PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please feel free to call our office any time should you have any questions, or are experiencing any unusual symptoms following your treatment.

IF YOU HAVE HAD SEDATION OR GENERAL ANESTHESIA Return home immediately upon discharge and lie down with the head elevated until all the effects of the anesthetic have disappeared Anesthetic effects vary by individual and you may feel drowsy for a short period of time or for several hours.

  1. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours or longer if you feel any residual effect from the anesthetic. Do not drive or use appliances or equipment that could be dangerous, such as power tools, stoves, lawnmowers, and garbage disposals.
  2. Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.
  3. Do not make any important decisions. You may change your mind tomorrow.
  4. Do not drink any alcoholic beverages. The drugs in your body may cause your reaction to alcohol to be dangerous and impede wound healing.
  5. Diet: If you feel nauseated or sick to your stomach, drink clear liquids like broth, apple juice, ginger ale, tea, soda, cola, or eat jello.
  6. In the event of a medical emergency, call 911.

ORAL HYGIENE AND CARE: Start rinsing your mouth the next day with a warm salt water rinse (1/2 teaspoon of salt with 1 cup water) every 2-3 hours. Continue this for several days, then rinse 3-4 times a day for the next 2 weeks. You may start normal brushing and flossing the day after the surgery or after bleeding is controlled. It is imperative to keep your mouth clean, since an accumulation of food or debris promotes infection and poor wound healing.

  1. DO NOT drink with a straw or spit.
  2. DO NOT disturb the surgical area or probe the area with the tongue, any objects or your fingers. You may brush and floss your teeth gently, carefully avoiding the surgical site.
  3. DO NOT SMOKE since it is detrimental to the healing process.

BLEEDING: Some bleeding is normal and blood-tinged saliva may be present for 24 hours. If you have bleeding, bite down gently but firmly on the gauze pack that we have initially placed over the surgical area. Do not change the packing for the first hour unless the bleeding is not being controlled. This is important to allow blood clot formation on the surgery site. The gauze may be changed when necessary and/or repositioned for comfort.

STEADY BLEEDING: Bleeding should not be severe. This may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes. . If bleeding persists, this may due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site so try repositioning the gauze. If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in water, squeezed dry, and wrapped in a moist gauze) on the area for 20-30 minutes. If bleeding continues, please call our office.

SWELLING AND BRUISING: Swelling is to be expected, and usually reaches its maximum in 48 hours. To minimize swelling, cold packs or ice bag wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied 20 minutes on then removed for 20 minutes during the first 48 hours after surgery. After 48 hours, it is usually best to switch from using the cold pack to applying moist heat or heating pad to the same area, until swelling has receded. Bruising may also occur in your face and neck and usually disappears in a week. Tightness of the jaw muscles may cause difficulty in opening the mouth and should disappear within 7 days. Keep lips moist with cream or vaseline to prevent cracking or chapping

DIET: VERY IMPORTANT Clear liquids the first two days after surgery. After the second day you can progress to thicker liquids. Examples include clear chicken broth, clear juices, and jello, then later pudding, ice cream, protein shakes, etc. Avoid foods with seeds, nuts, or popcorn which may get lodged in the wounds. Over the next several days, you may progress to more soft foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and maintain tight control of your blood sugars.

PAIN AND MEDICATIONS: Unfortunately, most oral surgery is accompanied by some degree of discomfort. The local anesthetic administered during your surgery normally has three hour duration and it may be difficult to control the pain once the anesthetic wears off. Stay ahead of the pain and take your first pain medication about one to two hours after your surgery. Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset. If you were prescribed a narcotic and ibuprofen, the two may be taken together.

If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.

ORTHODONTIC APPLIANCES: If you wear orthodontic appliances, replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.

OTHER POSSIBLE POST-SURGERY EFFECTS

DRY SOCKETS: The blood clot on the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office to report these symptoms.

SKIN DISCOLORATION: This may be expected, and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week for this to completely disappear. Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. Application of heat on the area will usually correct these symptoms.

NUMBNESS: Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.

It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at 415-931-3100. If it is after hours and you feel that you must be seen immediately, please call our main number and there will be instructions on how to reach the surgeon on call. Call 911 if you have a medical emergency.