Patient Information

Our surgery and recovery areas feature negative pressure airflow for robust air exchange, while a bipolar ionization system helps purify all circulating air— to protect patients from airborne pathogens.”

We would be honored to meet your oral surgery needs. No referral from a dentist or physician is necessary. Office hours are by appointment, Monday through Friday. Every effort is made to see emergencies immediately. We pride ourselves in seeing you at your appointed time. Dr. Florine is available for after-hours emergencies, and questions are encouraged at any phase of your treatment.

Our office staff is committed to making your visit as comfortable and stress-free as possible.  We are proud of our commitment to excellence and we welcome you to our practice!

A complete medical history is necessary for every patient of record. Please bring all pertinent medical information to your appointment. Any insurance information is also necessary. Call our office at (651) 688-8592 if you have any questions.

If you are to be sedated (“going to sleep”) for your procedure:

1. NOTHING TO EAT OR DRINK (INCLUDING WATER), COFFEE, SODA FOR AT LEAST 6 HOURS PRIOR TO YOUR APPOINTMENT TIME.
2. A RESPONSIBLE ADULT MUST BE WITH YOU TO DRIVE YOU HOME.
3. The day before surgery please hydrate well.
4. Please wear short sleeves and remove nail polish.
5. Do not wear contact lenses (or bring your lens case.)
6. Regular prescriptions may be taken with a small amount of water.
7. Bring your ID, insurance card and referral slip to your appointment.

• If covered by insurance, please call us with insurance information beforehand.
• If you are certain you will only want local anesthesia (“novocaine”) for your procedure, you may eat and drink as usual.

A panoramic radiograph that shows your full jaw is usually necessary for oral surgery. If your dentist has taken x-rays in the past six to twelve months they may be adequate, but we often need additional films to properly evaluate you and provide care. Digital x-rays taken at Oral Surgery Care expose you to 80% less radiation than conventional radiographs. Digital radiography also eliminates the environmentally hazardous waste products produced by conventional radiograph processing.

If you want to be asleep for your procedure, you must have nothing to eat or drink (not even water) for at least six hours beforehand, and you should not be wearing nail polish. A responsible adult must be with you to drive you home. Please wear short sleeves so that a blood pressure can be taken, and bring a case if you wear contacts. A parent or guardian must accompany children under 18 even if local anesthesia is planned.

