Preoperative (Before Surgery) Instructions for IV Anesthesia
- The patient should have nothing to eat or drink (including water) for six (6) hours prior to the surgery. If you have been instructed to take medication on the morning of surgery, this can be taken with a small sip of water.
- A responsible adult must accompany the patient to the office, remain in the office during the surgery, and be able to drive the patient home.
- The patient should not drive a vehicle, operate any machinery or sign any legal documents for 24 hours following administration of IV anesthesia.
- Wear loose fitting clothing with sleeves which can be rolled up past your elbow, and low healed shoes.
- Please remove any loose objects from the oral cavity (dentures, partials, retainers)
The removal of impacted wisdom teeth and surgical extraction of regular teeth is quite different from routine dental extractions. The following conditions may occur, all of which are considered normal:
- The surgical area will probably swell.
- Swelling usually peaks on the 2nd or 3rd post-operative day.
- Slight blood taste is common for the first 24 hours.
- Delayed healing and increased pain due to smoking.
- Stitches will usually dissolve in 3-5 days.
- Elevation of temperature up to 101°F for 24-48 hours.
- Extraction sites usually take 4-6 weeks to fill in and completely heal.
- Avoid strenuous exercise for at least 5-7 days.
- Chewing for the first 7-10 days may be uncomfortable.
- Trismus (stiffness) of the muscle may cause difficulty opening your mouth.
- Adjacent teeth may be tender due to referred pain.
- Bruising may develop.
- A sore throat may develop.
Post-operative (After Surgery) Instruction for IV Anesthesia
Activities: Avoid ANY physical exertion or exercise the day of surgery. Each person is different but rest and good nutrition increase healing potential. Most patients are able to resume relatively normal activities 2 to 3 days after surgery, but strenuous exercise such as swimming, soccer, football or running should be avoided for 5 to 7 days.
Prescriptions: Medications are prescribed for specific purposes and should only be used as directed. Pain medications inhibit reflexes, therefore you should not drive or operate machinery while taking these medications. Alcohol is not to be used while taking any prescription medication. If antibiotics are prescribed, complete the prescription even if you are feeling fine. WARNING - Antibiotics have been reported to alter effects of oral contraceptives. To prevent pregnancy, alternative forms of birth control are recommended for one month after use of any antibiotic.
Bleeding: Some bleeding is to be expected for 12-24 hours following oral surgery. For the first few hours after surgery, pressure applied over the surgical area by biting on gauze pads will usually control active bleeding. Do not change gauze pads any more often than every 30 minutes. Firm pressure should be maintained as these pads may become dislodged and cause gagging or choking. We recommend removal of the pads prior to eating, sleeping or if bleeding has subsided.
If bleeding should persist, continue the ice packs, semi-reclined position and biting pressure on the area with gauze pads. Do not worry about the saturation of the pack with saliva or blood (A TEA BAG can be wrapped in gauze and placed over the socket as a pressure dressing. The tannin in the tea is an effective blood clotting agent.)
Excessive bleeding can be caused by:
- Smoking, refrain from smoking for at least 5 days after surgery.
- Sucking on straws
- Spitting-you should wipe saliva from our lips with a tissue.
- Vigorous rinsing mild rinsing is acceptable.
- Hot liquids cool or lukewarm liquids are acceptable.
- Lying flat in bed elevate your head above your feet
PAIN: Some discomfort after oral surgery is to be expected. Most patients are given a prescription to relieve severe pain. The first pain medication should be taken BEFORE the numbness wares off. Take all medication as directed. If you were not given a prescription, any medication you use for a headache will be helpful. We encourage the use of Advil, Motrin or Ibuprofen four (4) times a day to minimize tenderness and swelling.
NAUSEA/VOMITING: The majority of nausea is cause by medications on an empty stomach or excessive activity. Any medication, especially pain medications taken on an empty stomach greatly increase the chance of nausea or vomiting. The normal swallowing of blood or the anesthesia which was used may also cause nausea. If nausea occurs, stop all medications, remain at rest in a quiet, dark room. A cold towel to the throat, neck or forehead may help. Small sips of tea, carbonated beverages or Gatorade taken very slowly may help to calm the stomach. If nausea persists more than 4-6 hours, contact our office or the doctor on call.
DIET: Initially, only liquids should be taken, then try to maintain an adequate diet by eating soft foods and liquids as tolerated. Examples of a soft diet include milk shakes, ice cream, soups, Jello, custards, baked or mashed potatoes, eggs or pastas. Avoid hard, crisp foods which require chewing.
ORAL HYGIENE: Do not brush your teeth or rinse your mouth vigorously for the first 12 hours after surgery. You should keep your mouth clean starting the day after surgery by using a soft toothbrush and gently rinsing with warm salt water. (1/2 teaspoon of salt in an 8 oz. glass of water) after meals and at bedtime. Salt may be omitted in patients on salt free diets.
SWELLING: Swelling is a normal and expected response to surgery. You may help decrease swelling by applying an ice pack to your face immediately after oral surgery, then on and off about every 20 minutes for the first 24-48 hours after surgery. Most swelling peaks on the 2nd or 3rd post-operative day and lasts 5-7 days. Moist heat such as a warm wash cloth may produce relief of pain and swelling when used after the initial 48 hours.
BONE SPICULES: These small fragments of bone sometimes work their way through the gum tissue and feel sharp to the touch. In most cases, they will work out on their own but it may be necessary for your surgeon to assist in their removal.
TEMPERATURE: Any time surgery is performed in the mouth, there can be an elevation in body temperature. The main cause is inadequate water intake resulting in dehydration. To keep your temperature to a minimum, drink 2-3 quarts of fluids per day and if necessary you may take Tylenol if you are not allergic to this medication. Any increase in temperature greater that 101ºF should be reported to your doctor.
VENIPUNCTURE: Some bruising and tenderness at the injection site is expected. The needle being placed into the vein or the medication used for sedation can sometimes cause an inflammation of the vein called phlebitis. This is a firm tenderness of the vein which usually resolves without treatment. Should this situation arise, contact our office.
DRY SOCKET: This complication is seen in less than 5% of patients and unfortunately cannot be predicted or prevented. The blood clot which forms in the open extraction site may prematurely dissolve, resulting in a throbbing type pain in the jaw which may radiate to the ear. This is an uncomfortable situation which usually occurs on the 3rd to 8th day after surgery. Recovery usually takes 7-10 days during which time a medicated dressing must be placed in the socket to control the discomfort. Please contact our office if these symptoms arise and pain medications do not control the discomfort.
SPECIAL CONSIDERATIONS: Severity of postoperative pain will depend on the procedure performed and your physical condition. Rest, adequate intake of fluids and nutrition, minimizing swelling and following post-operative instructions will decrease recovery time. Most sutures dissolve away in the first 3-5 days. A normal recovery, especially chewing, takes 7-14 days before you are back to a normal daily routine. Healing of surgical sites is variable.
EMERGENCIES AND CALL POLICY: Since we share night and weekend emergency calls, the doctor who did your surgery may or may not be the doctor to return your call. If an emergency develops such as extreme prolonged bleeding, allergic reactions, temperature elevated greater that 101ºF, prolonged nausea and vomiting or pain; you can always reach a doctor by calling the OFFICE at 214.363.6415 or the ANSWERING SERVICE at 972.566.8212 (after regular hours).