Surgical Instructions

Preoperative Instructions for All Patients Having Surgery

1. Nothing to eat or drink for 8 hours prior to surgery. This includes water, tea, and coffee. Failure to do so will cause your surgery to be postponed.

2. Someone must drive you home following surgery if you are having IV sedation.

3. If taking aspirin or any prescription blood-thinner, be sure to follow Dr. Kelly’s or Dr. Reece’s instructions for discontinuation if advised.

4. If you were given or prescribed an antibiotic to take BEFORE surgery, please take it 1 hour prior to surgery with a small amount of water.

5. Take other medications as directed with a small amount of water at your regularly scheduled time, unless instructed otherwise.

6. Wear a short sleeve shirt or loose-fitting clothing to allow access to both elbow areas where the anesthetic will be administered. Please no turtlenecks or hoodies.

7. A parent or guardian must accompany patients 17 years old or younger.

8. Bring your insurance card to help us assist you with your claim if you have not already done so.

9.Please bring a photo ID if you have not already done so.

10. We ask that you leave cell phones or electronic devices at home or turned off and put away during your surgery.

General Postoperative Instructions for All Patients

PLEASE READ THESE INSTRUCTIONS CAREFULLY

Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office any time for clarification.

Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. Changing the gauze may be necessary.

Do not disturb the surgical area today. DO NOT rinse vigorously or probe in the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing, DO NOT USE A STRAW or do anything to create a suction in your mouth. This can delay healing and potentially cause a dry socket.

*IF YOU HAVE HAD A BONE GRAFT, PLEASE CONTINUE THE ABOVE INSTRUCTIONS FOR 1 WEEK.

Intermittent bleeding or oozing is normal. It may be controlled by placing fresh gauze over the surgical areas and biting down firmly for 30-60 minutes.

Bleeding should never be severe. Severe bleeding means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas. Try repositioning fresh packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 20-30 minutes. If bleeding remains uncontrolled, please call our office.

Often there is swelling associated with oral surgery. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face and cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24 to 48 hours after surgery. After 72 hours, it is usually best to switch from ice to moist heat to the same areas. Typically swelling is at a maximum 48-72 hours after surgery. Soft swelling is normal. Hard swelling may represent infection.

Most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to better manage any discomfort. Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as Tylenol or Ibuprofen. Some people may even require two of the pain pills at one time during early stages (but that may add to the risk of upset stomach). Remember that the most severe discomfort is usually within the first six hours as the local anesthetic wears off; after that your need for medicine should lessen.

Nausea is not an uncommon event after surgery, and it may be caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of food. Non-carbonated cola drinks may help with nausea. Fortunately, postoperative nausea is gone the day following surgery.

Initially, eat soft food or drink liquid until the numbness is gone. It is sometimes advisable to confine the first day’s intake to liquids or pureed foods (creamed soups, puddings, yogurt, milkshakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.

If you feel sharp edges in the surgical areas with your tongue, it is probably the bony walls which originally supported the teeth. Rarely small slivers of bone may work themselves out during the first week or two after surgery. They are not pieces of tooth. Please call the office if you are concerned.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS AFTER SURGERY

Keeping your mouth clean after surgery is essential. Use one-quarter teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily for the next five days.

Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.

If you were given an irrigating syringe at your first office check-up visit, start using it the third day after surgery to keep sockets clean. Fill it with warm water and irrigate any open sockets gently, especially after eating.

Normal healing after tooth extraction should be as follows: The first day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day should be more comfortable and, although possibly more swollen, you can usually begin a more normal diet. From the third day on, GRADUAL, STEADY IMPROVEMENTS should mark the remainder of your postoperative course. If a DRY SOCKET occurs (loss of blood clot from socket, usually on the third to fifth day), there is a noticeable, distinct, persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache. If you do not see steady improvement during the first few days after surgery, don’t suffer needlessly. Call the office and report symptoms so you can be seen as soon as possible. It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. Please try to call during office hours; however, 24-hour answering service is available for after-hours contact with a doctor. Calling during office hours will afford a faster response.

Postoperative Instructions for Implants

PLEASE READ THESE INSTRUCTIONS CAREFULLY

Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office any time for clarification.

Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. Intermittent bleeding or oozing is normal. Do not disturb the surgical area today. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office. DO NOT rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing.

Often there is some swelling associated with oral surgery. You can minimize this by using an ice pack applied firmly to face or cheek next to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 12 to 24 hours after surgery. Swelling can be at a maximum 48-72 hours after treatment. Heat can be used after this initial two-to-three-day period.

Most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you will be able to better manage any discomfort. Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as Tylenol or Ibuprofen. Some people may even require two of the pain pills at one time during early stages (but that may add to the risk of upset stomach). Remember that the most severe discomfort is usually within the first six hours after the local anesthetic wears off.

