Post Operative Instructions




1. Do not eat anything until the numbness is gone from your local anesthesia.

2. You may drink fluids if desired

3. Avoid chewing on the tooth until it is restored by your general dentist.

4. Some soreness may be present in the treated area for several days. This is normal.

5. Take 2-3 Advil, Tylenol, or Aspirin immediately after leaving the office. It may be necessary to take Advil, Tylenol or Aspirin for 24-72 hours after treatment as well.

6. If you are given a narcotic prescription such as hydrocodone, take it only if the over the counter medication is not effective.

7. If antibiotics have been prescribed, take them as directed. Women who are taking birth control pills should use barrier contraception when taking an antibiotic.

8. Return to our office for any necessary completion, check-up, or re-care appointment.

9. RETURN TO YOUR GENERAL DENTIST FOR A CROWN or other restoration 2-10 days after root canal therapy.


SURGERY (Apicoectomy, extraction, bone graft, implant) AFTER CARE:

1. Do not disturb the wound immediately after surgery.

2. Some bleeding noticed in the saliva is normal for 24 hours. Call the office if the bleeding is excessive.

3. Some swelling and bruising is normal. To minimize swelling, apply an ice pack to the outside of the face at intervals of 20 minutes on and 20 minutes off for 3 hours. Discontinue ice and switch to moist heat for 20 minutes on and 20 minutes off for the next 24 hours.

4. Take the pain medication as soon as you get home. For moderate to severe pain, ibuprofen (Advil, Motrin) may be taken in addition to the prescription pain reliever. These come in 200 mg. tablets over the counter. 3 tablets may be taken every 6 hours as needed for pain. For mild pain, the ibuprofen may be taken without the prescription pain medication.

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

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

7. Refrain from smoking until healing is complete. Using tobacco increases the risk of poor healing and implant rejection. Good oral hygiene is also essential to good healing. Brushing is not a problem, but be very gentle around the surgical area.

8. BONE GRAFT: If a bone graft was placed, do not rinse for 5 days. Use a Q-tip to very gently dab the area with Peridex or Perioguard. Do not swish or rinse. Do not drink through a straw.

9. NO BONE GRAFT: If no bone graft was placed, begin using Peridex or Perioguard rinse 3 times a day and warm salt water 5 times a day starting 24 hours after surgery. Continue this for 2 weeks. Do not drink through a straw.

10. Drink plenty of fluids and get adequate rest. Water, milk, clear juice, and non-carbonated sports drinks are recommended. Avoid hot liquids and food, spicy food, and crunchy snacks. Softer foods such as soup, eggs, potatoes, jello, macaroni and cheese, meatloaf, and cooked vegetables are recommended until the stitches are removed.



Botox, Dysport , and Xeomin are all trade names for botulinum neurotoxin A.

Before BOTOX Treatment:

In an ideal situation it is prudent to follow some simple huidelines before treatment that can make all the difference between a fair result or a great result by reducing some possible side effects associated with the injections. We realize this is not always possible; however, minimizing these risks is always desirable.

1. Patient must be in good health with no active skin infections in the areas to be treated.

2. Patient should not be needle phobic.

3. Avoid alcoholic beverages at least 24 hours prior to treatment. Alcohol may thin the blood which will increase the risk of bruising.

4. Avoid anti-inflammatory/blood thinning medications ideally, for a period of two (2) weeks before treatment. Medications and supplements such as aspirin, vitamin E, ginko biloba, St. John’s Wart, ibuprofen (Motrin, Advil), Aleve, Vioxx, and other NSAIDs are all blood thinnning and can increase the risk of bruising/swelling after injections.

5. Schedule Botox appointment at least 2 weeks prior to a special event which may be occurring i.e., wedding, vacation etc. It is not desirable to have a very special event occurring and be bruised from an injection.

BOTOX After Care Instructions


Most patients have no problems after Botox treatments. Overall, it is extremely safe with very high satisfaction! The most common problem is not having realistic expectations. Botox can not always last as long as desired, or improve wrinkles, as much as hoped. Because there is no way to reverse the effects of the Botox, we start out with the smallest number of units on the first visit. Then when we re-evaluate you 2 weeks later, we can enhance the result by adding extra units. This way we can determine the minimum effective dose for you. We charge by the unit.

General care after Botox:

Most patients need to do absolutely nothing. Strenuous workouts are not recommended on the day of your treatment, but can be resumed the next day. Light activity and walks can be done immediately. Patients do not need to do facial exercises to facial muscles. These have been shown to be unnecessary.

1. Ice application to the area – 20 minutes on and then 20 minutes off three times a day. Extra ice application is fine if desired.

