Pre-Surgery Instructions for IV SEDATION/GENERAL ANESTHESIA (going to sleep)
POST SURGERY INFORMATION AND INSTRUCTIONS REGARDING REMOVAL OF TEETH
The removal of impacted wisdom teeth is quite different than the extraction of erupted teeth. The following conditions may occur, all of which are considered normal.
1. The area operated on will swell, so you’ll need to use ice bags for the first 24-48 hours.
2. Tightness of the muscle may cause difficulty in opening the mouth, so stretch full range of motion the first few days.
3. Dry socket may develop as a result of loss of the blood clot from the socket where tooth came out. Please call the office for the placement of a packing in the socket which will need to be changed everyday for couple of days. Dry socket can usually be prevented by not smoking, not disturbing the blood clot and not using alcohol-based mouthwash.
4. A sore throat may develop.
5. Your other teeth possibly will ache. This we refer to as sympathetic pain and is a temporary condition.
6. If the corners of your mouth are sore and cracked from being stretched during surgery, use an antibiotic cream like Polysporin for comfort.
7. The cavity (hole) where the tooth was removed will gradually fill with new tissue. This area should be rinsed after meals and at bedtime starting the day after surgery with warm salt water 4 times a day for 7 days until you return for your post –op appointment.
8. Be sure to take plenty of fluids. There may be a slight elevation of temperature for 24 to 48 hours. If elevated temperature should continue, notify us.
9. Should a bruise appear at the injection site on your arm, do not be alarmed as this will disappear shortly.
10. During the healing process, a bone spicule may work through the gum. It’s rare, but should that happen, call and we will gladly remove it.
11. You may eat soft foods (like soups, mashed potatoes, scrambled eggs) for the first day after surgery. You may advance back to your regular diet as the discomfort level decreases during the following days.
WHAT TO DO AFTER SURGERY
Extraction wounds usually heal quickly and without complications if simple precautions are taken. However, these wounds should not be neglected and they should be given certain attention. Cooperation with your Oral Surgeon is important. You should reduce your activities for several days after surgery. This helps reduce bleeding and permits the formation of a clot in the area of operation, which is necessary for healing.
DRIVING/WALKING: Patients who have received intravenous medication / anesthesia should not drive on the day of surgery. They should also walk with assistance to avoid stumbling and injury until fully recovered from the anesthetic. Patients who have received Nitrous Oxide (Laughing Gas) should wait 15-30 minutes following the surgery before driving on their own.
BLEEDING: Slight bleeding for a short time after the operation is expected and may persist until the next day. Remove the gauze upon arriving home and take your medicine. However, if there is more than just oozing or if the gauze you removed was red, soggy and soaked the following procedure will help control it.
1. Take a clean gauze pad and gently wipe the blood from the mouth and from over the wound.
2. Place another clean, rolled -up gauze directly on the bleeding area.
3. Close the teeth tightly over this pad so that there is contact and pressure against the bleeding area. The gauze must contact the gum tissue so that pressure is applied where the bleeding occurs.
4. Maintain the pressure for about twenty to thirty (20-30) minutes at a time. Be sure to swallow your saliva because a wet pad will act like a wick.
5. If bleeding still continues, take a moistened tea bag, wrap it in opened gauze, and place this directly over the bleeding area. Close the teeth tightly over the tea bag, maintaining a direct pressure against the gum tissue. If bleeding persists, or any unusual symptoms occur, call our office number.
Swelling is to be expected, but can be diminished by using ice. Place ice bags (in light weight socks to protect the surface of your skin) as soon as possible on the affected areas. Do this for 24 hours. Swelling usually reaches its maximum after the first 48 hours and then slowly decreases.
As soon as you get home, drink a milkshake or something cool after discarding the gauze, and take your medications as prescribed . No straws please, so use a spoon! This way the pain medication will take effect before the numbness wears off. Take antibiotics as prescribed until the whole bottle is gone. Always take pain medication after food. An upset stomach is usually due to not eating enough when you take the pain medication. If stomach upset occurs, stop the pain medication, use the Jello technique described below, and allow the stomach to settle; then try ½ of a pain pill. If upset stomach still continues or rash and itching occurs, discontinue the antibiotic also,and call our office. Please also note that birth control pills may not be effective for the cycle in which you take the antibiotics; you need to take additional contraceptive precautions for that cycle.
To terminate nausea, mix a tablespoon of Jell-O in 4 ounces of water and take a teaspoon every minute till all gone. Coca-Cola syrup may also be taken two tablespoons every hour for four hours. Either of these will give you necessary sugar and fluid to settle the stomach. Follow this with mild tea or clear soup, etc.
To help the healing process, try not to miss a meal after surgery. A liquid diet is wise the day of surgery. Soft foods high in vitamins and protein, are recommended for the next several days. These foods would include:
Yogurt Mashed potatoes Eggs
Soups(broth) Custards Cooked cereals
These may be taken without disturbing the blood clot. Increase your fluid intake. Eat as often as you can for the first few days. Please do not eat anything crunchy like nuts, seeds, chips, wafers, pretzels, popcorn, etc. for at least 4 weeks after surgery.
No heavy lifting or exercise for one week following wisdom teeth and three days following other procedures.
Absorbable sutures may fall out on their own. If not, they can be removed easily on your post-op appointment.
Smoking delays healing and increases your chances of infection and pain. Smokers are advised not to smoke for at least three days following surgery. If you have to smoke, please wait for a minimum of 24 hours. Drawing on a cigarette may disturb the blood clot and thus interfere with the healing process, causing a painful dry socket.
The blood clot should be given time to form and should not be disturbed. Therefore , do not brush, or rinse, or spit during the day of your surgery. The day following surgery, and for one week after, the mouth must be rinsed gently with warm salt water solution – ½ teaspoon of salt in a small glass of warm water - after each meal and at bedtime. The teeth should be brushed starting the day after surgery as usual but the soft tissue of the surgery site should be avoided. It is imperative that you keep your mouth clean to ensure proper healing.
EMERGENCIESIf any problems or questions arise before the post-op appointment, please do not hesitate to call us at our office number.
One Bank St, Suite 240
Gaithersburg, MD 20878