Please bring any referral slip from your referring dentist or physician. Please do not eat or drink anything for six to eight hours before your procedure. Please wear loose fitting comfortable clothing. Please remove any contact lenses and all jewelry prior to surgery. Please make sure that you bring a responsible adult with you who can wait in the waiting room during your procedure and then drive you home afterwards. Please bring a list of medications you are taking. Also, if you have asthma please bring your inhalers. If you are taking prednisone, please bring this medication with you. Patients who require antibiotic prophylaxis because of heart murmurs, artificial joints, the VP shunts, and artificial heart valves should take the appropriate antibiotic dosage one hour prior to surgery with a small sip of water. Patients who are treated with heart medications, blood pressure medications, thyroid medications, and gastric reflux / ulcer medications should take these medications as prescribed without food and with small amounts of water. Insulin dependent diabetic patients should take 1/2 their normal of NPH insulin and not take any regular insulin dose. We always schedule diabetic patients' appointments in the morning. Diabetic patients who are controlled with Resulin should not take this medication on the day of surgery. ALL PATIENTS UNDER THE AGE OF 18 YEARS MUST BE ACCOMPANIED BY A PARENT OR LEGAL GUARDIAN. It is always helpful to have your medical and dental insurance information with you, as well as any required insurance forms. Following oral surgery it is necessary to control bleeding and swelling. BLEEDING Bleeding is best controlled by biting on gauze packs immediately following the surgical procedure. These packs are best changed every 45 minutes until bleeding subsides. If bleeding still persists after two to three hours, this bleeding is best treated by keeping your head elevated and sitting upright. The use of one or two moistened tea bags placed over the surgical site. While this may sound archaic, biting firmly on a couple of tea bags for 45 minutes, perhaps repeated once, usually stops any residual post-operative bleeding. The most frequent cause of bleeding post-operatively is caused by patients who are spitting or rinsing their mouths. PLEASE DO NOT RINSE OR SPIT FOR THE FIRST 24 HOURS FOLLOWING SURGERY. SWELLING Swelling is best controlled by the immediate application of ice packs for the first 36 hours following surgery. Bags of frozen peas or corn are very inexpensive, readily available, and effective ice packs for controlling swelling. Ice packs should be applied to the outside of the face in intervals of 30 minutes on and 5 minutes off. Following oral surgery it is necessary to maintain a proper diet. DRINKING Drinking plenty of fluids with meals and in between meals is essential in the post-operative period. If upper posterior (back) teeth have been removed please avoid using a straw. EATING Eating soft nutritious food is encouraged as soon as bleeding has stopped. Hot foods and drinks should be avoided for several hours. Foods which contain seeds, nuts, or kernels such as popcorn and peanuts or are hard or crunchy, should be avoided for several days or weeks. Following oral surgery it is necessary for proper healing to maintain oral hygiene. RINSING For the first 24 hours, it is advised not to rinse as this may disturb the newly formed blood clot. However after 24 hours, rinsing with a saltwater or baking soda solution is encouraged. The addition of some mouthwash to this solution to freshen ones breath is also desirable. Rinsing is to start the day after surgery and continue for one week or until the sutures are removed. Rinsing is to be done for 5 full minutes vigorously after each mealtime and at bedtime. BRUSHING For the first 24 hours, it is advised not to brush your teeth as this may disturb the newly formed blood clot. However after 24 hours, careful gentle brushing of the teeth with a toothbrush whose bristles have been made soft by running them under hot water is encouraged. Please avoid areas where there are sutures. Please avoid the area adjacent to the extraction site. SMOKING It is advised that you refrain from all use of tobacco products. Not only does smoking adversely affect oral hygiene, but it also promotes a painful condition known as a "dry socket". Following oral surgery it may be necessary to take narcotic pain medications. DRIVING AND ACTIVITIES In the peri-operative period, while under the influence of any anesthetic agent or narcotic pain medication, it is advised that you not drive a car, operate machinery, climb ladders, or make any important financial decisions. It is also advised that you refrain from any strenuous activity, as this may lead to an increase in swelling as well as the potential for injury because of impaired coordination caused by narcotic medications. Whenever possible, we encourage patients to use nonsteroidal anti-inflammatory medications such as Advil, Motrin, Aleve, or Tylenol. Following oral surgery, occasionally these conditions can occur. BRUISING Discoloration of the IV site or the facial skin adjacent to the surgical site can occur because of age, medications (aspirin, motrin, anticoagulants), and skin complexion. While cosmetically undesirable, this skin discoloration is harmless and will resolve over the next several days on its own without any medical intervention. BONE CHIPS Following the removal of teeth, in the process of healing small bone splinters may form. These bone splinters commonly may fall out by themselves, occasionally they may need to be removed by the doctor. These splinters usually do not form for several days or weeks after the extraction. They are very common in patients with diabetes and heart disease, but can occur in any patient. LIMITED OPENING Decreased opening and range of motion of the lower jaw, is especially common after removal of posterior (back) teeth. This is a normal response by the muscles that control the lower jaw. Complete return to normal range of motion may take several weeks in some patients. FEVER There may be a slight elevation of temperature for the first 24 to 48 hours after surgery. If fever is present, it is extremely important to drink plenty of fluids. For fevers which exceed 101 degrees, please call the doctor especially if this fever is associated with limited opening. It is also appropriate to make sure that prescribed antibiotics are being taken correctly. Please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.