Surgical Instruction

Before Your Surgery- Preparation Instructions

It is critical that you DO NOT EAT any solid food for eight (8) hours before your appointment.
You may have CLEAR FLUIDS ONLY until four (4) hours before anesthesia. Clear fluids are anything you can hold to the light and see light through it: black coffee, water, plain tea, clear soda, pulpless apple juice (NO milk or orange juice). Ask us if you have any questions before the day of surgery. This is critical for your safety.
A minor patient MUST arrive with his/her parent or legal guardian who needs to stay at our facility during the procedure.
A responsible adult driver must be present to drive you home. You cannot take a taxi home without an escort; it is not adequately safe by our standards.
A sedated or anesthetized patient must have their escort’s full attention during recovery and the drive home. A small child SHOULD NOT be here on surgery day unless there is a second adult to supervise the child.
An adult should be at home with you for the surgery day.
Please wear a short sleeve shirt or one with sleeves that easily pull up.
Please remove contact lenses, tongue rings, and protruding facial ornaments before your surgery.

Important: Critical to Your Safety

You were asked by Dr. Levy avoid alcohol for two (2) days prior to surgery. Marijuana should be stopped at least two (2) weeks prior to surgery. In addition, it is Critical for your Safety that Dr. Levy be told about any use of “street drugs” such as: Cocaine, Heroin, Ecstasy (E), Methamphetamine (Meth), Crystal Meth, “Designer Drugs,” etc. or any other recreational drugs at consultation, before the day of surgery. Please understand: this is not a value judgment about your lifestyle. We are not required by law to “report” you to “the authorities”; it is a safety concern about your well-being during surgery.

After Surgery Homecare Instructions

WE WOULD LIKE YOUR RECOVERY FROM SURGERY TO BE AS PLEASANT AS POSSIBLE. THESE SUGGESTIONS WILL HELP YOU.

BLEEDING – Oozing is normal for the first day or two after oral surgery.

If you have some oozing, it is important that the gauze which we gave you be placed directly on the surgical site, not in the general area in your mouth. Just as when you get a cut on your hand, you have to press directly on it. Bite firmly on the gauze for 30-minutes continuously, without checking the area.
If the bleeding or oozing starts up again, put a cold, moist tea bag (regular tea, not herbal tea) directly on the spot and bite firmly for half an hour. Tea has a chemical in it which helps to control ooze.

RINSING – Do not rinse on the day of surgery. The next morning, rinse several times a day with warm water. You can use a toothbrush, gently. You may use mouthwash if you wish.

SWELLING – Swelling IS NORMAL after oral surgery; usually much greater the morning after surgery.

Use ice packs to your jaw for the first two days.
On the third day, STOP USING ICE COMPLETELY. Then USE A HEATING PAD OR HOT WATER BOTTLE. This will make the area feel better and reduce the swelling.
Continue to use heat for a tight jaw, for up to a week. Our patients recover more quickly if they use HEAT frequently.
Please read #2 and #3 again! If you continue to use heat, starting Day 3, you’ll feel better much faster.

SMOKING – Smoking during the first three days postoperatively can cause a painful “dry socket”. If you must smoke, then cut back as much as you can for the first 3 days.

DRY SOCKETS – This occurs when the blood clot from a tooth socket does not stick properly to the healing jaw. You may have a dry socket if there is a MARKED INCREASE IN DISCOMFORT on about the third (3) day post-operatively. If this occurs, it is not dangerous; but you should call the office during office hours. We will arrange to see you promptly.

STIFF JAW – It is normal for your mouth to be stiff and hard to open for several days. Don’t try to force your jaw open. Instead, USE HEAT until you are pain-free and your jaw opens fully.

BRUISING – This can occur in the upper part of the neck and this is not dangerous; it will pass like any other bruise.

SEDATION- If you had anesthesia or sedation, do not drive, or do things requiring coordination on the day of surgery. You may be uncoordinated even though you don’t recognize it. Driving a car, working at a job where there is dangerous equipment, riding a bicycle, sports, etc. can be dangerous due to your coordination being off.

POSTOPERATIVE MEDICINES- We often give you prescriptions for “pain medicine” and antibiotics. Pills taken on an empty stomach are irritating. WE FIND THAT A SMALL AMOUNT OF STOMACH-COATING REMEDY, SUCH AS PEPTO-BISMOL HELPS TO PREVENT NAUSEA/IRRITATION. Take Pepto as directed 10 minutes before your medicines on the first 2 or 3 days after your surgery. In addition, any drugs, including “over the counter” should be taken only as prescribed as an excess can harm your body; this includes Tylenol and Ibuprofen.

FOOD AND DRINK- For the first 24 hours, please refrain from eating or drinking any hot items: soup, coffee, etc. After 24 hours you are free to eat any type of food that feels comfortable but we find our patients prefer soft, cool items such as ice cream, yogurt, pudding, jello. However, eating solid food will NOT rip out stitches. In addition, you CAN drink from a straw; it is not true that straws “remove blood clots”. Even if you do not have an appetite, please drink as much fluid as possible to stay hydrated.

ALCOHOL- Do not consume alcohol while taking narcotic pain medications. Similarly, recreational drugs cannot be used while taking narcotics. Combining them is very dangerous and can be fatal.

IMPORTANT: For Women who use BIRTH CONTROL:
Dr. Levy has consulted with a number of qualified Ob/Gyn Doctors, who confirmed that Antibiotics can decrease the strength of your birth control. Extra protection (condoms) is needed for Birth Control Pills (BCP’s), Birth Control Patch, or vaginal inserts such as “NUVA-Ring”. Extra protection is NOT needed for IUD devices.
Recommendations: For ANY type of Antibiotics, use extra protection (condoms, etc) for the time you’re taking antibiotics PLUS ONE (1) week after. Antibiotics include all “cillin” drugs: Penicillin, Amoxicillin; others are: Clindamycin, Keflex, Augmentin, etc. If you don’t use extra protection as described, you could become pregnant despite using your “regular” birth control.

STITCHES- We often use dissolving stitches that will fall out within a few days. As the swelling goes down you will feel them more; this is normal. A common concern is that “my cheek is sutured to my teeth or gums”. This is not true. Please rest assured that Dr. Levy has been a surgeon and has done suturing for more than 25 years. As you heal you’ll see that the tissue is just as it should be.

SHARP BONY EDGES- Sometimes after surgery, you may feel a SHARP EDGE of bone. This is the jawbone reshaping itself; it is NOT an infection or a piece of tooth left in the jaw but part of the natural healing process. TREATMENT: MASSAGE the area three times a day for 15 seconds with a clean finger. Rinse afterwards with warm water as this will help the bone chip dissolve or flake out. If the bone chip doesn’t dissolve on its own, Dr Levy can smooth the edge; please call the office for a visit.

POST-OP VISIT- If we made a post-op appointment for you, this is for Dr Levy to check your surgical site and discuss your healing. If you feel “great” and have no questions for Dr Levy, you may cancel this visit. Kindly call the office the morning of your visit to notify us that you will not need your post-op visit so we can notify Dr Levy.

SUMMARY:

Take Medicines only as directed.
Use an ice pack to surgical sites for 48 hours then use a HEATING PAD for the next 5 days. It greatly helps your recovery. PLEASE DO THIS!
Drink lots of fluids. Begin eating soft food or blenderized drinks (milk, fruit etc.) as soon as possible.

Please re-read these instructions frequently. It is easy to forget them after your surgery. This will give you the quickest and most comfortable recovery possible.