While we are very concerned about all of our patients comfort, our top priority is our patient's safety and well being, therefore it is imperative that you adhere to the following instructions when preparing for you upcoming treatment:
Nothing to eat or drink (this includes NO gum, mints, candy, water, coffee or any other beverage) for 6 hours prior to your surgery. No heavy, greasy or fatty foods 8 hours prior to your surgery. You may take a small sip of water (only water) to take any regular medications unless instructed differently by your doctor.
It is important that you take all regularly schedule medications as usual (with only a small sip of water) unless specified by your doctor.
If you are a minor, you must be accompanied by your parent or legal guardian (must bring paperwork of guardianship) and they must remain present during the entire consultation appointment and surgical appointment. Patients are not permitted to drive or operate heavy machinery for 24 hours after IV sedation/general anesthesia.
For patients over the age of 18, you must have a responsible adult drive you to and from the surgical appointment and they must remain in the office for the duration of the surgery. Patients are not permitted to drive or operate heavy machinery for 24 hours after IV sedation/general anesthesia.
Please wear comfortable, loose fitting clothing. A short sleeve t-shirt is recommended, or that can be rolled up past the elbows. Wear comfortable sneakers. (No heals, flip flops, sandals)
Be sure to brush and floss your teeth the morning of surgery.
Please remove all facial and or tongue piercings (earrings are permitted so long as they are small and close to the ear, no large hoops).
Please remove artificial nails and/or nail polish as they will interfere with our anesthesia monitors and wear as little make up as possible.
If you wear contacts, please do not wear them the day of surgery. Please wear your glasses. If you must wear your contacts, please bring a case so you may remove them prior to your surgery.
Contact our office if there are any changes in medical history including new medications or recent cough, cold, stuffy nose/congestion, fever, chills, sore throat.
Please be aware that if these instructions are not followed or if the doctor feels it is unsafe to proceed with scheduled treatment due to changes in your medical history, you may be asked to reschedule.
Nitrous oxide (laughing Gas) (pre-op)
While we are very concerned about all of our patients comfort, our top priority is our patient's safety and well-being, therefore it is imperative that you adhere to the following instructions when preparing for you upcoming treatment:
A light meal may be consumed 3 hours prior to treatment, but please do not eat or drink anything within 3 hours before your treatment with laughing gas.
If you are a minor, you must be accompanied by your parent or legal guardian (must bring paperwork of guardianship) and they must remain present during the entire consultation appointment and surgical appointment.
If you are over 18 years of age, you do not have to come with a driver, although you may wish to have someone to drive you home.
Be sure to brush and floss your teeth the morning of surgery.
Please wear comfortable, loose fitting clothing. A short sleeve t-shirt is recommended. Wear comfortable sneakers. (No heals, flip flops, sandals)
Please remove all facial and or tongue piercings (earrings are permitted so long as they are small and close to the ear, no large hoops).
If you wear contacts, please do not wear them the day of surgery. Please wear your glasses. If you must wear your contacts, please bring a case so you may remove them prior to your surgery.
Contact our office if there are any changes in medical history including new medications or recent cough, cold, stuffy nose/congestion, fever, chills, and/or sore throat.
Please be aware that if these instructions are not followed or if the doctor feels it is unsafe to proceed with scheduled treatment due to changes in your medical history, you may be asked to reschedule.
general post-operative instructions
Immediately Post-Surgery
BLEEDING: bleeding is normal, however to help control the bleeding it is important that you keep firm, continuous pressure with a gauze pad (you may need one or more pieces folded up to create the needed pressure, especially if you are missing the opposing teeth). Keep the gauze pad in with firm pressure for at least 30 minutes. Do not check the gauze sooner than 30 minutes as this may tear the clot and induce more bleeding. If you find that after changing the gauze out 3 times (90 minutes), that you do not feel the bleeding has slowed please try a moistened tea bag (no green tea), as the herbs may help allow the clot to stabilize. Everyone’s experience is different and a slight ooze or rosy colored saliva may persist for up to 24 hours after treatment (especially once you resume brushing and rinsing), however if you experience profuse continuous bleeding please call our office immediately.
