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Surgical Instructions

Instructions for Patients Receiving IV Anesthesia.

  1. Do not eat or drink anything (including water) for 8 hours prior to your appointment.
  3. Arrange for a relative or friend to accompany you after the surgery. The person giving you a ride must accompany you during your appointment.
  4. The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
  5. Minors under the age of 18 must be accompanied by a parent or legal guardian.
  6. Please wear loose fitting clothing and a short sleeved shirt.
  7. Get plenty of rest the night before your procedure.
  8. Contact lenses, jewelry, and dentures must be removed at the time of surgery.
  9. Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
  10. If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.

Post operative instructions after Wisdom tooth Removal:

BLEEDING: After your surgery is completed, keep biting on the gauze pad in your mouth for 60 minutes but be sure to NOT chew on the gauze pad. Change the gauze pad by folding it into a small thick pad, and placing directly over the surgical site - you should change the pad every hour, or as needed, until the bleeding stops. In order to minimize bleeding, avoid exercise and sit upright. Blood-tinged saliva is normal after your surgery.

Other tips to control bleeding:

-Elevate your head for the first 24 hours

- Sit up instead of lying down.

- When you go to bed, use two pillows, or fold your pillow in half.

If bleeding is excessive during the night and you are concerned, please call our office.

ANTIBIOTICS: Make sure to start as soon as possible

ANESTHETICS: The length of time that you will experience numbness will vary depending on the type of anesthesia used. While you feel numbness in your mouth, do not bite your cheek, lip or tongue. The numbness from the anesthetic should wear down within a couple of hours. Drowsiness is a normal side-effect following the procedure and may persist for several hours after your surgery. If you are prescribed a pain control medication, please be aware that these medications may cause drowsiness, in which case you should not drive a car or operate any machinery.

SWELLING: Swelling of your face is a normal side-effect following wisdom tooth removal. Swelling and pain may be reduced by applying cold compresses to the face (20 minutes on and 20 minutes off for the first 4-6 hours as necessary). The swelling may not be immediate, and will likely become more apparent on the

day following your surgery, and will reach the maximum 2-3 days after your surgery. The swelling will begin to subside by the fifth day following your surgery.

PAIN: You will have been given a prescription to control pain. Be sure to follow the provided instructions. Take these medications with a full glass of water after meals in order to avoid an upset stomach. If you experience severe pain after a few days, or if the pain was going away and then starts to increase again, come back to the office, or call and speak to your doctor.

ORAL HYGIENE: DO NOT rinse your mouth or brush your teeth immediately following surgery. The day following your surgery, you can gently rinse your mouth with warm water (1/2 teaspoon of salt to a large glass of warm water). Use this warm water solution in the morning, after meals and before bed. This is important after each meal in order to keep food out of the extraction site. Do not use commercial mouthwash or mouth rinse. On the day following your surgery, you may brush your teeth using care in the surgical areas. Use a soft bristled brush in order to avoid injuries to the tissues in your mouth.

DIET: A liquid diet is initially required. Do not use straws. You may eat anything soft only if you chew away form the surgical site. A high calorie and high protein diet is very important. In order to prevent dehydration, you must take fluids regularly (at least 5-6 glasses daily). Try not to miss any single meals.

DISCOLORATION: In some cases, you may experience a discoloration of the skin due to bruising. This is a normal occurrence following your surgery, and it may occur several days following your surgery. You can apply moist heat to the area to speed up the removal of the discoloration.

What is a Dry Socket?

Dry sockets are the most common problem following dental surgery. After a tooth extraction, a blood clot forms and lines the empty tooth socket covering the walls of the socket. If the blood clot is prematurely lost, the walls of the socket become exposed . The exposed bone inside of the socket causes a deep, continuous aching pain, similar to an earache. Dry socket pain will even persist after taking your pain medication.

Although both jaws can be affected, dry sockets typically occur in the lower jaw and normally 3-5 days following your surgery. Although we do not know exactly what causes a dry socket, they occur more frequently in people who smoke. Dry sockets are also seen more frequently in patients on birth control pills.

Dry sockets are treatable by placing a medicated dressing in the extraction socket. This dressing will greatly decrease the pain and discomfort. Depending on the severity of the dry socket, the area may need to be treated by replacing the medicated dressing 2 to 3 times during the week.

If you think you have developed a dry socket please call us.

Sinus Precautions

If a sinus communication occurred during your surgery as a result of the positioning between the roots of an upper tooth and your sinus, or if you had a surgery near or in your sinus, please follow these additional instructions:

  1. Do not blow your nose.
  2. Do not sneeze through your nose. If a sneeze happens, sneeze with your mouth open.
  3. Do not smoke.
  4. Do not use a straw.
  5. Avoid swimming and strenuous exercise for at least one week.
  6. A decongestant may be prescribed if sinus congestion occurs.
  7. Afrin Nasal Spray may also be prescribed to help prevent nasal congestion and keep your sinuses clear while healing.

It is normal to have a slight amount of bleeding from your nostril on the affected side for several days. Please note that a second procedure may be required in the event of a persistent sinus communication.

After Placement of Dental Implants

Bleeding: Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 60 minutes. If bleeding continues please call for further instructions.

Swelling: Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours.

Diet: Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain: You should begin taking pain medication prior to the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 4-6 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.

Antibiotics & Prescription Oral Rinse: If prescribed, be sure to take an antibiotic as directed to help prevent infection. Make sure to gently use the oral rinse 2-3 times daily until gone.

Oral Hygiene: Good oral hygiene is essential to proper healing. The night of surgery, use the prescribed Oral Rinse before bed. The day after surgery, use the Oral Rinse for at least 30 seconds twice daily, after breakfast and before bed. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, particularly following a meal. Be gentle when brushing teeth near the surgical areas.

Activity: Keep physical activities to a minimum following surgery. Exercise may lead to bleeding.

After Socket Bone Grafting

Bone grafts are made of many fine particles. Do not be alarmed if you discover small granules in your mouth for the first several days. To minimize the amount of dislodged granules:

  1. Do not spit or rinse vigorously for the first 3 to 5 days
  2. Do not apply pressure with your fingers or tongue to the grafted area. It is best to leave the area undisturbed.
  3. Do not pull your lip back to look at the sutures as this can cause damage.

Immediately following your surgery, let the area settle and allow the blood clot to stabilize the graft material. During the first day, do not rinse your mouth. On the second day, you may gently rinse with warm salt water.

Post-Operative Instructions Following Sinus Grafting

If you have had a sinus grafting performed, either separately or in conjunction with implant placement, it is important to remember the following important points:

  1. Do not blow your nose
  2. If you must sneeze, sneeze with your mouth open. This will avoid pressure within the sinus
  3. Do not smoke.
  4. Do not drink liquids through a straw
  5. Do not lift or pull your lip up to look at the stitches.
  6. Take antibiotics as prescribed.
  7. You may experience a slight nose bleed.
  8. If you feel congested, you may take antihistamines or decongestants.
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