your surgery is complete. They will sit with you while you recover and then drive you home. A responsible adult must stay with you for 24 hours after surgery.
  • Where to Park
    • We have reserved spots for you at the back of the building for your convenience; signs designate the parking spots for sedation patients.
  • Getting ready:
    • We recommend having either gel ice packs or bags of frozen peas in the freezer so they are ready for use once you get home.
    • You will eat soft foods with no straws for a week. Prepare by making sure you have foods like soup, smoothies, eggs to scramble, mashed potatoes, and other soft foods at home.
  • If you have any questions, please call WisNova at 262-654-6770.

*If you need to cancel your appointment, please provide 48 hour notice to avoid a $180 cancellation fee*

Post-Operative Instructions After Tooth Extractions

Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions apply to all patients. Common sense will often dictate what you should do. Your surgeon will review recommendations for pain control and instructions tailored to you and your procedure. If you have any questions, please call our office for clarification. Our telephone number is: 262-654-6770.

General Surgical Site Care

It is best to refrain from rinsing on the day of the procedure as it may cause continued bleeding. Avoid vigorous rinsing/spitting for one week.

Starting the day after your surgery, you may brush the rest of your teeth as normal, taking care to avoid brushing directly on the surgical site. You may also rinse your mouth gently after meals and before bed with warm salt water. In some cases a mouth rinse is prescribed; if so, use it as directed.

If you have stitches, they will dissolve on their own unless your surgeon told you otherwise.

Do not smoke for two weeks after your extraction, since this can cause delayed healing and worse pain. We do not advise smoking at all, but if you must resume do not do so until you are completely healed.

Bleeding

Bleeding after oral surgery is expected. You should make it a goal to get bleeding to stop the day of the procedure, before going to bed the first night. As with most other wounds, pressure will stop bleeding. If you have a bleeding disorder, or you are on a ‘blood thinner,’ it may take longer for the bleeding to stop.

Initially, gauze should be changed every 30-45 minutes, though the interval should lengthen as bleeding subsides. Gauze should be placed directly on the area that is bleeding, and firm pressure should be applied. You should see the gauze going from red to pink, and pink to clear, if you are doing it appropriately. If you feel you are not making progress after several hours, you should make sure the gauze is in the correct spot and enough pressure is being applied. If there is minor oozing but the bleeding has been mostly stopped with the use of pressure, you may place the gauze in a cup of heavily steeped black tea, squeeze out the liquid, and apply pressure using this tea-infused gauze. Avoid this in the first few hours, as there is no substitute for pressure to control bleeding.

If you are unable to get bleeding to stop before going to bed on the day of the procedure, do not sleep with gauze in your mouth because it is a choking hazard. Moreover, swallowing blood can make you feel sick and even cause vomiting.  If you are still bleeding the morning after the procedure, and are unable to get it to stop promptly, please call the office.

Swelling/Mouth opening

As with any surgical procedure, some amount of swelling should be expected. Typically, swelling will worsen for a few days before it starts to subside. Post-operative day three is often the day of greatest swelling, though this is not necessarily accompanied by increased pain. (Note: the day of the procedure is considered post-operative day zero.) Removal of impacted wisdom teeth will often times result in significant swelling. If you are concerned with the appearance, please contact your surgeon.

Tips to help minimize swelling: Sleep with your head elevated above your heart. Ice will help with swelling when applied for the first 24-48 hours. Apply ice (use a gel pack or bag of frozen peas wrapped in a light towel) to the outside of your face over the surgical sites for 20 minutes, then remove for 20 minutes. After 2 days, some patients find heat more helpful for discomfort, though you can continue to use ice if you prefer. Do not sleep with heat in place.

After removal of wisdom teeth or multiple extractions many patients have stiffness when they open their mouths. Normal mouth opening typically returns within 7-10 days after the procedure, and you may gently stretch after the first few days if desired.

