Patient Information

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Please call us at 416-789-5335 with any questions or to schedule an appointment. Or request an appointment online:

What is an Oral and Maxillofacial Surgeon?

Oral and maxillofacial surgeons (OMFS) are uniquely trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. OMFS are dental specialists who are surgically trained in hospital-based residency programs and work with medical residents in numerous different medical specialities to gain comprehensive knowledge. To make procedures more comfortable for patients, various methods of sedation are available to patients, including local anaesthesia, intravenous conscious sedation, and general anaesthesia in the office setting. OMFS treat problems such as the extraction of wisdom teeth, benign tumors and cysts of the jaw and mouth, and to perform bone grafting and dental implant surgery. Oral and maxillofacial surgery is a surgical specialty and is one of nine dental specialties recognized by the Royal College of Dentists of Canada.

Training and Scope of Practice

Typical training for an oral and maxillofacial surgeon includes:

  • Two to four years of undergraduate study
  • Four years of dental study (DDS or DMD).
  • Four years of residency training
  • Additional fellowship training

After completion of surgical training, surgeons must undertake final specialty examinations, and are conferred Fellowship in the Royal College of Dentists of Canada. Oral and maxillofacial surgeons will have the designation “FRCD(C)” to indicate that their status as specialists.

Dr. Freilich’s expertise and focus is in the following areas:

  • Management of diseases and pathology associated with the teeth, jawbones and supporting soft tissues
  • Bone grafting/jaw reconstruction
  • Dental implant surgery (simple and complex)
  • Full-arch implant rehabilitation
  • Patient-Specific Jaw Implants for severe bone deficiency
  • Surgical rehabilitation of patients with acquired, developmental or congenital dentofacial deformities, including the following: Cleft Lip and Palate, Ectodermal Dysplasia, Oligodontia, Down Syndrome, Cerebral Palsy, Gorlin Syndrome, Cleidocranial Dysplasia, Amelogenesis Imperfecta, Dentinogenesis Imperfecta, and others.
  • Removal of impacted teeth, including wisdom teeth
  • Paediatric oral and maxillofacial surgery
  • Provision of deep sedation and general anesthesia
  • Removal and surgical exposure of teeth as required for orthodontic treatment
  • Non-surgical management of temporomandibular joint disorders
  • Oral medicine and orofacial pain management

You do NOT require a referral from either a physician or dentist to be seen by Dr. Freilich

Our staff is trained in assisting with Intravenous (IV) sedation or outpatient general anesthesia in our office setting. Patients are continuously monitored during and after surgery.

Our Surgical Staff includes experienced Registered Nurses (RNs), who assist in the administration of intravenous sedation and anesthesia, as well as in your supervision throughout your post-anesthetic recovery in our office, as well as specialized physician anesthesiologists. Our surgeons and nursing staff are trained in Advanced Cardiac Life Support (ACLS) and Paediatric Advanced Life Support (PALS). Patients are continuously monitored during and after surgery. We strictly adhere to the Guidelines for the Use of Sedation and General Anesthesia in Dental Practice established by the Royal College of Dental Surgeons of Ontario.

Our experienced Surgical Assistants assist our Surgeons throughout your procedure. A treatment coordinator will ensure a smooth transition from your consultation to the front desk staff. Your office administrative needs are cared for by our front desk team, which includes our office manager and receptionist.

New Patients

We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day.

  • We do NOT require a referral for you to see Dr. Freilich.
  • If you do have a referral and/or radiograph (x-ray) from a dentist, it will expedite your appointment if these are forwarded to our office in advance, or if you bring with them with you to our office.
  • If you are taking blood thinning medications (Coumadin, Warfarin, Plavix, Aggrenox, Aspirin) please advise our receptionist when you are making your appointment, so that any necessary bloodwork can be arranged before your visit with us.
  • We try our best to stay on schedule to minimize your waiting. Due to the fact Dr. Freilich provides many types of surgical services, various circumstances may lengthen the time allocated for a procedure.
  • We make every effort to accommodate the provision of emergency oral surgical care, which can sometimes arise and cause delays.
  • We appreciate your understanding and patience.

Please call us at Dr. Marshall Freilich Phone Number 416-789-5335 with any questions or to schedule an appointment.

You do NOT require a referral to schedule an appointment with Dr. Freilich.

First Visit

Welcome to our office! We look forward to meeting with you to find out how we can be of help. You do not require a referral by a dentist or physician to schedule an appointment to meet with Dr. Freilich.

At your initial appointment, you will have a consultation with Dr. Freilich, where your medical history will be thoroughly reviewed, and a clinical examination is performed. A radiograph (x-ray) may need to be taken as well. Dr. Freilich will then provide you with recommendations for a treatment plan that is safe, comfortable and predictable. Occasionally, minor surgical procedures can be performed the same day as the consultation. In most cases, particularly for patients with complex medical histories or who require larger surgical procedures or general anesthesia, a pre-surgical evaluation is required before surgery can be scheduled. In some cases a hospital booking may be required, and this is usually determined at the initial consultation.

