Patient Information

Dr. Cullum is a Board Certified Oral and Maxillofacial Surgeon with expertise in dental implants, wisdom teeth removal, bone grafting, and soft tissue procedures. He regularly teaches advanced techniques and participates in continued education to treat patients with the most current, technologically advanced, and minimally invasive treatment options..

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Patient Forms

The following forms are required for treatment at Implants Northwest. Please review and fill out prior to your first consultation. Please note, your registration information must be filled out at least 24 hours in advance. Thank you!

Post-Op Instructions

Post-Operative Oral Surgery Instructions

WOUND CARE:
Following your surgery gauze pressure packs have been placed in your mouth and should stay in place with biting pressure for 30 minutes. Make sure the gauze pads (usually 2-3 pads) are folded together and thick enough to put pressure directly on the extraction site. You should replace the gauze only if bleeding reoccurs. Some mild oozing is expected following surgery and may continue for as long as 24 hours. Rest and sleep with your head elevated by two pillows and place a towel over your pillows to help protect them as it may ooze while you sleep. Persistent bleeding may be stopped by placing and moistening tea bag over the surgery site and biting down with firm pressure for 45 minutes. If you are unable to control bleeding contact our office at 208-667-5565. The sutures used are often dissolvable and will come out on their own. If non-dissolving sutures are used, they will need to be removed within 10-14 days post-surgery at your scheduled follow-up appointment. To help prevent bleeding and interruption of the blood clot, do not rinse your mouth, spit, or suck through a straw for 36 hours post-surgery.

To help limit swelling, place an ice pack on your face next to the jaw for 20 minutes on and 20 minutes off, taking care to ice over the surgery area, repeating until bedtime and continuing for 2-3 days post-operation as directed.
For wisdom teeth, the ice should be place horizontally between the corner of your lip and ear

Two days after surgery, you may apply a heating pad intermittently to your jaw- 20 minutes on, 20 minutes off- placing a towel between the heat source and the skin. Remember, it can take 2-3 days for swelling to reach its peak; this is expected and the site around your extraction(s) or surgery can become quite large. Swelling usually subsides 7-10 days after surgery.

MEDICATIONS:
When you arrive home, remove the gauze sponges from your mouth and take your medicine as directed. The medications should be taken with plenty of fluids or food to avoid stomach irritation. Take the medication as directed, as prescribed to make the first few days after surgery more comfortable for you. After the first few days, 600-800 mg of Ibuprofen is generally excellent for managing discomfort. If you are allergic to Ibuprofen or Aspirin, use acetaminophen (such as Tylenol) instead.

If you have been placed on antibiotics, FINISH all of the tablets or liquids as directed.

​Although most patients benefit from prescribed drugs, occasional side effects such as rash, itching, nausea, excitement, vomiting, constipation, diarrhea, or other reactions can occur. If you have these side-effects, stop the medication immediately and contact our office.

DIET:
A soft diet is best following oral surgery and it is very important to maintain adequate fluid intake (at least two liters per day) for the first 24 hours after surgery to avoid dehydration. It’s best to start with clear liquids first after surgery to avoid nausea and vomiting, and then advance to other liquids and foods with more substance. Avoid extremely hot liquids and foods until the numbness in your mouth has worn off to avoid injury to the surgical sites. Additionally, take care to avoid biting your lip, cheek, or tongue.

ORAL HYGIENE
Keep your mouth as clean as possible. This is very important to promote healing, prevent infections, and to avoid dry sockets. Begin gentle brushing to keep your mouth clean, being careful to not bother the surgery area. Soften the bristles of your toothbrush under warm water prior to brushing and avoid use of an electric toothbrush, ultrasonic toothbrush, or waterpik in the surgery sites for several weeks.

PERIDEX RINSE / CHLORHEXIDINE:
Please continue with your Peridex/Chlorhexidine mouth rinse as directed by the office after surgery. You may need to wait a few days after surgery before continuing use of the mouth rinse, depending on the type of procedure that was done. When you begin rinsing regime, use a gentle swishing technique in the surgery area (not vigorous swishing) as instructed until the rinse is gone.

ACTIVITY:
You should go home and rest the remainder of the day with someone caring for you for the next 8 hours. Sudden position changes can result in dizziness or lightheadedness. When using the restroom, do not lock the door, should you need sudden assistance. You should not drive a car, operate any machinery, or make any financial/business decisions for at least 24 hours or 8 hours after your last dose of prescribed pain medications. The day after surgery you may resume your normal activities as tolerated.

