Surgical Instructions

Extraction/Sedation Post-Operative Instructions

  1. POST-I.V. ANESTHESIA: Patients who have received I.V. anesthesia should be escorted home and cared for during the remainder of the day. Sedated patients are at risk for falling. Avoid standing or shifting positions too quickly. Immediately lie down with your head elevated until all of the effects of the anesthesia have subsided. Anesthetic effects vary by individual and you may feel drowsy for a short period of time or several hours. You should not operate any mechanical equipment or operate a motor vehicle for at least 24 hours or longer if you feel any residual effect from anesthetic. Local anesthesia will be present for 1–4 hours. To avoid injury, do not bite or pinch your lip or tongue until the numbness wears off.

  2. BLEEDING: Maintain firm biting pressure on the gauze packing for 30-60 minutes after your extraction, then remove the gauze and eat/drink something very cold. If bleeding is light do not replace gauze. Light bleeding or “oozing” is normal for the first 24 hours. Do not be alarmed. For persistent bleeding, gauze may be replaced. If excessive bleeding persists longer than a few hours, contact the office for further instructions.

  3. MEDICATIONS / PRESCRIPTIONS: You can expect to experience discomfort following your extraction. Mild-to-moderate pain can be relieved by non-prescription pain medication such as Advil or Ibuprofen. For severe pain, use the prescription medication that was given to you by the doctor. Pain medicine should be taken before the local anesthetic wears off.
    • Take all medications as prescribed.
    • Do not take pain medications on an empty stomach (1 cup of clear liquid should be taken before medications are given.)
    • Do not mix medications with alcoholic beverages.
    • While taking narcotic pain medication that may make you sleepy, it is very important to avoid driving a vehicle or operating any heavy machinery.
    • IMPORTANT: If an antibiotic is prescribed, all female patients utilize birth control pills must be advised that you need to use an alternative method of birth control during this time.

  4. SWELLING Swelling is normal and usually peaks at about 48-72 hours after surgery.
    • Apply an ice pack for the first 24 hours after surgery (20 minutes on, 20 minutes off).
    • After 24 hours, moist heat can be applied to help decrease stiffness soreness in the jaw or face.

  5. BRUISING: Bruising may be present in varying degrees. It will subside over a period of 5-14 days.

  6. BRUSHING AND RINSING: Do not brush, rinse or spit for the first 24 hours. After that, gently rinse with warm salt-water following meals and before bedtime (1 teaspoon of salt in an 8oz glass of warm water). Continue to do so over the next few weeks. If a medicated rinse is prescribed, then use it as directed along with the salt-water rinses. Gentle brushing may be resumed after the first 24 hours.

  7. DIET: For two days: Have cool, soft, mild foods that can be easily swallowed. Avoid chewing. Avoid hot-temperature foods (nothing above room temperature). Avoid hot and spicy foods, seeds, nuts, popcorn, etc. Avoid using straws; doing so may dislodge the blood clot and delay healing. Supplements such as Ensure or Carnation Instant Breakfast provide excellent added nutrition. After two days: Advance diet as tolerated.

  8. SUTURES: Sutures may have been placed to promote healing. If sutures were placed, they will dissolve or fall out on their own within 7-14 days, or they will be removed at the appropriate post-operative appointment.

  9. SMOKING: Smoking is detrimental to healing. Do not smoke or use smokeless tobacco for several days to decrease the chance of delayed healing and infection.

  10. ACTIVITY: Limit physical activity during the first 3 days after surgery. Over exertion may lead to post-operative bleeding and discomfort.

IMMEDIATE DENTURE INSTRUCTIONS

The denture that was placed in your mouth immediately after surgery will serve as a surgical bandage. Do not remove the denture for 24 hours. Usually a follow up visit with your dentist is needed 1 to 2 days after insertion of your denture.

POSSIBLE CONDITIONS AFTER SURGERY

DRY SOCKET: A dry socket is when part of the blood clot either dissolves or falls out at the surgical site. This is not a serious complication, but is often a painful one. Symptoms include severe throbbing pain in the jaw that radiates toward the ear, usually 3-5 days after surgery. If this is the case, please contact the office, as a medicated dressing may need to be placed into the site to improve comfort as the healing progresses.

ANTIBIOTICS: Antibiotics may cause diarrhea or upset stomach. Eating active yogurt culture may help decrease the incidence.

FEVER: Your temperature may rise slightly for a day or two after surgery and is usually of no concern. If you feel warm or sweaty, we recommend that you take and record your temperature. If your temperature is persistently raised, please contact our office and continue drinking plenty of liquids.

MUSCLE STIFFNESS: Tenderness and stiffness within the chewing muscles may develop during the post-operative period and should not alarm you. It is best treated with moist heat therapy. It will slowly resolve over a 5-10 day period.

IV INJECTION SITE: The point where the needle entered the vein may develop a bluish color, which will change to yellow and then to normal in a matter of days. There may be a slight tenderness to the area and perhaps some small lumps. These signs and symptoms are usually of no concern and are the best treated with a hot moist towel and elevation of the arm. Should the arm begin to swell or tenderness progress up toward the shoulder, please contact our office.

NUMBNESS: Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and subsides within a few days or weeks. Occasionally, some numbness may persist for months. We will need to document and discuss this numbness during your follow up visit.

NAUSEA/VOMITING: Sipping 7-Up, ginger ale, or cola may help. If severe nausea or vomiting persists, please contact our office.

SHARP BONY EDGES: Small pieces of bone may work out of the surgical area as long as 5-6 weeks following surgery. This may resolve on it’s own over a period of a few weeks. If necessary, removal of bone spicules is a simple and routine process.

SORE LIP/CHEEKS: The corners of your mouth may be dry and cracked after surgery. This is best treated by gently applying Vaseline.