Pain

Unfortunately most oral surgery is accompanied by some degree of discomfort; the pain is typically the most bothersome for the first few days after surgery. Over the counter pain medications such as ibuprofen and acetaminophen (provided these are safe for you to take) offer the best pain control after tooth extractions. Take your first dose of pain medication before the numbing medication wears off to maximize your comfort.

Your team will review your pain management strategy with you, and will give you a prescription medication if necessary. Take all pain medications with food, and do not exceed recommended doses.

Diet

Under most circumstances, it is best to maintain a pureed diet for about one week after tooth extraction. Avoid crunchy foods and foods with small pieces (chips, rice, nuts, raw veggies, crusty bread) for at least one week. This will help prevent trauma to the incisions and food trapping in the extraction sites. The gum tissue will not close over the top of food if it is trapped in the extraction sites. The sooner the gum tissue closes, the faster you will be back to regular diet and hygiene. Older patients will need more time for the gum tissue to close. When you being to advance your diet, start with softer foods (fish, pasta, scrambled eggs) before going back to a completely normal diet.

You should avoid using drinking straws for at least one week after tooth extraction. Using drinking straws will increase the risk for developing a dry socket, which can be very painful.

Do not skip meals, especially if you are taking pain medication or antibiotics. Eating regularly will help you feel better and may contribute to better healing. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor; aim to keep your blood sugar well controlled.

Activity

Avoid strenuous activity and exercise for at least 48 hours after you have finished bleeding. Once bleeding has been stopped for 48 hours, you may resume activity as tolerated.

Some Exceptions: Swimming should be avoided for at least one week after surgery. Also, it is best to avoid playing a wind or brass instrument for about one week after surgery.

After Sedation

If you were sedated or “put to sleep” for your procedure, drink clear liquids such as water or juice before eating soft foods. Do not drive, drink alcohol, or make important decisions for 24 hours after your procedure. A responsible adult must be present with you for 24 hours after the procedure.

Post-Operative Instructions After Dental Implants and/or Bone Grafting

We are excited to help you restore your smile through placement of dental implants. The following serves as a general guide for care after your procedure.

Sometimes the after effects post implant placement or grafting are quite minimal, so not all of these instructions apply to all patients. Common sense will often dictate what you should do. Your surgeon will review recommendations for pain control and instructions tailored to you and your procedure.

If you have any questions, please call our office for clarification. Our telephone number is: 262-654-6770.

General Surgical Site Care

It is best to refrain from rinsing on the day of the procedure as it may cause continued bleeding. Avoid vigorous rinsing/spitting for one week.

Starting the day after your surgery, you may brush the rest of your teeth as normal, taking care to avoid brushing directly on the surgical site. You may also rinse your mouth gently after meals and before bed with warm salt water. In some cases a mouth rinse is prescribed; if so, use it as directed.

Most often if stitches are placed they will dissolve on their own. If your stitches or membrane require removal, your surgeon will explain this and an appointment will be scheduled for the removal. Avoid playing with the stitches and the surgical site.

Do not smoke for three weeks after your graft or implant placement, since this can cause delayed healing, increased risk of graft and implant failure, and worse pain. We do not advise smoking at all, but if you must resume do not do so until you are completely healed.

If you had a graft, it is common to see small pieces of graft that resemble sand in your mouth. This is an expected, normal part of the healing process.

Bleeding

Minor bleeding after oral surgery is expected. You should make it a goal to get bleeding to stop the day of the procedure, before going to bed the first night. As with most other wounds, pressure will stop bleeding. If you have a bleeding disorder, or you are on a ‘blood thinner,’ it may take longer for the bleeding to stop.

Initially, gauze should be changed every 30-45 minutes, though the interval should lengthen as bleeding subsides. Gauze should be placed directly on the area that is bleeding, and firm pressure should be applied. You should see the gauze going from red to pink, and pink to clear, if you are doing it appropriately. If you feel you are not making progress after several hours, you should make sure the gauze is in the correct spot and enough pressure is being applied. If there is minor oozing but the bleeding has been mostly stopped with the use of pressure, you may place the gauze in a cup of heavily steeped black tea, squeeze out the liquid, and apply pressure using this tea-infused gauze. Avoid this in the first few hours, as there is no substitute for pressure to control bleeding.

