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Surgical Instructions

What to Expect

Before you have any kind of surgical procedure performed in our office, you will be required to have a consultation. This provides the surgeon with an opportunity to evaluate your condition, take medical images (such as X-rays), and confirm that you are a good candidate for a safe and successful procedure. It also allows the surgeon a chance to talk with you about your treatment plan and answer any questions you might have.

There is a full range of topics that might be discussed during this appointment. For example, your surgeon will discuss some of the anesthesia and sedation options that are available to you, ensuring your comfort and safety during the procedure. You and your surgeon will also talk about the expected surgical results, aftercare, and recovery instructions.

It is important to us that your experience is positive and comfortable. Below, we have outlined a few of the options we offer to make that happen. If you have any questions, we recommend writing them down so that you can ask us during your consultation.

Sedation

Not only does sedation help keep you out of physical pain, but it can also mitigate any anxiety you are feeling about your procedure. Our team offers the option of intravenous sedation, also referred to as IV sedation or IV anesthesia. This is one of the best options to keep you comfortable, helping to manage pain and anxiety throughout your surgery.

Training and Experience

Our team has years of experience evaluating patients for surgery and administering anesthesia. Additionally, they are skilled in recognizing the signs of surgical complications and other medical emergencies, managing and responding to them in a way that promotes patient health and best outcomes. We have state-of-the-art facilities and advanced surgical technologies that are designed to provide our patients with safety throughout their entire experience.


Before Sedation (Pre-Op Instructions)

During your consultation, your oral surgeon will go over some basic guidelines about how to prepare for surgery, and specifically how to prepare for the administration of IV sedation. Here is a summary of the general surgical guidelines. Always ask your surgeon if you have any questions or concerns.

Some guidelines for preparing for your oral surgery include:

  • Avoid having anything to eat or drink, including water, for eight (8) hours before surgery.
  • Avoid smoking for at least 12 hours before surgery. Ideally, we recommend patients cut out smoking altogether, as soon as possible.
  • You will need a responsible adult to come with you to the appointment, wait for you, listen to any important post-surgical instructions, and drive you home. We cannot discharge patients who do not have a ride lined up.
  • Following the anesthesia experience, you will need to avoid driving or operating heavy machinery for at least 24 hours.
  • We advise patients to wear loose-fitting clothes, with sleeves that can be rolled up past the elbows. Also, wear low-heeled shoes.
  • Before surgery, you will be asked to remove dentures, contact lenses, and jewelry.
  • On the day of your surgery, avoid wearing lipstick, nail polish, or any kind of excessive makeup.
  • Notify the office if you have any kind of illness on the day of your surgery, including a sore throat, upset stomach, etc.
  • Ensure that you discuss any medications you take with your surgeon. Ideally, you should furnish a current list of medications you take at your consultation, then bring a copy of that medication list on the day of your procedure.


After Wisdom Teeth Removal

Wisdom teeth removal is very common and safe. With that said, it is also a serious surgery and requires care during the recovery process. Following these aftercare instructions can significantly minimize your risk of ongoing discomfort or infection.

Immediately Following Surgery

  • There will be a gauze pad placed over the incision site. Keep this gauze pad in place for half an hour after surgery. After half an hour has passed, remove and discard it.
  • Avoid touching the wound area or any kind of vigorous mouth washing, following surgery. Touching or mouth washing may dislodge the blood clot that has formed, which can in turn cause bleeding.
  • As soon as you start feeling pain or discomfort, take the prescription pain medication as instructed. This will usually happen around the time the anesthesia wears off.
  • Try to rest on the day of your surgery. Take it easy and restrict physical activities. Get back to your normal physical activities when you feel able.
  • Use ice packs on the side of your face where you had wisdom teeth removed. This is an important way to minimize swelling.

Bleeding

Following surgery, a little bit of bleeding is normal and can be anticipated. Some slight bleeding, or red saliva, is nothing to worry about. If you experience excessive bleeding, you may be able to control it by rinsing and wiping away any old blood clots in your mouth. Then, place a gauze pad over the wound area, and bite down on it for at least half an hour. If bleeding continues, repeat this step, or else try biting down on a wet tea bag for half an hour. You can also minimize bleeding by resting, avoiding physical exercise or excitement.

