Surgical Instructions

Wisdom Teeth Removal – Post-op Guide

Day 1

Drink a lot of Fluids – it is important to stay hydrated with water or Gatorade, especially to avoid nausea, dehydration and other problems associated with pain medications.

Hold gauze packs between surgical sites with gentle pressure. Change the gauze after one hour, checking the bleeding while changing. After one more hour, check the bleeding again. If the bleeding has stopped, you may leave the gauze out. If bleeding continues you can replace moistened gauze every 30-45 minutes or place a black tea bag over surgical site with pressure. It is normal to have oozing or intermittent bleeding, but NOT severe bleeding.

Take your first pain pill BEFORE the local anesthetic (numbing) has worn off (1-2 hours). We recommend you take your prescribed Motrin and/or over the counter Tylenol on a regular schedule and the narcotic you were prescribed (tramadol, hydrocodone or oxycodone) as needed. It is okay to take Motrin, Tylenol and narcotic at the same time, but we recommend layering medications per your individual needs. Some patients will not be prescribed Motrin due to being on a blood thinner, diabetic or other health concerns that prohibits Motrin usage. In those instances, take Tylenol on a regular schedule. If you were given Toradol through your IV then take your first dose of Motrin 6 hours after leaving the facility.

You will need a responsible adult with you for at least 5 hours after IV anesthesia. Avoid rinsing vigorously, spitting, or sucking through a straw for the first 24 hours. Do not probe surgical area. Do not drive, drink alcohol, or operate any kind of machinery for 24 hours after anesthesia. Do not smoke for at least one week after surgery. It is okay to brush your teeth and wear retainers as comfortable.

Begin applying an ice pack to the face over the surgical area to reduce swelling. Ice should be used for 20 minutes every few hours while awake for 2-3 days. Starting day 2-3 apply a warm compress for 20 minutes 3 times a day to decrease swelling and stiffness.

Once bleeding has stopped, begin by drinking clear fluids. If you tolerate this well, you may begin taking other fluids including Jell-o, pudding, and ice cream.

Days 2 to 5

• Numbness should last 1-8 hours after the procedure. If numbness continues to the next day, please schedule a 1-2-week follow-up appointment.
• Stitches are not required for every procedure. When they are used, they should dissolve on their own in 1-7 days.
• Bruising can occur a few days after the procedure. Gravity can pull the bruising down to the neck or upper chest.
• Swelling will increase for 3 days and gone by 7-10 days.
• Cracking at corner of mouth is common after oral surgery. Keep the area clean and use Vaseline or Aquaphor ointment.
• Sharp edges in the surgical area, it is normally bony walls which originally supported the teeth.
• Tissue white appearance is normal, also tissue can be loose after procedure and will tighten up with healing.

Continue eating soft foods and drinking lots of fluids. Advance your diet as you tolerate per comfort. Do not to skip meals. You will have some jaw stiffness and muscle soreness for up to 2 weeks.

Keep your mouth clean by rinsing with Peridex prescription mouth rinse or warm saltwater (1/4 tsp salt to 8 oz. water) at least 2-3 times daily beginning 1 day after surgery and continuing for at least 1 week. It is okay to brush your teeth

Often after a procedure you should take 2-3 days off of work or school. Avoid excess exertion, working out, athletic competition, band and choir participation for 3-5 days.

Concerns

• Infection – Infection occurs in about 2% of patients after surgery and are generally caused by bacteria from the mouth. Signs of infection include pain, firm swelling, redness of the soft tissue, and soft tissue that may be warm to the touch. If you suspect an infection, please call us right away so we can get you treated. Infection can occur up to 2 months after the procedure.
• Allergy – Allergic reactions can occur with any medication. The most common signs of an allergic reaction include rash, hives, and itching. If these occur, stop the medication, take an antihistamine (Benadryl), and call your doctor.
• Osteitis “dry socket” – Dry socket occurs about 5% of the time and is more common in females (especially if taking birth control) or as a result of smoking or drinking through a straw the first 5 days. The blood clot fails to form or is lost prematurely, leaving the bony walls of the socket exposed. Bacteria can colonize and irritate the socket, causing pain and inflammation. Uncontrolled pain during the first week after surgery is the main symptom of dry socket. This will heal on its own, but if the pain is intolerable, please call and we can get you treated with a packing.