If you are unable to get bleeding to stop before going to bed on the day of the procedure, do not sleep with gauze in your mouth because it is a choking hazard. Moreover, swallowing blood can make you feel sick and even cause vomiting.  If you are still bleeding the morning after the procedure, and are unable to get it to stop promptly, please call the office.

Swelling/Mouth opening

As with any surgical procedure, some amount of swelling should be expected. Typically, swelling will worsen for a few days before it starts to subside.

Tips to help minimize swelling: Sleep with your head elevated above your heart. Ice will help with swelling when applied for the first 24-48 hours. Apply ice (use a gel pack or bag of frozen peas wrapped in a light towel) to the outside of your face over the surgical sites for 20 minutes, then remove for 20 minutes. After 2 days, some patients find heat more helpful for discomfort, though you can continue to use ice if you prefer. Do not sleep with heat in place.

Pain

Unfortunately most oral surgery is accompanied by some degree of discomfort; the pain is typically the most bothersome for the first few days after surgery. Over the counter pain medications such as ibuprofen and acetaminophen (provided these are safe for you to take) offer the best pain control after oral surgical procedures. Take your first dose of pain medication before the numbing medication wears off to maximize your comfort.

Your team will review your pain management strategy with you, and will give you a prescription medication if necessary. Take all pain medications with food, and do not exceed recommended doses.

Diet

Under most circumstances, it is best to maintain a soft diet for about one week after dental implant placement, and for 1-3 weeks after a grafting procedure. Avoid crunchy foods for at least one week. This will help prevent trauma to the surgical site.

You should avoid using drinking straws for at least one week after your procedure to optimize healing.

Do not skip meals, especially if you are taking pain medication or antibiotics. Eating regularly will help you feel better and may contribute to better healing. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor; aim to keep your blood sugar well controlled.

Activity

Avoid strenuous activity and exercise for at least 48 hours after you have finished bleeding. Once bleeding has been stopped for 48 hours, you may resume activity as tolerated.

Some exceptions: Swimming should be avoided for at least one week after surgery. Also, it is best to avoid playing a wind or brass instrument for about one week after surgery.

After Sedation

If you were sedated or “put to sleep” for your procedure, drink clear liquids such as water or juice before eating soft foods. Do not drive, drink alcohol, or make important decisions for 24 hours after your procedure. A responsible adult must be present with you for 24 hours after the procedure.

Post-Operative Instructions After Orthognathic Surgery

Our experienced surgeons are here to help you through every phase of Orthognathic Surgery, and patients have shared that understanding the recovery process is extremely helpful.

Please note that the below instructions are general guidelines that apply to most patients. Your surgeon will discuss recovery in detail with you at your consult, before surgery, and before you leave the hospital. Please consult your individualized instructions first.

If you have any questions, please call our office for clarification. Our telephone number is: 262-654-6770.

Wound Care

Keeping your teeth and braces clean is very important to help prevent infection and to improve pain management. Brush your teeth after meals and before bed with small amount of toothpaste. Use the prescription mouth rinse (chlorhexidine) as instructed. This rinse does not replace brushing. A small, extra-soft children’s toothbrush will be easiest to use. Keep your braces shiny! Some patients have difficulty brushing the tongue side of the teeth at first; do your best and know brushing will get easier with time.

Avoid vigorous rinsing and spitting since this can disturb the incisions

If needed apply Vaseline or Aquaphor to your lips (including the corners) to help avoid cracking

If the inside of your lips and cheeks get sore, you may apply orthodontic wax to your surgical posts and braces

If you have incisions outside your mouth, apply a thin layer of Vaseline or Aquaphor to the incisions daily. Keep the incisions clean and dry. You may shower 24 hours after surgery, but avoid direct spray to these incisions and gently pat the incisions dry. Do not put the incisions underwater for 2 weeks.

