PATIENTS RECEIVING IV-SEDATION or “SLEEP” ANESTHESIA should return home from the office immediately upon discharge. You may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours.
Oral Hygiene and Care
Do not disturb the surgical area today. BITE DOWN firmly on the gauze packs that we have initially placed over the surgical area, making sure that they remain in place. DO NOT change them for the FIRST hour unless the bleeding is controlled. DO NOT drink with a straw and DO NOT rinse or brush your teeth vigorously or probe the area with your tongue, fingers, or any other object.
After the first 24 hours, you may brush your teeth gently, carefully avoiding the surgical site. DO NOT SMOKE for at least 72 hours, since it is detrimental to the healing process. Beginning the day after surgery, start rinsing your mouth with a warm salt-water rinse (1/2-tsp. salt with 1-cup water) 3-4 times a day for the next 2 weeks. It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.
Bleeding should not be severe. Biting down the first hour firmly will assist your pattern of bleeding. If bleeding persists, this may be due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site. Try repositioning new gauze and hold for 20-30 min. Other than the initial gauze, no gauze should be left in for more than 30 minutes at a time. If bleeding persists or becomes heavy, substitute a moist caffeinated tea bag on the area for 20-30 minutes. Gauze is to be removed while eating, drinking or if bleeding has stopped. If bleeding becomes severe or continues for more than 24 hours, please call our office immediately.
Swelling or Bruising
Swelling is to be expected and usually reaches its maximum within 48 hours. To minimize swelling, cold packs, ice, or even frozen peas should be applied to the face adjacent to the surgical area by the jaw line. This should be applied for 20 minutes, then removed for 20 minutes during the first 24 to 48 hours after surgery. Try to rotate surgery sides. Bruising may also occur, but should disappear soon. After 48 hours you may switch and apply moist heat with a warm wash cloth to bring down swelling, 20 minutes on and off.
Introduction of foods and pain medications should be done gradually if I.V.-sedation was administered. Follow this protocol to minimize post operative vomiting: 1. Sleep for 1-2 hours when arriving home. 2. Awaken and drink a glass of water, wait 15 minutes. If no upset stomach occurs, then introduce cool liquids/soft foods and wait 15 minutes again. 4. If no upset stomach occurs, then take the pain medication as prescribed. Then check if more gauze is needed. After this introduction period, eat any nourishing food that can be taken with comfort. It is advisable to confine the first day’s food intake to cool bland liquids or pureed or soft foods. Avoid foods like nuts, sunflower seed or popcorn, which may get lodged in the socket areas. Over the next several days, you may progress to more solid foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.
Pain and Medications
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication prescribed as directed and according to the protocol listed in the “Diet” section above if I.V.-sedation or “sleep” anesthesia was administered. If the extraction(s) were performed with only local anesthesia, take the pain medication immediately. If you do not achieve adequate pain relief, you may supplement each pill with an analgesic such as ibuprofen (Advil / Motrin) or acetaminophen (Tylenol). 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 an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.