Here are a few things to think about the week leading up to and after procedure at Green Hills Oral Surgery.

 

BEFORE A CONSULTATION

  • Please bring the following to your appointment:
  • Driver’s License
  • List of any medications you are currently taking 
  • Dental & Medical Insurance Cards
  • Referral slip from your dentist 
  • Any necessary radiographs

We understand that every case is unique and every patient’s individual level of anxiety is different.  For that reason, we offer several types of sedation methods to best serve our patient needs and to keep patients as comfortable as possible during procedures.


PRE-OPERATIVE INSTRUCTIONS FOR LOCAL ANESTHESIA AND NITROUS


Before a Procedure
For patients scheduled with local anesthesia:  There are NO eating or drinking restrictions or driver required for patients having a procedure done with local anesthesia. You may eat and drink as usual and you will be able to drive yourself to and from your appointment. 

Patients scheduled with Nitrous Oxide or "Laughing Gas" : There are NO eating or drinking restrictions or driver required for patients having a procedure done with local anesthesia. You may eat and drink as usual and you will be able to drive yourself to and from your appointment. 


PRE-OPERATIVE INSTRUCTIONS FOR SEDATION
 

Unless directed otherwise, please adhere to the following instructions.
If you choose to be sedated, we ask that our patients adhere to the following instructions to enable us to administer medications safely and effectively.  Please read the entire Pre-Operative instruction sheet and feel free to contact our office with any questions or concerns.

Patients scheduled with IV Sedation:  

  • Nothing to eat or drink for 8 hours before the start of the procedure. Failure to comply with these requirements may result in cancellation or rescheduling of your sedation appointment.
  • If you take prescription medications on a regular basis, please take them as instructed with a minimal amount of water unless otherwise noted by Dr. Adamiak. 
  • Patients should wear clothing that is not restricting to the neck or arms. Patients should wear loose-fitting tops on which the sleeves can be rolled to the shoulder.  
  • If you were given prescriptions at the time of your consultation, have them filled and ready prior to the date of surgery.
  • Women should wear shoes with low or flat heels.
  • Right index fingernail needs to be without polish or artificial nail the day of the procedure.

A responsible adult, that the patient knows and trusts, must accompany the patient to the clinic and remain here throughout the entire procedure.  Following the sedation, it is crucial that a responsible adult escort the patient home, and should remain with the patient for 3-4 hours after the procedure.  A parent or legal guardian must accompany minors (persons under 18 years of age).  

Escort the patient from the car to the house by supporting them under the arm.  Do not leave the sedated patient alone in the car unassisted.

Once the patient is home, they may still be drowsy and must remain under adult supervision until

fully recovered from the effects of sedation.  During this period, be mindful of the patient’s breathing.  If snoring, reposition the patient’s head until the snoring ceases and he/she is breathing normally.  If breathing becomes abnormal or you are unable to arouse the patient, contact 911 immediately.

Nausea and vomiting are occasional but rare side effects of sedation.  Avoid eating dairy products for the first 24 hours, as dairy can increase nausea.   If vomiting occurs, immediately clear the material from the patient’s mouth.  Use of the antiemetic medication prescribed by our office should resolve issues with nausea and vomiting, but if vomiting persists beyond 1 hour please contact our office. 

Upon arriving at home, allow the patient to drink water and monitor him/her for a few minutes.  If water is tolerated well, the patient may have other clear liquids and soft foods.  It is very important the patient eats before taking narcotic pain medication to decrease the risk of nausea and vomiting.

It is imperative the patient refrains from driving an automobile, operating machinery, performing hazardous tasks or drinking alcohol for 24 hours after sedation, and/or while on narcotic pain medication.  Have the patient rest for the remainder of the day.  Do not engage in strenuous activity.


POST-OPERATIVE INSTRUCTIONS GENERAL SURGERY

Day of Surgery

FIRST HOUR: Bite down firm but gently on the gauze packs that have been placed over the surgical areas. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site as necessary. Avoid pulling dry gauze off of the surgical site as this could further traumatize the area. It is best to moisten the gauze with water prior to use.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If heavy bleeding persists you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.