Swelling

Following wisdom teeth removal, you can expect some swelling around the mouth, cheeks, eyes, and side of the face. This is the body’s normal response to surgery. Usually, the swelling does not become evident until the day after surgery and will reach its peak on day two or three. You can control the swelling with the use of ice packs. Place them against the side of the face where surgery was performed, and keep them there continuously while you are awake. Note that, after 36 hours, ice no longer has any beneficial effect. At this point, moist heat (e.g., a warm compress) works best.

Also, be aware that your jaw may become a little stiff following your surgery, especially during the second and third days of your recovery. This is a normal response to surgery and is nothing to worry about.

Pain

If you experience mild to moderate pain, you may take one or two tablets of Tylenol® or Extra Strength Tylenol® or two to three 200 mg of Ibuprofen (Motrin® or Advil®) tablets every three to four hours.

For more severe pain, take the pain medications that are prescribed by your surgeon, and use them as directed. Note that prescription pain medications can cause you to feel groggy, and they may also slow your reflexes. When taking prescription pain medicines, avoid driving, operating machinery, and drinking alcohol. 

Following your surgery, pain should become less and less pronounced each day. If pain persists or intensifies, contact your surgeon.

Diet

After anesthesia or IV sedation, you will want to resume your diet with liquids first. Drink from a glass and avoid using straws. (The sucking motion from the straw may dislodge your blood clot and cause more bleeding.) You can enjoy soft foods, though we recommend chewing on the side of your mouth away from the incision site. 

Seek nourishment regularly, and drink lots of fluids to ensure that you avoid dehydration. Over the first couple of days, your food intake may be lower, so compensate by drinking more liquids. Aim for a minimum of five to six glasses of liquid daily.

Try to get plenty of calories and protein, and not miss any meals. Getting sound nutrition will help you feel better and regain your strength more quickly.

Exercise

If you exercise regularly or play a sport, be aware that your normal nourishment intake will be temporarily reduced. If you become lightheaded, stop exercising.

Keep Your Mouth Clean

On the day of your surgery, avoid rinsing or mouth washing of any kind. You may brush your teeth at night, but be very gentle in your rinsing. On the day after surgery, start by rinsing with a mixture of warm water and salt five to six times daily, especially after eating. 

Discoloration

Some patients may experience some slight discoloration of the skin, in addition to swelling. Any black, blue, green, or yellow discoloration may be caused by blood spreading beneath the tissues. This is very normal and may happen within two to three days of your procedure. A warm compress can help manage this discoloration.

Antibiotics

Antibiotics can help prevent infection, so make sure you take them as directed. Do not continue using antibiotics in the event of a rash or other adverse reaction. Contact the office if you have any questions.

Nausea and Vomiting

If you experience nausea or vomiting the day after your surgery, avoid taking anything by mouth for at least an hour, including prescription medications. Then, try sipping on ginger ale, tea, or Coke. Sip slowly for 15 minutes or more. When nausea subsides, you can try eating solid foods and taking your medications again.

Sutures

Sutures will be used to minimize bleeding and expedite your healing. In some instances, the sutures may become dislodged. This is nothing to worry about. Simply remove the dislodged suture from your mouth and discard it.

The sutures will be removed about a week after your surgery. This process takes just a few minutes, does not require anesthesia, and does not cause any pain or discomfort. 

There will be a cavity where the wisdom tooth was removed, and over the course of a month, this cavity will fill with tissue. Use saltwater rinses and tooth brushing to keep this area clean, especially following meals.

A dry socket occurs when the blood clot gets dislodged prematurely from the tooth socket, causing pain in the mouth or even in the ear. If this happens, reach out to our office for further guidelines.