2. Headache – Tylenol or Motrin as needed.

3. Welts, redness, or itching – Benadryl over the counter as needed.

4. Avoid strenuous exercise on the day of the procedure.

5. Understand realistic results and how long Botox lasts in general. Additional treatments or touch-ups can require more Botox. Please see above overview.

 Potential Side Effects after Botox:

1. Do not rub or massage the area of injection, especially over the eyes. This may result in diffusion of the toxin to adjacent muscles.

2. Bruising – Recovering from Botox is extremely easy. Most people have minimal to no bruising and can resume normal activities right away. Rarely, someone gets unlucky and gets more significant bruising. Although disappointing, it is important to understand it will not affect the Botox from working. It just takes time for the bruising to go away. Makeup can be used to hide the bruising following Botox.

3. Headache – Headache also can happen after Botox. This is usually minimal and goes away quickly. Dr. Germain recommends Tylenol or Motrin for headache pain.

4. Redness, Welts, and Itching – Minor redness or welts can occur after a treatment. Sometimes itching as well. This is normal and you should not worry. Benadryl is recommended for these symptoms. Please call if they do not quickly improve over a day or two.

5. Drooping of Eyelids or Eyebrows – Drooping of eyelids or eyebrows is very uncommon and most people do not get this. If you do, do not worry and please call the office for an appointment with Dr. Germain. Some patients might feel their eyebrows are too low even after Botox. In this case, cosmetic eyelid lift or cosmetic blepharoplasty might be something that helps with the aesthetic appearance and your rejuvenation. Within a short period of time, drooping of the eyelids or forehead tends to resolve. In unusual cases, Dr. Germain might prescribe an eye drop to help with this. Again, Botox is extremely safe. This type of problem is very rare.

6. Results – Remember: “realistic” expectations after Botox or any cosmetic procedure is extremely important! This means patients can be disappointed that the Botox didn’t do enough. Botox is a chemical that works to “diminish” facial lines by relaxing facial muscles. It does take several days to reach its maximal potency. This means that the best results take 2-10 days to appear. People often want to “get rid of” all their wrinkles. Botox frequently just “diminishes” wrinkles. “Getting rid of” all wrinkles often doesn’t happen. Also, the Botox might not last as long as desired. This is something that happens. Botox usually lasts 2-4 months, and we want it to last a long time. However, if it goes away too quickly, you just need more Botox. Some people metabolize Botox more quickly than others and need treatments more frequently. Men often have larger muscles and need bigger doses and more frequent treatments. Additional Botox treatments do have additional expense.




Before Dermal Filler Treatment:

A few simple guidelines can make the difference between a good result and a fantastic result.

1. Patient should be in good overall health. A full medical and dental history must be performed on all patients for optimal results.

2. If you develop a cold sore, blemish, or rash, etc. prior to your appointment you must reschedule.

3. If you have a special event or vacation coming up, schedule your treatment at least 2 weeks in advance.

4. Let us know if you are prone to cold sores-a pre-operative prescription for an anti-viral medication (Valtrex) may help prevent cold sores after treatment.

5. No aspirin, ibuprofen (Advil, Motrin), ginko biloba, garlic, flax oil, cod liver oil, vitamin A, vitamin E, or any essential fatty acids at least 3 days to 1 week before and after treatment.

6. Discontinue Retin-A two days before and two days after treatment.

7. Avoid alcohol, caffeine, Niacin supplement, high sodium foods, high sugar foods, refined carbohydrates, and cigarettes 24-48 hours before and after your treatment.



After Care for Dermal Fillers:

1. Do not touch, press, rub, or manipulate the injected areas for the rest of the day after treatment and for 2 days following. Avoid kissing, puckering, and sucking movements (ie., do not drink from a straw or a water bottle) as these movements can displace the filler and distort the result.

2. Avoid aspirin, ibuprofen (Advil, Motrin), gingko biloba, garlic, flax oil, cod liver oil, Vitamin A, Vitamin E or other essential fatty acids at least 2 days after treatment.

3. Avoid alcohol, caffeine, niacin supplement, high-sodium foods, high sugar foods, refined carbohydrates, spicy foods, and cigarettes 24-48 hours after treatment.

4. Avoid vigorous exercise and sun and heat exposure for 3 days after treatment.

5. Discontinue use of Retin-A for 3 days after treatment. It is best to wear no makeup or lipstick until the next day. Earlier use can result in infection and scarring

6. One side may heal faster than the other side. This is normal

7. You can expect some bruising and swelling around the areas that were injected. Gently apply ice for the first hour after treatment for ten minutes on and ten minutes off do not push hard as it may move the material.

8. Don’t love it or hate it for 2 weeks. Enhancement visits are usually necessary and can be done 2 weeks after treatment.