Surgical Instructions

Before Intravenous Sedation or General Anesthesia Fargo, Grand Forks, Bismarck and Minot

Patient in the dental chair.
  • You may not have anything to eat or drink for six hours prior to the appointment.
  • No smoking at least 12 hours before surgery. Ideally, stop smoking two weeks or longer prior to the day of surgery.
  • Do not drink any alcoholic beverages for 24 hours prior to your 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 bring your eyeglasses and a contact lens case to the appointment, or wear your eyeglasses.
  • Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
  • If you have an illness such as a cold, the flu, bronchitis, sore throat, stomach or bowel upset, please notify the office.
  • If you take routine oral medications, please check with our office prior to your surgical date for instructions. Many medications may still be taken with a sip of water.
  • The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Oral Surgery

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.

Mouth rinsing or touching the wound area following surgery should be avoided. This may cause bleeding by disturbing the beneficial blood clot.

Take the recommended and/or prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.

Place ice packs to the sides of your face where surgery was performed. Refer to the section on Swelling for an explanation.

Activity

It is not necessary to go home and go to bed – but you should go home without stopping for activities, restaurant meals, or shopping beyond picking up prescriptions. Quiet activities at home such as reading, watching television, or sitting at a computer are recommended. Minimal talking, especially while the gauze packs are in place, is recommended. We usually recommend about 72 hours before resuming aerobic exercise and weight training.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 30 minute while sitting upright. Repeat if necessary. If bleeding continues, sit upright and bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, avoid rinsing, spitting, talking, chewing on the pack, and exercising. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the bodys normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. After 36 hours, ice has no beneficial effect. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

If you should have swelling that is hard, painful, and increasing after two to three days, or is accompanied by fever, please contact our office.

Pain

For moderate pain, your surgeon may recommend an over-the-counter medication.

For severe pain, take the medication prescribed as directed. Most prescription pain medications will make you groggy and will slow down your reflexes. Do not drive an automobile, climb ladders, or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Diet

Drink plenty of liquids after general anesthesia or intravenous sedation to avoid dehydration. Do not use straws or suck from a sport-top drink bottle. The sucking motion can cause more bleeding by dislodging the blood clot. We recommend a non-chew diet the remainder of the day following surgery, for example, yogurt, soup, smoothies, ice cream, and milk shakes. Ensure, Boost, or Carnation Instant Breakfast Essentials can be an excellent supplement. Adequate fluid and nutrient intake can promote optimum healing. The day after surgery, you may eat soft foods. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep The Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the morning after surgery, but rinse gently. You may use either a sonic toothbrush or manual toothbrush. Do not use a Waterpik for at least three weeks after wisdom tooth removal or any other oral surgery.

The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a half teaspoon of salt, especially after eating.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the prescription as directed. Discontinue the antibiotic use in the event of a rash, diarrhea or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take any solids by mouth for at least an hour. You may sip on water or carbonated beverages. You should sip small amounts, slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods.

Other Concerns

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call our office if you have any questions.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the elevated temperature persists, notify the office.
  • Dizziness. You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be evaluated at a follow-up appointment.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as lip balm or Vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
  • The molars (back teeth) may feel sore as you begin to chew normal foods. A softer diet may keep you more comfortable until this normal healing reaction subsides.

Finally

Sutures (stitches) are placed in the area of surgery to stabilize gum tissue, minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. Most sutures used in our office are the dissolving type.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.

There will be an empty spot where the tooth was removed. This area will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur three to six days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that due to many factors, you may need to resume exercising after 72 hours with a light workout.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: our office or your family dentist.