FRENULOPLASTY PRE-OPERATIVE FAQ'S

Terence Q.L. Young, D.D.S. Airway-Focused Dental Care

3660 Waialae Avenue, Suite 212 Honolulu, HI 96814

FX 808.945.2210 PH 808.945.9977

admin@terenceyoungdds.com airwayfocuseddentalcare.com

Your active participation is important to the post-operative success of your treatment. The following frequently asked questions (FAQ's) will help you know what to expect in the days following surgery, and will help to optimize a successful surgical outcome. Do not, however, hesitate to call if you have any questions or concerns.

Q: CAN YOU DESCRIBE THE TREATMENT FOR A PATIENT THAT IS TONGUE TIED? DOES IT HURT?: A frenuloplasty is a straightforward outpatient procedure that can be completed in office without the need for general anesthesia. If a release is recommended, the treatment takes 60-90 minutes. Dr. Fong will apply an effective topical anesthetic gel on the frenular tissue underneath the tongue prior to treatment, followed by an injection of lidocaine, allowing for zero to minimal discomfort during the procedure. The anesthetic wears off approximately 30-45 minutes after the procedure is completed. For the first several days (occasionally up to five (5) days) following surgery, pain is to be expected. This is typically controlled with over- the-counter (OTC) medication such as Acetaminophen or Ibuprofen. We recommend having enough LIQUID pain reliever on hand for approximately one (1) week, taking dosages as prescribed on packaging.

Q: ARE THERE ANY PRE-OPERATIVE INSTRUCTIONS?: We encourage you to eat a full meal prior to your procedure. We also encourage getting a good night's sleep the night before. Please refrain from consuming caffeine prior to the procedure. HOWEVER, if you are receiving Nitrous Oxide, eat a light meal no less than two (2) hours prior to appointment time. Remember to take your preferred pain reliever one (1) hour before your scheduled procedure.

Q: WHAT HAPPENS AFTER THE PROCEDURE?: It is normal to experience some swelling and inflammation in the first 2-7 days after surgery. We recommend using LIQUID Acetaminophen and Ibuprofen as needed for pain and as directed on packaging. Staying ahead of discomfort with pain reliever will make first few days more comfortable. During the first few days, we recommend a liquid diet such as protein shakes, smoothies, jello, pudding, yogurt, apple sauce, broth, ice cream, etc. After post op follow-up appointment, you may eat soft, cool foods; avoid hot or spicy foods or that require a lot of chewing.

Q: ARE ANTIBIOTICS ADMINISTERED?:

No, antibiotics are not administered. We recommend rinsing with salt water and/or alcohol-free mouthwash several times a day to keep the wound clean and reduce the risk of infection. Staying ahead of discomfort with pain reliever will make first few days more comfortable.

Q: WHAT ARE THE POSSIBLE RISKS?:

Complications of surgery are rare, but may include numbness, bleeding, pain, failure of procedure, infection, injury to adjacent structures, and scarring. It is crucial to follow the post-operative instructions to prevent scarring or re-attachment of the frenum. Pre and post-operative myofunctional therapy is essential for optimal recovery after frenuloplasty.

Q: WHAT IS THE PROPER WAY TO ACTIVELY MANAGE THE WOUND POST-PROCEDURE? WHAT CAN I EXPECT TO SEE AFTER THE PROCEDURE?:

We use absorbable sutures that will usually fall off or dissolve on their own within 3-5 days and sometimes anywhere from 1- 30 days after surgery. Within a few days after surgery, a white diamond-shaped area may appear where the frenum was. This is normal and not an infection, rather, it is granulation healing tissue that will heal and disappear in approximately two weeks.

After surgery: Patients should expect some mild swelling, pain, and/or discomfort as a normal process of wound healing. Some patients describe the discomfort as a stinging sensation. Pain is often controlled with over-the-counter pain medications, and other symptoms usually self-resolve over the course of 1-2 weeks with proper rest and myofunctional therapy. Possible (but very rare) complications of frenuloplasty may include bleeding, pain, numbness, failure of procedure, scarring, and injury to adjacent structures which may result in salivary gland dysfunction.

1. Bleeding: It is normal to experience some bleeding during the first 1-2 days. If steady bleeding occurs, place gauze under the tongue and hold pressure until bleeding stops, call Dr. Fong or Dr. Young, or go to your local emergency department. 2. Swelling and Inflammation: It is normal and expected to experience some swelling and inflammation in the first 2-7 days after surgery. Your tongue may feel larger than usual and more painful to move-this is normal. We recommend using LIQUID Acetaminophen and Ibuprofen as needed for pain. Some patients research holistic approaches which you may find helpful. 3. Wound Care: Gently, very gently, swish with mildly warm salt water. You may find this helpful to repeat multiple times throughout day. 4. Oral Hygiene: Continue brushing teeth as usual with brush provided in your take home care kit. We recommend gently rinsing with salt water and/or alcohol-free mouthwash several times a day to keep the wound clean and reduce the risk of infection.

9. Myofunctional Therapy Exercises: We recommend that you rest until your next scheduled follow-up / myofunctional therapy appointment. Avoid looking under your tongue until you have been cleared by your Myofunctional Therapist. It is extremely important to perform the stretches and exercises as prescribed by your therapist to obtain he most optimal results and to prevent tissue for re- attaching. At any time, call our practice if you experience any of the following:

Severe pain that does not improve with medication Brisk bleeding Severe swelling at the site of surgery Difficulty breathing Fever higher than 102 degrees (~39 0 C)

For emergencies, please call 911 or proceed to your local emergency department and call or text Dr. Young directly at 808-358-0725 OR Dr. Lyndon Fong at 808-258-6856.

5. Food/Drink: During the first few days, we recommend a liquid diet such as protein shakes, smoothies, jello, pudding, yogurt, apple sauce, broth, ice cream, etc. After post op follow-up appointment, you may eat soft, cool food; avoid hot or spicy foods or foods that require a lot of chewing.

6. Sutures: We use absorbable sutures that will usually fall off or dissolve on their own anywhere from 1-30 days after surgery. Within a few days after surgery, granulation healing tissue will fill the open wound.

7. No sports for 10 (ten) days. 8. For patients in any oral appliances, discontinue wearing until first post-op follow-up appointment.