Surgical Instructions

Because anesthetic medications cause prolonged drowsiness, you MUST be accompanied by a responsible adult to drive you home and stay with you until you are sufficiently recovered to care for yourself. This may be up to 24 hours. Children must be accompanied by a parent or legal guardian.

During recovery time (24 hours) and if taking narcotic pain medications after surgery, you may not drive, operate complicated machinery or devices, or make important decisions such as signing documents, etc.

Teenagers & Adults should have no solids or liquids after midnight or for at least six hours prior to elective surgery. It is important that you take any regular medication (high blood pressure, antibiotic, etc.) or any medications provided and recommended by this office. Prescribed medications are to be taken with a small sip of water only and at the usual time as instructed preoperatively.

Children 0-12 years should have clear fluids. (i.e., water, fruit juice without pulp, carbonated beverages, clear tea and black coffee) up to 2 hours before surgery. The amount of clear fluid should not exceed eight ounces.

Well monitored anesthesia is very safe, comfortable and well tolerated.

Risks of anesthesia include but are not limited to bruising and infection at the IV site, and allergic reactions. There may be inflammation at the site of an intravenous (IV) injection (phlebitis) which may prolong discomfort and/or disability and may require special care. Nausea and vomiting, although very uncommon, may be unfortunate side effects of IV anesthesia. Intravenous anesthesia is a serious medical procedure and, although considered very safe, does carry with it the risk of heart irregularities, heart attack, stroke, brain damage and death.

For at least one week before surgery, it is important to avoid aspirin or aspirin-like products (e.g. ibuprofen, Motrin, Advil) as these medications may increase bleeding at the time of operation. Ask us about other medications that you may be taking. All of this is to ensure your safety. 

Ideally, smoking should be avoided for 6-8 weeks prior to anesthetic or surgical procedure. Smoking delays healing, may promote “dry sockets” (if you are having dental extractions) and makes your airway more “reactive", increasing risk during anesthesia.

Relax!!! We understand your natural fears and will make every attempt to provide you with a pleasant experience. Please feel free to call us with any questions or concerns.

1. First 30 minutes after procedure: Bite on gauze for 30 minutes after your procedure, to help stop bleeding. It is best that you do this without checking the site until the 30 minutes is up. Do not chew on the gauze, as continued pressure is desired. During this time, do not speak or do other activities that could dislodge the gauze packs. If bleeding continues after 30 minutes, bite on fresh gauze as follows:  dampen the gauze first so that it is moist (not wet) and fold it twice. Place the dampened gauze on the extraction sites for another 30 minutes. Repeat as necessary. A small amount of continued blood, which tinges the saliva, is expected during the first 24 hours and does not require further pressure. If bleeding restarts after it has stopped, use gauze pressure again or consider gently biting on a dry tea bag placed over the extraction site for 30 minutes. If the bleeding does not stop despite repeated attempts as above, please call 275‐5531.
2. Avoid excessive exertion for 72 hours after your procedure. No bending, lifting, strenuous activity, sports or gym‐class. After this time, resume normal activity gradually as you become comfortable.
3. Mouth opening will be limited during the first week to ten days after surgery. This is expected due to swelling and tightness of the jaw muscles.
4. Bruising (black and blue areas) may develop after surgery. Should this occur, expect bruising to resolve after the first week to ten days.
5. Earache or TMJ (jaw joint) tenderness may develop that will gradually resolve over the first week.
6. NO ORAL CARE during the first 24 hours. Beginning on the day after surgery, rinse your mouth after meals (or 4‐5 times per day) with warm salt water (1/2 teaspoon of salt in an 8oz. glass of warm water). A prescription mouth rinse may be given in selected cases. Begin tooth brushing on the day after surgery, as you normally would; however this should be performed gently in the area of extractions.
7. DO NOT USE STRAWS for the first week after surgery. Straws create suction pressure inside your mouth and could dislodge the blood clots that normally form in the extraction sites.
8. DO NOT SMOKE during the first 7 days after surgery. Smoking greatly increases the risk of dry socket and other healing complications.
9. SWELLING is normal and will maximize 48 – 72 hours after surgery. Apply ice in a damp towel against your cheeks for the first 24‐48 hours, as follows: 20 minutes on 40 minutes off, then repeat. Keep your head elevated with 2 or 3 pillows when lying down during the first 24 hours. This will reduce bleeding, swelling and improve your level of comfort. May apply Vaseline or Chapstick to the lips to keep them moist.
10. Mild to moderate pain may be encountered after the local anesthetic wears off. If not contraindicated by your health history, take two Extra‐Strength Tylenol (500mg ea.) or two Motrin/Advil/Ibuprofen (200mg ea.). Avoid aspirin‐containing products since these may lead to more bleeding. For moderate to severe pain, take the prescription medication as prescribed for you. Do not operate heavy machinery or make important decisions while on narcotics.
11. In case of uncontrolled bleeding, extreme pain or unusual circumstances, please call the office immediately.

1. Avoid eating or drinking anything within the first hour after surgery.  After this time, drink lots of liquids and eat soft, cool foods. Avoid excessively hot liquids and foods for the first 24 hours.
2. During the first week, avoid hard, crispy foods such as chips, hard pretzels, and popcorn.
3. The following food choices are recommended (“liquid foods on the day of the procedure, soft “mushy” foods during the first week advancing to regular food as tolerated”):
   • During the first few days, blenderized foods, soup broth, well‐cooked pasta, eggs, yogurt, cottage cheese, Jell‐O, pudding, custard, applesauce, bananas and ice cream.
   • After the first few days, gradually increase your diet to include: fish, chicken, meatloaf, mashed potatoes, cooked vegetables, soups and cereals, etc.

1. Keep your head elevated during sleep with two to three pillows.
2. Do NOT blow your nose.
3. If you sneeze do not sneeze through the nose and do not “hold back.”  You may sneeze with your mouth open. 
4. Expect slight nose bleeds. Call the office immediately for heavy bleeding from the nose that you are unable to control with pressure.
5. Do NOT do anything that requires a sucking‐in or blowing‐out motion such as smoking, use of straws or blowing up balloons.
6. Take all prescribed and/or recommended medications as directed.