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General Pre-Operative Instructions

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Every surgery is different and every patient is different, you probably will receive additional post-op instructions as well as these general instructions depending on your surgery.

Bleeding
After oral surgery it is important for a blood clot to form to stop the bleeding and begin the healing process. It is common to have abundant saliva production and some blood for the first 1-2 hours. If you swallow a lot your chances of vomiting go up. That is why we ask you to bite on a gauze pad for 30–45 minutes after the appointment during the trip home. If the bleeding or oozing persists, insert another gauze pad and bite firmly for another 30 minutes while siting down, not talking, not eating or drinking. There will always be a small amount of blood for the first 24 hours, but it should stop after that.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse or split vigorously, suck on straws, smoke, drink alcohol, or brush the surgical area for 1 week. These activities will dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 5-7 days as this will increase blood pressure and may cause renewed bleeding from the extraction site.

On rare occasions as the body heals the blood clot can dissolve early, this can happen 7-14 days after the surgery and a re-bleed ensues. Please call us if this happens.

If you are on anticoagulants, especially Xarelto, Pradaxa, Eliquis or coumadin please call you anti-coagulation clinic if you are bleeding because they may need to adjust your medication dosing.

Swelling
After surgery you may feel some pain and experience some swelling and later bruising. An ice pack (or an unopened bag of frozen peas or corn) wrapped in a single layer of paper towel, applied to the area will keep swelling to a minimum. Be careful not to cool the face too much because you may give yourself frostbite. Elevating the head 30 degrees by sitting/sleeping in a recliner or on pillows will also help.

Swelling peaks at 72 hours and gradually subsides over the next 1-2 weeks depending on how much surgery you had.

If you had surgery involving your sinuses or a surgery that perforated into the sinus you may receive instructions not to blow your nose or sneeze through your mouth for the next month so that the wounds do not open up. It can take 8-12 weeks for the mucosa/gingiva to heal back to normal.

Pain
Use the pain medication as directed. Usually it is a combination of 8hr Tylenol and 8hr Aleve with additional narcotics as needed, or regular Tylenol with Motrin. The goal is to make you comfortable enough, the goal is not to make you pain free. Call the office if the medication does not seem to be working. Take pain medications as prescribed, typically the nonsteroidal anti-inflammatory medications and Tylenol will help the most and the narcotic pain medication will provide a “boost” for pain relief. Usually you will benefit from the narcotics before you go to sleep. Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take it. This may include patients with liver or kidney disease, stomach ulcers or patients that are already on chronic pain medications. If you are on sleep aid drugs such as valium or muscle relaxants such as flexeril consult your medical doctor if you can also take our narcotics.

Infection
Typically you were given an IV dose of antibiotics prior to surgery. This gives you a great benefit with few side effects. Sometimes you will also receive a prescription for antibiotics to take after surgery, usually diabetics, immune compromised patients, dental implant and bone graft patients will receive postoperative antibiotics.

If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Discontinue antibiotics if you develop diarrhea or a rash and give us a call. If you have difficulty breathing or swallowing go to the emergency room for further evaluation.

Diet
Drink plenty of fluids and eat nutritious, soft foods on the day of surgery. We recommend a soft food diet consisting of foods such as chunky soup, mashed potatoes, ground beef, ravioli, pancakes, eggs etc., rather than foods such as applesauce, Jell-O, broth, pudding, and yogurt, which have minimal substance and could result in an upset stomach, nausea, and/or vomiting. You can eat normally as soon as you are comfortable.

Oral Hygiene
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least twice a day. This will speed healing and help keep your mouth fresh and clean. If you had your wisdom teeth removed you may have been given a syringe to irrigate the extraction sites. You can being gentle irrigation with water 5-7 days after surgery to wash out any debris that collects in the area. Please do not smoke or vape for the first 7-10 days as this will delay healing, increase your chances of bleeding, contracting an infection or “dry socket”.

Activity
After a few days, you will feel better and can resume your normal activities as tolerated typically this takes 5-7 days. If you have heavy bleeding, severe pain, continued swelling after 3 days, a reaction to the medication or your swelling changes from a doughy consistency to a harder feeling, please calls us. If it is after 8pm please call acute care or go to the emergency room, especially if you have trouble swallowing, breathing or if the swelling is going towards your eye.