Before Anesthesia
You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.No smoking 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 the anesthesia experience.Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.Contact lenses, jewelry, and dentures must be removed at the time of surgery.Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.If you take routine oral medications, please check with Dr. Padgett prior to your surgical date for instructions.Implant Post-Operative Care
Leave gauze in place for 30 minutes and then remove. Replace gauze only if significant bleeding occurs. Wet slightly with water so the gauze does not stick to the site.
DO NOT SMOKE.
Keep your head elevated and place an icepack on the area until bedtime, use 24-48 hours, 20 minutes on and 20 minutes off. After 48 hours, you may apply heat to reduce any swelling, 10 minutes on and 60 minutes off. Cold pack provided can also be used as a heat compress, please follow instructions at bottom of page.
Take medications as directed. If possible, avoid taking medications on an empty stomach. **Please take the antibiotic and anti-inflammatory until finished.
- Antibiotic as directed (Amoxicillin, Clindamycin, Cephalexin, Augmentin)
- Anti-inflammatory following surgery four times a day for five days (600mg Ibuprofen). One Extra strength Tylenol can be taken with the Ibuprofen to double up on pain relief (avoiding the narcotic).
- Pain medication as needed every 4-6 hours (Hydrocodone, Oxycodone, Tramadol). Patient will be numb 6+ hours.
- Antiseptic rinse once in the morning and once at night for 30 seconds and spit out starting the morning after surgery.
Eat cold soft foods on the day of surgery. Warm foods may be eaten the next day.
Avoid eating on the surgical site for 2-4 months.For soft tissue comfort (sore/irritated mouth), warm salt water rinses can be done 12 hours following surgery (1/4 teaspoon of salt per ½ cup of warm water; 4-5+ times per day).
Brush your teeth for two minutes and then rinse with Listerine (antiseptic) or Peridex (Chlorhexidine) for 30 seconds twice daily. Cleanliness of the mouth is essential to good healing and prevention of infection. Use Q-tips, fluff end by pulling fibers out to tip to soften and dip into mouth rinse and roll around teeth near surgical site to remove plaque and debris. If an abutment was placed, it should be clean of plaque and debris too. After 7-10 days, use toothbrush. (Do not scrub surgical areas use Q-tip) Do not use an electric toothbrush or WaterPik in the surgery site for 10 days (sutures can vibrate loose).
If brown facial tape was applied, leave in place for 48 hours. To remove, wet with warm water and roll down from upper jaw and/or roll up from lower jaw. Do not pull from side.
Be sure to schedule follow up appointments as recommended.
If problems or concerns arise, please phone our office at 804-379-7120.
Cleanliness of the mouth is essential to good healing and the prevention of infections.
- Cold Therapy Application: Frozen cold pack 20 minutes on, 20 minutes off.
- Hot Therapy Application: Moistened, heated towel or therapy pack, 10 minutes on and 60 minutes off.
After Wisdom Tooth Removal
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.
Following Surgery
1. Leave gauze in place for up to 30 minutes, and then remove. Replace with a moistened piece of gauze if bleeding continues for an additional 30 minutes at a time until bleeding stops.
2. Do NOT take medications on an empty stomach unless directed.
3. Eat cold soft foods on the day of surgery. Warm foods may be eaten the next day.
4. Apply an ice bag (30 minutes on/30 minutes off) for 48 hours to minimize swelling. After 48 hours you may apply heat to reduce the swelling if present.
5. 12 hours following your surgery, begin brushing your teeth and gently rinsing your mouth with warm salt water rinses.
6. DO NOT SMOKE for 5-7 days following surgery.
7. If problems develop, please call our office .
** NOTE: Warm or hot food and beverages should not be consumed until bleeding has stopped.
Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. 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 bleeding does not subside, call for further instructions.
Swelling
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 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, 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 36 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. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Diet
After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites.
High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. 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 should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.
Discoloration
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.
Antibiotics
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.
Other Complications
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. Padgett 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. It was also difficult to take fluids. 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. Padgett.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. This is a normal post-operative event which will resolve in time.In Conclusion...
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. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call my office for instructions.
There will be a cavity where the tooth was removed. The cavity 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: Dr. Padgett or your family dentist.
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. Call the office if this occurs.
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.
IMPORTANT MEDICATION INFORMATION
- Do NOT take medications on an empty stomach unless indicated on the prescription.
- Take the IBUPROFEN and the ANTIBIOTIC prescriptions with food as soon as possible after surgery. Please take these two prescriptions until they are finished.