If you had a chin surgery, wear your chin support for 23 hours a day until follow up. You may remove this to shower or while eating. If the chin support gets dirty you may hand wash and dry with a blow dryer.

Avoid all tobacco products, since these can cause significant healing problems.

If you had upper jaw surgery, do not blow your nose even if you feel stuffy. It is normal to have stuffiness after upper jaw surgery. You may use saline nasal spray as needed for comfort. Sneeze with your mouth open and avoid bending over with your head below your waist. After upper jaw surgery do not put your head fully underwater for 3 weeks.

 

 Pressure/Swelling/Numbness

Unfortunately, the sensation of pressure and a degree of discomfort are expected after this surgery. The medications recommended by your surgeon will help with these sensations.

Swelling is usually the worst the third day after surgery and will then start to decrease slowly. Most patients see a significant improvement in swelling within the first two weeks.

It is normal to feel numb inside your mouth and on parts of your face after jaw surgery. Resume your vitamin B12 when you get home.

You may apply ice packs for comfort. For many patients this helps with the pressure sensation more than pain medications do. Use a gel pack or bag of frozen vegetables wrapped in a light dish towel or use the hands-free ice pack you will be provided. Apply for 20 minutes at a time as needed for discomfort. You may switch to heat after 3 days if this feels better. Use a microwavable heat pack or a heating pad on low for 20 minutes at a time; do not sleep with heat in place.

Sleep on your back with your head elevated above your heart to reduce swelling

 

Bleeding

Blood tinged spit and minor oozing from your incisions is normal at first and will decrease with time

 

Diet

Eating will take longer than usual after jaw surgery, especially in the first week. Follow a non-chew diet. Aim for a high calorie, protein-rich diet – you may blend most foods. Concentrate on high protein, calorie dense foods such as blended bean or meat based soups and smoothies with added protein (nut butters, tofu, protein powder). You may add powdered milk to any food for a protein boost.

Use a cup and spoon for eating initially; avoid straws and other adjuncts like syringes.

 

Activity

Avoid strenuous physical activities and contact sports where your jaw may be bumped or injured. Avoid heavy lifting. Your surgeon will discuss the types of activities you can introduce and the timeline for this.

It is important to walk every day beginning the day you get home from the hospital. When you walk outside be sure another adult is with you.

 

Medications

Your specific medications will be discussed in the hospital. You will typically leave with an antibiotic mouth rinse, and oral antibiotic, and pain medications

 

Elastics (orthodontic rubber bands)

You may remove your elastics for meals and when brushing your teeth. Keep the elastics in place at all other times, even when sleeping. Apply new elastics at least once daily. If one elastic breaks replace all of the elastics with new ones.

You may need help changing your elastics, especially at first. It is OK to have another adult help you with this initially

 

Follow-up

You will typically see your surgeon for follow up around 1 week after surgery.

Your surgical team is available to you 24/7 after surgery; if you have concerns, call us any time!

 

 

Post-Operative Instructions After Skeletal Surgery for Sleep Apnea

Our experienced surgeons are here to help you through every phase of skeletal surgery for sleep apnea, and patients have shared that understanding the recovery process is extremely helpful.

Please note that the below instructions are general guidelines that apply to most patients. Your surgeon will discuss recovery in detail with you at your consult, before surgery, and before you leave the hospital. Please consult your individualized instructions first.

If you have any questions, please call our office for clarification. Our telephone number is: 262-654-6770.

Wound Care

Keeping your teeth and braces or “surgical braces” (arch bars) clean is very important to help prevent infection and to improve pain management. Brush your teeth after meals and before bed with small amount of toothpaste. Use the prescription mouth rinse (chlorhexidine) as instructed. This rinse does not replace brushing. A small, extra-soft children’s toothbrush will be easiest to use. Some patients have difficulty brushing the tongue side of the teeth at first; do your best and know brushing will get easier with time.

