Surgical Instructions
We’ve included instructions and downloadable/printable PDF documents for you to help you prepare for and recover from your upcoming procedure. As always, please contact us with any questions!
Email Us:
reception@carlsbadoms.com
Phone Us:
(760) 434-4301
Open Hours
Mon – Th: 8AM – 5PM
Fri: 8AM – 4PM
Surgical Instructions
Click on any of the topics to read more. PDF links are inside each topic.
Before Anesthesia
- You may not have anything to eat or drink (including water) for eight hours prior to the appointment.
- No smoking for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery. Six weeks of no smoking give optimal results.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following anesthesia.
- Please wear loose fitting and comfortable clothing. If you are having a sedation procedure you should have short sleeves or sleeves which can be rolled up past the elbow.
- 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 upset bowels, please notify the office.
- If you take routine oral medications, please check with Dr. Breese and Dr. Tracy prior to your surgical date for instructions.
Dental Implant Surgery
After Placement of Dental Implants
Do not disturb the surgical site. Avoid rinsing, spitting, or touching the area on the day of surgery. The day after surgery we recommend gentle rinsing with warm salt water to help soothe the tissues and allow optimal healing.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Direct pressure by biting on a gauze pad will decrease the bleeding. Extra gauze will be given to you after surgery to take home to switch out every 1-2 hours until the bleeding stops. If bleeding is uncontrollable and is not slowing down after 24 hours please call for further instructions.
Swelling
Swelling is a normal occurrence after surgery. To minimize swelling apply an ice bag, or a plastic bag or towel filled with ice, on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 24-48 hours as needed.
Diet
You should be drinking 1-2 liters of water a day after surgery. Avoid hot liquids or hot food. The day of surgery your diet should consist of mostly fluids, and anything that is soft and cold. It is recommended to stick to a soft diet for 1-2 weeks following surgery to allow for tissue healing without disruption.
Pain
You should begin taking pain medication prior to feeling the local anesthetic wearing off. Most patients will receive percocet or vicodin for severe pain control, as well as ibuprofen to keep inflammation down. We recommend that when you get home, get a little food in your stomach and take one tablet of the narcotic medicine. Three hours later you may take the ibuprofen. Three hours after that you may take another narcotic tablet. Alternating like this throughout the first day after surgery every three hours will provided the most optimal pain control and keep you comfortable. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Antibiotics
If given antibiotics please take them as directed to help prevent infection.
Oral Hygiene
Good oral hygiene is essential to good healing. The day after surgery, use the prescribed Peridex Oral Rinse 2-3 times daily. You should also be rinsing with warm salt water rinses (one teaspoon of salt in a cup of warm water) 2-3 times a day. All rinsing should be performed gently and without spitting. Once you are through rinsing you should lean forward over the sink and let the liquid fall out from your mouth without spitting. Be sure to rinse for at least 30 seconds. Brush your teeth and the healing abutments if they placed. Be gentle initially while brushing the surgical areas.
Activity
Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur due to increased heart rate. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures, should not be used immediately after surgery for at least 10 days, unless otherwise directed in the pre-operative consultation.
After Wisdom Teeth
After Wisdom Tooth Removal
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for 1-2 hours. After this time, the gauze pad should be replaced every 1-2 hours with the extra gauze given. The gauze should be used until the bleeding has slowed or stopped. Each time a new piece of gauze is placed you should get it moist with water so it does not stick to the tissues. Do not sleep with gauze in your mouth.
- Vigorous mouth rinsing and/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 directed.
- Restrict your activities for the first 4-5 days after surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed for the first 24-48 hours. Refer to the section on swelling for a more thorough explanation.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Direct pressure by biting on a gauze pad will decrease the bleeding. Extra gauze will be given to you after surgery to take home to switch out every 1-2 hours until the bleeding stops. The gauze should be moist with water when placed in your mouth to avoid sticking to the tissues. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding is uncontrollable and is not slowing down after 24 hours please call for further instructions.
Swelling
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 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed for the first 24-48 hours. The ice packs should be left on continuously while you are awake. 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. 48 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Diet
After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.
Pain
You should begin taking pain medication prior to feeling the local anesthetic wearing off. Most patients will receive percocet or vicodin for severe pain control, as well as ibuprofen to keep inflammation down. We recommend that when you get home, get a little food in your stomach and take one tablet of the narcotic medicine. Three hours later you may take the ibuprofen. Three hours after that you may take another narcotic tablet. Alternating like this throughout the first day after surgery every three hours will provided the most optimal pain control and keep you comfortable. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Keep the mouth clean
Good oral hygiene is essential to good healing. The day after surgery, use the prescribed Peridex Oral Rinse 2-3 times daily. You should also be rinsing with warm salt water rinses (one teaspoon of salt in a cup of warm water) 2-3 times a day. All rinsing should be performed gently and without spitting. Once you are through rinsing you should lean forward over the sink and let the liquid fall out from your mouth without spitting. Be sure to rinse for at least 30 seconds. Brush your teeth and be careful as you approach the extraction sites so you don’t disrupt the tissue healing. Be gentle initially while brushing around the surgical areas.
Discoloration
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 may speed up the removal of the discoloration. Discolored lines may appear at the corner of the mouth after surgery which typically resolve within 1 week.
Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given if active infection is occurring. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.
Nausea and Vomiting
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 coke, 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. Contact the office if it does not resolve.