Implant and/or Bone Grafting – Post-op Guide

Day 1

Drink a lot of Fluids – it is important to stay hydrated with water or Gatorade, especially to avoid nausea, dehydration and other problems associated with pain medications.

Hold gauze packs between surgical sites with gentle pressure. Change the gauze after one hour, checking the bleeding while changing. After one more hour, check the bleeding again. If the bleeding has stopped, you may leave the gauze out. If bleeding continues you can replace moistened gauze every 30-45 minutes or place a black tea bag over surgical site with pressure. It is normal to have oozing or intermittent bleeding, but NOT severe bleeding.

Take your first pain pill BEFORE the local anesthetic (numbing) has worn off (1-2 hours). We recommend you take your prescribed motrin and/or over the counter tylenol on a regular schedule and the narcotic you were prescribed (tramadol, hydrocodone or oxycodone) as needed. It is okay to take motrin, Tylenol and narcotic at the same time, but we recommend layering medications per your individual needs. Some patients will not be prescribed motrin due to being on a blood thinner, diabetic or have condition that does not allow motrin usage. In those instances, take Tylenol on a regular schedule. If you were given Toradol through your IV then take your first dose of motrin 6 hours after leaving the facility.

You will need a responsible adult with you for at least 5 hours after IV anesthesia. Avoid rinsing vigorously, spitting, or sucking through a straw for the first 24 hours. Do not probe surgical area. Do not drive, drink alcohol, or operate any kind of machinery for 24 hours after anesthesia. Do not smoke for at least one week after surgery. It is okay to brush your teeth and wear retainers as comfortable – if you have teeth remaining.

Begin applying an ice pack to the face over the surgical area to reduce swelling. Ice should be used for 20 minutes every few hours while awake for 2-3 days. Starting day 2-3 apply a warm compress for 20 minutes 3 times a day to decrease swelling and stiffness.

Once bleeding has stopped, begin by drinking clear fluids. If you tolerate this well, you may begin taking other fluids including jello, pudding, and ice cream.

Days 2 to 5

• Stitches are not required for every procedure. When they are used, they should dissolve on their own in 1-7 days. If bone grafting long lasting sutures placed and will be removed at follow-up appointment.
• Bruising can occur a few days after the procedure. Gravity can pull the bruising down to the neck or upper chest.
• Swelling will increase for 3 days and be gone in 7-10 days.
• Cracking at corner of mouth is common after oral surgery. Keep the area clean and use Vaseline or Aquaphor ointment.
• Sharp edges in the surgical area, it is normally bone fragments or edges. If does not smoothen after 2 weeks schedule a follow-up appointment.
• Tissue white appearance is normal, also tissue can be loose after procedure and will tighten up with healing.

Continue eating soft foods and drinking lots of fluids. Advance your diet as you tolerate per comfort. Do not to skip meals. If bone grafting occurred eat soft foods in that area for 4 weeks.

Keep your mouth clean by rinsing with Peridex prescription mouth rinse or warm saltwater (1/4 tsp salt to 8 oz. water) at least 2-3 times daily beginning 1 day after surgery and continuing for at least 1 week. It is okay to brush your teeth.

Often after a procedure you should take 1-3 days off of work or school. Limit exercise for 3-5 days.

If sinus grafting occurred practice sinus precautions. No blowing nose, sneeze and cough with mouth open for 1 week.

Do Not pull-on lips or surgical sites for bone grafting cases!

Concerns

• Infection – Infection occurs in about 2% of patients after surgery and are generally caused by bacteria from the mouth. Signs of infection include pain, firm swelling, redness of the soft tissue, and soft tissue that may be warm to the touch. If you suspect an infection, please call us right away so we can get you treated. Infection can occur up to 2 months after the procedure.
• Allergy – Allergic reactions can occur with any medication. The most common signs of an allergic reaction include rash, hives, and itching. If these occur, stop the medication, take an antihistamine (Benadryl), and call your doctor.
• Dentures – If dentures, partial denture placed do not expect it to fit right away. You will need to follow-up with your dentist to adjust the appliance for it to fit better. If you are having bleeding you will need to remove the appliance and bite on gauze. Otherwise leave appliance in place until your dentist can adjust your appliance.
• Flipper (retainer) – Can be removed as needed. Appliance may not fit well with swelling. Appliance will need to be removed with eating. If you had bone grafting appliance may not be worn for 2 weeks.

