Surgical Instructions

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Looking for more information on your pre and post surgery care? Use the various resources below to read up on tips or download detailed instructions regarding your oral surgical procedure.

Jaw Surgery

Before IV Sedation

• Do not eat or drink for at least eight hours before your procedure, including water.
• Consult your doctor if you take any routine oral medications for instructions on what to do on the date of your surgery.
• Please let our office know if you are experiencing any symptoms of illness such as a sore throat, cold symptoms, or upset stomach.
• Do not smoke for at least twelve hours before your procedure; if you are able to cease smoking earlier, do so.
• Make sure that a responsible adult is able to accompany you to the procedure, stay in the office for the duration of the surgery, and drive you home.
• Keep in mind that you should not operate a motor vehicle or any machinery for at least 24 hours after anesthesia.
• Wear loose, comfortable clothes and low-heeled shoes. Make sure your sleeve can be raised past your elbow for anesthetic administration.
• On the day of surgery, refrain from wearing heavy makeup, in particular lipstick or nail polish.
• Ensure that jewelry, contacts, dentures, and other items are removed before the procedure.

Swelling

Pain Management

If your pain is more severe and over-the-counter painkillers are insufficient, take your prescribed pain medication as instructed. Do not take any medication your doctor has instructed you not to take, or that you are allergic to. While taking these medications, avoid driving or operating machinery, as well as drinking alcohol. Your pain should gradually reduce over the course of each day, but if you find that your pain is continuous, contact us.

Oral Hygiene

Prostheses

Immediately After Your Surgery

• A gauze pad will be placed on the surgical site and should be left in place for thirty minutes. Once this thirty minutes is up, the gauze should be disposed of.
• As the local anesthetic wears off, you will start to feel some discomfort, at which point you should begin taking any prescribed pain medication.
• Refrain from touching or irritating the area in any way, such as through aggressive mouth rinsing. It’s essential that the blood clot that has formed at the extraction site is left undisturbed for optimal healing and minimized bleeding.
• Hold ice packs on either side of the face at the surgical area. For more information, consult the section on swelling.
• Refrain from physical activity or exertion on the day of your procedure. When you begin to recover, you may resume your day-to-day activities at a rate that is comfortable to you.

Swelling

Food & Drink

Immediately after anesthesia, it’s important to only consume liquids. Do not use straws, as the sucking motion can dislodge the blood clot in the extraction site and exacerbate bleeding. Once you begin eating, begin with soft food and chew away from the surgical site. Ensure that you’re taking in foods regularly that are protein-rich and calorie-dense. However, because your consumption will still be limited, make sure to compensate by drinking plenty of liquids (ideally five to six glasses per day.) The more you eat, the stronger and more comfortable you will feel during the healing process.

WARNING: It’s important to note that dizziness may result from sitting or standing up quickly from a lying position– sit up slowly, and wait at least one minute before standing.

Discoloration

Nausea

Takeaways

With each day after your procedure, the pain and swelling will reduce. However, if you find that you are experiencing unusual symptoms or your swelling and discomfort becomes worse, please contact us for assistance.

Over the next month, the cavity where the tooth once resided will fill with new tissue. During this time be sure to keep the area clean by rinsing with saltwater or gently using a toothbrush, particularly after eating.

Because every case is different, be sure to let your doctors know about any problems or questions you might have, so that Drs. Ganoe, Gray, Griffeth, or Ludwig can best help you.

Be sure to brush gently while the area is healing.

In some cases, a blood clot will be prematurely dislodge from the socket. This is known as a dry socket. You may also experience pain at the site or close to your ear two to three days after your procedure. If this happens, please contact our office.

Swelling

Pain

If your pain is more severe and over-the-counter painkillers are insufficient, take your prescribed pain medication as instructed. Do not take any medication your doctor has instructed you not to take, or that you are allergic to. While taking these medications, avoid driving or operating machinery, as well as drinking alcohol. Your pain should gradually reduce over the course of each day, but if you find that your pain is continuous, contact us.

