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Surgical Instructions

I. Preoperative Instructions for Patients Undergoing IV Medications

  1. FASTING: You may not have anything to eat or drink (including water) for six (6) hours prior to the appointment.
  2. TRANSPORTATION: A responsible adult must accompany the patient to the office, remain in the office during the procedure, and be able to drive the patient home.
  3. RESTRICTIONS: The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
  4. CLOTHES: 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.

The removal of impacted wisdom teeth and the surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

  1. Swelling peaks on the 2nd or 3rd post -operative day
  2. Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
  3. You may have a slight earache.
  4. A sore throat may develop.
  5. Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
  6. The corners of the mouth may be dry or sore. Your lips should be kept moist with cream or ointment.
  7. 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 tooth socket will gradually fill in with new tissue.
  8. There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
  9. It is not unusual to develop bruising in the area of an extraction.

Please take all prescriptions as directed.

II. 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. Do not rinse your mouth or brush your teeth for 24 hours. Do not drink through a straw or spit. These activities may hinder formation of a blood clot, which is necessary for proper healing. It is important to drink a large volume of cold liquids during the first 24 hours following your procedure.

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 touch due to the IV.

After surgery you may experience jaw muscle stiffness and a limited opening of your mouth. This is normal and should improve in 7 to 14 days. Regular doses of an anti-inflammatory medication and warm, moist compresses will help decrease jaw stiffness.

Follow the simple instructions below to minimize complications and help ensure prompt recovery.

To control bleeding

Some blood may ooze from the area of surgery for the first 24 hours. This is a normal occurrence. 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. Gently remove the compress when you get home following the surgery.

After 24 hours... some oozing of blood may persist. If necessary, place gauze or moist tea bags directly over the socket and bite firmly for 20 minutes. 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 in your lip, tongue, and chin are back to normal. Application of an ice bag can also help relieve discomfort. Extra strength Tylenol or Advil can be taken at first or at the same time as your pain medication.

After 24 hours, continue to take your medication if pain persists, and use an ice bag if needed.

Some discomfort is normal after surgery. If by the fourth or fifth day the pain has not subsided and cannot can be controlled by pain medication, please contact our office and report these symptoms so that you can receive additional instructions and clinical advice.

To minimize swelling

Immediately following procedure: apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for up to 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. Tie end securely and cover with a soft cloth to avoid skin irritation.

After 48 hours, a warm moist compress is recommended. Swelling is normal and usually reaches its maximum approximately 2-3 days after surgery before it begins to subside.

Special considerations following removal of impacted teeth:

  1. Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications.
  2. Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.
  3. Healing of the surgical site is variable.
  4. Swelling can be expected. Be certain to apply ice bags as directed above.
  5. Difficulty in opening your mouth widely and discomfort upon swallowing should be anticipated.
  6. 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 teaspoonful of salt dissolved in 8 ounces 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. You may be given an irrigating syringe at one of your post-op appointments to help keep the surgical site clean.

Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot.

Stitches may have been placed in your extraction area. They are either dissolvable or will be removed at one of your post-operative appointments.

Maintain a proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of cold liquids - with meals and in between. Be careful not to disturb the blood clot. Add more solid foods to your diet as instructed by your doctor. You will be given a list of eating suggestions at the time of your appointment.

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. One of our doctors is always on call and can be reached by calling 703-506-1414 and following the instructions.

Remember your follow-up visit

It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. These follow-up visits will be scheduled 7- 10 days after the procedure. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and visit your dentist for regular checkups.