Use of Medication and Safety Protocols
Review the information on this page to learn more about our team’s approach to pain management and safety protocols for the use of anticoagulants when undergoing surgical treatment.
Our Approach to Pain Medication
At the Center for Oral Surgery + Dental Implants, we view effective pain management as a vital shared responsibility between you and our surgical team. Our primary goal is to manage discomfort effectively—not necessarily eliminate all sensation—to ensure you have adequate rest and a smooth recovery, while prioritizing your long-term health and safety.
We are committed to an opioid-sparing and often opioid-free approach, utilizing advanced multi-modal techniques that combine powerful non-narcotic medications and long-lasting numbing agents. The amount of post-surgical discomfort depends on various factors, but by empowering you with this comprehensive philosophy and preparation, we aim to help you manage your discomfort effectively and return to your normal activities more quickly.
Advanced Opioid-Sparing Techniques
We can administer pain medicines before, during, and after surgery. The exact combination depends on your unique situation. We aim for you to be comfortable after the operation while avoiding excessive reliance on narcotics.
EXPAREL® (Long-Acting Anesthetic): This is a long-acting numbing medicine administered directly at the surgical site during your surgery, before you feel pain. Unlike opioids, which affect the whole body, EXPAREL® provides targeted pain control for the first few days after surgery when you need it most. Patients who receive EXPAREL® often require fewer opioids later and go a longer time before any narcotics are needed.
Ketorolac (IV/Injection): This medication is similar to Advil® or Motrin®, but it is administered either by IV or as a shot for robust, long-lasting pain control.
Socket! Gel (Drug-Free Relief): This FDA-approved hydrogel wound dressing is drug-free, non-toxic, and all-natural. It provides fast, consistent pain relief without causing numbness. It is applied in the office and sent home for you to use as often as needed for safe, continuous pain relief and wound management.
Post-Surgical Medication Protocol
The first line of defense for most patients is over-the-counter medication. It is important to take pain medications exactly as recommended.
First Line of Defense (Non-Opioid)
Ibuprofen (Motrin® / Advil®): The primary pain reliever for mild to moderate pain. Take the recommended dose every 6-8 hours with food or water. Do not sleep for longer than 8 hours the night following surgery without waking up to take this medication.
Acetaminophen (Tylenol®): For moderate to severe pain, add over-the-counter Tylenol®/acetaminophen. You may take Tylenol® following ibuprofen. For more involved procedures, you will be advised to take Tylenol® along with ibuprofen for the first few days, as they work in different ways to control pain.
Opioid Use and Policy
Opioid medication is to be taken only for severe pain not managed with other measures.
Tapered Dosage: Opioid medications, if prescribed, will be tapered.
Safety: Some opioid medications contain Tylenol®/acetaminophen; you will be advised about the maximum combined dose you can take in 24 hours.
Risk: Opioids can cause serious problems if taken in excess or mixed with other medicines (including anti-anxiety medications, sleeping pills, or alcohol). Opioids can also lead to addiction. Stop taking the medicine as soon as your pain gets better.
Strict Regulation: These medications are strictly regulated by the DEA and are reported to the Michigan Automated Prescription Service (MAPS) due to their potential for addiction.
Non-Medication Comfort Measures
These additional measures are very effective in lessening the pain after surgery:
Rest and Ice: Rest and apply ice to the surgical area (as instructed in your procedure-specific instructions).
Hydration: Drink plenty of fluids.
Hygiene: Maintain good oral hygiene (as instructed by your doctor).
Other: Utilize mindful practices, heat, stretching, and other measures as directed by your clinical team.
Our Medication Policy For Refills and New Scripts
Renewals: Prescriptions will be renewed only from 8:00 a.m. to 4:00 p.m., Monday through Friday. No prescriptions are issued for non-hospitalized patients during evenings, weekends, or holidays.
Evaluation: Opioid medication is not ordered for patients who come to the office for second surgical opinions or for routine assessments.
Outside Medication: Sleeping medications, tranquilizers, or similar medications must be prescribed by your primary care or referring doctor.
Need to Discuss Your Pain Plan?
Your doctors and nurses will work together with you to keep you as comfortable as possible. If you have questions about your prescribed pain management plan or require a consultation, please contact our office.
Safety Protocols for Anticoagulants (Blood Thinners)
We understand that many patients take anticoagulant medications (like Warfarin/Coumadin, Plavix, Aspirin, Eliquis, and Xarelto) to prevent severe medical conditions such as stroke or heart attack. While these medications are critical for your health, they can increase the risk of bleeding during surgery.
Coumadin (Warfarin) Testing: If you are taking Coumadin, we will ask you to have a simple blood draw to check your INR (International Normalized Ratio) a day or so before your procedure. This helps us precisely determine your anticoagulation level.
Collaborative Care: In most cases, our surgeon will perform your procedure and take special measures to prevent bleeding, allowing you to safely continue your medication throughout the operative period.
Consultation is Key: Every patient's medical situation is unique. Please discuss your specific circumstances and any blood-thinning medication with your treating surgeon so we can ensure the safest possible surgical plan. In some cases, we will help you work with the physician prescribing your blood thinner if a brief interruption is helpful, given the extent of the planned surgery.