PAIN: Pain can be expected after surgery. The numbing medicine (local anesthesia) that was provided during treatment may last from 1-4 hours after treatment, however it is important that once you feel it is beginning to wear off (the pins and needles/tingling feeling) that you get pain medication on board to help decrease post-operative discomfort. We recommend starting with 600mg (3 tablets-each 200mg) of over the counter Motrin, Advil, or Ibuprofen every 6 hours then between your dose of Motrin, Advil, or Ibuprofen you may supplement with regular or extra strength Tylenol (acetaminophen) or if you are having more severe pain you may take your prescription pain medication as directed. * if you are taking a blood thinner you should not take the Motrin/Advil/Ibuprofen * all medications should be taken with some food on your stomach, do not take medications on an empty stomach * narcotic pain medications can be addictive and should be taken only for severe pain and under adult supervision, they may also cause negative side effects such as nausea/vomiting/constipation/dizziness/lightheadedness
SWELLING: Pain and swelling go hand in hand, so if we can minimize the swelling, we can limit the pain. The peak pain and swelling is generally 2-4 days after treatment. To help reduce swelling, keep your head elevated with an extra pillow or two while resting. Do not lay flat as this will increase the swelling and discomfort. As listed above Motrin, Advil, or Ibuprofen 600mg should be taken every 6 hours (for the first 3 days), this is not only to help reduce discomfort, but is also a great anti-inflammatory which will help keep the swelling to a minimum. Keep ice to the area (20 minutes on/20 minutes off while awake) for the first 72 hours (3 days). After the 3rd day change to a moist heat compress on the area with massage and stretching to get the jaw muscles moving again.
Other Post-Op Considerations
DIET: for the first few days after surgery you should eat a soft diet (pudding, Jell-O, applesauce, eggs, yogurt, ice cream, soft/overcooked pasta, mashed-potatoes, pancakes). Be sure you are getting enough protein as this will help you heal and drink plenty of fluids. No straws for 7 days after surgery (as this could draw out the blood clot and lead to a dry socket) Avoid hard/chewy/crispy foods such as: chips/pretzels/nuts/popcorn/raw vegetables. After the 3rd or 4th day you may slowly begin advancing your diet and by about 1-2 weeks after surgery you should be back to a normal diet unless otherwise instructed by your doctor. * While still numb you should avoid any hot foods or beverages as you cannot tell temperature and could burn your lip/tongue; you should also avoid anything that requires chewing while numb as you could bite your lip/cheek/tongue.
BRUISING: bruising may occur, however should resolve within 7-10 days after surgery. * If you take a blood thinner you may notice more significant bruising.
ANTIBIOTICS: if prescribed antibiotics be sure to complete the entire dose as directed, unless you experience a true allergic reaction such as rash/hives/swelling in which case stop taking the medication immediately and contact us right away. In rare cases patients may develop a stomach issue such as severe, persistent and watery diarrhea; if this occurs stop taking the medication immediately and contact us right away. To help decrease the risk of these stomach issues it is recommended that you take an over-the-counter probiotic (your pharmacist may be able to help recommend one) *If you experience a severe/life threatening reactions such as throat swelling or you are unable to breath, call 911 immediately. *If you are on birth control medication, antibiotics may interfere with the effectiveness of the birth control and other contraceptive means should be used.