Activity

Following Tooth Extraction

Once this clot forms, be careful not to dislodge it. Refrain from using straws, drinking alcohol, smoking, or brushing your teeth for 72 hours, as any of these actions may interrupt the healing process by disturbing the blood clot. It’s important that you also refrain from vigorous exercise for at least a day following surgery, as this can increase bleeding.

To help reduce some of the pain and swelling that can follow a tooth extraction, apply ice (whether via an ice pack, a plastic bag filled with ice, or a bag of unopened frozen produce) to the area and take your prescribed pain medications as directed. After the first two days, swelling typically reduces.

If your pain medication does not treat your discomfort, let our office know as soon as possible. Continue to take any antibiotics for the prescribed amount of time regardless of whether you are still experiencing symptoms of infection. Drink plenty of fluids and eat a soft, nutrient-dense diet on the first day following surgery. Once you are comfortable doing so, you may resume a normal diet.

After 24 hours, resume your standard dental hygiene routine, including brushing and flossing at least once per day. Maintaining good oral hygiene will ensure that the healing process occurs as quickly as possible.

Within a few days’ time, you should begin to feel well again and may go about your typical day-to-day activities again. If your discomfort or symptoms such as bleeding and swelling continue or worsen after two to three days, please contact us as soon as possible.

Following the Extraction of Multiple Teeth

Some bleeding is normal after an extraction procedure. Should you experience bleeding, bite down on a gauze pad for half an hour. If this does not staunch the bleeding, you may bite down on a moist black tea bag, as the tannic acid contained in the tea helps to promote clot formation. Refrain from exercise, elevation of the head, and hot liquids in the event of bleeding. Should the bleeding continue, contact us as soon as possible. Unless you are experiencing severe bleeding, do not remove the immediate denture. It’s normal for some oozing to occur around the side of the denture, as well.

Apply ice packs to the area on the outside of your cheek continuously while you are awake for the first 36 hours following your surgery.

Over-the-counter pain medications such as acetaminophen or ibuprofen may be taken to treat discomfort. Tylenol may be taken in doses of two tablets every three to four hours, whereas two to three tablets of ibuprofen medications like Motrin or Advil may be taken every three to four hours. For more severe pain, take the pain medication that has been prescribed to you. If your pain is not reduced after two days or increases after this time, please contact us. Unless you experience an allergic reaction, be sure to finish your antibiotic prescription completely.

Especially if you have had many teeth removed, it’s important to drink lots of fluid to recover from blood loss. You should drink a minimum of six glasses of liquid on the first day following your procedure.

On the first day following surgery, do not rinse your mouth. Once this time period has passed, begin rinsing your mouth using a warm salt water rinse every four hours and after eating. This rinse can be made with one cup of warm water and one teaspoon of salt. After your dentist has conducted a denture adjustment, remove the denture and rinse three to four times a day.

Immediately following surgery, stick to a diet of soft foods and liquids. Once healing is underway, you can return to your normal diet as soon as you are comfortable.

Having many teeth removed in one surgery is a much different process than having only one or two teeth extracted. The bone must be smoothed and shaped before a denture can be inserted, and as a result you may experience the following symptoms:

• The area(s) of the extractions will swell. This swelling will reach its peak in about two days following surgery. You may also experience swelling in the eye area, as well as some discoloration. To reduce the discoloration, apply a warm, moist towel to the area. This should be applied after the first 36 hours following surgery, as ice packs are only useful prior to that time frame.
• Swelling may also cause a sore throat, as the throat muscles are close to the surgical site. After two to three days, the pain should reduce.
• Dryness and cracking of the lips may occur. To prevent this, use an ointment such as Vaseline to keep your lips moist.
• You might find that your temperature is elevated during the first day or two following surgery. This is normal, but if the temperature persists, please let us know.

You may develop sore spots if immediate dentures have been inserted. Your dentist will typically make any needed adjustments 24 to 48 hours after your procedure and relieve any discomfort. It’s important to see your dentist in this time period, as these sores can become more severe and delay healing.

