Surgical Instructions

PreOperative Instructions with Sedation

PostOperative Instructions




PreOperative Instructions with Sedation

Seven to Ten Days Before Surgery:

Do not take any aspirin or ibuprofen. Tylenol is recommended if necessary.

Three Days Before Surgery:

Day Before Surgery:

Day of Surgery:



PostOperative Instructions

We have tried to address most of your questions about your surgery and recovery before leaving the office. Here is some information about what to expect in the next few days. Please remember that we are partners in caring for your health. We have done our best to minimize your discomfort and start you off properly in your recovery.

Driving a Car: If you had IV sedation for your surgery, you may not drive or operate machinery for the first 24 hours after the surgery. It will take some time for your alertness and coordination to return to normal. Also, you should not drive if you are taking narcotic pain medication after the surgery.

Bleeding: Some oozing of blood from the surgical site is common after extractions. Minimal oozing can continue for up to four days after surgery. Gauze sponges were placed over the surgical site before you left the office. After one hour, replace the gauze with new ones and bite down for one additional 45 minutes. Continue changing the gauze every 45 minutes until the bleeding slows or stops. Bleeding can continue for quite a while, but in general, should lessen as time goes by. Avoid spitting or drinking with straws which can cause or prolong bleeding.

Oozing can be quite heavy after the removal of some teeth. If the bleeding seems heavy, gently rinse your mouth with salt water to remove any large clots. Then take two gauze sponges, folded into fourths and place it over the extraction sites and apply hard biting force for one hour without changing the gauze. Repeat the procedure if bleeding continues. If active bleeding continues, call the office and let us know. Avoid smoking for 7 days after surgery. Smoking delays healing, increases discomfort, and can cause bleeding.

Eating: Before the bleeding has stopped, remove the gauze, eat, then replace the gauze and change as directed. For the first few hours, soft cold foods such as ice cream, milk shakes, water ice, yogurt, Jell-O, pudding, and cold drinks are best. Avoid hot foods, hot drinks, straws, carbonated drinks and spitting for 48 hours, as these can increase bleeding. Also avoid foods such as nuts, seeds, rice, popcorn or any other small foods which can become lodged in the extraction sites for 2-3 weeks. By later in the evening, cool foods such as scrambled eggs, mashed potatoes, or even pancakes can be eaten.

Discomfort: The amount of discomfort you’ll feel after surgery will depend on the extent of your surgery. The local anesthesia will last for one to six hours after surgery. Start taking your pain medication before you local anesthesia is totally worn off. It’s a good idea to eat something before you take any pain medication. Take your prescription pain medication as directed by your doctor and labeled on the bottle. If you are taking prescription narcotic pain medication, do not drive a car, operate machinery, or drink alcohol. If you were not given a prescription for pain medication, your doctor feels that your pain will be minimal. If your discomfort is minimal, or you need to drive a car Advil or Extra Strength Tylenol may be sufficient. If you feel that you need something stronger then Advil or Tylenol, please call the office. If the pain seems to be worsening instead of improving after 3 to 4 days, please call the office. It’s not unusual for pain medication to cause nausea or vomiting in some people. If this occurs, stop taking the narcotic medication. If you continue to feel ill after stopping the medication, call the office.

Swelling: Swelling is a normal part of the healing process. Facial swelling usually peaks in 48 to 72 hours after surgery. Swelling can make it difficult to open your mouth wide or swallow. If you had teeth removed from both sides of your mouth, it’s not uncommon for one side to be more swollen or uncomfortable than the other. In most cases, ice packs placed on the side of the face for 30 minutes (alternating sides) each hour for the first 48 hours will help with swelling. Also, if you had wisdom teeth removed, elevate your head and upper body with 3 pillows while sleeping after surgery and during the first two nights. This will help minimize swelling. Do not sleep on your side for the first two nights, as this will increase swelling in the morning. Remember, swelling is usually worse in the first two mornings after wisdom tooth surgery.

Brushing and Rinsing: Good oral hygiene is essential after the surgery in order to insure proper healing and to reduce the possibility of infection. You may resume brushing your teeth before bedtime. Starting the day after the surgery, rinse your mouth with salt water 10 times a day for 2 weeks. Mix 1 teaspoon of table salt with eight ounces of water. If you have high blood pressure or on a salt restricted diet, use plain water. If you have stitches, salt water will help them dissolve in 7-14 days.

Antibiotics: Depending on the extensiveness of your surgery, or the presence of infection, your doctor may prescribe antibiotics. You should carefully follow the directions on the bottle and continue taking the medications until they are completely finished. If you should develop a reaction to the medication such as itching, a rash or hives stop taking the medication and call your doctor.

Important Note about Antibiotics: Antibiotics can interfere with effectiveness of birth control pills to prevent pregnancy. If you are taking antibiotics, you should use additional methods of birth control pills until your next menstrual period.

Smoking: No smoking of any kind should be done for the first 7 days. Smoking interferes with the normal healing process, will increase pain, prolong bleeding, and will increase your risk of developing a dry socket.

Activities: You can resume light activities as soon as you feel up to it. Strenuous activity or heavy lifting should be limited for 7 days.

Other things you may experience: Occasionally, some individuals may notice bruising on the side of the face where the surgery was done, or experience numbness or tingling of the lips, chin and/or tongue. Let your doctor know about this on your post-operative visit. Also, during the normal healing process, small fragments of bone may work up through the gum. These are not pieces of tooth and often come to the surface themselves. These usually will fall out on their own. If not, please call our office to schedule an appointment.

If you need to reach your doctor: We are here to answer your questions or concerns. The doctor can be reached 24 hours a day by calling the office number (215-591-9354). There is an answering service you can speak to after office hours. After you call, kindly keep your telephone line open so the doctor can return your call. Please return to the office for follow-up care or a check-up as instructed by your doctor.