ORAL CARE: no rinsing or brushing during the first 24 hours (as doing such may disturb the blood clots). After the first 24 hours you may resume brushing and rinsing your teeth. We encourage you to brush gently around the surgical site, do not avoid brushing the area as plaque and food debris will accumulate and increase risk of pain and infection. Keep fingers and tongue away from the surgical site. Rinse as instructed with the prescription mouth rinse for 7-10 days (the rinse may stain you teeth, generally only with use longer than 2 weeks, and tongue, however this is not permanent staining and can easily be removed with a dental cleaning). Warm salt water after meals is also encouraged: ½ teaspoon of salt in 8oz. warm water
DRY SOCKET: dry socket is an unlikely complication of tooth extraction, but if it occurs can delay healing and cause significant pain that does not respond to pain medication. Ways to help avoid a dry socket include avoiding the following for 7 days: spitting, straws, smoking or vaping, sucking or drawing actions as these may cause the blood clot to become dislodged and lead to a dry socket. A dry socket typically occurs during days 3-5 of recovery. If you think you may be experiencing a dry socket please call us so we can help treat you.
ELEVATED TEMPERATURE: a mild increase in temperature 1-3 degrees is normal in the first few days after surgery, however if this persists or worsens please contact us.
LIMITED OPENING: within the first 1-2 weeks after surgery your mouth opening may be limited due to the swelling and inflammation around your jaw muscles. The warm-moist compress to the sides of the face after the 3rd day along with massage and stretching of the muscles (simply opening and closing the mouth) will usually allow you to get back to your normal opening within 1-2 weeks after surgery.
We are always concerned about how you’re doing afterwards, so if there are any questions regarding your instructions or medications, or feel that you need urgent medical attention during your recovery please call us right away.
sinus precautions (post-op)
For patients who have undergone an indirect or direct sinus lift or for patients advised of a sinus opening/communication. *It is important that you follow these instructions for 2 weeks (or until you are scheduled back to see your surgeon for follow-up evaluation)
Keep your head elevated during sleep with two to three pillows.
Do NOT blow your nose
If you sneeze do not sneeze through the nose and do not “hold back.” You may sneeze with your mouth open.
Expect slight nose bleeds. Call the office immediately for heavy bleeding from the nose that you are unable to control with pressure.
Do NOT do anything that requires a sucking-in or blowing-out motion such as smoking, use of straws or blowing up balloons.
Take all prescribed and/or recommended medications as directed.
Bone grafting / implant patients (post-op)
No electric/mechanical toothbrush or waterpik at or near grafted/implant site for at least 2 months, use of only a soft manual toothbrush is recommended. If the electronic devices are utilized they may delay and/or disrupt the healing and lead to failure of the graft and need for additional procedures.
Rather than rinsing with the prescription oral rinse or warm salt water after the first 24 hours, we advise you do not rinse the area for 3 days, rather gently swab the area with a q-tip dipped in the antimicrobial rinse. After the 3rd day you may gently rinse with the prescription rinse as directed and warm salt water after meals.
Pressure to the grafted or implant site may alter the healing of the bone and or soft tissue anatomy in the area and if you wear a “flipper” or other prosthetic device you may be advised to keep it out as much as possible while at home or out of the public eye.
planning for your or your family's upcoming treatment
Time for recovery: Generally the peak swelling and pain occurs the first 2-4 days after surgery, depending on what treatment was provided this may vary. Usually most patients are ready to resume light to normal activity 2-3 days after surgery. Any activity that elevates the heart rate and blood pressure such as sports or vigorous exercise we would recommend waiting at least 1 week until resuming these activities. You should generally refrain from any long distance travel the first week after surgery as many times your doctor may wish to schedule a follow up appointment at that interval.
Things to have ready:
Soft food like pudding/Jell-O/eggs/pancakes/mac n’ cheese/mashed potatoes/applesauce/yogurt/ice cream/fish/soup (NO STRAWS)
Over the counter medications (Motrin, Advil, or Ibuprofen and extra strength Tylenol (acetaminophen)
Frozen bags of peas/corn (they conform nicely around the corners of the jaw and are great to use as post-op ice packs—and can be re-frozen as needed; but once thawed and re-frozen multiple times don’t recommend eating them)
Old pillow cases-nice to have if there is a bit of ooze/rosy colored saliva that finds its way onto the pillow