Following Jaw Surgery

What you may need at home:

• Saline (Dissolve 1 teaspoon of salt in 8 ounces of water)
• Child size toothbrush/Waterpik
• Scissors/wire cutter (for cutting elastics or wires depending on what is holding the jaw closed)
• Vaseline or lip balm
• Blender

Medications: 

You will be prescribed a pain medication and antibiotic upon discharge. These medications may be in liquid or pill form. If given a liquid medication then use the syringe provided by the pharmacy to measure and administer. If given a pill then you may crush the pill and mix it with a small amount of water or juice. Please take medications as prescribed by the doctor. We recommend that you take an over the counter non-steroidal anti-inflammatory such as Ibuprofen, Motrin or Advil. Take 600 mg every 6 hours for the first week to help reduce pain and swelling. Please remember that most narcotic pain medication already have Tylenol in it, so do not take any extra Tylenol as this may cause serious issues. For patients that have had an upper jaw surgery nasal decongestants, expectorants or nasal sprays may be used to help with any difficulty breathing through your nostrils. A humidifier or frequent warm showers may also help aid in congestion.

Swelling: 

Expect significant swelling. Swelling will maximize during the first week then should start to diminish. It is beneficial to use ice/ice packs/frozen peas wrapped in a towel and applied to the cheeks for a period of 20-30 minutes at a time. Ice should be used for the first 48-72 hours. It takes approximately two weeks for the majority of swelling to disappear. If any there is an increase in swelling and pain after 10-14 days then that could indicate an infection, which may require treatment. Should this happen, please contact the doctor. Bruising may also occur with swelling. The bruising should dissipate as swelling subsides. The bruising may travel in the skin and change in color. This is normal and will resolve in 2 weeks.

Bleeding: 

Minor oozing from the incisions made inside the mouth should be expected for the first 72 hours. Upper jaw surgeries usually experience some minor trickling of blood through the nose. Nasal sprays and decongestants will help with this. Dark blood clots may be coughed up or expressed through the nose toward the end of the first week for upper jaw surgeries. If in any case there is a gush of bright red blood from any incisions or the nose then contact the doctor.

Numbness: 

Numbness to the face and jaw depending on the surgery that was done is normal. This may persist for weeks, sometimes months. This will be monitored by your doctor during your office visits.

Oral Hygiene: 

It is very important to keep your mouth and teeth clean following surgery. Gentle rinsing and spiting with salt water or prescribed Peridex oral rinse should be done the first week. Then a Waterpik can be used to aid in cleaning. Use a child toothbrush to brush the outsides of your teeth. If you are wired or have elastics then you will not be able to brush the tongue side of your teeth.

Nausea: 

Avoid any foods that may cause your stomach to become upset. If you do that you are going to vomit then you should:

• Bend forward
• Put your finger inside your cheek alongside the teeth and gently pull your cheek outward.
• Remember that everything that you are ingesting is liquid, therefore if anything comes out it will also be liquid. Vomit can escape around the teeth and out the side of the cheek. Try not to cut the wires or elastics if at all possible.
• Anti-nausea medication can be prescribed if necessary.

Diet: 

It is essential that your body receives adequate fluids and nourishment in order to promote healing. You will be limited to a liquid diet for 4-6 weeks. Suggestions for a full liquid diet include: milk shakes, smoothies, Jell-O, blended foods, ensure and protein shakes. The doctor will instruct you as to when you can resume a soft diet. Avoid alcohol, sugary and carbonated drinks.

2. Pain

4. Swelling

• ICE: For the first day or two following surgery, apply ice to the cheeks for twenty minutes at a time. Remove the ice for twenty minutes and repeat.
• HEAT: Beginning on the third day after your procedure, apply warm, moist heat to treat stiffness and swelling. You may also chew gum and engage in light stretching beginning the day after surgery to deal with stiffness.

6. Hygiene

8. Bruising

10. Odor and Taste

12. Emergencies

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