Pre & Post Op Instructions

Pre-Op Instructions

  1. Nothing to eat or drink for 8 hours before appointment (no water, juice, gum, etc.). If surgery is scheduled for the morning, have nothing to eat or drink after midnight.
  2. No smoking the day of surgery.
  3. Someone must come with you who can wait for you in the office while you are in surgery and can drive you home after. You cannot drive for 24 hours after general anesthesia or IV sedation.
  4. Please make arrangements for someone to take care of you at home after the procedure.
  5. Please remove all nail polish, make-up and contact lenses before surgery.
  6. Please wear clothing with short or loose-fitting sleeves.
  7. If the patient is a minor (under 18), he/she must be accompanied by a parent or legal guardian.

Post-Op Instructions

  1. Remove the GAUZE SPONGES that have been placed in your mouth 1 HOUR after surgery, unless told otherwise. Place fresh ones as needed. Do not lie down or go to sleep with gauze in your mouth.
  2. Upon reaching home, place an ICE BAG or COLD TOWEL to the face for the remainder of the day of surgery. Apply 15 minutes on, 15 minutes off. Keep the area of surgery as cold as possible, as this will help reduce the amount of swelling that you are going to have. Continue cold for at least 24 hours. Do not smoke or drink through a straw during the first 24 hours.
  3. On the second day following surgery (48 hours) and thereafter, if swelling has occurred, apply MOIST HEAT on the outside of the face in the form of a bath towel dipped in hot water, wrung out and folded several times over. DO NOT USE HEAT CONSTANTLY, but apply only 20-30 minutes in a 2-hour period. Hot water rinses are especially helpful if there is pain.
  4. For any pain or discomfort, use the PRESCRIPTION that has been given to you. Don’t be afraid to use the medication, as it is designed to make those first few days after surgery more comfortable to you. When taking this medication, be sure to drink at least a half to a full glass of water or milk. This will ensure RAPID ASSIMILATION by the body, and MINIMIZE the amount of IRRITATION to the stomach itself. CODEINE, as well as other NARCOTIC DRUGS, can cause nausea and sometimes even vomiting, so drink plenty of liquids when taking oral medications. If you do experience nausea, try drinking ginger ale, mild tea or clear broth. Do not drink alcohol or drive an automobile for the rest of the day or while taking pain pills.
  5. Do very LITTLE RINSING until the following morning, as rinsing may dislodge the BLOOD CLOT and initiate BLEEDING. When rinsing, which you may begin the day following surgery, use ONE-HALF TEASPOON of table salt in an 8-OUNCE GLASS of warm water.
  6. Drink plenty of FLUIDS, such as orange or tomato juice, ginger ale, water, tea, etc. Drink at least FOUR to EIGHT GLASSES of liquids daily. DEHYDRATION must be guarded against when having oral surgery.
  7. Follow your own inclination as to diet, but for your own comfort, stick to a SOFT, LIQUIDY DIET. Keep taking nourishment. A diet high in PROTEIN and COMPLEX CARBOHYDRATES is best. Homemade EGGNOG, using fresh milk, eggs and fresh fruit blended into it, is an excellent source of both. Try not to skip a single meal. Begin by eating soft foods or liquids, such as heavy soup, milkshake, soft-boiled eggs, cereals, etc. As soon as possible, change to solid food.
  8. Clean your mouth thoroughly after each meal and BRUSH YOUR TEETH as best you can. CLEANLINESS after surgery is a cardinal “MUST” for a rapid and uncomplicated recovery. Food left in the wounds retards healing and invites infection. Stitches often trap food and bacteria. Rinsing the mouth vigorously will help to keep them clean.
  9. The stitches in your mouth are dissolvable. Do not be concerned if some of them fall out during the first day or two following surgery.
  10. A certain amount of bleeding is to be expected following surgery. It is often possible to control mild oozing by placing folded gauze the size of the thumb over the wound. Bite down firmly and hold for 30 minutes. Sit upright and remain quiet. It is normal to see a little oozing for the first 24 hours.
  11. If bleeding continues in spite of the above, dip a tea bag in cold water, wrap in a clean gauze and place this over the wound, BITING FIRMLY. It also helps to stop the bleeding if you will lie down, with your head raised on several pillows. Apply an ice bag or COLD COMPRESS to your cheek on that side. Do NOT become alarmed or excited. If unable to control excessive bleeding, CALL OUR OFFICE so that you may talk to the doctor.
  12. If you have been given any medications or prescriptions for medications, take them faithfully as directed. If you have been placed on an ANTIBIOTIC, which you will be told, take all of the tablets as directed. The medications which you may have been placed on will help to:
    1. MINIMIZE swelling
    2. REDUCE discomfort
    3. PREVENT infection
    4. PROMOTE healing
    5. AID in oral hygiene and would CLEANLINESS
  13. You should CALL THIS OFFICE IMMEDIATELY if you have any of the following:
    1. SUDDEN swelling
    2. DIFFICULTY in breathing
    3. Feel you are having a REACTION to your medication
    4. UNCONTROLLABLE BLEEDING
    5. EXCESSIVE VOMITING

