Post-Op Instructions For IV/General Anesthesia

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1.) DO NOT DISTURB THE AREA: Do not touch the area with your tongue or fingers. Disturbing the area can cause bleeding. Do not lift your lip away to look at the area. Do not spit, drink with a straw, or suck on the area because it can cause more bleeding for at least a week

2.) DO NOT SMOKE FOR 48 HOURS AFTER YOUR SURGERY: Smoking disturbs the healing process. For proper healing, it is recommended that you stop smoking for 2-3 days following any surgery in your mouth to help prevent dry socket.

3.) DO NOT RINSE YOUR MOUTH OR BRUSH YOUR TEETH FOR 24 HOURS: After waiting 24 hours, you may gently brush your teeth and rinse your mouth. You may use warm water or a mixture of 3/4 water and peroxide. Do not use hot water. It will cause you to bleed more. Warm water is OK.

4.) SWELLING: Swelling is part of the healing process. Swelling may continue to increase for 2-3 days after your surgery. Ice packs should be used on the outside of your face to keep the swelling down. Place it on for 20 minutes and then leave it off for 10 minutes. Repeat this process for two to three days as much as possible. Do not use heat until 7 days after your surgery. Heat will make the swelling worse. Sleep with your head elevated on 2-3 pillows if possible. Bruising will occasionally happen and is normal.

5.) BLEEDING: Some bleeding for a day or two is normal. If you think you are bleeding too much, roll up a piece or two of your gauze and place it on the surgical site and bite down on it for hour. Pressure stops all bleeding. If biting down doesn’t help, wet a tea bag in cold water, ring it out, place it on the site, and bite down on it for 3/4 hour. If neither of these options work and you are still bleeding excessively, call our office.

6.) PAIN: Pain is part of the healing process. You may be in pain after your surgery. Pain medicine will be prescribed if needed. Keeping your head elevated and applying ice will help keep the pain down. Pain medication may not take away all of the pain. Overexerting yourself will increase pain & swelling.
7.) EATING: You can eat and drink after surgery. Wait until the numb feeling is gone before you eat solid food. Do not have hot liquids (coffee, tea, and soup) for a few days. They may make you bleed more. Do not eat food with small seeds (poppyseeds, sesame seeds, popcorn, etc) for 2-4 weeks following surgery. Try not to eat on the surgery site. Start with liquids, soft foods, and then start your regular dietif you can.
8.) IV SITE: The IV site and surrounding area may be sore for days to months if being irritated by typing, lifting, etc. In some cases the vein can be sore and have hard lumps. This is normal for the healing process. If you have any questions, please call the office. Ice on the IV site will help. 325mg aspirin once a day for a week will help.
9.) DRY SOCKET (the blood clot breaks down): If something happens to the blood clot in the socket, you may develop dry socket. A dry socket usually occurs the 3rd day after surgery causing severe pain. No one knows the reason dry sockets happen. If you haveextreme pain, call the office. We will place medicated packing if it is found to be dry socket. Moderate to severe pain in normal. Extreme pain is not. Orajel helps.

10.) MEDICATIONS: If a prescription for pain is given from Dr. Smith, please make sure to read all of the information given with the prescription. It is important to know that if a pain medication (narcotic) is given, one of the side effects is drowsiness. Therefore DO NOT DRIVE, or do anything that requires coordination or decision-making skills. If you are taking other medications, you may consult Dr. Smith,your pharmacistor your physician for further questions. Advil 400-600mg four times a day and Oragel can help with discomfort.

11.) DRIVE PATIENT HOME IN FRONT SEAT. Responsible adult must be at home with patient after discharge. Patient must use seat belt for three weeks.
12.) Tempromandibular joint can be sore for a few weeks.

If you have upper back teeth extracted, do not blow your nose, spit or hold in your sneeze for 1 week. If you are unable to reach Dr. Smith or your dentist, for a true emergency, go to the hospital emergency room.

The I.V. site and general area can be irritated, red, and lumpy for months after surgery. Often the joints in and around the I.V. site are most uncomfortable along with the veins being hard.

I.V.’s and medicines are not meant to be in the veins. The pain, swelling, hardness and lumps are the way the vein heals itself. Veins cannot form scabs or healing coatings (aschars) like the mouth and skin so they heal often with hardness and or lumps.

The I.V. site can be treated with ice and/or heat, reduced use and one (1) baby aspirin/day for one week. The I.V. site can be easily irritated by lifting, sports, typing, playing hand instruments.

Post-Operative Nausea/Vomiting

1. After anesthesia, some nausea/vomiting can be normal, especially for fair-skinned people.
2. Decreasing movement after surgery reduces nausea. Lie down and try to rest. Try to keep head slightly elevated with extra pillows.
3. Stop eating and drinking until your stomach feels better. Call doctor if you have questions.
4. When you get home, start with sips of clear liquids: water, 7UP, gingerale, soda, etc. If nausea persists, try to sleep or call the doctor if diabetes in uncontrolled.

5. When you wake up, try clear liquids (water) again. If nausea does not lessen, or you vomit, stop all liquids and food until you feel better.

6. As you begin to feel better, start again with clear liquids (water). Progress to full liquids (7UP, gingerale), moist crackers, etc. Then move on to soft foods until you tolerate it.

7. Over the counter , 2Tblsp of baking soda in a 12oz glass of water, Maalox or Mylanta can be used for abdominal discomfort and to control bleeding.

8. Over-the-counter Zantac, taken as directed on the box, can also help.

9. Narcotic use can also cause nausea. If you think this is the cause, stop the narcotic prescribed and switch to 400-600mg Advil (Motrin) every 6 hours with food (moistened crackers) or cut narcotic in half.

Pain and Swelling Is a Normal Part of The Healing Process

1. Mouth pain varies with everyone and with every tooth location.

2. Usually lower jaw extractions hurt more than upper extractions.

3. Upper extractions usually have minimal to no pain except for front teeth and canines.

4. Keeping ice on the site helps to reduce the pain. (2-3 days 20 minutes on, 10 minutes off). Applying Oragel with a cotton swab is helpful

5. Rest helps pain. Take it easy. Keep head elevated.

6. Sleep helps relieve pain. You heal while you sleep.

7. Decrease your work activity for 2-3 days, especially if you do a lot of lifting or talk for long periods. This applies to both your job and home life.

8. The 3rd day is usually the worst for pain and swelling. (the 3rd day after surgery-not including the day of surgery)

9. Warm water and peroxide rinses (75%/25%) help with pain. Start 2nd day. Rinse several times a day starting the day after surgery.

10. 400-600mg of Advil (Motrin) taken every 6 hours with food helps with pain.
11. Do not take over-the-counter Tylenol while taking Vicodin or Tylenol 3. These medications already contain Tylenol.
12. Oragel and/or toothpaste on the painful tooth can help.