Surgical Instructions
PLEASE READ AND FOLLOW THESE SURGICAL INSTRUCTIONS CAREFULLY.
It is reasonable to expect that your normal activities will be disrupted following any surgical procedure. Frequently, the after-effects of oral surgery are quite minimal and some of the following instructions may not apply. Common sense will often dictate what you should do. However, when in doubt please follow these guidelines or call our office for clarification. If needed, a 24-hour answering service is in place to contact Dr. Wendling and Dr. Taylor after hours. It is our desire that your recovery is as smooth and pleasant as possible.
Pre-Operative Instructions
If sedation is planned for your procedure, you will require:
- A pre-operative fast:
- DO NOT EAT or DRINK anything six (6) hours prior to your appointment.
- Take your daily prescribed medications (high blood pressure, etc.) as usual with a small sip of water unless instructed otherwise.
- Take any prescribed pre-medication as directed with a small sip of water, 1 hour prior to your appointment.
- An adult escort to:
- Stay on the property during surgery;
- Drive you home;
- Stay with you at home for at least 3-4 hours while you recover.
- WEAR COMFORTABLE, LOOSE-FITTING CLOTHING WITH SHORT SLEEVES.
- Drink a lot of water the night before surgery to hydrate your vascular system.
- A legal guardian must accompany minors for all procedures.
Post-Operative Instructions
If You Received Sedation
Bleeding
Swelling
Discomfort
Oral Hygiene & Care
Dental Implants & Bone Grafting
Diet
Healing
Nausea
Infection
If You Received Sedation
- Immediately return home and lie down with your head elevated until the effects of the anesthetic have disappeared.
- Anesthetic effects vary by individual. Drowsiness may last for a short period of time or for several hours.
- Plan to rest for the remainder of the day. Do not drive or operate mechanical equipment for 24 hours following surgery.
Bleeding
- Bite down gently on the gauze packs for 30 minutes to ensure that any post-operative bleeding stops.
- Check the extraction site after gauze pack removal. If rapid blood flow continues, place a moistened new gauze pack over the site and bite down firmly for another 30 minutes without talking or releasing pressure. Once rapid blood flow has stopped, leave the gauze out.
- Intermittent bleeding, oozing, or pink saliva is often present for several days depending on activity. Repeated gauze pack placement is not required for this and actually contributes to unnecessary bleeding.
- Bleeding should never be severe. If it is:
- Reposition the gauze packs to ensure they are exerting pressure over the surgical areas.
- Try biting on a tea bag for 30 minutes. Moisten the tea bag, squeeze damp-dry, wrap with moist gauze, and insert over the site.
- If the bleeding remains uncontrolled, please call our office.
Swelling
- Swelling is usually noticeable the morning after surgery, maximizes over the first 48 hours, and may last over a week.
- First 72 hours:
- Apply a cold compress to the face over the surgical area while awake. Alternate applications 20 minutes on, then 20 minutes off.
- Keep head elevated. Do not alternate cold compress application with warm compress application.
- After 72 hours:
- Apply a warm compress to the swollen areas. Alternate applications 20 minutes on, then 20 minutes off.
- Delay warm compress application for 24 hours if swelling increases.
- Hot showers, cheek massage, and jaw stretching exercises will help resolve swelling and limited jaw opening.
Discomfort
- Prescription pain medication is usually provided to ensure adequate relief of post-operative discomfort.
- Take the medication before the numbing effect of the local anesthetic has worn off (2-10 hours) and then on schedule.
- Eat something 15-20 minutes prior to taking the medication to reduce the chance of nausea or stomach discomfort.
- Try taking Ibuprofen 800 mg every 8 hours in addition to the prescribed medication if you continue to have discomfort.
- The most severe discomfort is usually within the first six hours of the local anesthetic wearing off. It should gradually improve afterward.
- Jaw pain 3-5 days after surgery that is dull, throbbing, and not controlled by pain medication may be a sign of a “dry socket”.
- The effects of pain medication vary widely among individuals. Common side effects include nausea, headaches, and feeling “wired”. If you are experiencing side effects, “dry socket” symptoms, or having difficulty staying comfortable, please call our office.
Oral Hygiene & Care
- Leave the surgical area undisturbed. Do not rinse vigorously or probe the area with any objects.
- Do not smoke (for at least 72 hours). Smoking is very detrimental to healing and commonly causes a “dry socket”.
- Chew on the opposite side (if applicable).
- Gently brush your teeth as usual.
- Rinse your mouth 2-3 times daily with salt water (1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water).
- Do not use Listerine, Scope, or any other mouthwash containing high levels of alcohol.
- Plastic irrigating syringes are usually given out at your follow-up appointment. If you were given one early, please do not use it for the first week – it may cause a dry socket. After that, it may be used daily to remove any food debris that has collected in the extraction sites.
- Immediate dentures (if inserted) should remain in place for the first 48 hours, and removed only briefly to clean and rinse with saltwater.
Dental Implants & Bone Grafting
- It is extremely important that the implant or graft remain immobile during the healing phase to avoid failure or unaesthetic results.
- Do not chew over the surgical site.
- Do not use immediately placed temporary crowns to chew.
- Temporary dentures or “flippers” should not touch the surgical site. If they do, please return to the office for an adjustment.
- Sutures and tissue cement are often placed around the surgical site to provide a tight seal. They will be removed at your post-op visit.
Diet
- Proper nourishment is very important to the healing process. Eating regularly will allow you to feel better, gain strength, have less discomfort, and heal faster. Your diet should gradually return to normal as the swelling and jaw stiffness resolve.
- Start with liquids or pureed foods (ice cream, yogurt, pudding, soup). Advance to a normal diet as tolerated. Avoid foods like nuts, sunflower seeds, and popcorn that may become lodged in the extraction sites. Avoid extremely hot foods.
- Do not drink alcohol for 24 hours after surgery or while taking pain medication.
- Avoid carbonated beverages and DO NOT USE A STRAW for a week to reduce the risk of a “dry socket”.
- If you are a diabetic, maintain as normal a diet as possible, monitor your blood sugar, and take your diabetic medication.
Healing
- The first two days are generally the most uncomfortable, followed by gradual steady improvement. If you don’t see continued improvement or feel like you are getting worse, please call our office.
- Sutures typically dissolve on their own over the first week.
- Bruising may occur. It is usually limited to the cheek & neck near the surgical site and may take over a week to completely disappear.
- The altered sensation of the lower lip and chin may occur if surgery is close to the nerve. It usually returns to normal over several weeks.
- The bony walls that once supported the tooth may become irregular or sharp during healing.
- These areas typically resolve over several months without the need for a bone smoothing procedure.
- Occasionally small slivers of bone fail to survive and work themselves out during the weeks following surgery.
- If the irregularity or sharp spot fails to resolve or causes discomfort, please call the office.
Nausea
- Nausea can occasionally occur after receiving general anesthetic medications despite preventative anti-nausea medication.
- Usually, pain medications are the cause, especially if they are taken on an empty stomach.
- If you become nauseated:
- Limit your intake to clear liquids. Avoid milk products.
- Use Ibuprofen (800 mg every 8 hours), and try taking only half of a prescription pain pill every 4 hours.
- Please call the office if this does not help.
Infection
- Fortunately, post-operative infections are rare. They do not occur until after the third post-operative day.
- Food debris can become trapped in lower extraction sites and cause a delayed infection 4-6 weeks after surgery.
- Please follow the irrigation syringe oral hygiene instructions during healing to prevent this complication.
- Signs of infection include increased pain, swelling, bad taste, redness, or temperature.
- If you suspect you have an infection, please call the office.