14. IMPORTANT INFORMATION REGARDING YOUR POST-OPERATIVE MEDICATION: 

The pharmacy may give you generic medication instead of the name brand. The following are some of the more common medications and their generic names.

Percocet Oxycodone Narcotic pain medication
Vicodin Hydrocodone Narcotic pain medication
Lodine etodolac Non-narcotic pain medication

Possible Side Effects

The removal of IMPACTED TEETH is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered NORMAL SIDE EFFECTS:

  1. The operated area will probably SWELL. Swelling is the most marked on the second or third day and begins to disappear on the fourth day.
  2. STIFFNESS (Trismus) of the jaws is Nature’s way of splinting and resting the part which needs to be repaired and usually relaxes from about the fourth to sixth post-operative day.
  3. NUMBNESS of the corner of the mouth, chin, lip and possibly even the tongue, following the removal of wisdom teeth or surgery of the jaw itself may develop. This is called “PARESTHESIA” and is the result of a probable bruising of the nerve. Paresthesia, or numbness, is predictable when the teeth lie in CLOSE PROXIMITY to the NERVE CANAL. This numbness may correct itself within a matter of days, or may last for weeks, months and even years. While permanent paresthesia is rare, it is always considered a RISK and possible SIDE EFFECT when removing teeth that are in close proximity to the nerve canal. When paresthesia is temporary, the area of numbness will become reduced in size and change from a numb feeling to a TINGLING feeling to a feeling of WARMTH. It is very similar to the feeling one has when a hand or foot falls asleep and then comes back to “life.” Prolonged numbness should be brought to the attention of the oral surgeon so that it can be properly evaluated.
  4. BLACK and BLUE MARKS (ecchymosis) on the face are caused by bleeding internally into the cheeks or chin. This appears first as a swelling, but often on the second or third day, it may discolor the face black and blue, then yellow. It will gradually DISAPPEAR in a week to 10 days. A hot, wet towel, wrung out, may be applied for 10 minutes, 3 times a day. This will be comforting but will not greatly speed up the fading process.
  5. There may be a slight earache, RINGING of the ear or SORE THROAT. This is due to swelling of the tissues in the area.
  6. Other teeth will possibly ache temporarily. This is a REFERRED PAIN and is a temporary condition.
  7. If the corners of the mouth are stretched, they may dry out and become cracked. The lips should be kept MOIST WITH A CREAM or ointment.
  8. There will be a CAVITY where the tooth was removed. As well as possible, this area should be RINSED following meals. It will gradually fill in with new tissue.
  9. During the HEALING PROCESS, small, sharp fragments of bone may work up through the gum. This is especially true of multiple extractions and is Nature’s way of RE-SHAPING the ridge. This process of “SHEDDING” slivers and splinters of bone may last anywhere from two weeks to four months. If there is difficulty with some of these, please call the office and let the doctor see you. Impressions for dentures should be postponed until the ridge is well healed.
  10. There may be a slight TEMPERATURE variation for 24-48 hours following surgery. If your temperature continues to rise, please notify our office. It may be that you are dehydrated and just need more fluids, or you could be developing an infection.
  11. Return to the office for POST-OPERATIVE TREATMENT and suture removal as instructed and feel free to contact us if any doubt arises as to your progress and recovery. If you have any questions regarding these instructions, please let us know.

IMPORTANT NOTICE TO WOMEN TAKING BIRTH CONTROL PILLS:

Penicillin and other antibiotics can decrease the effectiveness of birth control pills. If you have been given a prescription for penicillin or another antibiotic, please utilize other forms of birth control during the time you are taking the medication and during the remainder of your present cycle.

IN CASE OF EMERGENCY:

If you have an emergency and need to speak with the doctor call the office at 856-772-1500. If the office is closed you can contact Dr. Rebhun by calling his emergency phone number at 856-335-5280. Please leave a voice mail with your name, the nature of the emergency and your phone number. Dr. Rebhun will then return your call. If Dr. Rebhun does not return your call within 30 minutes, please call again.