Tooth/Teeth Removal Post-Op

Day 1

Drink a lot of Fluids – it is important to stay hydrated with water or Gatorade, especially to avoid nausea, dehydration and other problems associated with pain medications.

Hold gauze packs between surgical sites with gentle pressure. Change the gauze after one hour, checking the bleeding while changing. After one more hour, check the bleeding again. If the bleeding has stopped, you may leave the gauze out. If bleeding continues you can replace moistened gauze every 30-45 minutes or place a black tea bag over surgical site with pressure. It is normal to have oozing or intermittent bleeding, but NOT severe bleeding.

Take your first pain pill BEFORE the local anesthetic (numbing) has worn off (1-2 hours). We recommend you take your prescribed motrin and/or over the counter tylenol on a regular schedule and the narcotic you were prescribed (tramadol, hydrocodone or oxycodone) as needed. It is okay to take motrin, Tylenol and narcotic at the same time, but we recommend layering medications per your individual needs. Some patients will not be prescribed motrin due to being on a blood thinner, diabetic or have a condition that does not allow motrin usage. In those instances, take Tylenol on a regular schedule. If you were given Toradol through your IV then take your first dose of motrin 6 hours after leaving the facility.

You will need a responsible adult with you for at least 5 hours after IV anesthesia. Avoid rinsing vigorously, spitting, or sucking through a straw for the first 24 hours. Do not probe surgical area. Do not drive, drink alcohol, or operate any kind of machinery for 24 hours after anesthesia. Do not smoke for at least one week after surgery. It is okay to brush your teeth and wear retainers as comfortable – if you have teeth remaining.

Begin applying an ice pack to the face over the surgical area to reduce swelling. Ice should be used for 20 minutes every few hours while awake for 2-3 days. Starting day 2-3 apply a warm compress for 20 minutes 3 times a day to decrease swelling and stiffness.

Once bleeding has stopped, begin by drinking clear fluids. If you tolerate this well, you may begin taking other fluids including jello, pudding, and ice cream.

Days 2 to 5

• Stitches are not required for every procedure. When they are used, they should dissolve on their own in 1-7 days.
• Bruising can occur a few days after the procedure. Gravity can pull the bruising down to the neck or upper chest.
• Swelling will increase for 3 days and will be gone in 7-10 days.
• Cracking at corner of mouth is common after oral surgery. Keep the area clean and use Vaseline or Aquaphor ointment.
• Sharp edges in the surgical area, it is normally bone fragments or edges. If does not smoothen after 2 weeks schedule a follow-up appointment.
• Tissue white appearance is normal, also tissue can be loose after procedure and will tighten up with healing.

Continue eating soft foods and drinking lots of fluids. Advance your diet as you tolerate per comfort. Do not to skip meals. You may have some jaw stiffness and muscle soreness for 2 weeks.

Keep your mouth clean by rinsing with Peridex prescription mouth rinse or warm saltwater (1/4 tsp salt to 8 oz. water) at least 2-3 times daily beginning 1 day after surgery and continuing for at least 1 week. It is okay to brush your teeth.

Often after a procedure you should take 1-3 days off of work or school. Limit exercise for 3-5 days.

If upper back tooth removed practice sinus precautions. No blowing nose, sneeze and cough with mouth open for 1 week.

• Infection – Infection occurs in about 2% of patients after surgery and are generally caused by bacteria from the mouth. Signs of infection include pain, firm swelling, redness of the soft tissue, and soft tissue that may be warm to the touch. If you suspect an infection, please call us right away so we can get you treated. Infection can occur up to 2 months after the procedure.
• Allergy – Allergic reactions can occur with any medication. The most common signs of an allergic reaction include rash, hives, and itching. If these occur, stop the medication, take an antihistamine (Benadryl), and call your doctor.
• Dentures – If dentures, partial denture placed do not expect it to fit right away. You will need to follow-up with your dentist to adjust the appliance for it to fit better. If you are having bleeding you will need to remove the appliance and bite on gauze. Otherwise leave appliance in place until your dentist can adjust your appliance.
• Flipper (retainer) – Can be removed as needed. Appliance may not fit well with swelling. Appliance will need to be removed with eating. If you had bone grafting appliance may not be worn for 2 weeks.