If you are taking Coumadin (Warfarin), any other blood thinning medications, or prednisone, please advise our office before your appointment. You may require an INR blood test, or other medical tests or modification arranged by your family doctor, before your surgical procedure can be completed.

Please assist us by providing the following information at the time of your consultation:

  • If you are being referred by a dentist or physician, please bring your referral note and any x-rays if applicable.
  • A list of ALL medications (including over-the-counter medications, vitamins and supplements) you are presently taking.
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, etc.), if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc.), or if you require prophylactic antibiotic coverage for dental procedures.

X-Rays

If your dentist or physician has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional x-rays are necessary, our surgeons and staff will discuss this with you at your consultation.

Patient Instructions

Before Intravenous Sedation or General Anesthesia

  • PLEASE CHECK WITH OUR OFFICE REGARDING OUR CURRENT REQUIREMENTS FOR COVID-19 TESTING PRIOR TO YOUR SURGERY
  • You may not have anything to eat or drink (including water) for eight (8) hours prior to your appointment.
  • No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
  • A responsible adult must accompany the patient to the office, remain in the office during the procedure, drive the patient home, and stay with the patient at home.
  • A responsible adult must be with you to take you home by car or by taxi. Please ensure that this person will be available to attend to you at home after your surgery. You must not travel by T.T.C.
  • The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
  • Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
  • Contact lenses and dentures must be removed at the time of surgery.
  • If you have a nose piercing – this must be removed prior to surgery, as in many cases a nasal breathing tube will be placed after you are asleep. The piercing can be placed again following surgery.
  • Any piercings inside of your mouth must be removed prior to surgery. Ear and facial piercings (other than nose piercings) do not require removal.
  • Do not wear lipstick, excessive makeup, jewelry or nail polish on the day of surgery.
  • If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
  • If you take routine oral medications, please check with your doctor prior to your surgical date for instructions.
Following oral surgery for placement of dental implants, do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There can be a metal healing abutment protruding through the gingival (gum) tissue.

Pain

You should begin taking pain medication within an hour of arriving home. For moderate pain: 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 4-6 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. You should not take Ibuprofen if you are on any blood thinners. For severe pain: the prescribed medication should be taken as directed. Do Not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad or moist tea bag placed directly on the bleeding wound for 30 minutes. If uninterrupted bleeding continues please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or towel filled with ice on the cheek in the area of surgery. Apply the ice 20 minutes on, 20 minutes off while you are awake for the first 48 hours.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed. Avoid hard crunchy foods such as nuts, chips, candy, popcorn for one month.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection.

Oral Hygiene

Good oral hygiene is essential to good healing. The day after surgery, if you were prescribed Peridex (a.k.a. Chlorhexadine) it should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 14 days. This was discussed in the pre-operative consultation. Follow the advice of your doctor.
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Pain

For moderate pain: one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours. For severe pain: take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the bodys normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be used 20 minutes on, 20 minutes off while you are awake. After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Forty-eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the day after surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction such as diarrhea, nausea and/or vomiting. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on apple juice, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking foods such as bananas, toast, applesauce and rice, and the prescribed medicine.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Freilich if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by your doctor.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time. Heat applied to the area will help to relax the muscles.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures are dissolvable and will disintegrate over the next week. If sutures do not self-dissolve, they will be removed approximately two weeks after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So its really nothing to worry about. The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions. You have been provided with a plastic syringe which you can use about five days after surgery – for the LOWER sockets only. Gravity and chewing tend to pack food into the sockets and the curved tip of the syringe is designed to flush out these areas. Use warm salt water or dilute mouthwash in the syringe. Flush each socket 2 – 3 times after each meal and this should be continued for three or four weeks until the socket gradually fills in and no longer traps food. This can prevent a post-operative infection. Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: our doctor or your family dentist. Brushing your teeth is okay – just be gentle at the surgical sites. A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

After oral surgery for exposure of an impacted tooth, do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out do not get alarmed.

Pain

You should begin taking pain medication within one hour of arriving home.

For moderate pain: 1 or 2 Tylenol or Extra Strength. Tylenol may be taken every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. Ibuprofen should not be taken if you are on blood thinners.

For severe pain: the prescribed medication should be taken as directed.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad or moist tea bag placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag filled with ice cubes on the cheek in the area of surgery. Apply the ice continuously as much as possible for the first 48 hours.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

Bleeding

After tooth extraction, its important for a blood clot to form to stop the bleeding and begin the healing process. Thats why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, drink alcohol or brush teeth next to the extraction site for 24 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site. Avoid smoking as long as possible – it delays healing and may cause complications.

Pain

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesnt seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone.

Diet

Drink lots of fluid and eat nutritious soft food on the day of the extraction. Avoid foods/drinks that are hot in temperature for 24 hours. You can eat normally as soon as you are comfortable.

Oral Hygiene

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

Activities

After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately at 416-789-5335.

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.

  • Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 48 hours only. Apply ice 20 minutes on/20 minutes off while you are awake.
  • For mild discomfort use aspirin, Tylenol or any similar medication; two tablets every 3-4 hours. Take prescribed pain medication as suggested.
  • For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
  • Drink plenty of fluids. Drink at least six glasses of liquid the first day.
  • Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.
  • Restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.

The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

  • The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm compress will help eliminate the discoloration quicker. The compress should be applied 20 minutes on/20 minutes off as needed.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.

The first night after your surgery it is important that you NOT remove the denture(s) for any reason. Should you do so the gums could swell and you may not get the denture back in for several days. Your dentist or denture therapist should see you within 24 to 48 hours after surgery to remove your denture, show you how to rinse your mouth, and check the initial fit of the teeth. 24 to 48 hours after surgery you can remove the denture(s) for cleaning your mouth, and a mouth rinse of lukewarm water with a teaspoon of salt in it is recommended. If you feel the teeth are loose when you replace them in your mouth, use a denture adhesive to help hold them in.

After Socket Bone Grafting

The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant placement of the extracted tooth.

Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. Its normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:

  • Do not disturb or touch the wound.
  • Avoid rinsing or spitting for 24 hours to allow blood clot and graft material stabilization.
  • Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
  • Do not smoke.

Food/Nourishment

Nothing too hot for the first 24 hours. Drink plenty of fluids such as ginger ale, fruit juices, cooled soups. Eat soft foods such as apple sauce, pudding, yogurt, eggs, pasta, porridge/cream of wheat, mashed potatoes. It is very important to maintain a soft, non-chewing diet for 2 weeks after surgery. Do not drink through a straw for the first 2 days after surgery – it prolongs bleeding.

Following the second day, gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules. If a partial denture or a flipper was placed in your mouth, you may have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.

If you have any questions or concerns, or in case of emergency, do not hesitate to contact our office at 416-789-5335.

The following information applies when upper jaw bone height or width have been lost. The graft is placed to help restore your jawbone in preparation for possible implant replacement of the missing tooth or teeth.

You have had a Sinus Lift Augmentation procedure in your upper jaw. This procedure regains lost bone height in the area of your first and second molar and occasionally second premolar. It is an important procedure as it allows implant placement in an area that could not be implanted otherwise because of insufficient bone height due to an enlarged sinus.

The bone that has been grafted is most commonly a combination freeze-dried bone, artificial synthetic bone and your own bone. Because of this you may have two post-surgical wounds: the donor site and the recipient site.

DO NOT UNDER ANY CIRCUMSTANCES BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS. This may be longer if indicated. You may sniff all you like but NO BLOWING.

  • Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open.
  • Do not drink with straws and do not spit.
  • Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided.
  • Decongestants such as Drixoral, Dimetapp, or Sudafed will help reduce pressure in the sinuses.
  • You may also be given a prescription for antibiotics. Please take these as directed.
  • Anything that causes pressure in your nasal cavity must be avoided.
  • Avoid bearing down as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure.
  • Smoking must be stopped. If necessary your doctor can prescribe Nicoderm patches.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection

Oral Hygiene

Do not rinse or spit on the day of your surgery. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. You should not have a significant amount of blood in your mouth. Saliva can be swallowed, even if slightly blood tinged.

Keeping your mouth clean after surgery is essential to reduce the risk of infection. Start salt water rinses the day following your procedure. Use one-half teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least four to five times daily and always after eating for the next five days.

Do not brush the teeth in the area of surgery for 24 hours. When brushing, be very gentle. When expectorating, also be gentle.

We may prescribe an antibacterial rinse (Chlorhexadine, Peridex) for certain procedures. This rinse should be used the following day in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse for 30 minutes. Using this rinse more than two times a day will cause staining of your teeth.

Smoking

Do not smoke for at least two weeks after surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of bone graft and sinus augmentation failure.

Wearing your Prosthesis or Nightguards

Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary flipper to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or our office can see you.

Post-Operative Problems or Complications

As with any procedure, unexpected post-operative healing can occur.

  • If you notice the unexpected flow of air or liquids between your mouth and nose, please let us know immediately.
  • If you are aware of several small particles of graft material being discharged from your nose, let us know as well.
  • If you experience sinus or nasal congestion on the side your surgery was performed, let us know.
  • If there is an increase in swelling in your mouth, cheek or under your eye after 3 days, let us know.

If you have any questions or concerns, or in case of emergency,do not hesitate to contact our office at 416-789-5335.

Financial and Insurance Info

For your convenience, we accept Visa, MasterCard and Interac Debit. We strive to deliver the highest quality of care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance.

While we do not accept direct payment from third party insurance companies, our administrative staff is happy to assist in providing you with any necessary forms for you to be reimbursed by your insurance providers. We work closely with the Ministry of Health Cleft Palate/Craniofacial funding program, and are able to accommodate patients who require treatment and are registered through either The Hospital for Sick Children or Holland Bloorview Kids Rehabilitation Hospital. Pre-treatment estimates can be submitted prior to surgery, to allow you to determine the extent of coverage that you will receive from your insurance provider.

If you have questions regarding your financial arrangements, please feel free to contact us at 416 789-5335.