I. Preoperative Instructions for Patients
Undergoing Intravenous Sedation
- You may not have anything to eat or drink (including water) for six (8) hours prior to the appointment.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive 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.
II. Post-Operative Instructions
The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:
- The surgical area will swell.
- Swelling usually peaks on the 2nd or 3rd postoperative day.
- Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of several days.
- You may experience a slight earache.
- A sore throat may develop.
- Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
- If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
- There will be a space where the tooth was removed. After 24 hours this area should be rinsed with warm salt water following meals until it is healed. This cavity will gradually fill in with new tissue.
- There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
- It is not unusual to develop bruising in the area of an extraction.
Please take all prescriptions as directed. For women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.
III. Care of the Mouth After Oral Surgery
- Do not rinse or spit for 24 hours after surgery.
- Keep fingers and tongue away from socket or surgical area.
- Use ice packs on surgical area (side of face) for first 24-48 hours, apply ice 20 minutes on – 10 minutes off. Bags of frozen peas work well as a substitute for ice packs.
- For mild discomfort take Tylenol or Ibuprofen every three to four hours.
- For severe pain use the prescription given to you.
- Drink plenty of fluids. Do not use a straw.
- If the muscles of the jaw become stiff, chewing gum at intervals will help relax the muscles, as well as the use of warm, moist heat to the outside of your face over these muscles.
- After the first postoperative day, use a warm salt-water rinse following meals for the first week to flush out particles of food and debris which may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water; mouthwash can be added for better taste.)
- Your diet may consist of soft foods which can be easily chewed and swallowed.
- Please avoid “harder” foods such as seeds, nuts, rice, popcorn, etc.
- A certain amount of bleeding is to be expected following surgery. Bleeding is controlled by applying pressure to the surgical area using small rolled gauze for 60 minutes. After that time, remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists call our office.
- We suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a “dry-socket”.
Feel free to contact us if any questions arise as to your progress and recovery!
What you should do following extractions and other oral surgery procedures:
A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours. Avoid eating, drinking, and unnecessary talking. Do not rinse your mouth or brush your teeth for 24 hours. These activities may hinder formation of a blood clot which is necessary for proper healing.
Do not be alarmed if your vision is blurred for a time following anesthesia or if a “black and blue” bruise should appear at the site of an injection. The arm also may be “black and blue”, swollen and tender to the touch due to the IV.
Follow these simple instructions below to minimize complications and help ensure prompt recovery.
To control bleeding:
Immediately following the procedure, keep a steady pressure on the bleeding area by biting firmly on the gauze placed there by your doctor. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. Gently remove the compress after about 30-45 minutes when the local anesthesia has worn off and normal feeling has returned.
After 24 hours, some oozing of blood may persist. If necessary, use moist tea bags.
After bleeding has stopped, cautiously resume oral hygiene.
To relieve pain:
Immediately following the procedure, begin taking medication as directed by your doctor to minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an ice bag can also help relieve discomfort. Continue ice for 24-48 hours. Then continue to take your medication if pain should persist, and use an ice bag if needed.
To minimize swelling:
Immediately following the procedure, apply an ice bag over the affected area. Use 20 minutes on and 10 minutes off for 24-48 hours to help prevent development of excessive swelling and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice, or use a bag of frozen peas. Tie the end securely and cover with a soft cloth to avoid skin irritation.
After 24 hours, it should not be necessary to continue with cold applications. You may expect swelling for 10 to 14 days and a fever of 99 degrees F to 100 degrees F.
Special considerations following removal of impacted teeth:
- Removal of impacted teeth is a surgical procedure. Postoperative problems can arise, and extra care must be taken to avoid complications.
- Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.
- Healing of the surgical site is variable.
- Swelling can be expected. Be certain to apply ice bags as directed above.
- Difficulty in opening your mouth widely and discomfort upon swallowing should be anticipated.
- Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.
Oral hygiene is important!
24 hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing. Brush your tongue with a dry toothbrush to keep bacteria growth down, but be careful not to touch the extraction site.
Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot.
Maintain a proper diet!
Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids – with meals and in between. Have what you wish, but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.
In case of problems . . .
You should experience no trouble if you follow the instructions and suggestions as outlined above. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, please do not hesitate to call our office immediately for further instructions or additional treatment.