Preparing for IV Sedation/General Anesthesia

• The patient may not have anything to eat or drink (including water) for 8 hours prior to the appointment.
• No smoking for at least 12 hours before surgery. Please 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. Someone should stay with the patient for several hours after the surgery to assist as required.
• 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 that 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 the patient has an illness such as a cold, sore throat, stomach or bowel upset, please notify the office prior to the surgery.
• If you take routine oral medications, please check with the doctor prior to your surgical date for instructions. In most cir
  cumstances, your medication should be continued the day of your surgical procedure. Please do not alter your normal
  medication schedule unless Dr. Kang instructs you to do so.
• The removal of impacted teeth is a serious surgical procedure. Appropriate post-operative care is very important to mini
  mize complications and speed your recovery. Unnecessary pain and the complications of infection and swelling can be
  minimized if the instructions are followed carefully.

After Wisdom Teeth Removal

Immediately after wisdom tooth removal:

• Go home and rest in a semi-reclined position.
• Bite on gauze for 1-2hrs afterward or until bleeding has mostly stopped, expect blood-tinged saliva for multiple days.
• Avoid foods that are: Crunchy or hard, Spicy, Hot, Sour, or require chewing. (Think yogurt, milkshakes, broth).
• Avoid straws/sucking, avoid vigorous swishing and carbonated drinks.
• Do not move around a lot immediately after surgery—this makes you more likely to become ill feeling. Drink or eat something as
  soon as tolerable, and before taking prescription pain medications.
• You will likely require prescription pain medication for 2-3 days and over-the-counter pain medication following that for up to a
  week. You should be able to perform light activities within the 2-3 days following surgery, days 4-7 should be moderate activity,
  and after a week you should likely be able to resume pre-surgical activity levels.

When to Call (Immediately call AOFS if you have any of the following):

• Fever >101.5F
• Uncontrollable pain
• Excessive bleeding (Liver-like clots forming in the mouth)
• Difficulty breathing/speaking or any changes in patients breathing or airway
• Any worsening symptoms such as swelling/pain/bleeding
• Or for any condition that concerns you and seems unanswered

After extractions

Mild bleeding and oozing can be expected for the first 24 hours. Place the gauze over the surgical site and bite firmly for 30-45 minutes and repeat as necessary. If bleeding is heavy or excessive, please call the office for further instructions.

Swelling:

Swelling and edema is expected after surgery and can be significant 2-3 days after surgery, especially after wisdom teeth removal. This swelling may involve the cheeks, mouth, face, and around the eyes. Cold compresses applied to the outside of the cheek will help with post-operative swelling and discomfort for the first 24 hours. It is strongly discouraged to smoke, drink from or straw, or vigorously rinse for 72 hours from the extraction to prevent dislodgement of the blood clot.

Diet:

Start with a liquid diet and advance to softer foods such as milkshakes, smoothies, yogurts, and blenderized foods. Do not drink out of straws as the sucking motion may dislodge the clot that is forming and cause more bleeding. Adequate hydration and nutrition is very important. Try to maintain normal caloric intake by increasing fluids to compensate for any lack of calories.

Pain:

It expected to have pain after surgery. Begin taking pain medication as soon as you begin to feel the anesthetic wear off. It is okay to take over the counter pain medication for mild to moderate pain. For more severe pain, take the prescribed pain medication as instructed by the office staff.

Brushing:

Continue to brush your teeth but avoid the teeth directly adjacent to the extraction sites for the first 24 hours. On day two, resume routine gentle brushing of all of your teeth. Avoid commercial mouth rinses as they can irritate the area. It is okay to use salt water rinses (½ teaspoon of salt in a cup of warm water) after meals and before bed.

Nausea and vomiting:

A common site of effect of IV sedation/general anesthesia or narcotic medication is nausea and vomiting. In case of vomiting, do not eat anything for an hour and then gently sip on fluids in small increments until the nausea subsides. Slowly advance to soft foods, take the prescribed medication, and follow instructions. Do not take the prescribed medication on an empty stomach. If nausea and vomiting continue, please call our office.

