Pre-Surgical Care Instructions
- Please arrive 15 minutes earlier than your appointment time so the front office can collect your payment and provide you with post-op instructions and complete/sign your surgery and anesthesia consent forms.
- You may NOT have anything to eat or drink after midnight the night prior to your surgery! This is extremely important as we are serious about our patient's safety during their procedure. Do not chew gum and do not consume anything, including water or coffee.
- You must not smoke prior to your scheduled procedure. This could irritate your primary airway and cause complications during your procedure.
- You must bring an escort with you to the surgery that can remain on site during your surgical procedure and they may not leave the premises during your procedure.
Please contact us if you have questions or concerns about these important pre-surgical care instructions.
Post-Surgical Care Instructions and Helpful Information
PLEASE READ THESE INSTRUCTIONS CAREFULLY. It is important that you follow these instructions in order to promote comfort and healing and to help you prevent possible complications. We have prepared a list so you can easily refer to it to answer your questions which may arise at home. Sometimes the after effects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines and feel free to call our office at any time for clarification.
Controlling bleeding
Bleeding is a normal occurrence following oral surgery. You will be provided with gauze pads. Water moistened pads should be placed directly over the surgery site and you must bite firmly on the pads. The pads should not be clenched between the teeth but rather placed directly over the extraction site. Change pads every 20-30 minutes until bleeding slows down.
Two to three hours after the surgery, the bleeding will usually decrease enough to leave the gauze out. The gauze may be dampened for more comfortable positioning. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in warm ·water and then squeezed out to damp dry) for 20-30 minutes per application. If bleeding remains uncontrollable, please call our office.
Dealing with swelling
Swelling is also a normal occurrence after oral surgery - especially when wisdom teeth are removed. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to the face or cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 12-24 hours after surgery.
If you have been prescribed medicine to control swelling, be sure to take it as directed. After 48 hours it is usually best to switch from ice to moist heat to the same areas. If you use moist compresses such as damp wash cloths, a heating pad or hot water bottle, care must be taken to prevent chaffing and burning the skin. Heat should be used cautiously. Apply for 20 minutes every hour. Peak swelling usually occurs 2-3 days after surgery. Swelling will usually resolve about 7 days after surgery.
Oral Hygiene Best Practices
Do not disturb the surgical areas on the first day of surgery. Do not rinse vigorously or probe the area with any objects or your fingers. DO NOT SMOKE/USE ANY TOBACCO PRODUCTS FOR AT LEAST 3 DAYS AFTER SURGERY - THIS WILL SLOW HEALING.
Following the first day of surgery you may brush your teeth but use caution around the surgical site. If you have been given an antibiotic medication mouth rinse (Peridex or Perioguard) please use it as directed. You may also rinse your mouth with warm salty water. This can be created by dissolving 1 tsp. of salt in an 8 oz. glass of warm water. Gently swish the water around in your mouth at least 4-5 times every day for 1 week.
Medications
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Your pain medicine is prescribed to be taken on an as-needed basis throughout the first day and night. We suggest that it be taken regularly every 4 hours unless you have an excessive reaction to the medication. The first dose should be taken shortly after you reach home while you are still numb from the local anesthesia. With some patients a long lasting local anesthetic is used which may cause numbness of the lip, chin, tongue or cheeks for up to 24 hours after surgery.
Please be very careful when eating so that you do not bite or pinch the mouth or lips. With the numbness still present, you could cause damage to the tissues. Remember that effects of pain medications vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as Advil. Some people require two of the pain pills at one time during the early stages. Remember that the most severe discomfort is usually within the first 6 hours after the anesthetic wears off; after that your need for medication should lessen.
IMPORTANT: No prescriptions can be called in over the weekend, therefore if you should need a refill, you must call before noon on Friday.
WHEN TAKING PAIN MEDICATION, YOU MUST NOT DRIVE A VEHICLE, OPERATE MACHINERY OR DRINK ALCOHOLIC BEVERAGES. TO DO SO COULD BE HAZARDOUS TO YOUR HEALTH.
