The Day Before Anesthesia
Ensure you hydrate yourself drinking plenty of fluids such as water. Limit your intake of diuretics such as coffee and tea.
Please do not smoke for at least 24 hour prior to surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
The Night Before Anesthesia
Eat a full dinner the night before your surgery.
DO NOT EAT OR DRINK ANYTHING INCLUDING WATER AFTER MIDNIGHT.
It is not safe to have anything to eat or drink for eight hours prior to your surgery.
The Day of Anesthesia
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow
- Contact lenses, jewelry and dentures must be removed at the time of surgery
- Do not wear lipstick or excessive makeup or nail polish on the day of surgery
- A responsible adult must accompany you to the office and remain in the office waiting room during the procedure.
If you suspect you may be pregnant please notify us immediately. Sedation is unsafe if you are pregnant.
Cough or Cold?
If you develop a cough, cold, sore throat, any upper respiratory infection, or stomach or bowel upset, call our office to reschedule your surgery.
Herbal Supplement Risks for Preoperative Patients
The following is a summary taken from the Journal of American Medical Association on eight herbs that can potentially pose harm during and after surgery. We recommend that the following herbs should be stopped before surgery in order to avoid any potential complications from their use:
- St. John’s Wort can significantly increase the breakdown of other routinely administered drugs during surgery, some of which are vital to the care of patients after surgery. This should be discontinued at least 5 days before surgery.
- Echinacea should be used with caution in patients with asthma or allergic problems and should be discontinued as far in advance of surgery as possible.
- Ephedra causes a potential increase in blood pressure and heart rate. This herb has also been associated with sudden death under anesthesia. This should be discontinued at least 7 days before surgery.
- Garlic supplements have a potential for reducing clotting function and platelet function and should be stopped 7 days prior to surgery.
- Ginseng has also been shown to have effects on clotting pathways and should be discontinued approximately 7 days preoperatively.
- Ginkgo should be discontinued 7 days prior to surgery because it can inhibit platelet clotting factors.
- Kava should be discontinued 7 days preoperatively because it can increase the sedative effects of anesthetics.
- Valerian can increase the sedative effects of anesthetics. This should not be discontinued abruptly because there is risk of physical dependency to Valerian and withdrawal symptoms may develop. This should be tapered over several weeks before surgery.
Post-operative care is very important. Unnecessary pain and complications can be minimized if the instructions by our Marietta oral surgeons are followed carefully.
The Day of Surgery
- Place ice to your cheek in the area of surgery. Ice is most effective if placed on the cheek for 20 minutes then removed for 20 minutes for the first 24 hours.
- Start pain relievers BEFORE your anesthesia wears off (30-60 minutes after your appointment)
- Avoid driving, strenuous activity, or drinking alcohol if given prescription pain pills that contain narcotics.
- Take your ENTIRE antibiotic prescription if prescribed
- Drink plenty of liquids and eat cool or lukewarm foods that can be easily chewed. Avoid foods or activities that create a suction in the mouth (straws, rinsing, spitting). Avoid thermally hot foods (coffee, tea, soup). Avoid foods with sharp edges for four to five days.
- Do not smoke.
- Restrict your activities to the day of surgery and resume normal activity when you feel comfortable.
- A certain amount of bleeding is expected after surgery. Slight oozing or redness in the saliva is not uncommon. Excessive bleeding may be controlled by placing gauze of the area and biting firmly for 30 minutes. If bleeding still continues, bite on a moistened tea bag for 30 minutes. The tannic acid from the tea bag helps form a clot. If bleeding does not subside, call for further instructions.
The Day After Surgery
- Swelling. The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day after surgery and will not reach its maximum until three days post-operatively and this will coincide with a peak in pain. However, the swelling and pain may be minimized by the immediate use of ice packs. Two plastic bags filled with ice can be applied to the sides of the face where surgery was performed. The ice packs should be left on intermittently while you are awake. After 24 hours, ice has no beneficial effect. Twenty-Four hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the swelling (a face towel in hot but not scalding water or a hot water bottle can be used).
- Pain. For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every six hours and two to three 200 mg tablets of ibuprofen (Motrin or Advil) may be taken every six hours. Dr. Chaudhary and Dr. Walls will elaborate on this, depending on your specific medical history. For severe pain, take the tablets prescribed as directed. The prescribed pain medication will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery is normal, expected, and temporary. It can last a week but will usually subside more and more every day. If pain persists more than a week, it may require attention and you should call the office. Pain is expected to peak in the first 3 days after surgery.
- Diet. Drink liquids after general anesthesia or IV sedation. Do not use straws when drinking from a glass. The sucking action can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
- Hygiene. No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least two times a day with a cup of warm water mixed with a teaspoon of salt (1/8 tsp salt in 8 oz. of water) especially after eating. Brush your teeth gently with a soft bristle brush. Avoid the area of the surgery.
- Bruising/Discoloration. 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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration. Bruising after surgery is a normal response and is no cause for alarm. It will improve in seven to 14 days.
- Stiffness. Some jaw muscle stiffness is common, especially after longer procedures. This may result in difficulty opening your mouth wide. This is normal and will improve in five to 10 days. Moist heat and Ibuprofen will help relieve some of these symptoms.
- Stitches. Depending on the surgery, we most often use dissolvable stitches. Dissolvable stitches dissolve on their own and will not have to be removed. The stitches will fall out within the week (some even come out the same day). Swallowing the stitches is no cause for alarm. Never pull at loose stitches. Some stitches may last two weeks, depending on the type used.
- Exercise. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
What To Look Out For
- 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. Chaudhary or Dr. Walls if you have any questions.
- A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
- You should be careful in changing position from the lying down position to standing. You are not able to eat or drink prior to surgery. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and 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 the projections persist, Dr. Chaudhary or Dr. Walls can remove them at a later time.
- 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 throat 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 (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
- Dry Socket (Alveolar Osteitis) is when the blood clot formed after tooth extraction gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur. It usually occurs about five to seven days after surgery. Call the office if this is a concern.