After Implant and Bone Grafting

Medication:

• Take Antibiotics as prescribed.
• Start using the antiseptic mouth rinse (Chlorhexidine or Peridex) the morning of the procedure and continue for 2 weeks or until
  you see the doctor.
• Start taking pain medications within 30 minutes after the procedure. It is important that food be eaten with the pain medication to
  prevent nausea.
• If you develop any rash, diarrhea or other bad reaction because of any medicine that we have given you, stop taking it immediately and call the office. You may or may not be given a different prescription.
• Usually you should also take 400 mg Ibuprofen every 6 hours in addition to your other pain medicine. Ask the AOFS team or your  pharmacist if you should not be taking this in addition.
• If you are taking Antibiotics—it is recommended to take OTC Probiotics with yogurt or smoothie etc.

Diet:

Do not chew over the area that you had surgery until you see the doctor.
You should have soft diet (smoothies, eggs, well-cooked pasta) for 1-2 weeks or until you see the doctor.

Other:

Use an ice pack on your face to help with swelling – 20 minutes on and 20 minutes off for the first 24 hours.
If you have sutures, they may dissolve on their own or they may need to be removed. Just ask the team if you are unsure.
Brushing and flossing are important to keep your mouth clean. Just be sure not to brush directly over the surgery site.
If you had bone grafting DO NOT vigorously rinse or disturb the area other than light brushing.

After Sinus Procedure

What is a Sinus and Why be Careful of it?

The maxillary sinus is normally filled with air and sits behind your cheekbone. The inside is covered with very delicate tissue and drains fluid into your nose when you have a cold or allergies or surgery that fills it up with fluid. The mucosa is so thin that just by blowing your nose could rupture a hole through it.

Sinus Precaution:

DO NOT Blow your nose, smoke, suck on a straw or build up pressure in your nose for 3 weeks.
DO open your mouth if you have to sneeze.

Medication:

If you are prescribed an antiseptic mouth rinse (Chlorhexidine or Peridex) use it for a week.
Start taking pain medications and eat something within 30 minutes after the procedure.
If you have a reaction to any medicine that AOFS gave you, stop taking it immediately and call the office.
Usually you should also take 400 mg Ibuprofen every 6 hours in addition to your other pain medicine. Ask the AOFS team or your pharmacist if you should not be taking this in addition.
Use the Afrin nasal spray or Sudafed decongestant as you are prescribed.
If you feel like you need to clear your nose, it is okay to use a saline (salt water) nasal spray gently.

Diet:

Do not chew on the affected site for 2-3 weeks and have a soft diet (smoothies, eggs, well-cooked pasta).

Other:

Bleeding – Put gauze on the site and apply constant pressure for 30 minutes. Repeat as necessary.
The sutures may dissolve or may need to be removed. Just ask the team if you are unsure.
Brushing and flossing are important to keep your mouth clean. Just be sure not to brush directly over the affected site.

After Biopsy

Medication:

• If you are prescribed an antiseptic mouth rinse (Chlorhexidine or Peridex) use it for a week.
• Start taking pain medications within 30 minutes after the procedure. It is important that food be eaten with the pain medication to
  prevent nausea.
• If you develop any rash, diarrhea or other bad reaction because of any medicine that we have given you, stop taking it immediately and call the office. You may or may not be given a different prescription.
• Usually you should also take 400 mg Ibuprofen every 6 hours in addition to your other pain medicine. Ask the
  AOFS team or your pharmacist if you should not be taking this in addition.
• If you are taking Antibiotics—it is recommended to take OTC Probiotics with yogurt or smoothie etc.

Diet:

You should have soft diet (smoothies, eggs, well-cooked pasta) for 1-2 weeks or until your see the doctor.

Other:

• Bleeding – Put a gauze on the site and apply constant pressure for 30 minutes. Repeat 2 times if necessary.
• Use an ice pack on your face to help with swelling – 20 minutes on and 20 minutes off for the first 24 hours.
• If you have sutures, they may dissolve on their own or they may need to be removed. Just ask the team if you are unsure.
• After 24 hours, begin warm salt water soaks after each meal and at bedtime. (1 teaspoon of salt to an 8 ounce glass of warm water.)
• Brushing and flossing are important to keep your mouth clean. Just be sure not to brush directly over the biopsy site.

What About the Biopsy Specimen?

The specimen that was removed will be sent to a pathology laboratory for analysis. You will receive a separate bill from the lab.
Call AOFS if you have not heard back within 2 weeks to talk about the results.

After hours emergency

We have an emergency call service that is available at all times. Leave a message and a member of our team will quickly return your call and assist you accordingly.