Surgical Instructions

Pre-Operative Instructions for Patients Receiving Intravenous (IV) Anesthesia

The anesthesia technique used in our office is primarily for your comfort and to enable Dr. Pausa to complete your treatment more comfortably and efficiently. This medication will relax you so that you may lapse into a light sleep. Since the medications will affect both your ability to think clearly and your equilibrium, the following policies have been implemented for your safety:

1. It is necessary for someone to accompany you and drive you home after surgery. The effects of the medications can remain with you for several hours. You must not drive, work with power tools or sharp knives or perform any tasks that require good coordination for the remainder of the day. In addition, do not drink alcoholic beverages on the day of surgery.
2. If your appointment is scheduled for the morning, you must not have anything to eat or drink after midnight the night before surgery. If your appointment is scheduled for the afternoon, you may have a cup of water, juice or soda up to 8 hours prior to surgery.
3. Wear a CLEAN loose-fitting shirt with short sleeves to your appointment. No shorts or opened toed shoes! PLEASE DO NOT WEAR PERFUME, COLOGNE, lipstick or make-up. Nail polish, and mouth jewelry should not be worn.
4. If a prescription for medication was given to you to take prior to surgery, take your medication as directed with only a small sip of water. Continue to take any medication you usually take as prescribed, unless specifically advised not to prior to surgery.
5. Smoking on the day of surgery should be avoided.
6. If symptoms of a common cold, sore throat, running nose, fever, chills, cough or other illnesses develop prior to surgery, please call to reschedule your appointment.
7. Post- operative instructions and prescriptions for pain medication will be given to you after surgery.
8. Have soft foods available for post-operative consumption including ice cream, smoothies, eggs, mashed potatoes, pasta, lukewarm soups, & Jell-O. Please remember to refrain from using a straw immediately after your surgery.
9. Have 1-2 ice packs available at home to minimize swelling after surgery.

Post Operative Instructions for Wisdom Teeth Extractions

The Day of Surgery:

First Hour After Ariving Home

Upon arriving home, remove the gauze packs. Eat something soft and cold (AVOID STRAWS AND CARBONATED BEVERAGES FOR 5 DAYS, EAT WITH A SPOON ONLY) and take the pain medication. Be sure to remove the gauze to eat and take pain medication. After pain medication has been taken, replace the gauze. Be sure to place the gauze over the surgical site as opposed to in between your teeth. Bite down gently and firmly on the gauze that has been placed over the surgical area(s), to be sure they remain in place. Change the gauze every 20 minutes until the bleeding stops. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in warm water and squeezed damp-dry) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office. The gauze is no longer needed once the bleeding has stopped.

Oozing

Intermittent bleeding or oozing is normal; to control the oozing, place fresh gauze packs over the surgical sites and bite down for 30-60 minutes. Do not disturb the surgical areas during recovery. Do not probe the areas with objects or your fingers.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. Therefore, you have been given a prescription for pain medication. Before taking medication for pain, you must eat something in order to avoid nausea or vomiting. To best manage discomfort, you should take the first dose within 2 hours following surgery. Side effects of pain medication vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with two analgesic tablets, such as ibuprofen, approximately every two hours in between pain medication doses. Remember that the most severe discomfort is usually within the first six hours after anesthesia wears off.

Antibiotics

If you received a prescription for an antibiotic, you may begin taking it the afternoon of your surgery.

Nausea

Nausea is not an uncommon side effect of surgery and is sometimes worsened by pain medication. Preceding each dose with a small amount of soft food, and then taking the dose with a large volume of water may reduce nausea. If nausea or vomiting remains an issue, please call our office.

Diet

Please do not use a straw for 3 days following surgery. It is best to eat soft foods for the first 3 to 4 days. Avoid extremely hot foods. It is advised to confine the first day’s food intake to bland liquids such as soups, pudding, mashed potatoes, scrambled eggs, pastas, yogurt or ice cream. Milk shakes are okay if eaten with a spoon. If you eat 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 our office or your physician regarding your insulin schedule. For 3 weeks, avoid foods such AS POPCORN, POTATO CHIPS, PEANUTS AND HARD CEREALS. These types of foods can get lodged in the socket areas and cause infection.

Brushing

Starting the day of surgery, you may begin your normal oral hygiene routine. 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.

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 pieces of bone may extrude from the socket sites during the first or second week after surgery, therefore, do not be alarmed if this happens.

The Day After Surgery - Mouth Rinses

Starting the day after surgery, use one half teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions over a course of 5 minutes. Repeat at least three times daily for five days.

One Week After Surgery - Syringe Irrigation

Starting one week after surgery, irrigate the lower extraction sites twice daily using the provided syringe and a salt water solution. To mix the solution, add 1 teaspoon of salt to 8 oz of drinking water.

Dry Sockets

After a tooth is removed, a blood clot forms in the socket site within a few hours. If you drink from a straw, smoke or spit, that blood clot will remove itself from the socket site, causing a DRY SOCKET. You will then feel a distinct, persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache. Therefore, it is imperative that you do not spit, smoke or drink from a straw for at least 5 days following surgery.

Stitches

Stitches may have been placed at the surgical site(s) and will dissolve within 3 to 5 days

Activities

Avoid all strenuous exercise for 5 to 7 days after surgery, including, but not limited to running, swimming, weight lifting and most school P.E. class activities.

