Special instructions that you should follow when preparing for your surgery.
Surgical Instructions – Before IV Sedation
- You may not have anything to eat or drink (including water) for six (6) hours prior to the appointment.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and take the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
- Contact lenses, jewelry, and dentures must be removed at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office prior to treatment.
- If you must take oral medications, you may do so with a small sip of water.
Surgical Instructions – After Tooth Extraction
The amount of post-operative discomfort and swelling is related to the amount of surgery necessary to remove the tooth and the number of teeth removed. Wisdom teeth usually cause the most post – operative discomfort and swelling.
After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 45 minutes. You may have to do this several times.
After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise until a stable clot is formed as this will increase blood pressure and may cause more bleeding from the extraction site.
After the tooth is extracted you may feel some pain and experience some swelling. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 6-8 hours if allowed by your physcian. For severe pain use the prescription given to you. The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will peak 1 1/2 to 2 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Baggies filled with ice or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be placed 5 minutes on and 5 minutes off, when practical, for the first 24 hours. After which the ice has no beneficial effect and moist heat may then be helpful. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm.
Use the pain medication The swelling will peak 1 1/2 to 2 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Baggies filled with ice or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be placed 5 minutes on and 5 minutes off, when practical, for the first 24 hours. After which the ice has no beneficial effect and in fact’ moist heat may be beneficial. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
Use the pain medicationas directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.
After general anesthesia or I.V. sedation, liquids should be initially taken. Do not drive or operate machinery while still under the influence of the anesthesia. This is usually a 24 hour period.
After the first day, use a warm salt water rinse every 4 hours if possible and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.)
Surgical Instructions – Other Complications
Nausea is common with the use of narcotic pain medication. If you have nausea discontinue any narcotics. Regular use of ibuprofen will decrease the need for narcotics and the likelihood of nausea.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
Bone spicules or splinters may work their way through the gums after the surgery. This is not unusual. Call the office if this occurs.
Severe throbbing pain at the surgical site and even pain to the ear, first occurring a few days following surgery could represent a “dry socket”. Call the office if this occurs.
There will be a cavity where the tooth was removed. The cavity will fill in with the new tissue gradually over the next month. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
Swelling of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
Surgical Instructions – After Dental Implants
Many of the same instructions apply as for extractions please read them as well
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.
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 continues please call for further instructions.
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.
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.
You should begin taking pain medication as soon as you feel 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 6-8 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.
It is imperative that you take the prescribed antibiotcs regularly following the procedure and until finished.
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to 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 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures may be used after surgery if they have been altered to accommodate any changes in the implant site. They may be left out when it is practical.