​No alcohol or tobacco for 5 days following surgery for optimum healing benefits.

Post-Operative Instructions for Oral Surgery with Implants/Grafting

WOUND CARE:
Some mild oozing is to be expected following surgery and may continue for as long as 24 hours. You may place gauze into the cheek area to absorb any oozing for approximately 30-45 minutes. Rest and sleep with your head elevated by two pillows and place something that is easy to wash over your pillows to help protect them. If you are unable to control the bleeding, contact our office immediately.

​The surgery sites are usually sutured. The sutures are usually removed 12-14 days post-surgery at your follow-up appointment. Some sutures may come out on their own over that time period which is normal. If you should notice anything abnormal prior to us seeing you back for your follow-up, please contact our office.

​To help limit swelling, place an ice pack on your jaws, 20 minutes on, 20 minutes off, repeating until bedtime and continuing for 2-3 days post-op as directed. Be sure the ice is over the surgery area. Two days after surgery you may apply heat intermittently to your jaw, 20 minutes on, 20 minutes off, placing a towel between the heat source and the skin. It can take 2-3 days for the swelling to reach its peak after surgery and is usually gone 7 to 10 days after surgery.

MEDICATIONS:
Take your medications as instructed with plenty of fluids or food to avoid stomach irritation. Take the medication as directed, as prescribed to make the first few days after surgery more comfortable for you. After the first few days, 600-800 mg of Ibuprofen is generally excellent for managing discomfort. If you are allergic to Ibuprofen or Aspirin, use acetaminophen (such as Tylenol) instead. For breakthrough discomfort, you can use any prescribed medications from our office or Benadryl along with Ibuprofen and Tylenol at bed time to help you through this short interval period.

​If you have been placed on antibiotics, FINISH all of the tablets or liquids as directed.

​Although most patients benefit from prescribed drugs, occasional side effects such as rash, itching, nausea, excitement, vomiting, constipation, diarrhea, or other reactions can occur. If you have these side-effects, stop the medication immediately and contact our office.

DIET:
A soft diet is best and it is very important to maintain adequate fluid intake (at least 2 liters per day) for the first 24 hours after surgery to avoid dehydration. It’s best to start with clear liquids first to reduce the risk of nausea, vomiting and biting on the surgery sites, and then advance to other liquids and foods with more substance. You may advance your diet as tolerated to more solid foods, while avoiding chips, peanuts, popcorn, etc. Avoid extremely hot liquids and foods until the numbness in your mouth has worn off to avoid injury to the surgical sites. Additionally, take care to avoid biting your lip, cheek, or tongue.

​Listed below are a few suggestions of soft foods and drinks:
Applesauce
Oatmeal
Jello
Yogurt
Pudding
Cottage Cheese
Scrambled Eggs
Mashed Potatoes
Macaroni & Cheese
Soups
7 Up
Apple Juice
Ginger Ale
Ensure or Boost

It is very important to maintain a diet high in proteins!

NOTE: If you are diabetic, maintain your normal calorie requirements. Take your medication as prescribed and check your sugar level more often for the next 2-3 days following surgery.

ORAL HYGIENE
Keep your mouth as clean as possible. This is very important to promote healing and prevent infections. Begin gentle tooth brushing to keep your mouth clean, with warm water only due to the use of barriers. Avoid the use of any kind of toothpaste with whitening agents, home remedies, saltwater, hydrogen peroxide, baking soda, natural remedies, essential oils, and Ozone in and near the mouth. We will provide you with further hygiene care instructions at your follow-up visit. You must be extra careful to not bump or bite the implant site with anything. We do not want you to use an electric toothbrush, ultrasonic toothbrush, or waterpik in the area for at least three months or until the implant is restored.

PERIDEX RINSE / CHLORHEXIDINE:
Please continue with your Peridex/Chlorhexidine rinse as directed by Dr. Cullum and his staff after surgery. When you begin your rinsing regime, use a gentle swishing technique in the surgery area as instructed until gone.

ACTIVITY:
After anesthesia, you will require supervision and assistance for at least the first 8 hours post-surgery. Sudden position changes can result in dizziness or lightheadedness. When using the restroom, do not lock the door, should you need sudden assistance. You should not drive a car, operate any machinery, or make any financial/business decisions for at least 24 hours or 8 hours after your last dose of prescribed pain medications. No strenuous or heavy activity for approximately 1 week post-surgery to avoid bleeding or disturbing the healing process.