Other Complications

  • Following surgery, you may notice numbness of the lip, tongue, or chin. This is normal and should prove temporary. However, the numbness may cause you to accidentally bite your tongue or your lip, so be extra careful as you eat.
  • You may have a slight uptick in temperature after surgery. This is normal and can be managed with Tylenol or Ibuprofen.
  • Be careful moving from a lying down position to standing. You will likely feel weak and a bit dizzy. To avoid lightheadedness, you should sit for one minute before you stand up.
  • Some patients feel hard projections in the mouth with their tongue. These are the bony walls that support the wisdom tooth. Most of the time, they smooth out on their own. If they cause an ongoing problem, your surgeon can remove them very easily.
  • If the corners of your mouth are stretched out, it may result in dry, cracked lips. Use ointments such as Vaseline to keep your lips moist.
  • It is also common to experience a sore throat, especially when swallowing. This is simply the result of swelling in the throat muscles, and should subside within a couple of days.
  • Stiffness in the jaw muscles may cause difficulty in opening your mouth for a few days after your surgery. This stiffness is normal and will resolve on its own.


After the Removal of Multiple Teeth

Following the extraction of multiple teeth, it is normal to experience some bleeding. If this happens, place a gauze pad over the wound site and bite down for half an hour. If bleeding continues, you can either repeat this step with a clean gauze pad, or bite down on a moist tea bag. 

If you do experience bleeding, keep your head elevated, and avoid exercise and hot liquids. If bleeding persists, reach out to our office for further instruction.

Denture wearers can expect some oozing from the sides of their dentures. Do not remove the dentures unless the bleeding becomes severe.

Ice packs can help keep swelling under control. Apply ice to the sides of the face where you had teeth extracted. Use ice continuously while you are awake, for the first 36 hours following your procedure.

If you experience mild to moderate pain, you may take one or two tablets of Tylenol or Extra Strength Tylenol, or two to three 200 mg of Ibuprofen (Motrin or Advil) tablets every three to four hours.

For more severe pain, take the pain medications that are prescribed by your surgeon, and use them as directed.

If an antibiotic is prescribed, take it as directed, regardless of the symptoms you experience.

If you have had teeth extracted, it is important to replenish the blood you lost. The best way to do this is by ensuring plenty of fluid intake. Drink at least six glasses of water on the first day following your procedure.

On the day of your surgery, avoid rinsing or mouth washing of any kind. You may brush your teeth at night, but be very gentle in your rinsing.

On the day after surgery, start by rinsing every four hours or so, especially after eating. Rinse with a mixture of salt and warm water.

Initially, you will want to restrict your diet to liquids, then graduate to soft foods. You are welcome to advance your diet as you feel comfortable doing so.

Having many teeth extracted at one time is quite different from having just one or two teeth removed. During extraction of multiple teeth, the bone must be shaped and smoothed prior to the insertion of a denture. In this case, the following conditions may occur and are considered normal:

  • You may experience swelling and discoloration, sometimes around the eye. Swelling usually begins the day after surgery and reaches its peak within two or three days, then dissipates on its own. You can minimize swelling by applying a warm compress to the affected area.
  • It is normal to experience a sore throat, simply due to the throat muscles swelling. This should resolve on its own over the course of two or three days.
  • Also, note that your lips may become dry or cracked. Application of Vaseline or other ointments can help a great deal.

If immediate dentures have been placed, you may notice the development of some sore spots. In most cases, your regular dentist will see you within 24-48 hours after surgery and make  the necessary adjustments to relieve sore spots. Failure to make this appointment may result in severe denture sores, which can, in turn, extend your healing process.


Dental Implant Surgery

Following dental implant surgery, it is important to avoid disturbing the wound. On the day of your procedure, avoid touching it, rinsing your mouth, or spitting.

Bleeding

It is very normal to experience some minor bleeding or red saliva for the first 24 hours following your surgery. If you have excessive bleeding, bite down on a piece of gauze for half an hour. Ensure that the gauze pad is placed directly over the incision site. If bleeding persists or cannot be controlled, contact our office.

Swelling

Swelling is a normal occurrence after any kind of surgery. The best way to control swelling is by applying ice to the side of the face where the implants have been placed. For the first 36 hours after surgery, use ice continuously while you are awake.

