Surgical Instruction

Central New Hampshire Oral Surgery | Concord

Call us at Central New Hampshire Oral Surgery Phone Number 603-228-9050 if you have any questions or concerns.

Before Your Surgery using General Anesthesia- Preparation Instructions

  1. These instructions are vital for your well-being during Anesthesia Care. Please follow them precisely. If you have any questions, kindly call us at Central New Hampshire Oral Surgery Phone Number 603-228-9050 before the day of your surgery.
  2. It is critical that you DO NOT EAT any solid food for eight (8) hours before your appointment.
  3. 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, and is the standard used in hospital-based anesthesia.
  4. A minor patient MUST arrive with his/her parent or legal guardian. That adult needs to stay at our facility during the minor’s care.
  5. 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 accepted Anesthesia standards.
  6. A sedated or anesthetized patient must have their escort’s full attention during recovery and the drive home. A small child  (aside from the patient) SHOULD NOT be here on surgery day with you,  unless there is a second adult to supervise the child on the way home.
  7. An adult should be at home with you afterwards on the surgery day.
  8. Please wear loose, comfortable clothing, with sleeves which are easily pulled up.
  9. Please remove contact lenses, tongue rings, and protruding facial ornaments before your surgery. If the facial ornament can’t be removed, then Dr. Levy will confirm that it is secure and won’t come off during your procedure.
  • You were asked by Dr. Levy to  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 at your initial consultation about any use of street drugs such as: Cocaine, Heroin, Ecstasy (E), Methamphetamine (Meth), Crystal Meth, Designer Drugs, etc. or any other recreational drugs which you may use.  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 safety  during surgery and anesthesia.

After Surgery Homecare Instructions


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

  1. 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 excessively.
  2. 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; it’s often much greater the day  after surgery.

  1. Use ice packs to your jaw for the first two days.
  2. On the third day, STOP USING ICE COMPLETELY. The benefit of ice has “maxed-out” after two days. Beginning on Day 3: USE HEAT. An electric heating pad or a microwave heating pad will make you feel better, ansd will help to decrease the post-op swelling.
  3. Continue to use heat for a tight jaw, for up to a week. Our patients recover more quickly when they use HEAT frequently.
  4. 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 post-operatively can cause a painful dry socket. If you must smoke, then cut back as much as you can for the first 3 days. We know that it’s hard. If you can’t stop completely for the first few days, then smoke the least that you can. It will help in your comfort and healing.

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 us during office hours. We’ll  arrange to see you promptly and help you with this delay in healing.

STIFF JAW It is normal for your mouth to be stiff and hard to open for several days. The chewing muscles near the surgery can get a temporary spasm. Don’t try to force your jaws open- you’ll just hurt yourself. Instead, USE HEAT (see above) until you can open comfortably.

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” .

POST-OPERATIVE 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” or a glass of milk, soft ice cream (etc.) helps. Take this as directed about 10 minutes before taking  your medicines, on the first 2 or 3 days after your surgery. Also, any drugs, including over the counter should be taken only as prescribed as an excess can harm your body; this includes “over the counter”  Tylenol and Ibuprofen.

FOOD AND DRINK- For the first 24 hours, please avoid eating or drinking any hot foods. Warm coffee, tea or soup is fine. 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 at first. However, eating solid chewy food will NOT rip out your stitches. Also,  you CAN drink from a straw. It isn’t  true that the normal use of a straw ” sucks out the blood clot”. Even if you do not have much of an appetite at first, please drink plenty of fluids  to stay hydrated.

ALCOHOL- Do not consume alcohol while taking narcotic pain medications. Similarly, recreational drugs cannot be used while taking narcotics. Combining alcohol or “recreational drugs” with the narcotic pain medicine which  Dr.  Levy may prescribe for you is very dangerous, and can be fatal.  Please take this seriously.

Dr. Levy has consulted with a number of qualified Ob/Gyn Doctors, who confirmed that Antibiotics can decrease the strength of your birth control  pills. Extra protection (condoms) is needed along with the Birth Control Pills (BCPs) and for 10 days after you finish your antiobiotics.  The strength of a Birth Control Patch, birth control skin implant, or vaginal inserts such as a NUVA-Ring or an IUD IS NOT weakened by antibiotics. If you are in doubt, feel free to ask your Gyn Provider. Not using extra protection when you’re taking antibiotics could cause an unexpected pregnancy.

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 to my gums”. This is not true, although it may look that way at first.  Please rest assured that Dr. Levy has been a Surgeon and has been carefully  suturing for about 25 years . As you heal you’ll see that the tissue is just as it should be.

SHARP BONY EDGES- Some patients feel a small SHARP EDGE of bone in the tissue after the surgery. It may appear a few weeks after the procedure was done. This is the jaw reshaping itself;  it is NOT an infection and it isn’t a piece of tooth left in the jaw .It’s part of your body’s 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 come free. If the bone chip doesn’t dissolve on its own, Dr. Levy can smooth the edge to help healing along.   Please call the office so Dr. Levy can “take a look”.

POST-OP VISIT- If we made a post-op appointment for you, this is for Dr. Levy to check your surgical site and your healing.  Dr. Levy takes your surgery and how you’re doing afterwards to heart. Many extractions are routine enough that we won’t take up your time for a post-op check, unless you call with a concern. Then, please call. We’re happy to check on how you’re doing.


  1. Take Medicines only as directed.
  2. 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!
  3. 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.