ALL PATIENTS:

• If under 18 years of age, parental (or guardian) consent is necessary prior to any surgical procedure.
• Diabetics call for special instructions.
• Payment arrangements must be made prior to surgery.

LOCAL ANESTHESIA PATIENTS ONLY:

• If local anesthesia only is to be used, you may drink and eat as usual.

INTRAVENEOUS (IV) SEDATION, GENERAL ANESTHESIA OR NITROUS OXIDE PATIENTS:

• No food or fluid (including water, coffee, and soda) within 8 hours of your appointment. The previous meal should be light and easily digested.
• Wear loose-fitting clothing. Sleeves should be easily drawn up above the elbows.
• Please empty your bladder and bowel before the appointment.
• If you use contact lenses, please leave them out or bring their case and remove prior to surgery.
• A responsible adult must accompany you to the office, remain in the building, be able to drive you home after your procedure, and be your caregiver at home.
• Following sedation or general anesthetic, you must not drive an automobile, operate any dangerous machine, or undertake any responsible business matters for the next 24 hours.
• If, prior to your procedure, you develop a cold, fever, or otherwise become ill, please contact us at (916) 689-7837. Your appointment may need to be rescheduled.

• Following the procedure, it is important to not disturb the wound and avoid any spitting, touching or rinsing.
• Bleeding is normal for the first 24 hours after the procedure. To control bleeding, place a gauze pad directly over the wound. If bleeding continues after 24 hours, contact our office.
• Swelling is normal. You should place an ice pack on your cheek over the surgery site as often as possible for the first 36 hours to minimize swelling.
• Drink plenty of fluids. Avoid any hot liquid or food. It is important to eat soft foods immediately after the surgery until you are comfortable to return to a regular diet.
• Begin taking pain medication as soon as you feel the anesthetic wear off. For moderate pain, take one or two Tylenol or Ibuprofen every three to four hours. For more severe pain, take the prescribed medication as directed.
• Take any antibiotics prescribed as directed to help prevent infection
• The night of the surgery, use the Peridex Oral Rinse once before bed. The following day, use Peridex rinse twice, after breakfast and before bed. A salt-water rinse should be used four to five times during the day, especially after meals. It is important to maintain good oral hygiene to promote better healing. Brushing should not be a problem, but be gentle around the wound.
• Keep physical activity to a minimum immediately following surgery. Exercise may cause throbbing and bleeding.
• Do not wear any prosthesis – full dentures, partial dentures, or flippers, for at least ten days following the procedure.

This procedure will be performed using local anesthesia, so there are no restrictions after the procedure for driving or returning to work. A doctor is available for consultation at all times should a problem arise after your treatment.

You may continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as directed by your doctor. If there is a concern involving any medications, please call our office prior to the appointment.

We recommend that you eat a full breakfast or lunch on the day of the treatment.

If you have been advised by your physician or dentist to use the antibiotic premedication, please make sure you are on the appropriate antibiotic on the day of your appointment. You only need to premedicate prior to your treatment appointment. If you have any questions, please call our office prior to the appointment.

• Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery
• Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues, please call our office.
• Swelling is normal after surgery. To minimize swelling, apply an ice pack on the cheek in the area of surgery. Apply the ice for 20 min. on/ 20 min. off, as often as possible, for the first 36 hours. Do not apply heat.
• Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery or until instructed. Return to a normal diet as soon as possible unless otherwise directed.
• You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, one to two Tylenol or Extra Strength Tylenol may be taken every three to four hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Two to three tablets may be taken every three to four hours as needed for pain.
• Take the prescribed antibiotics as directed to help prevent infection.

• Some bleeding is expected. Keep the gauze pad placed over the surgical site for one hour following surgery. Change the gauze every hour until the bleeding has stopped.
• Pain medication should be started as soon as you feel the anesthetic wearing off. For moderate pain, 1-2 Tylenol or Extra Strength Tylenol may be taken every three to 4 hours. If you prefer Ibuprofen (Advil or Motrin) rather than Tylenol, you may take two to three tablets every three to four hours as needed for pain. For severe pain, take the tablets prescribed by your doctor as directed. Do not drive or consume alcohol while taking pain medication.
• Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. To minimize swelling, apply an ice pack on the cheek in the area of surgery. Apply the ice for 20 minutes on, 20 minutes off, as often as possible for the first 36 hours. Do not apply heat.
• Do not rinse your mouth the day of surgery. Brush your teeth gently the night of surgery, being careful to avoid the surgical site. The day after surgery you can gently rinse five or six times a day with a cup of warm water mixed with a teaspoon of salt. Try not to spit as spitting could dislodge the blood clot. If your doctor prescribes a mouthwash, use it for one week.
• Limit physical activity. Do not over exert; avoid exercise for at least one week. Rest at home – keep your head propped up with pillows to reduce swelling. If you are an athlete, please confer with your doctor to determine when it is safe to resume activity.
• Take antibiotics as prescribed.
• Eat soft foods. Stick to a liquid or soft food diet for a few days after surgery. Food suggestions are: soups with mushy vegetables and noodles, jello, pudding, apple sauce, ice cream, yogurt, milkshakes, smoothies, mashed potatoes, eggs, protein shakes. Avoid hot or hard food for at least 48 hours. Drink five to six glasses of liquid each day. Do not use a straw for at least five days.
• Smoking increases the incidence of post-operative complications (specifically “dry socket”) and should be avoided for a minimum of one week following surgery.
• If nausea or vomiting occurs, do not consume anything for at least an hour including prescribed medicine. Sip on tea or ginger ale. Continue eating solid foods and taking medication when the nausea subsides.

Never hesitate to call the office with questions or in any of the following circumstances:

• Throbbing pain that does not respond to medication
• Bleeding that continues even when you apply pressure
• A fever that lasts for more than 24 hours after surgery
• Pus, which can indicate an infection
• Trouble swallowing or breathing

• Do not disturb the wound. Any placed surgical packing helps to keep the tooth exposed.
• Some bleeding is expected following surgery. Excessive bleeding may be controlled by placing a gauze pad over the area and biting firmly for 30 minutes. If bleeding continues, you may bite on a moistened tea bag for 30 minutes. The tannic acid in tea helps form a blood clot.
• Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. To minimize swelling, apply an ice pack on the cheek in the area of surgery. Apply the ice for 20 min. on/ 20 min. off, as often as possible, for the first 36 hours.
• Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible.
• You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, one or two Tylenol or Extra Strength Tylenol may be taken. Tylenol may be taken every three to four hours. Two to three tablets may be taken every three to four hours as needed for pain.
• Beginning the day after surgery, brush your teeth as best you can. Rinse with warm salt water (one teaspoon of salt in a cup of warm water) six times a day. Continue until healing is complete.
• Limit physical activity following surgery.

• Allow a blood clot to form. Bite on a gauze pad for 30-45 mins after the appointment.
• After the clot forms, it is important to avoid disturbing or dislodging the clot. Do not rinse your mouth vigorously, use a straw, smoke, drink alcohol, or brush teeth next to the extraction site for 72 hours.
• Limit exercise for the next 24 hours.
• Apply an ice pack to cheek if swelling occurs.
• Take medications as prescribed.
• Drink lots of fluid and eat nutritious food on the day of the extraction.
• Resume normal dental routine after 24 hours.