Surgical Instructions

You may not have anything to eat or drink (including water) for six (6) hours prior to the appointment.

A responsible adult driver, 18 years or older, must accompany the patient to the office, remain in the office during the procedure and drive the patient home. Driver services like Uber or Lyft are not acceptable. (Need a driver? Visit designateddriversinc.com)

No smoking at least twelve (12) hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.

The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.

Please wear loose-fitting clothing with sleeves that can be rolled up past the elbow, and low heel shoes.

Contact lenses, jewelry and dentures must be removed at the time of surgery.

Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.

If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office prior to you appointment.

If you take routine oral medications, please check with Drs. Johnson, Holtzen, and Hunter prior to your surgical date for instructions. Questions? Call us at (702) 360-8918.

You can take your regular medications with a sip of water.

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. If the area is still oozing replace the gauze placing it over the surgical area. (Not just between the teeth. Firm pressure must be placed to the surgical area). Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged. Take the prescribed pain medications as soon as you begin to feel discomfort. Make sure you eat before taking ANY pain medications or it will increase the likelihood of nausea/vomiting. Restrict your activities the day of surgery and resume normal activity when you feel comfortable.

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. If bleeding continues, rinse lightly with hydrogen-peroxide and water half and half for 30 seconds, SPIT and QUICKLY replace the gauze or tea bag. Again, it is not abnormal to continue to ooze for the first 24 hours after surgery. To minimize further bleeding, do not disturb the area and avoid exercise.

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs to the face where surgery was performed.

The ice packs should be left on continuously while you are awake (15 minutes on, 15 minutes off). After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Forty eight (48) hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

For mild to moderate pain, one or two tablets of Ibuprofen, (Motrin or Advil) 200 mg may be taken every 6 hours.

For moderate to severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. DO NOT drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day after the 2nd to 3rd post-operative day. If pain persists, it may require attention and you should call the office at (702) 360-8918.

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws for 1 week after surgery. Drink from a glass. You may eat anything soft by chewing away from the surgical sites. It is very important to eat normally to keep up your strength and to promote healing.

NO RINSING of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing 5-6 times a day especially after eating, with a cup of warm water mixed with a teaspoon of salt.

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area will help resolve the discoloration.

In the event of nausea and/or vomiting following surgery, DO NOT take anything by mouth for at least an hour including the prescribed medicine. You should then sip on water, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call the office if you have any questions. Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or Ibuprofen should be taken to reduce the fever. You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.

Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, your surgeon can remove them. If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.

Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days. Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Johnson, Holtzen, and Hunter.

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. If the area is still oozing replace the gauze placing it over the surgical area. (Not just between the teeth. Firm pressure must be placed to the surgical area). Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged. Take the prescribed pain medications as soon as you begin to feel discomfort. Make sure you eat before taking ANY pain medications or it will increase the likelihood of nausea/vomiting.

Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Place ice packs to the sides of your face where surgery was performed. Place ice packs (wrapped in a towel) on for 15 minutes/off for 15 minutes, while awake for the first 36 hours following surgery. DO NOT rinse vigorously, suck on straws, smoke, drink alcohol or brush your teeth following your extraction.

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. If bleeding continues, rinse lightly with hydrogen-peroxide and water half and half for 30 seconds, SPIT and QUICKLY replace the gauze or tea bag. Again, it is not abnormal to continue to ooze for the first 24 hours after surgery. To minimize further bleeding, do not disturb the area and avoid exercise.

TThe swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs to the face where surgery was performed.

The ice packs should be left on continuously while you are awake (15 minutes on, 15 minutes off). After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six (36) Forty eight (48) hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

For mild to moderate pain, one or two tablets of Ibuprofen, (Motrin or Advil) 200 mg may be taken every 6 hours.

For moderate to severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. DO NOT drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day after the 2nd to 3rd post-operative day. If pain persists, it may require attention and you should call the office at (702) 360-8918.

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws for 1 week after surgery. Drink from a glass. You may eat anything soft by chewing away from the surgical sites. It is very important to eat normally to keep up your strength and to promote healing.

NO RINSING of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing 5-6 times a day especially after eating, with a cup of warm water mixed with a teaspoon of salt.

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat will help resolve the discoloration.

If you have been placed on antibiotics, take the tablets or liquid as directed until gone. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office at (702) 360-8918 if you have any questions

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call the office if you have any questions. Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or Ibuprofen should be taken to reduce the fever. You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.

Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, your surgeon can remove them. If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.

Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days. Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Johnson, Holtzen, and Hunter.