1. If you were SEDATED, do not operate any vehicle or hazardous device, or do any activity that requires alertness, until the day after surgery. Women taking BIRTH-CONTROL PILLS: Any drugs administered or taken (antibiotics, anesthetics, pain medications, etc.) may decrease the effectiveness of birth-control pills. As a precaution, additional means of birth control are recommended for the remainder of your current menstrual cycle. Take care to DISTURB THE WOUND/S AS LITTLE AS POSSIBLE with food, and chew on the other side if possible.
2. EXPECT TO BE UNCOMFORTABLE for the next few days. We do everything possible to help you manage the pain; recognizing that not all pain relief comes from a pill. Ice (20 minutes on, 20 minutes off) can be helpful. Quiet relaxation and meditation are effective for pain management. Expectation of success is a powerful pain management tool and studies show that a strong expectation of successful pain relief (being very determined that you will successfully manage your pain), causes the brain to release pain-relieving chemicals into your bloodstream. The most effective pills for postsurgical dental pain are usually ibuprofen and Tylenol (acetaminophen), taken together, unless you are allergic to or have been told not to take these medications. Start before the local anesthetic (“Novocain”) wears off, to keep ahead of the pain.  We recommend staggering; with 2 ibuprofen (400mg) taken first, followed in 2 hours with Tylenol (either one 325mg regular strength or one 500mg extra strength), followed in 2 hours with two more ibuprofen; then Tylenol in two hours, etc. Continue by the clock on the day of surgery and the following day, up to and including bedtime; then as needed. In this way ibuprofen and Tylenol are each taken at 4-hour intervals, with only 2 hours between a dose of one or the other. Aleve (naproxen), taken as directed on the bottle, may be substituted for ibuprofen. Prescription pain medication is available, but usually not needed. Call if the pain is unrelenting or not improving.
3. If you are sent home with GAUZE PACKS over the surgical areas, bite down firmly but gently on them. Do not change them for the first hour unless the bleeding is not controlled. If active bleeding persists, place enough new gauze to obtain pressure directly over the surgical site for another hour; change as necessary. If bleeding persists, repeat the process.  The bleeding should be slowing down on the night of surgery, but it is not unusual to have a small amount of blood on your pillow the following morning or the taste of blood in your saliva on occasion for a few days.
4. PERSISTENT BLEEDING: Bleeding should never be severe. If it is, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs to put pressure directly on the wound. If bleeding persists you may try one or more tea bags (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 20-30 minutes. If bleeding remains uncontrolled, please call our office.
5. DIET is regulated by the comfort of chewing. Liquids should always be taken freely, but do not suck through a straw for the first 24 hours.  If you have a malt, use a spoon. Begin drinking and/or eating as soon as you feel comfortable doing so.  Start slowly on the day of surgery with liquids and soft foods, and slowly work yourself up to a normal diet as you feel comfortable.  There is less chance of nausea from pain medication if you have something in your stomach first.  SMOKING increases the risk of healing complications and should be avoided for at least one week following surgery. STRENUOUS ACTIVITY should be avoided post-surgically for the first 24 hours.  Activity may be slowly increased, as you feel comfortable doing so.
6. Unless you are told otherwise, any STITCHES (sutures) placed will dissolve and do not need to be removed. Avoid RINSING OR SPITTING on the day of surgery, but if necessary do so very gently. If you were given a prescription for an antibacterial mouth rinse, rinse gently for the first time before going to bed on the night of surgery, then three times a day for 10 days.  Excessive rinsing or spitting may cause continued bleeding and oozing.
7. If you feel HARD OR SHARP EDGES in a surgical area, you are probably feeling the bony walls which once supported an extracted tooth. Small slivers of bone will sometimes work themselves out in the days or weeks following surgery. If they cause concern or discomfort, please call our office.
8. CHILDREN, especially those who have not previously had local anesthetic (“Novocain”) should be watched so that they do not bite or chew on their lip while it is numb.
9. The following are considered normal:
10. Slight and/or intermittent oozing of blood for several hours or overnight.
11. Swelling which follows surgery within the first 24-48 hours. The swelling usually doesn’t peak until 24-48 hours after surgery and can last for a week or more, but should not increase after the first 48 hours.
12. Moderate discomfort that can be controlled by taking ibuprofen and Tylenol, or the prescribed pain medication.
13. Bruising of skin on the face on the side of surgery.
14. A slightly elevated temperature within the first 24 hours.
15. Mild nausea that clears within a few hours.

Contact our office (651-688-8592) for any of the following: 

1. Profuse bleeding that cannot be controlled with firm biting pressure on a gauze dressing placed directly on the surgical site.
2. Severe pain that does not begin to improve within 2-3 days following surgery and cannot be controlled with pain medications.
3. Swelling which continues to increase after the first 48 hours following surgery.
4. A markedly elevated temperature.
5. Firmness, swelling or tenderness at the site of the intravenous needle.
6. Numbness in your lip or chin that remains for more than one day.
7. Anything else that does not seem right or concerns you.

For emergencies, the office number (651-688-8592) is answered 24 hours a day with instructions for contacting Dr. Florine.

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You can expect to be uncomfortable for the next few days, but we will do everything possible to help you manage your pain, and to manage it safely. Keep in mind that not all pain relief comes from a pill. Application of ice (20 minutes on, 20 minutes off) can be helpful. Quiet relaxation and meditation are effective for pain management, and many online resources describe the basics of these techniques. Expectation of success is also a powerful pain management tool. Studies show that a strong expectation of successful pain relief and being very determined that you will successfully manage your pain, causes the brain to release pain-relieving chemicals into your bloodstream.

The most effective and safest pills to take for postsurgical dental pain are usually Advil (ibuprofen) and Tylenol (acetaminophen), taken together, if you are not allergic to or have not been told to avoid these over-the-counter medications. We recommend staggering them; with 2 over-the-counter Advil (400mg) taken first, followed 2 hours later with Tylenol (either one 325mg regular strength or one 500mg extra strength), followed 2 hours later with two more Advil; then Tylenol again two hours later, etc. Continue by the clock on the day of surgery and the following day, up to and including bedtime; then as needed. In this way Advil and Tylenol are each taken at 4-hour intervals, but there are only 2 hours between a dose of one or the other. Aleve (naproxen), taken as directed on the bottle, may be substituted for Advil.

Double-blind studies routinely show that nonsteroidal anti-inflammatory drugs, such as Advil and Aleve, taken along with Tylenol, are as good or better than opioid pain medications such as Vicodin, at controlling postsurgical dental pain. Vicodin and other opioids also come with
common side effects of nausea, vomiting, dizziness, drowsiness, and constipation. We are especially concerned about the risk of opioid abuse and addiction in the adolescent and young adult population. Their still-developing brains are especially vulnerable to permanent changes in brain chemistry that opioids can cause, which prime the brain for future substance misuse and addiction. Recent data showed a 33% higher incidence of misusing opioid pain pills during the college-age years for children who took legitimately prescribed opioid pain pills before finishing high school.

