Oral Surgery Instructions

Pre-Surgery Instructions

For Local Anesthesia:

You may eat and drink as you normally would and do not need a chaperone.

For Nitrous Oxide Analgesia (laughing gas):

You should not eat or drink for two hours prior to the appointment and a chaperone is recommended, but not required.

For Intravenous Anesthesia:

You must have nothing to eat or drink (including water) six hours before surgery. Any deviation from this will usually require postponement of your anesthetic. Wear a short-sleeved garment that is loose fitting about the arms and neck. Preferably the garment should be button down in front.

Brush your teeth and rinse your mouth thoroughly before arriving; a clean mouth will heal faster.

Contact lenses should be removed prior to arrival for surgery.

A responsible and mature person must be available post-operatively to take you to your residence and be with you for the rest of the day. Before you are anesthetized, we must know how that individual may be contacted. You must not drive. Although you may think that the anesthetic has completely worn off, minimal effects of the drugs often last all through the day. These drugs may impair your reflexes and judgment; thus, such ordinary activities as climbing stairs, crossing streets, and driving become greater hazards. Allow your driver to help you up and downstairs and across streets. Relax and remain quiet after your anesthetic.

Don’t be in a hurry to eat or drink when you leave the office. Wait until you are hungry or thirsty; then take small amounts. Each person reacts to anesthesia individually – If you have any questions concerning your recovery from the anesthetic after you leave the office, be sure to give us a call.

Information for the Driver & Chaperone:

To assure safety after an anesthetic or sedation, patients must be accompanied to their residence and for the rest of the day by a responsible and mature chaperone. As the driver/chaperone, we ask that you be available when the patient is dismissed from the office. Since the precise time of dismissal cannot be predicted, please accompany the patient to the office.

Assist the patient to his lodging. Be sure to help when crossing streets, climbing the stairs, or passing other obstacles. The patient must not drive an automobile or operate potentially dangerous equipment.

Use every means to assure that the patient remains quiet and rests for the balance of the day. Alcohol and un-prescribed drugs should be avoided overnight. The effect of the anesthetic drugs may seem to be completely worn off when you take the patient home; however, there may still be slight residual effects that impair judgment and coordination. This is the primary reason why we ask that the patient be chaperoned for the rest of the day.

Post-Surgery Instructions

Pain: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to manage the discomfort better. The effects of pain medicines vary widely among individuals. Some people may even require two of the pain pills at one time during the early stages (but that may add to the risk of stomach upset). Remember that the most severe discomfort is usually within the first six hours after the anesthetic wears off; after that, your need for medicine should lessen.

Swelling: This is normal after the operative procedure. Swelling usually starts during the first day and may gradually increase on the second day. Starting on the third day, the swelling normally begins to decrease and will no longer be noticeable after 3-5 days. To minimize swelling, apply ice to the outside of the face at the surgical area for approximately 30 minutes, 3-4 times a day for the first 48 hours. After that, a warm compress 3-4 times a day for 30 minutes will help the swelling abate more quickly. As a rule, swelling appears larger in the morning upon awakening due to fluid accumulation when lying down. It is not unusual for the swelling to spread widely, either upwards toward the eye, or downward toward the neck. Exercise should be avoided for the first 48-72 hours following oral surgery.

Bleeding: Avoid smoking, spitting, and drinking through a straw for the first day, as this will promote bleeding. A certain amount of bleeding is to be expected for the first 24-48 hours. If bleeding is excessive, place a folded gauze pad directly over the area and bite or hold down firmly for 30 minutes. If closing does not produce enough pressure, add another gauze pad. Bleeding should never be severe. If it is, it usually means that the packs are being clenched between your teeth rather than exerting pressure on the surgical area. Try repositioning fresh packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in moist gauze) for 20 to 30 minutes. Remove any large excess jellied blood clots before applying the pressure. Pressure will stop the bleeding. Repeat the process as necessary. If this is not effective and bleeding remains uncontrolled, please call our office.

Diet: It is important to maintain proper nutrition during the healing period. Liquids or soft foods are usually more comfortable for the first day or so. A normal diet should be resumed as soon as possible. Avoid chewing in the area of the operation.

Oral Hygiene: Beginning the day after surgery, rinse your mouth with warm saltwater or mouthwash after meals. Also, gently brush the teeth in the affected area beginning the day after surgery.

Nausea: Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medication. Nausea may be reduced by preceding each pill with a small about of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medication but call us if you do not feel better or if repeated vomiting is a problem. Cola drinks that have less carbonation may help with nausea.

Discoloration: A black and blue discoloration may appear on the face, possibly spreading up or down a few days after the surgery. This is a harmless condition and requires no treatment. The normal skin color will return in about 10-14 days.

Temperature: There may be a slight elevation in temperature for the first day or two following the removal of impacted wisdom teeth or other extensive oral surgery procedures. If the increase in temperature persists, call us at 743-8311 or 624-7116.

Post-Op Vermilionectomy

You have just undergone a surgical procedure with a carbon dioxide laser. The laser has a number of advantages over conventional surgery. It allows us to perform treatment in a more precise fashion through increased accuracy. Tissue injury in the area of the therapy is diminished, thus decreasing scar formation, bleeding, swelling and post-operative pain. These advantages will become more apparent if you follow these simple instructions.

What to expect: Typically, the wounds will heal relatively quickly. The immediate response, however, may be a slight whitening of the surface with redness of the surrounding skin. Swelling and redness may increase 24 to 48 hours after the procedure, depending upon size and location of the treated areas. There will likely be some flaking and superficial crusting for the first week.

Wound Care: Apply antibiotic ointment, such as Aquaphor to the treated area 4 to 6 times daily after rinsing and cleansing the area with hydrogen peroxide. There is no need to cover with a dressing. Keep the crust clear, soft and lubricated always.

Pain Relief: Fortunately, significant pain is not common following laser surgery. However, like sunburn, you may feel tingling or stinging. This may be diminished with mild analgesics or applying an ice bag to the area. If you do not have an ice bag, try using a bag of frozen peas wrapped within a thin towel.

Exercise: Mild to moderate physical exercise is permitted, but heavy perspiring should be avoided. Do not swim for at least two weeks.

Medication: Take all medications, which have been prescribed, as directed.