Post Operative Instructions for Tooth Extraction

1. It is normal and expected to experience bleeding and some discomfort following a dental extraction. If a tooth is surgically removed or sectioned for removal, some bruising and swelling of the cheek may occur.
2. The gauze that is placed over the surgical site at the completion of the treatment should be left in place for 20 minutes and replaced with new gauze if bleeding is still evident. Continue this process until the bleeding stops. Usually this is necessary for the first 2 hours.
3. In some cases, sutures may have been used and will dissolve in 3 to 5 days and/or be removed at follow up appointment.
4. If medication was prescribed for pain control, it should be taken as directed beginning as soon as possible after surgery. Minor discomfort can be controlled with Tylenol or Advil.
5. Diet varies from patient to patient, but it is best to start with soft foods and return to a regular diet as tolerated. Generally anything that is comfortable to eat is okay. When eating, it is best to chew on the opposite side of the extraction site. Please avoid crunchy foods and foods with seeds for two weeks.
6. Do not rinse, spit, or use a straw during the first 3 days following surgery; Beginning the day after surgery, patients can brush their teeth gently but, do not brush over the extraction site and do not rinse forcefully. Patients should not smoke or drink alcoholic beverages for 3 days following the extractions.
7. If you had a bone graft procedure performed, please keep your tongue away from the site. Do not brush the area in order to prevent premature loss of sutures. It is normal to have an unusual taste or smell in your mouth for approximately 7 – 10 days.
8. Keep your head elevated while lying down during the first 24 to hours which will help minimize swelling. You can use an ice pack or frozen bag of peas wrapped in a towel and applied firmly to your cheek adjacent to the surgical area. Avoid all strenuous activity for 5 to 7 days.
9. Avoid all strenuous exercise for 5 to 7 days after surgery, including but not limited to running, swimming and weight training.

Post Operative Instructions for Biopsy

1. It is normal and expected to experience some bleeding and discomfort following a mouth biopsy. Some swelling and bruising may appear depending on the surgical area. Applying an ice pack to the area, 20 minutes on and 20 minutes off, for the remainder of the day, can minimize this.
2. In most cases, sutures are used and will need to be removed in our office. Occasionally resorbable sutures may have been placed. Our surgical staff will advise you regarding which type were used and whether or not you need to return to our office for follow up.
3. Diet varies from patient to patient, but it is best to start with soft foods, avoiding chewing on the side closest to the surgical area.
4. Begin rinsing with salty water the day after your procedure, using 1 tea. salt dissolved in 8 oz. of water. Continue this process for several days.
5. Do not rinse, spit or use a straw for approximately 3 days following surgery; Beginning the day after surgery, patients can brush their teeth gently but, do not brush over the surgical biopsy site. Patients should not smoke or drink alcoholic beverages for 3 days following the procedure.
6. Biopsies are routinely submitted to a Dental College of Georgia at Augusta University for analysis. Results are mailed to our office in approximately 10-14 days. It is important to schedule a follow-up appointment to receive the results and to make sure the area is healing well.

Post Operative Instructions for Dental Implants

1. It is normal and expected to experience bleeding and some discomfort following a dental implant. Some swelling and bruising of the cheeks or lips may appear depending on the location of the surgery. It is recommended to use ice packs to the area 20 minutes on and 20 minutes off for the first 72 hours.
2. The gauze that is placed over the surgical site at the completion of surgery should be left in place for 20 minutes and replaced with new gauze if bleeding is still evident. Continue this process until the bleeding stops. Usually this is necessary for the first 1 to 2 hours.
3. Sutures were used to close the surgical incision and will need to be removed here in our office within 10-14 days.
4. Diet varies from patient to patient, but it is best to start with soft foods and return to a regular diet in 2 to 3 days as tolerated. It is important to chew on the opposite side of mouth, and if implants were place on both sides, it will be necessary to continue consuming soft foods for several more days.
5. Medication was prescribed for pain management and should be taken as directed, beginning as soon as possible. If you have not eaten prior to surgery, we advise eating before taking the medication, which may help avoid nausea.
6. Do not rinse, spit, or use a straw during the first 24 hours following surgery; however, rinsing gently with warm salt water (saline) or 50/50 diluted mouthwash and brushing is necessary beginning the day after surgery. When brushing, you must try to avoid the surgical area until it is comfortable. Patients should not smoke or drink alcoholic beverages for 3 days following surgery.
7. Avoid all strenuous exercise for 5 to 7 days after surgery.
8. Please sleep with your head elevated with a minimum of 2 pillows behind head.

Post Operative Instructions for Sinus Lift

1. Take all prescriptions as directed.
2. Refrain from forcefully blowing your nose for 7 days.
3. Try not to sneeze. If you do, try to keep your mouth open.
4. Do not use a straw for the consumption of liquids for 72 hours.
5. Refrain from smoking for 7 days, including cigars and pipes.
6. Eat soft foods for several days. Chew your food on the opposite side as much as possible.
7. Refrain from vigorously rinsing your mouth for 2 to 3 days.
8. Refrain from physical activity/exercise for 7-10 days.
9. It is recommended to use ice packs on the surgical area for a minimum of 2-3 days.
10. *Maintain head elevated when sleeping for at least 5 days*
11. A recovery period of 5-7 days is required.