Diet

Following the placement of dental implants, you will want to get plenty of liquid intake. Avoid hot foods and beverages. On the day of surgery, stick to soft foods and liquids, then advance to a normal diet as soon as you feel comfortable doing so.

Pain

We recommend that patients begin taking their pain medications as soon as they notice the effects of the anesthesia wearing off.

If you experience mild to moderate pain, you may take one or two tablets of Tylenol or Extra Strength Tylenol, or two to three 200 mg of Ibuprofen (Motrin or Advil) tablets every three to four hours.

For more severe pain, take the pain medications that are prescribed by your surgeon, and use them as directed.

Antibiotics

Antibiotics can help prevent infection, so make sure you take them as directed. Contact us directly if you have any questions.

Oral Hygiene

Good oral hygiene is an important part of the healing process. On the night of your surgery, use the Peridex Oral Rinse before bed, if prescribed. The day after surgery, use Peridex twice daily, after breakfast and before bed. Rinse for at least 30 seconds, then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least four or five times a day, especially after meals. 

Brush your teeth and the healing abutments like normal. Be gentle when brushing the surgical areas.

Activity

The day after your surgery, we advise keeping physical activity to a minimum. Physical activity may result in bleeding or throbbing. Also, keep in mind that, following surgery, you may not have your normal level of nourishment, which means that exercise may weaken you or cause lightheadedness.

Wearing Your Prosthesis

Do not use partial dentures, flippers, or full dentures after surgery and for at least 10 days. This will help promote your recovery. If you have any questions, reach out to our office directly.


After Exposure of an Impacted Tooth

Following surgery, try not to disturb the wound. You may have surgical packing in place to keep the tooth exposed. Do not bother the packing, but also do not worry if it falls out on its own.

Bleeding

You may experience some minor bleeding or red saliva for the first 24 hours following your surgery. If you have excessive bleeding, bite down on a piece of gauze for half an hour. Ensure that the gauze pad is placed directly over the incision site. If bleeding persists or cannot be controlled, contact our office.

Swelling

Swelling is a normal occurrence after surgery. The best way to control swelling is by applying ice to the side of the face where the procedure took place. For the first 36 hours after surgery, use ice continuously, as much as possible, while you are awake.

Diet

Drink plenty of fluids and avoid hot foods and beverages. On the day of surgery, stick to soft foods and liquids, then advance to a normal diet as soon as you feel comfortable doing so.

Pain

We recommend that patients begin taking their pain medications as soon as they notice the effects of the local anesthesia wearing off.

If you experience mild to moderate pain, you may take one or two tablets of Tylenol or Extra Strength Tylenol, or two to three 200 mg of Ibuprofen (Motrin or Advil) tablets every three to four hours.

For more severe pain, take the pain medications that are prescribed by your surgeon, and use them as directed.

Oral Hygiene

Keeping your mouth clean is an important part of the healing process. Beginning the day after surgery, clean your mouth after every meal. Brush your teeth as best you can, and wash your mouth with a warm saltwater mix. Use this mix six times a day until your mouth is fully healed.

Activity

The day after your surgery, we advise keeping physical activity to a minimum. Physical activity may result in bleeding or throbbing. 


After Tooth Extraction

Following the extraction of a tooth, we will ask you to bite down on a gauze pad for 30 to 45 minutes, which helps a blood clot form. If bleeding persists, discard the gauze pad, replace it with a clean gauze pad, and repeat this process. You may need to do this multiple times in order to get a clot to form.

Following the formation of a blood clot, it is important not to disturb it. Avoid rinsing, spitting, or sucking on a straw for at least 72 hours. Also, be very gentle when brushing near the extraction site. Limit exercise or strenuous physical activity for at least 24 hours.

Pain and swelling can be expected for the first 48 hours or so. You can manage these symptoms with ice packs and pain medications, as recommended or prescribed by your surgeon.

On the day of the extraction, drink plenty of fluids and stick to soft foods. Move to a more normal diet as soon as you feel able to do so.

Within 24 hours, resume your normal oral hygiene habits, including brushing and flossing.

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