Please read the following instructions carefully. The after effects of oral surgery are quite variable, so not all of these instructions may apply to you. At a minimum, you must control bleeding, provide for good nutrition, maintain adequate pain control, and provide proper oral hygiene/wound care.

Taking proper care of your surgical site will have great impact on how well you heal.

1. BLEEDING CONTROL:
Bleeding after surgery may continue for several hours. Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not being controlled. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. The gauze may be changed as necessary and may be dampened and/or fluffed for more comfortable positioning. Intermittent bleeding or oozing is normal. It is typical for bleeding to continue for a few hours after simple extractions and for several (6-10) hours after more complex surgery such as removal of impacted teeth. Placing fresh gauze over the surgical areas and biting down firmly for 30-60 minutes may control it. Maintaining the head in an elevated position (use of recliner or several pillows) will also help to reduce bleeding and swelling. Bleeding should never be severe. If it is, it usually 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 moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office at (386) 738-2006.

2. SWELLING CONTROL:
As you leave the office, and when you arrive home, use a cold pack on your face next to the surgical site to keep down the swelling (use crushed ice in "Zip-Loc" bag wrapped in a wash cloth). Keep the cold pack on for 15 minutes then off for 15 minutes. Repeat this sequence for 2-4 hours. The swelling, if any, will be present for about 2 days after surgery and then subside.
Often times there is some swelling associated with oral surgery that will reach its peak in around 48 hours and can take 7-10 days to resolve. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area. This should be applied 15 minutes on and 15 minutes off during the first 12 to 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. After 24 hours, apply warm moist heat to reduce swelling and/or remove discoloration. If the swelling becomes severe and/or you feel feverish, call the office at 386-738-2006.

3. FEVER:
A slight fever is not uncommon the first few days after surgery (temperature up to 100.5F). If you have a high fever or fever persists, please call our office at 386-738-2006.

4. OPERATING A MOTOR VEHICLE:
Please do not operate any machinery or a motor vehicle for 24 hours after sedation or general anesthesia, or if you are taking any prescribed narcotic pain medication (Percocet, Oxycodone, Vicodin, Hydrocodone, Tylenol with Codeine etc). Also, do not consume any alcohol for 24 hours after intravenous sedation, general anesthesia or while taking any prescription pain medication.

5. SUTURES:
Sutures (or "stitches") may be placed to re-approximate tissue and help control bleeding. These sutures are usually dissolvable and do not need to be removed.

6. AVOID SMOKING and AVOID ALCOHOLIC BEVERAGES for at least 2 full days. Both of these items are best avoided altogether, as they interfere with blood clotting and healing.

7. EXERCISE CARE:
Please limit your physical activities following surgery. Do not clean the house, mow the lawn, jog, do aerobics, play tennis, etc. for at least 3 days after surgery. You should be able to go to work (light physical activity only!) in a day or two. Remember, your body should be spending most of its energy healing. Try to take it easy and get a lot of rest the day of the surgery. Keep your head slightly elevated by relaxing in a relaxing chair, or using an extra pillow on your bed or couch.

8. DIET:
On the day of the surgery, we ask that you will avoid hot foods that prolong bleeding. Cold soft foods (such as ice cream, milk shakes, instant breakfast, puddings and yogurt) are ideal. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals! Avoid foods like nuts, sunflower seeds, popcorn, grits, rice, etc, which might get lodged in the socket areas. If you are diabetic, maintain your normal eating habits as much as possible and follow our instructions or those from your physician regarding your insulin schedule.

9. MOUTH RINSES:
Do not disturb the surgical area today. DO NOT RINSE vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. Keeping your mouth clean after surgery is essential. Use 1/4 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 and always after eating for the next five days. We may prescribe an antibiotic rinse (Chlorhexedine, Periogard, Peridex) for certain procedures. This rinse should be used in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse.

10. SHARP EDGES:
If you feel sharp edges in the surgical areas with your tongue it is probably the bony walls that originally supported the teeth. Occasionally small slivers of bone may work themselves out during the first week or two after surgery. They are not pieces of   tooth and, if necessary we will remove them. Please call if you are concerned.

11. PAIN:
Unfortunately most oral surgery is accompanied by some degree of discomfort. If you have no history of allergies to non-steroidal anti-inflammatory medications like ibuprufen (Motrin, Advil) we recommend taking this prior to the local anesthetic wearing off. If pain is more severe, a narcotic pain medicine may be needed. You cannot take the narcotic along with the ibuprofen therefore you should alternate them every three hours. Narcotic pain medication may cause an upset stomach, which may include nausea, vomiting or constipation. Effects of pain medicines vary widely among individuals. Remember that the most severe discomfort is usually within the first six hours after the anesthetic wears off, after that your need for medicine should lessen. Take all the medications given or prescribed for you as directed. They have been given for very important reasons. The only type of medication that you do not have to take all of is the pain medication. Take that only as needed, as explained above. Take all of the medication with food, unless otherwise stated.

12. SINUS PRECAUTIONS:
Some procedures in the back part of the jaw may involve entry into the sinus cavity. If you are advised of this, please follow these precautions for 10 days after the surgery. Do not blow your nose vigorously or sneeze holding your nose. Flying in pressurized aircraft may also increase sinus pressure and should be avoided. Please take decongestants and antibiotics as directed.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have any questions about your healing progress, please call (386) 738-2006. Please try to call during office hours, which are 9:00 am-5:00 pm, Monday through Friday.