Before Intravenous Anesthesia Sedation
- You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
- No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
- Contact lenses, jewelry, and dentures must be removed at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
- If you take routine oral medications, please check with Dr. Coviello prior to your surgical date for instructions.
After Intravenous Anesthesia Sedation
- Gauze: Leave gauze in place for 30-60 minutes. Apply constant, firm pressure to stop any bleeding. It is not unusual to replace the gauze several times over the next few hours following a procedure.
- Rinsing: Do not rinse at all the day of surgery. Begin with warm salt water two days after surgery, using 1/4 teaspoon of salt per 1 cup of water. This may be done 4-6 times per day.
- Tooth Brushing: Brushing is encouraged the day after surgery, using special care when approaching the site of surgery. Some mild bleeding is common due to inflammation in the area.
- Diet: Do not drink through a straw. Consume only liquids until numbness has worn off. This will ensure that the cheek, lip and tongue are not inadvertently bitten. Begin a soft diet after 4 hours. Escalate to more substantial foods over the course of days, as tolerated.
- Pain: Take prescribed pain medicines as necessary, as soon as the numbness begins to fade. This could take several hours, as we routinely use long-acting local anesthetics for your comfort. If pain persists after the prescribed pill(s) is taken, ibuprofen (Advil) may also be taken. Ibuprofen may be used 2-4 tabs at a time, every 4-6 hours. Maximum daily ibuprofen doses vary based on weight, but adults are never to exceed 16 tablets per day. All tablets are to be swallowed (not allowed to dissolve in the mouth.) If swallowing is not possible, please call us so that we may prescribe elixir formulations. The prescribed medicines cause drowsiness and slowed reflexes- do not drive an automobile or work around machinery while taking these medications.
- Nausea: Nausea and vomiting are not uncommon the day of surgery. If this becomes excessive or prolonged, please contact us via telephone or pager so that an appropriate anti-nausea medication may be prescribed. These are available in a variety of types and forms, including topical gels and dissolvable tablets if pills are not tolerated.
- Antibiotics: If antibiotics are prescribed (they are often not necessary after routine tooth removal) please take as directed until all pills are finished. Some antibiotics have been known to impair the efficacy of birth control pills, so alternative methods of contraception are suggested during use.
- Ice: Ice is generally recommended for the day of surgery. Use ice intermittently (30 minutes applied to the external facial skin and 10 minutes off) while awake.
- Heat: Moist heat or a heating pad may be used starting the 3rd day after the surgery, 4-6 times per day. This can quicken the alleviation of swelling and bruising. Make sure that the temperature of any compress is tested over the skin of the arm before applying to the facial skin. Never apply heat (untested) if you are experiencing postsurgical numbness of the facial skin.
- Rest: Although strict bed rest is not mandated after surgery, excessive physical activity can lead to exacerbated bleeding, bruising, swelling and pain. The first 3-5 days are critical in terms of limiting physical activity. When resting, elevate the head with support pillows for a period of three days postoperatively.
- Tobacco and Alcohol: A three-day avoidance of tobacco and alcohol is generally recommended. The chemicals in these items impair wound healing and frequently lead to infection, dry socket, and prolonged pain.
- Dry Socket: The incidence of dry socket has gone down over the years, but it is still a painful complication of tooth extraction. It is not an infection, but rather the loss of the blood clot that normally forms within a tooth socket. A dry socket usually manifests around the 3rd day postoperatively. Please call our office or have a doctor paged if you experience a painful throbbing ache that radiates to the ear. A short appointment may be necessary to place a soothing medicament within the tooth socket. Sometimes over-the-counter remedies, such as “red cross toothache,” may be helpful.
- Bleeding: Following oral surgery, some bleeding or oozing is to be expected, sometimes for up to 24 hours. This is usually controlled by placing moist gauze over the wound and biting with firm, constant pressure for 60 minutes. If this does not control the bleeding, a moist tea bag maybe placed over the wound using the same firm pressure. Using ice over the face will constrict some of the blood vessels in the area and can help decrease the bleeding as well.
Questions: Please do not hesitate to call the office or have a doctor paged if there are any concerns about your recovery.