I. Preoperative Instructions for Patients Undergoing Intravenous Anesthesia
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 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.
Please remove nail polish (index finger of both hands) and apply as little makeup as possible.
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 peaks on the 3rd or 4th post-operative day
Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a few days.
You may have 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 following meals with warm salt water 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.
Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.
II. Care of Mouth After Oral Surgery
Do not rinse or brush for the rest of the day.
Keep fingers and tongue away from socket or surgical area.
Use ice packs on surgical area (side of face) for first 24 hours, apply ice 20 minutes on — 20 minutes off. Bags of frozen peas and corn work well.
For mild discomfort take Tylenol or Ibuprofen every four hours.
For severe pain use the medication prescribed 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 post-operative 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.) For the first 3 days this rinsing consists of gargling and then letting the water drool out of the mouth.
Your diet after surgery should consist of nonchewing foods for the remainder of the day. The following day you may advance your diet to more solid foods. Diet may consist of soft foods which can be easily chewed and swallowed. No 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 moist gauze.The gauze will need to be replaced as it becomes saturated (45-60 minutes). The gauze will need to remain in place, except when you eat or sleep, until bleeding stops. If bleeding persists, a moist tea bag should be placed over the area. Firm pressure should be applied for one hour straight. This will aid in the formation of a blood clot. Repeat if necessary. if bleeding still persists, call our office.
We suggest that you do not smoke, suck through a straw or spit for at least 5 days after surgery. These activities may dislodge the blood clot and cause a "dry-socket".
Feel free to contact us if any doubt arises as to your progress and recovery.
III. Post-Op Instructions
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. This blood clot 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 bruised, swollen and tender to touch due to the IV.
Follow the simple instructions below to minimize complications and help ensure prompt recovery.
To control bleeding
Immediately following 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.
After 24 hours... some oozing of blood may persist. If necessary, resume use of 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.
After 24 hours, continue to take your medication if pain persists.
To minimize swelling
Immediately following procedure. . .apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 24 hours to help prevent excessive swelling and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice. Tie 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 7 to 10 days and a fever of 99 to 100 degrees Fahrenheit.
Special considerations following removal of impacted teeth:
Removal of impacted teeth is a surgical procedure. Plan your schedule accordingly.
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. It is not possible to inform you exactly how long you will have discomfort.
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
Twenty-four 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 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. But if you should have any problems such as excessive bleeding, pain or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment.
Remember your follow-up visit
It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. A follow-up visit will be scheduled. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene and visit your dentist for regular checkups.
