Before your Surgery
If you chose to have oral or intravenous sedation, do not have anything to eat or drink, including water, for four to six hours before surgery. If you take medications regularly, you should take them with small sips of water at the regular time. Also, any additional medications which might be prescribed to you by our office should be taken with small sips of water as directed.
Wear comfortable, loose-fitting clothing with short sleeves and baggy pants. Avoid boots or high shoes.
If you have oral or intravenous sedation, a responsible person must accompany you, remain in the reception area, and take you home. We ask that your escort accompany you to the office so we can let him or her know when you will be ready to leave the office and give the person appropriate instructions.
- Do not wear jewelry, including any facial piercings, or makeup, including nail polish or eye cosmetics.
- Please tie long hair back.
- If you wear contact lenses, please remove them prior to your appointment.
- Wear loose clothing, short sleeves, and low shoes.
- No smoking the morning of surgery
- Your mouth and teeth should be well cleansed to help avoid infection.
- Do not ignore a head or chest cold when oral surgery is to be performed. Please call the office if you have any symptoms, because an appointment change may be necessary.
- If you are going to have local anesthesia (numbing shot) only, you may eat prior to your appointment and do not need somebody to accompany you to the office.
Instructions for Anesthesia
Together, you and the doctor will discuss the dental procedure to be completed, as well as the type of anesthesia you will receive. The different types of anesthesia require different pre-operative instructions. If you have any questions regarding these choices, you should contact Dr. Sam prior to surgery.
Local and/or Nitrous Oxide
Little or no special preparation for either of these types of anesthesia is required, other than a current medical history.
- You must take the medication 45 minutes prior to your appointment.
- You must not drive for 12 hours following taking this medication.
- You must have someone drive you both to and from your appointment.
- You must sign your consent form and give us an updated medical history prior to taking this medication.
Intravenous (IV) Sedation
- To reduce the chances of nausea, do not eat or drink anything (including water) for at least six hours prior to your appointment.
- If your surgery is in the morning, do not eat or drink anything between bedtime and your scheduled appointment.
- If your surgery is in the afternoon, a light breakfast before 7:00 a.m. is encouraged.
- Unless specified by Dr. Sam, all medicines taken on a routine basis should be continued without interruption. Please take your normal medications with a minimal amount of water.
- A responsible adult, over 18 years of age, should accompany you to the office and remain with you throughout the entire procedure. Following the sedation, this person should remain with you for the next 24 hours.
- Minors (persons under the age of 18 years) must be accompanied by a parent or legal guardian.
- If receiving I.V. sedation, you should wear clothing that is not restricting to the neck or arms. You should wear loose-fitting tops on which the sleeves can be rolled up to the shoulder.
- Contact lenses must be removed prior to sedation.
- Following the sedation, you should refrain from driving an automobile or engaging in any activity that requires alertness for the next 24 hours.
- Take prescribed medication as indicated by the doctor immediately following your surgery. If instructed by your doctor, you should take over-the-counter ibuprofen or Advil every 4 hours continuously for the first two days. Take the first dose immediately and before the local anesthesia has worn off. You may use the prescription medication on top of and in addition to the ibuprofen or Advil tablets as needed. Be cautious when taking all medications, since most pain management medications will more than likely cause stomach upset.
- If you have been placed on antibiotics, take the tablets as directed. Antibiotics will be given to help prevent or treat infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Please contact Dr. Sam or the office if you have any questions or concerns.
- Controlling bleeding after an extraction or surgery is a matter of applying continuous pressure over the area for an extended period of time. Bite down firmly on the gauze packs that have been placed over the surgical areas, and make sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is heavy.
- After 30 minutes, place enough new gauze to obtain pressure over the surgical site for another 30 minutes if needed. The gauze can then be changed as necessary (but only if the gauze is soaking wet with blood). It is best to slightly moisten the gauze with tap water and loosely fluff for more comfortable positioning.
- Bleeding from oral surgery may take up to 24 hours to fully stop. Once bleeding has stopped, you will no longer require the use of gauze.
- Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. Swelling and mild bruising is normally expected and is usually proportional to the surgery involved. This is the body’s normal reaction to surgery and eventual repair. Many times, the swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively.
- Swelling can be minimized by using cold packs applied firmly to the cheek nearest to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24 hours after surgery.
- If you have been prescribed medication to minimize swelling, be sure to take it as directed.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Immediately following surgery, you will want to rest and limit all activity.
After the First Hour
- A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for the first 24 hours post-surgery. If bleeding persists or becomes heavy, you may substitute the pressure gauze with a tea bag to bite on for 20 or 30 minutes. The tea contains a beneficial chemical that locally constricts blood vessels.