If we gave you a “just in case” prescription for another pain medication, we suggest that you not have it filled unless you find you actually need it. Most do very well with the Advil and Tylenol schedule described above. The optional prescriptions are not always covered by insurance, so you risk incurring an unnecessary expense if you fill one but don’t use it. (If you fill a flurbiprofen prescription, it should be taken instead of Advil or Aleve, while continuing with Tylenol. If you fill a Journavx prescription, you may take Journavx along with Advil (ibuprofen) but consider stopping Tylenol, since both Tylenol and Journavx are metabolized by the liver.)

If you are experiencing significant pain that does not seem to be improving despite the above recommendations, call us so we can look for other ways to help.

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Prescription Opioids in Adolescence

Opioids After Wisdom Teeth Extraction

PRESCRIPTION OPIOID PAIN MEDICATION

Not everyone responds well to or is able to tolerate the over-the-counter (OTC) nonsteroidal anti-inflammatory pain medications, such as ibuprofen (Advil) or Aleve. If pain is severe and unremitting while using Advil or Aleve, along with Tylenol, ice, and relaxation, a prescription pain medication may be helpful. Before considering an opioid (narcotic) pain medication, it is very important for you to read and understand the following information:

Side effects of opioid pain medications:

• Potential for misuse and addiction
• Slowing or stopping your breathing
• Dizziness and light-headedness
• Faintness or sleepiness
• Nausea or vomiting
• Constipation

Opioid medications are addictive. Usually, patients do not become addicted to opioids if used as prescribed and taken for a short period of time. However, people respond to medications in different ways, and on rare occasion abuse and addiction are triggered by a single legitimate prescription. It is important to understand the very real risk of addiction.

If you take an opioid prescription medication that contains Tylenol: Do not take any other Tylenol or Tylenol- containing medication, but continue to take 400mg of ibuprofen—Advil—every four hours.

You must not drink alcohol with an opioid pain medication. This can slow down your breathing, or stop it altogether.

Do not drive when taking an opioid medication. If you are driving and are stopped while taking a prescription opioid pain medication, you may be charged with a DUI.

Do not run machinery or other heavy equipment when taking an opioid medication. You may have difficulty thinking clearly, or you may not be able to respond quickly when taking an opioid medication, which could place you or others around you, in danger.

Store opioid medications in a locked cabinet, drawer or lockbox. Because of their potential for addiction and misuse, opioids should be kept away from anyone not prescribed and should not be shared with anyone.

Dispose of opioid medications properly if you have any leftover tablets. For disposal information, one source is www.dakotacountysheriff.org, in the “Services” drop down box.

Please keep this information until all opioid medication is either used up or disposed of properly.

Contact our office if you have reviewed this information and feel you may benefit from a prescription opioid pain medication.

For emergencies, the office number (651-688-8592) is answered 24 hours a day with instructions for contacting Dr. Florine.

Video discussion of Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop including segment on dealing with drug-seeking patients.

Video discussion of Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop.

Tips to overcome food (and drug) addiction.

Of Dry Sockets and Preemptive Opioids

Harnessing Placebo Analgesia: Another Avenue to Opioid Reduction in Oral Surgery

Is it Time to Relegate Routine Opioid Prescriptions to the Oral Surgery Archives?

Comment on “Investigation of an Opioid Prescribing Protocol After Third Molar Extraction Procedures”

For emergencies, the office number (651-688-8592) is answered 24 hours a day with instructions for contacting Dr. Florine.

We accept most insurance plans, but please confirm your coverage with us. Most insurance plans pay a portion of your bill. The non-covered co-payment and deductible amount is expected on the day of your procedure. We file claims promptly and we serve as your advocate.

Insurance issues are researched for you so that you have a good understanding of your insurance benefits prior to your procedure whenever possible, and we work as your advocate with the insurance company so that you are given the proper benefits that your premiums are paying for.

We are happy to provide you with a presurgical estimate of fees. Payment is expected on the day of service unless other arrangements have been made in advance. We accept Visa, MasterCard, Discover and American Express. Payment plans can also be arranged. Please talk with our business manager for more details prior to your procedure.

Another option is to finance your healthcare through CareCredit. Click here to learn more.