Pathology – Postoperative Guide

Day 1

Drink a lot of Fluids – it is important to stay hydrated with water or Gatorade, especially to avoid nausea, dehydration and other problems associated with pain medications.

Hold gauze packs between surgical sites with gentle pressure. Change the gauze after one hour, checking the bleeding while changing. After one more hour, check the bleeding again. If the bleeding has stopped, you may leave the gauze out. If bleeding continues you can replace moistened gauze every 30-45 minutes or place a black tea bag over surgical site with pressure. It is normal to have oozing or intermittent bleeding, but NOT severe bleeding.

Take your first pain pill BEFORE the local anesthetic (numbing) has worn off (1-2 hours). We recommend you take your prescribed motrin and/or over the counter tylenol on a regular schedule and the narcotic you were prescribed (tramadol, hydrocodone or oxycodone) as needed. It is okay to take motrin, Tylenol and narcotic at the same time, but we recommend layering medications per your individual needs. Some patients will not be prescribed motrin due to being on a blood thinner, diabetic or have a condition that does not allow motrin usage. In those instances, take Tylenol on a regular schedule. If you were given Toradol through your IV then take your first dose of motrin 6 hours after leaving the facility.

You will need a responsible adult with you for at least 5 hours after IV anesthesia. Avoid rinsing vigorously, spitting, or sucking through a straw for the first 24 hours if tooth removed. Do not probe surgical area. Do not drive, drink alcohol, or operate any kind of machinery for 24 hours after anesthesia. Do not smoke for at least one week after surgery. It is okay to brush your teeth and wear retainers as comfortable – if you have teeth remaining.

Begin applying an ice pack to the face over the surgical area to reduce swelling. Ice should be used for 20 minutes every few hours while awake for 2-3 days. Starting day 2-3 apply a warm compress for 20 minutes 3 times a day to decrease swelling and stiffness.

Once bleeding has stopped, begin by drinking clear fluids. If you tolerate this well, you may begin taking other fluids including jello, pudding, and ice cream.

Days 2 to 5

Other things to expect:

• Stitches are not required for every procedure. When they are used, they should dissolve on their own in 1-7 days.
• Bruising can occur a few days after the procedure. Gravity can pull the bruising down to the neck or upper chest.
• Swelling will increase for 3 days and should be gone by 7-10 days.
• Cracking at corner of mouth is common after oral surgery. Keep the area clean and use Vaseline or Aquaphor ointment.
• Sharp edges in the surgical area, is normally bone fragments or edges of bone. If does not smoothen after 2 weeks schedule a follow-up appointment.
• Tissue white appearance is normal, also tissue can be loose after procedure and will tighten up with healing.

Continue eating soft foods and drinking lots of fluids. Advance your diet as you tolerate per comfort. Do not to skip meals. You may have some jaw stiffness and muscle soreness for 2 weeks.

Keep your mouth clean by rinsing with Peridex prescription mouth rinse or warm saltwater (1/4 tsp salt to 8 oz. water) at least 2-3 times daily beginning 1 day after surgery and continuing for at least 1 week. It is okay to brush your teeth.

Often after a procedure you should take 1-3 days off of work or school. Limit exercise for 3-5 days.

Concerns

• Infection – Infection occurs in about 2% of patients after surgery and are generally caused by bacteria from the mouth. Signs of infection include pain, firm swelling, redness of the soft tissue, and soft tissue that may be warm to the touch. If you suspect an infection, please call us right away so we can get you treated. Infection can occur up to 2 months after the procedure.
• Allergy – Allergic reactions can occur with any medication. The most common signs of an allergic reaction include rash, hives, and itching. If these occur, stop the medication, take an antihistamine (Benadryl), and call your doctor.
• Pathology Results – Biopsy results should be available in 1-2 weeks after procedure performed. The doctor will call you with results unless a follow-up appointment was scheduled.