Other Complications
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. You will be numb for the first 4-6 hours after surgery from the local anesthetic. As reviewed in your consultation numbness 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. Call Dr. Breese or Dr. Tracy 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. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting 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 over time as the bone remodels. If not, they can be removed.
- 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 with time.
Finally
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures are dis-solvable and should fall out within a few days to a week. The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.
There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.
Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Tracy, Dr. Breese, or your family dentist.
Brushing your teeth is okay – just be gentle at the surgical sites.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain near the ear may occur 3-5 days following surgery. Call the office if this occurs.
If you are involved in regular exercise you should stop for seven days following surgery. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
Exposure of Impacted Tooth
After Exposure of an Impacted Tooth
Do not disturb the wound. If surgical packing was placed, leave it alone. The packing helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed but please contact our office for instructions.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Direct pressure by biting on a gauze pad will decrease the bleeding. Extra gauze will be given to you after surgery to take home to switch out every 1-2 hours until the bleeding stops. The gauze should be moist with water when placed in your mouth to avoid sticking to the tissues. To minimize further bleeding, do not do anything to increase your heart rate, sit upright, and avoid exercise. If bleeding is uncontrollable and is not slowing down after 24 hours please call for further instructions.
Swelling
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 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed for the first 24-48 hours. The ice packs should be left on continuously while you are awake. After 48 hours, ice has no beneficial effect.
Diet
Drink plenty of fluids. Avoid hot liquids or hard foods. Only consume soft food and liquids on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.
Pain
You should begin taking pain medication prior to feeling the local anesthetic wearing off. Most patients will receive percocet or vicodin for severe pain control, as well as ibuprofen to keep inflammation down. We recommend that when you get home, get a little food in your stomach and take one tablet of the narcotic medicine. Three hours later you may take the ibuprofen. Three hours after that you may take another narcotic tablet. Alternating like this throughout the first day after surgery every three hours will provided the most optimal pain control and keep you comfortable.
Oral Hygiene
Good oral hygiene is essential to good healing. The day after surgery, use the prescribed Peridex Oral Rinse 2-3 times daily. You should also be rinsing with warm salt water rinses (one teaspoon of salt in a cup of warm water) 2-3 times a day. All rinsing should be performed gently and without spitting. Once you are through rinsing you should lean forward over the sink and let the liquid fall out from your mouth without spitting. Be sure to rinse for at least 30 seconds. Brush your teeth and be careful as you approach the extraction sites so you don’t disrupt the tissue healing. Be gentle initially while brushing around the surgical areas.
REMEMBER: A clean wound heals better and faster.
Activity
Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
After Tooth Extraction
After Tooth Extraction
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for 1-2 hours. After this time, the gauze pad should be replaced every 1-2 hours with the extra gauze given. The gauze should be used until the bleeding has slowed or stopped. Each time a new piece of gauze is placed you should get it moist with water so it does not stick to the tissues. Do not sleep with gauze in your mouth.
- Vigorous mouth rinsing and/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 directed.
- Restrict your activities for the first 4-5 days after surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed for the first 24-48 hours.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Direct pressure by biting on a gauze pad will decrease the bleeding. Extra gauze will be given to you after surgery to take home to switch out every 1-2 hours until the bleeding stops. The gauze should be moist with water when placed in your mouth to avoid sticking to the tissues. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding is uncontrollable and is not slowing down after 24 hours please call for further instructions.
Swelling
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 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed for the first 24-48 hours. The ice packs should be left on continuously while you are awake. 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. 48 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Diet
After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.
Pain
You should begin taking pain medication prior to feeling the local anesthetic wearing off. Most patients will receive percocet or vicodin for severe pain control, as well as ibuprofen to keep inflammation down. We recommend that when you get home, get a little food in your stomach and take one tablet of the narcotic medicine. Three hours later you may take the ibuprofen. Three hours after that you may take another narcotic tablet. Alternating like this throughout the first day after surgery every three hours will provided the most optimal pain control and keep you comfortable. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Keep the mouth clean
Good oral hygiene is essential to good healing. The day after surgery, use the prescribed Peridex Oral Rinse 2-3 times daily. You should also be rinsing with warm salt water rinses (one teaspoon of salt in a cup of warm water) 2-3 times a day. All rinsing should be performed gently and without spitting. Once you are through rinsing you should lean forward over the sink and let the liquid fall out from your mouth without spitting. Be sure to rinse for at least 30 seconds. Brush your teeth and be careful as you approach the extraction sites so you don’t disrupt the tissue healing. Be gentle initially while brushing around the surgical areas.
Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given if active infection is occurring. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.
After Multiple Teeth Extraction
After the Removal of Multiple Teeth
A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.
For mild discomfort use aspirin, Tylenol, or any similar medication; two tablets every 3-4 hours. Two to three tablets of Ibuprofen (Advil or Motrin) can be taken every 3-4 hours.
For severe pain, use the prescription given to you. If the pain does not begin to subside after 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, make sure to finish your prescription unless you have an allergic reaction..
Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one cup of warm water). After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.
Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.
The removal of many teeth at one time is quite different from the extraction of just one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
- The area operated on will swell, reaching a maximum in two days. Swelling and discoloration around the eyes may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as is tolerable, beginning 36 hours after surgery. (Remember: ice packs are used for the first 36 hours only).
- A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.
- If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If your temperature continues to rise, notify our office.
If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
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Phone
(760) 434-4301
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Fri 8AM – 4PM
Address
1289 Carlsbad Village Dr. Carlsbad, CA 92008.