​No alcohol or tobacco for 5 days following surgery for optimum healing benefits.

Post-Operative Instructions for Sinus Elevation

​Think of your sinuses like a sail boat; avoid sucking and nasal pressure movements that might cause the sinus membrane to whip back and forth like a sail in the wind. This is especially important during the early stages of healing. It is important to follow these instructions for the instructed amount of days or weeks directed by Dr. Cullum.

Do not suck through a straw, spit, blow your nose, or rinse.
Do not sneeze if at all possible and if you must sneeze open your mouth and release it out of your mouth. Do not stifle the sneeze because it can cause back pressure on your sinuses. Avoid things that will cause you to sneeze, such as pepper, fresh-cut grass, dust, etc.
Avoid dusty environments where you must wear a protective mask.
Do not bear down hard when going to the bathroom, use a stool softener when needed.
Avoid nose blowing, instead, wipe gently. Congestion is not uncommon after having work done in and around your sinuses. You can use over the counter nasal decongestant if needed, such as Sudafed or Actifed.
No swimming or taking water into the nose or mouth.
Do not bend your head below your knees.
No heavy lifting, airplane travel, or elevation change until directed by Dr. Cullum when it is appropriate to do so.

Post-Operative Instructions for Barrier Usage

AMNION / CHORION BARRIER
A membrane placed to cover the bone graft at the defect. It is tucked under the gum margin and sewn in to maintain its position. Do not tug or manipulate the sutures or site with your tongue or fingers. Dr. Cullum will check the healing of the site at your follow-up appointments. Do not use the Peridex/Chlohexidine mouth rinse after surgery for the amount of days directed by Dr. Cullum or his staff after surgery. You may brush your teeth with a soft, manual toothbrush and warm water, avoiding the surgical site. Do not use an electric toothbrush or waterpik around the surgical site until released by Dr. Cullum to do so (usually around 4-6 weeks). Please avoid toothpaste, alcohol, peroxide, baking soda, mouthwash, and seeds or spices that can injure the area.

BARRICADE PROTECTIVE COVERING
Barricade is to remain in place until we see you in office for your follow-up appointment, typically 12-14 days following surgery. If it comes loose, carefully place it back on and schedule a time to come into the office for a check-up visit. Begin rinsing with Peridex/Chlohexidine mouth rinse twice daily following surgery as directed. Do not use an electric toothbrush or waterpik around the barrier or surgical site until instructed by Dr. Cullum.

CYTOPLAST BARRIER
This white plastic barrier remains in place for 4-8 weeks after surgery. Dr. Cullum will remove it at a follow-up appointment when the area is healed. Begin rinsing with Peridex/Chlohexidine mouth rinse twice daily following surgery. Do not use an electric toothbrush or waterpik around the surgical site until directed by Dr. Cullum.

Peridex Rinse / Chlorhexidine

Please continue with your Peridex/Chlorhexidine mouth rinse as directed by the office after surgery. You may need to wait a few days after surgery before continuing use of the mouth rinse, depending on the type of procedure that was done. When you begin rinsing regime, use a gentle swishing technique in the surgery area (not vigorous swishing) as instructed until the rinse is gone.

Financing and Insurance

At Implants Northwest, we make every effort to provide you with the most convenient financial options. Please bring your insurance information with you to your consultation. If you have any questions or concerns regarding insurance, please contact us prior to your consultation.

​Your insurance coverage or contracts are with the providers, but we are happy to assist you in the process. Our policy requires payment for services at the time of the procedure.

​Please remember that you are responsible for the fees incurred for treatment at this office regardless of your insurance coverage. We ask that you pay for your initial consultation in full if we are not in network with your insurance carrier at the time of service. For financing options, we offer CareCredit.

​Listed below are some of the dental insurance plans we are in network with. If you do not see your insurance carrier, contact our office.

Scheduling

Many patients mistakenly believe that they need a referral to consult with our surgeons. But you can visit our offices by scheduling an appointment online.

Schedule a Consultation

Work with the best oral maxillofacial surgeon in Utah today!

Coeur d'Alene Office

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Mon-Thurs | 8:30 - 5:00
Friday 8:30 - 3:30
Closed Sat & Sunday

Sandpoint Office

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Mon-Fri | 8:00 – 5:00
Closed Sat & Sunday

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