- If you are experiencing moderate to severe pain, add an extra strength Tylenol to the Ibuprofen dosage every 6 hours.
- The narcotic pain medication may be taken if needed to supplement the Ibuprofen for severe pain.
After Exposure Of An Impacted Tooth
Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out do not get alarmed.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.
Swelling
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or a plastic bag or towel filled with ice cubes on the cheek in the area of surgery. Apply the ice continuously as much as possible for the first 36 hours.
Diet
Drink plenty of fluids. Avoid hot liquids or 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.
Oral Hygiene
Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.
REMEMBER: A clean wound heals better and faster.
Activity
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. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
IMPORTANT MEDICATION INFORMATION
- Do NOT take medications on an empty stomach unless indicated on the prescription.
- Take the IBUPROFEN and the ANTIBIOTIC prescriptions with food as soon as possible after surgery. Please take these two prescriptions until they are finished.
- If you are experiencing moderate to severe pain, add an extra strength Tylenol to the Ibuprofen dosage every 6 hours.
- The narcotic pain medication may be taken if needed to supplement the Ibuprofen for severe pain.
After Extractions
1. Leave gauze in place for up to 30 minutes, and then remove. Replace with a moistened piece of gauze if bleeding continues for an additional 30 minutes at a time until bleeding stops.
2. Do NOT take medications on an empty stomach unless directed.
3. Eat cold soft foods on the day of surgery. Warm foods may be eaten the next day.
4. Apply an ice bag (30 minutes on/30 minutes off) for 48 hours to minimize swelling. After 48 hours you may apply heat to reduce the swelling if present.
5. 12 hours following your surgery, begin brushing your teeth and gently rinsing your mouth with warm salt water rinses.
6. DO NOT SMOKE for 5-7 days following surgery.
7. If problems develop, please call our office .
** NOTE: Warm or hot food and beverages should not be consumed until bleeding has stopped.
Bleeding
Some bleeding is expected. If profuse or continuous bleeding occurs after leaving the office, place a moistened gauze pad over the area and close the mouth firmly so that pressure is applied. A moistened tea bag may be used if gauze is not available. If profuse or continuous bleeding persists, call the office.
Pain
Surgical operations in the highly sensitive oral cavity can be expected to produce some post-operative pain. This can be controlled by taking the prescribed medication on a regular basis, usually every 6 hours. Occasionally, moderate to severe pain will develop 4-5 days after the surgery. This is usually caused by the decomposing of the blood clot which exposes the bony walls of the socket. Call the office if this should occur.
Oral Hygiene
Since vigorous rinsing may stimulate bleeding, refrain from rinsing the mouth for the first 12 hours. After that time use rinses of warm salt water (a pinch of salt in a glass of warm water) several times a day. Remove all white film from the gums with a cotton swab, or a clean piece of gauze, and brush your teeth with regular toothpaste, being careful to avoid the operative site. Cleanliness of the mouth is essential to good healing and the prevention of infections.
Diet
For the first few days avoid food that is difficult to chew. Eat plenty of fruit, and drink several glasses of water, fruit juice, or other fluids daily. If extensive work has been done, supplement your diet by taking vitamins or nutritional drinks like Ensure.
Swelling and Stiffness
Swelling will ordinarily increase for 48 hours following surgery. It can be minimized by the application of ice for the first 48 hours then heat until swelling resolves. Jaw stiffness is common following most oral surgical procedures and may last for 7-10 days.
Discoloration
Should there be bleeding into the tissues, a purplish-black discoloration similar to that seen in bruises may result. The application of heat in any form will help remove discoloration. This is not an uncommon occurrence and you should not be worried if it happens in your particular case.
Sharp Bony Projections
During the healing process small, sharp objects may be felt in the gums. These are not pieces of the tooth, but are usually small pieces of bone. If left alone they often work themselves out of the gum. If they are particularly bothersome, return to the office for evaluation.
IMPORTANT MEDICATION INFORMATION
- Do NOT take medications on an empty stomach unless indicated on the prescription.
- Take the IBUPROFEN and the ANTIBIOTIC prescriptions with food as soon as possible after surgery. Please take these two prescriptions until they are finished.
- If you are experiencing moderate to severe pain, add an extra strength Tylenol to the Ibuprofen dosage every 6 hours.
- The narcotic pain medication may be taken if needed to supplement the Ibuprofen for severe pain.