- To minimize further bleeding, relax, rest, and refrain from any type of vigorous movement or exercise. If bleeding remains uncontrolled, please call the office for further instructions.
- You can brush your teeth the night of surgery, but rinse and brush GENTLY.
Protect the Blood Clot
- Do not rinse vigorously, smoke, or drink with a straw for the first 48 hours following surgery.
- Chemicals in cigarettes are caustic and will significantly delay healing, and increase post-operative pain, swelling, risk of infection, and dry socket.
Nausea and Vomiting
- Nausea and vomiting are a common side effect of oral and IV sedation, and many narcotic medications. It generally improves within four to six hours. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed pain medication. Avoid all foods until you are feeling hungry and try sipping small amounts of clear liquids to prevent dehydration. 7 Up and/or ginger ale are a good choice to help with nausea. You should sip slowly over a 15-minute period. Once the nausea subsides, you can start eating food and restart the prescribed pain medication. If the nausea and vomiting do not resolve, please contact Dr. Sam or your dental office.
- Immediately following surgery, liquids should be initially taken. You may eat anything soft by chewing away from the surgical sites. Your food intake may be limited for the first few days due to a reduced appetite. It is important to eat, not only because of the medications you are taking, but because nourishment is essential to healing. You will feel better, have more strength, and heal faster if you continue to eat.
- Stick to soft and cold diet for the first 24 hours, such as Ice cream, milkshakes, yogurt, smoothies, etc. Keep in mind to use a spoon or sip from the cup, but absolutely no straws.
Pain Medication Precautions
- The prescription medication given to you by your doctor may contain narcotics and thus may cause drowsiness, decreased reaction time, blurred vision, and a change in mental status. Do not drive, operate dangerous machinery, make important decisions, or perform strenuous exercise while taking these medications. Failure to follow these instructions increases your risk of causing injury to yourself and others.
Post-Op Day 2 and Beyond
- Keeping your mouth clean after surgery is essential. No vigorous rinsing should be performed during the healing process. The day after surgery, you should begin rinsing at least five to six times a day (especially after eating) with a warm cup of water mixed with a teaspoon of salt. This mixture not only helps keep the area clean but it also controls swelling. Avoid commercial mouthwashes: the alcohol they contain may irritate the surgical site. You should brush and floss your teeth normally; just be gentle at the surgical sites.
- Normal healing after oral surgery should be as follows: The first three days after surgery are generally the most uncomfortable. It is normal to experience an increase in pain and swelling during this period. Beginning on the fourth day, things should start to improve. You should be more comfortable and, although still swollen, can usually begin a more normal diet. The remainder of the post-operative course should show gradual, steady improvement. If you do not see continued improvement, please call Dr. Sam or your dental office.
- A dry socket is a term to describe a painful but not serious postoperative condition that results from the premature loss of the blood clot. It usually occurs three to five days after surgery. An increasing amount of throbbing pain around the affected socket, which may radiate up to the ear or through the entire jaw, is an indication you may have a dry socket. If this pain is not responsive to the pain medication prescribed, this condition may require an office visit during which your dentist or Dr. Sam will gently place a medicated dressing into the tooth socket. Pain relief is often immediate once the site is treated.
- Sutures may be placed in the area of surgery to minimize postoperative bleeding and to aid in healing. Sometimes the sutures disintegrate early or are dislodged. This is no cause for alarm; simply remove the loose suture from your mouth and discard it. The sutures will typically dissolve within a couple of weeks. If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the bony walls, which once supported the extracted teeth or the ends of the sutures. Occasionally small slivers of bone may work themselves out during the following weeks. This is normal but if they cause concern or discomfort, please call Dr. Sam or your dental office.
- If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite them and not feel the sensation. If you experience this altered sensation, please contact Dr. Sam or your dental office. Appropriate care can be initiated, if indicated, at that time.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
- Many patients feel dizzy following surgery. You should be careful going from the lying-down position to standing. Remember, many times you were not able to eat or drink prior to surgery. It also can be difficult to take fluids. The prescribed pain medications may also make you feel dizzy. You could get lightheaded when you stand up suddenly. Before standing up, you should sit for one minute then rise.
- Sore throats and pain when swallowing are not uncommon. Since muscles are swollen, the normal act of swallowing can become painful. This pain will usually subside in 2 to 3 days.
- Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for several days following surgery. This is a normal post-operative event that will resolve in time.
* Following these instructions will assist you, but if you have any questions or concerns about your progress, please contact Dr. Sam or your dental office.