4175 N Hanson Ct, Ste #200, Bowie, MD 20716 301-383-9883

Oral Surgeon Bowie, MD

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will usually be a metal or rubber chain protruding through the gums and attached to the arch wire of your braces. Please take care to avoid heavy contact with the chain during eating or brushing. It is not uncommon for the chain to become loose or detached from the tooth. If this happens please keep the chain and bracket handy and call our office immediately.

SUTURES

Usually there will be sutures (stitches) placed to reapproximate the gingiva at the surgical sites. The sutures we place are usually resorbable and do not need to be removed. Please avoid tampering with the sutures, allow 7-10 days for sutures to dissolve. Occasionally sutures may break and fall out sooner than anticipated, this is not cause for alarm simply keep the area clean, healing typically progresses as normal.

BLEEDING

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a moistened gauze pad placed under pressure directly over the bleeding wound for 30 to 60 minutes. If bleeding continues profusely, please call for further instructions. Avoid the use of straws for 2-3 days.

SWELLING

Swelling is a normal occurrence after surgery. To minimize swelling apply an icepack, or towel filled with ice, on the face in the area of surgery. Apply the ice 20 mins on and 20 mins off at a time, as much as possible, for the first 24 hours.

DIET

Drink plenty of fluids. Avoid hot liquids or hard foods. Soft food and liquids should be eaten on the day of surgery and for 2-3 days. Return to a normal diet as soon as possible unless otherwise directed.

PAIN

  • You should begin taking pain medication as soon as possible prior to the local anesthetic wearing off which typically occurs 2-3 hrs after the procedure. For mild or moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours not to exceed the max daily dose written on the bottle. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: up to 4 tablets may be taken at a time, four times daily, not to exceed the max daily dose written on the bottle. Consult our office for additional recommendations.
  • For severe pain, you may be prescribed stronger medications. These medications should be taken as directed. Do not take any medication if you are allergic to it or similar medicines, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery and avoid alcoholic beverages while taking narcotic pain medications. Pain or discomfort following surgery should subside gradually. If pain persists, it may require attention and you should call our office.

ANTIBIOTICS

Antibiotics are sometimes necessary after exposure of an impacted tooth, especially when bone is removed or the tooth is luxated (loosened). If prescribed, antibiotics should be taken as directed to help prevent infection.

ORAL HYGIENE

  • Good oral hygiene is essential to good healing especially since braces attract debris and bacteria. The night of surgery no rinsing or brushing should be done. The day after surgery, the prescribed oral rinse should be used twice daily; after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 3 times a day as well, especially after meals. Brush your teeth along with the braces well. Be gentle initially while brushing the surgical areas and be sure to use a soft bristle brush and avoid excessive contact to the protruding chain.

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. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.

SMOKING

  • Smoking not only disturbs and delays the normal wound healing but it also increases risk of excessive post surgical bleeding as well as infection hence should be avoided for 3-4 days after surgery.

Oral Surgeon Bowie, MD

A small amount of bleeding is to be expected multiple extractions. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 – 45 minutes. If bleeding continues, bite on a moistened black tea bag for 30 minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding persists, call our office immediately. If you were instructed to wear an immediate denture/ prosthesis after extractions please do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the sides of the denture.

Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 24 hours only. Starting the following day you may use a warm wet rag against the face to help further minimize discomfort and swelling.

For mild discomfort you may use Tylenol, or any similar medication; two tablets every 3-4 hours. Two to four tablets of Ibuprofen (Advil or Motrin) can be taken every 6 hours. Care should be taken not to exceed the daily max dose indicated on the bottle.

For severe pain, use the prescriptions given to you. If the pain does not begin to subside after 3 days, or increases after 3 days, please call our office. If an antibiotic has been prescribed, please take as prescribed till completed. If you are allergic to any medication please do not take it, if allergy develops unexpectedly please stop medications and call our office immediately.

Drink plenty of fluids. If many teeth have been extracted, the volume lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

Do not rinse your mouth or brush your other teeth for the first day, or while there is bleeding. After the first day, use a warm salt water rinse following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one glass of warm water). If you were instructed to wear a denture, you way remove it after 48 hrs. Please rinse the denture and clean it with an antibacterial solution at which point it can be replaced, this is to be done 3-4 times a day especially after meals starting 48 hrs after surgery.

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 typically must be shaved and smoothed for patient comfort and optimal healing. The following conditions may occur, all of which are considered normal:

  • The area operated on will usually 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 48 hours after surgery. ( Remember: ice packs are used for the first 24 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 sometimes 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. Please call our office if severe soreness or tenderness develops.

Oral Surgeon Bowie, MD

PLEASE READ INSTRUCTIONS CAREFULLY

▪ You should not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.

▪ If medications must be taken by mouth, do so only after consulting with the doctor and with only a sip of water.

▪ Antibiotic prophylaxis should be taken 1 hour prior to surgery if recommended by the doctor.

▪ Please wear loose fitting clothing with short sleeves that can be easily rolled up past the elbows.

▪ 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. Women that wear acrylic nails should have the nail removed from at least one finger prior to surgery.

▪ 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.

▪ A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home after the procedure.

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

▪ If you have an illness such as a cold, sore throat, upset stomach or bowels, please notify the office within 24 hrs of your scheduled procedure.

▪If you take routine oral medications, please check with our office prior to your surgical date for specific instructions.

Please call our office at 301-383-9883 to speak with one of our clinical staff prior to your scheduled procedure, we’ll be happy to answer any questions or concerns you may have.

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