Patient Forms

For your convenience, you can fill out these forms online before your appointment to save you time in the office. All three forms will need to be filled out prior to your first appointment.

Instructions:

  1. Double click a form. (This will take you away from our website to RightSigniture.com)
  2. Fill out all questions with a red tag next to them. (Questions NOT tagged are not mandatory but are helpful to the Doctor)
  3. When all questions are complete SIGN, DATE and SUBMIT the form.(NOT FINISHED YET)
  4. Check your e-mail. (You should receive a confirmation from Right Signature)
  5. Open confirmation e-mail and click the link. (At this point the form should be submitted into our system)
  6. Repeat process for each form. (Dr. Hollingsworth and his staff look forward to meeting you at your appointment)

If you have any other questions give us a call and we can help you through this process. (816) 232-8788

 

 


Post Operative Instructions

Tooth Extraction
The following steps have been written so you may have clear instructions to follow during your healing process.

1. Please do not smoke for the next 48 hours.
2. Do not suck liquids through a straw.
3. Do not rinse your mouth vigorously
4. Do not spit.
5. Rinse your mouth frequently with warm salt water(1tsp per cup of water) beginning 24 hours after the extraction.
6. Stay calm, no vigorous exercise for 24 hours following the extraction.
7. Change the initial gauze pack 45 minutes after the extraction. Replace it with a clean, damp gauze.
8. Take the prescribed medication as indicated, or aspirin or tylenol can be used for discomfort.

Implant

1. NO SMOKING!! Smoking will delay th healing process and could cause the implant to fail.
2. DO NOT rinse with warm salt water. Dr. Hollingsworth has given a prescription rinse, Peridex to assist in the healing and to keep the site healthy. Follow instructions on bottle.
3. Avoid vigorous chewing, spitting or rinsing, gently rinse your mouth starting the day of surgery.
4. Limit physical activity during the first 24-48 hours after surgery. Over exertion may lead to postoperative bleeding and discomfort.
5. If sutures wer placed around your implant, they will be removed and checked by Dr. Hollingsworth in 1-2 weeks.
6. Swelling related to the surgical procedure may occur following the procedure. An ice pack can be placed to subside and also anti-imflammatory medications, such as Ibuprofen also help decrease swelling.
7. Following surgery it is best to restrict your diet to fluids and soft foods for the first day. Normal diet may be resumed the following day, but you will want to avoid chewing on the implant site until the tissue is completely healed.
8. Usually you are able to wear your present partial or flipper, if applicable. It is important to keep appliance clean during healing process.
9. Bleeding! A small amount of bleeding following surgery should not alarm you. If the bleeding is excessive or continuous, please call us at once.
10. A certain amount of pain is expected with all types of surgery. An appropriate pain medication has been prescribed for you. Please take it as directed. If Dr. Hollingsworth has prescribed pain medication, it is advised to not drive or operate machinery while taking the prescription. However, Ibuprofen can be taken and most patients are about to drive without a problem.

IMPLANT FOLLOW UP, We will see you for the periodic check-ups until the implant has healed. this is usually for a period of 5-6 months, depending on your implant surgery