EXERCISE CARE: Do not disturb the surgical area today. Do not rinse vigorously or probe the area with any objects.  Avoid spitting or using straws for the first 24 hours. You may brush your teeth gently.  PLEASE DO NOT SMOKE for at least 48 hours, since this is detrimental to healing and may cause a dry socket.

SWELLING: Swelling is often associated with oral surgery. It can be minimized by using an ice pack wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 48 hours after surgery. 

MEDICATION: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill BEFORE the anesthetic has worn off, you will be able to manage any discomfort more effectively. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with ibuprofen (Advil). Some patients may require two pain pills at once. This is ok, but do not exceed 2 prescription pain pills in 4-6 hours. If you were prescribed an antibiotic, it should be continued until all the pills have been taken.

NAUSEA: Nausea is not uncommon after sedation, but sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of food, and with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better.

DIET:  Avoid hot foods until the local anesthesia has worn off, and sensation has returned. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, etc.) It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you eat nourishing foods regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.


INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
 

MOUTH RINSES: Keeping your mouth clean after surgery is essential.  On day two use 1/4 teaspoon of salt dissolved in an eight 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 three times daily for five days.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: On day three you may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will help to relieve bruising/discoloration, swelling and inflammation.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office.

HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued improvement, please call our office.

It is our desire that your recovery be as smooth and pleasant as possible. If you have questions about your progress, please do not hesitate to call the office. Calling during office hours will afford a faster response to your question or concern. 


DENTAL IMPLANTS POST-OPERATIVE INSTRUCTIONS


Day of Surgery

FIRST HOUR: Bleeding is usually minimal with implant surgery.  Bite down gently on the gauze that has been placed over the surgical areas until the gauze is saturated mostly with saliva and is pink in color.  At this point you may remove the gauze.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site as necessary. Avoid pulling dry gauze off of the surgical site as this could further traumatize the area.  It is best to moisten the gauze with water prior to use.

PERSISTENT BLEEDING: Bleeding should never be severe.  If so, it usually means that the gauze packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs.  If heavy bleeding persists you may substitute a black tea bag (soaked in hot water, squeezed damp-dry and wrapped in gauze) for 20 or 30 minutes.  If bleeding remains uncontrolled, please call our office.

EXERCISE CARE: Do not disturb the surgical area today.  Do not rinse vigorously or probe the area with any objects.  In some cases sutures are required.  Sutures may dissolve, but if not they will be removed at your two week post-operative appointment.  You may brush your teeth gently.  Please do not smoke for at least 48 hours, since smoking can delay healing and cause increased discomfort.

SWELLING: Swelling is often associated with oral surgery.  It can be minimized by using an ice pack wrapped in a towel and applied to the cheek adjacent to the surgical area.  This should be applied 20 minutes on and 20 minutes off during the first 48 hours after surgery. 

MEDICATIONS: Unfortunately, most oral surgery is accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill BEFORE the anesthetic has worn off, you will be able to manage any discomfort more effectively.  The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with ibuprofen (Advil).  Some patients may require two pain pills at once.  This is ok, but do not exceed 2 prescription pain pills in 4-6 hours.   If you were prescribed an antibiotic, it should be continued until all the pills have been taken.

NAUSEA: Nausea is not uncommon after sedation, but sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and a large volume of water. Try to keep drinking clear fluids and minimize dosing of pain medications, but call us if you do not feel better.

DIET:  Avoid hot foods until the local anesthesia has worn off, and sensation has returned. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, etc.) Over the next couple days you may gradually progress to solid foods.  It is important not to skip meals!  If you eat nourishing foods regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.


INSTRUCTIONS FOR THE SECOND AND THIRD DAYS


MOUTH RINSES: Keeping your mouth clean after surgery is essential.  On day two use 1/4 teaspoon of salt dissolved in an eight 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 three times daily for five days.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: On day three you may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will help to relieve bruising/discoloration, swelling and inflammation.

HEALING: Normal healing after dental implant surgery should be as follows: The first two days after surgery are generally the most uncomfortable and there may be some swelling.  On the third day you should be more comfortable and, although possibly still swollen, can usually begin a more substantial diet.  The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued improvement, please call our office.

It is our desire that your recovery be as smooth and pleasant as possible. If you have questions about your progress, please do not hesitate to call the office at 615.385.1644.