Avoid vigorous rinsing and spitting since this can disturb the incisions

If needed apply Vaseline or Aquaphor to your lips (including the corners) to help avoid cracking

If the inside of your lips and cheeks get sore, you may apply orthodontic wax to your surgical posts and braces or surgical braces

If you have incisions outside your mouth, apply a thin layer of Vaseline or Aquaphor to the incisions daily. Keep the incisions clean and dry. You may shower 24 hours after surgery, but avoid direct spray to these incisions and gently pat the incisions dry. Do not put the incisions underwater for 2 weeks, and do not put your head fully underwater for 3 weeks.

If you had a chin surgery, wear your chin support for 23 hours a day until follow up. You may remove this to shower or while eating. If the chin support gets dirty you may hand wash and dry with a blow dryer.

Avoid all tobacco products, since these can cause significant healing problems.

Do not blow your nose even if you feel stuffy; stuffiness is normal after these procedures. You may use saline nasal spray as needed for comfort. Sneeze with your mouth open and avoid bending over with your head below your waist.

 

Sleep Apnea

If you previously used a CPAP device or an oral appliance, do not use these at home. Your breathing is monitored while you sleep in the hospital for safety, and typically the jaw movements made during maxillomandibular advancement result in immediate airway improvement.

Some patients and their bed partners notice a dramatic improvement in breathing immediately, but do not be discouraged if this is not the case for you. As swelling decreases and as you recover from surgery in general, you will begin to notice the improvement in your breathing.

 

Pressure/Swelling/Numbness

Unfortunately, the sensation of pressure and a degree of discomfort are expected after this surgery. The medications recommended by your surgeon will help with these sensations.

Swelling is usually the worst the third day after surgery and will then start to decrease slowly. Most patients see a significant improvement in swelling within the first two weeks.

It is normal to feel numb inside your mouth and on parts of your face after jaw surgery. Resume your vitamin B12 when you get home.

You may apply ice packs for comfort. For many patients this helps with the pressure sensation more than pain medications do. Use a gel pack or bag of frozen vegetables wrapped in a light dish towel or use the hands-free ice pack you will be provided. Apply for 20 minutes at a time as needed for discomfort. You may switch to heat after 3 days if this feels better. Use a microwavable heat pack or a heating pad on low for 20 minutes at a time; do not sleep with heat in place.

Sleep on your back with your head elevated above your heart to reduce swelling

 

Bleeding

Blood tinged spit and minor oozing from your incisions is normal at first and will decrease with time

 

Diet

Eating will take longer than usual after jaw surgery, especially in the first week or two. Follow a non-chew diet. Aim for a high calorie, protein-rich diet – you may blend most foods. Concentrate on high protein, calorie dense foods such as blended bean or meat based soups and smoothies with added protein (nut butters, tofu, protein powder). You may add powdered milk to any food for a protein boost.

Use a cup and spoon for eating initially; avoid straws and other adjuncts like syringes.

 

Activity

Avoid strenuous physical activities and contact sports where your jaw may be bumped or injured. Avoid heavy lifting. Your surgeon will discuss the types of activities you can introduce and the timeline for this.

It is important to walk every day beginning the day you get home from the hospital. When you walk outside be sure another adult is with you.

 

Medications

Your specific medications will be discussed in the hospital. You will typically leave with an antibiotic mouth rinse, and oral antibiotic, and pain medications

 

Elastics (orthodontic rubber bands)

You may remove your elastics for meals and when brushing your teeth. Keep the elastics in place at all other times, even when sleeping. Apply new elastics at least once daily. If one elastic breaks replace all of the elastics with new ones.

You may need help changing your elastics, especially at first. It is OK to have another adult help you with this initially

 

Follow-up

You will typically see your surgeon for follow up around 1 week after surgery.

Your surgical team is available to you 24/7 after surgery; if you have concerns, call us any time!

 

 

“I truly enjoyed my visits and am sorry to see the end. How many oral surgeons have patients who can comment as such?”

Nancy G., Kenosha