Nausea
Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medications, but call us if you do not feel better or if repeated vomiting is a problem.
Diet
Eat any nourishing food that can be taken with comfort. Stay away from carbonated beverages for the first 24 hours. The temperature of the food doesn't matter but avoid extremely hot foods. It is sometimes advisable but not required to restrict the first day's intake to bland liquids or pureed food (cream soups, puddings, yogurt, milk shakes, etc). Avoid foods like nuts, sunflower seeds, popcorn, etc. which may get lodged in the socket area.
Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals. If you eat regularly you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.
Sharp Edges
If you feel sharp edges in the surgical areas with your tongue, it is probably the bony walls which originally supported the teeth. Occasionally, small slivers of bone work themselves out during the first week or tw-o of the surgecy. They are not pieces of tooth, and if necessary we will remove them. Please call the office if you are concerned.
Sutures
Resorpable sutures are frequently used to close wounds. These sutures will come out on their own. DO NOT BE ALARMED. As long as there is not bleeding or pain, there is no cause for concern.
Dry Sockets
Normal healing after tooth extraction should be as follows: The first three days of the surgery are usually the most uncomfortable and there may be some degree of swelling and stiffness. The second day you can usually begin a more substantial diet. From the third day on, gradual, steady improvement should mark the remainder of your post-operative course. If a DRY SOCKET occurs, loss of blood clot from the socket, usually on the third - fifth day, there is a noticeable, distinct throbbing pain in the jaw often radiating toward the ear and forward along the jaw to cause other teeth to ache. To decrease the chance of forming a dry socket, DO NOT spit, smoke, or suck through a straw for three days after surgery. Do not suffer needlessly, call our office and report symptoms so that you can be seen as soon as possible.
Infection
Infection can occur with any surgical procedure in spite of treatment. If you experience unusual or increased swelling, notice foul tasting drainage, feel unusually ill or have an elevated temperature, please contact our office IMMEDIATELY. Untreated infections can be hazardous to your health.
Prolonged Numbness
Occasionally, injuries to the nerves that supply the teeth, the bones and the lips can occur from oral surgery or removal of teeth. We will follow your progress during the usual resolution of numbness and keep you posted concerning what we feel your progress has been. It is our desire that your recovecy be as smooth and pleasant as possible. Following these instructions will assist you, but if you have any questions about your progress, please call the office.
Please try to call the office during office hours which will afford a faster response; however, a 24 hour answering service is available for after-hours contact with the Doctor.
Instructions for Homecare following the Placement of Dental Implants
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gingival (gum) tissue.
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 30 minutes. If bleeding appears excessive, or continues after the third post-operative day, please call for further instructions.
Swelling
Swelling is normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 24-48 hours.
Diet:
Drink plenty of fluids. Avoid hot liquids or food for the first 24-48 hours. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet is generally achieved after three weeks of healing, or as directed by your doctor.
Pain:
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, two 200mg tablets of Ibuprofen, one or two tablets of regular or extra strength Tylenol may be taken every four hours instead.
For sever pain take the tablets prescribed for pain as directed. The prescribed pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around heavy machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists or worsens after the third post-operative day, it may require attention and you should call the office.
Antibiotics:
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Oral Hygiene:
Good oral hygiene is essential to good healing. The day after surgery, if an oral rinse was given to you by your surgeon, it should be used twice daily, after breakfast and before bed. A Q-tip may be used to clean the healing abutments. Dip the Q-tip in a cap of mouth rinse and gently clean the healing abutment twice a day prior to rinsing. Be sure to rinse for at least 30 seconds the spit. Warm saltwater rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, especially after meals. Gently brushing your teeth at least one tooth away from the implant sites is no problem. A soft bristled brush is best. The area of the implants or healing abutments should only be brushed after instructed by your doctor.
Activity:
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing, or bleeding may occur. If this occurs, you should discontinue exercising, keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your prosthesis:
Partial dentures, flippers, or fill dentures should be used only as discussed by your doctor during your pre-operative consultation.