Nausea is not an uncommon event after surgery, and it is sometimes caused by strong pain medicines. Nausea can be reduced by eating soft food along with taking the pain pills. If you feel the stronger narcotic pain pills are causing nausea, switch to Ibuprofen or Tylenol. Generally, nausea is gone by the next morning after surgery.

Soft foods are recommended for the first day. After that, you may resume a more normal diet.

Keeping your mouth clean after surgery is essential. After the first day, use one-quarter teaspoon of salt dissolved in an 8-ounce glass of warm water, and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, at least two or three times daily for the next five days.

Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth. As healing takes place, you should be able to brush over the implant after a few days.

After 48-72 hours, apply warm compresses (hot water bottle, moist hot towels, heating pad) to the areas of swelling for 20 minutes to help soothe those tender areas. This will also help decrease swelling and stiffness.

You will notice a small round metal cover cap where the implant is placed. Please keep this clean by brushing. Healing time will be anywhere from three to six months before the implant can be restored by your dentist.

The gum tissue, in some situations, will be covered over the implant. In those cases, a small second procedure will be required to uncover the implant. Healing time will be anywhere from three to four months before the uncovering procedure will be needed. After two to three weeks, the implant will be ready to be restored by your dentist.

After Wisdom Tooth Removal

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time remove and discard the gauze. If bleeding continues, place enough new gauze to obtain pressure over the surgical sites for another 30 minutes. Changing the gauze may be necessary.
  • Vigorous mouth rinsing, drinking through straws, or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Do not smoke for at least 48 hours, since it is detrimental to healing.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic diminishing.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

A certain amount of bleeding is to be expected following surgical wisdom teeth removal. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding means that the gauze pads are being clenched between your teeth and you are not exerting pressure on the surgical areas. Try repositioning fresh gauze pads. If bleeding continues, bite on a moistened tea bag for 30 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.

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face are 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 two to three days postoperatively. 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. This should be applied 20 minutes on and 20 minutes off during the first 24 to 48 hours after surgery. After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days after your wisdom teeth removal, there is no cause for alarm. This is a normal reaction to surgery. Seventy-two hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to better manage any discomfort . Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as Ibuprofen. Some people may even require two of the pain pills at one time during early stages (but that may add to the risk of upset stomach). Remember that the most severe discomfort is usually within the first six hours, as the local anesthetic wears off. After that, your need for medicine should lessen. While taking the prescribed pain medicine, do not drive or work around machinery and avoid alcoholic beverages.
Initially, eat soft food or drink liquid until the numbness is gone. It is sometimes advisable to confine the first day’s intake to liquids or pureed foods (creamed soups, puddings, yogurt, milkshakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days, you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.
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.
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 two to three times a day, especially after eating, with a cup of warm water mixed with one-quarter teaspoon of salt.
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 postoperative occurrence, which may occur two to three days postoperatively. Moist heat applied to the area may speed up the removal of the discoloration.
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.
In the event of nausea and/or vomiting following your wisdom teeth removal, 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 15-minute period. When nausea subsides you can begin taking solid foods and the prescribed medicine.
  • 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. Kelly or Dr. Reece 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 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. Kelly or Dr. Reece.
  • 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 two to three days.
  • Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal postoperative event which will resolve in time.

Sutures are placed in the area of surgery to minimize postoperative bleeding and to help healing. Sometimes they become dislodged, but this is no cause for alarm. Just remove the suture from your mouth and discard it. The pain and swelling should subside more and more each day following surgery. If your postoperative 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 meantime, 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. Kelly, Dr. Reece, or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

When having a wisdom teeth removal a dry socket can occur. 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 three to five 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. After your wisdom teeth removal if you notice you are getting light headed, stop exercising.

After Exposure of an Impacted Tooth

After the 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 be alarmed.
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 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.
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.
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength. Tylenol may be taken every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.
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.

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.

After Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol, or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted, you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days, you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for two to three days, or a reaction to the pain medication, call our office immediately at 970-245-2222.

For questions regarding preoperative or postoperative care for any procedure, please do not hesitate to call us at 970-245-2222.

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Grand Junction Location

2530 N 8th St #103

Grand Junction, CO 81501

 

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Monday 8:00 AM - 4:30 PM
Tuesday 8:00 AM - 4:30 PM
Wednesday 8:00 AM - 4:30 PM
Thursday 8:00 AM - 4:30 PM
Friday 8:00 AM - 3:00 PM
Saturday Closed
Sunday Closed

 

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Carbondale Location Verheul Family Dentistry

1199 Village Rd #100

Carbondale, CO 81623

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We see patients in Carbondale every Thursday. We work out of Verheul Family Dentistry. If this location is more convenient for you, please ask us about it when you schedule your appointment.

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970-245-2222

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frontdesk@cowestoms.com

 

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