Please follow the instructions related to your treatment plan:
Do NOT eat or drink anything, including water, for 6 hours prior to your scheduled appointment.
Do not smoke for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
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 IV anesthesia or while taking prescription narcotic medication.
Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
Remove contact lenses, jewelry, and dentures prior to surgery.
Do not wear lipstick, excessive makeup, or dark nail polish on the day of surgery.
If you have an illness such as a cold, productive cough, sore throat, upset stomach or fever, please notify the office.
If you are taking prescription, or non prescription medications, please check with Dr. Buch or Dr. Mansfield prior to your surgical date for instructions.
Please follow the instructions related to your treatment plan:
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 48 hours.
The swelling will not become apparent until late that evening or the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, frozen peas (corn) or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 72 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Three days following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Drink plenty of fluids. Avoid hot liquids and hot food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
You should begin taking pain medication before you feel the local anesthetic wearing off. For moderate pain. Ibuprofen (Advil or Motrin) may be taken. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.
Be sure to take the prescribed antibiotics as directed and until it is completely gone, to help
Good oral hygiene is essential to good healing. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 60 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing near the surgical areas.
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures may be placed immediately after surgery. The prosthesis must be adjusted to avoid overloading the implant. It may also be adjusted to avoid pressure on the wound, which could cause the gums to open up and expose bone. This will be discussed during the pre-operative consultation.
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 Surgery
The gauze pad placed over the surgical area should be kept in place for one hour. Then the gauze pad should be removed and discarded. If the extraction sites are still bleeding replace the gauze with a new one.
Avoid rinsing or touching the wound area following surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
Take the prescribed pain medications before you begin to feel discomfort. This will usually occur when the local anesthetic wears off.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where surgery was performed for at least 48 hours. Refer to the section on swelling for explanation.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon and may persist for 24 hours. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If brisk bleeding does not subside, call for further instructions.
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 body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until late that evening or the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, frozen peas (corn) or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 72 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Three days following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain, Ibuprofen, (Motrin or Advil) two to four (200 mg) tablets may be taken every 3-6 hours.
For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day after the first 3-4 days following surgery. If pain persists, it may require attention and you should call the office.
After local anesthetic or IV sedation, liquids can be taken. Do not use straws, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. After the local anesthetic wears off you may eat anything soft by chewing away from the surgical sites. Melt in your mouth type foods are best (yogurt, smoothies, shakes). High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. 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 is allowed on the day of surgery. You can brush your teeth gently the night of surgery. 48 hours after surgery you should begin gently rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.
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 post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash 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 anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. If vomiting continues, call our office.
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 Dr. Buch or Dr. Mansfield if you have any questions.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute 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 removed by Dr. Buch or Dr. Mansfield.
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 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 2-3 days.
Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. The tightness is due to bruising and swelling in the muscle. This is a normal post-operative event which will resolve in time.
Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. Most sutures will absorb in 7-10 days.
The pain and swelling should subside more and more each day after the first 3 days following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call our office for instructions.
There will be a hole where the tooth was removed. The hole will gradually, over the next month fill in with the new tissue. In the mean time, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.
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: one of our Doctors.
Brushing your teeth is okay – just be gentle at the surgical sites.
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 2-3 days following surgery.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.