Surgical Instructions

Before Intravenous Sedation

Do not eat or drink anything (including water or gum) for at least eight (8) hours prior to your appointment.
Do not smoke or chew tobacco on the day of your surgical appointment and preferably, 7-10 days after your procedure to avoid post-operative pain and infection.
If you are under the age of 18, a responsible adult must be present at the time of surgery and your parent or legal guardian must be available to give consent for any procedures.
In most cases you will be at the office for about 2-3 hours.
Following sedation, all patients must have a responsible adult to accompany you home and stay with you for the day. Public transportation is not suitable following anesthesia.
The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
Jewelry, Nose and Mouth piercings and dentures must be removed at the time of surgery.
Please wear comfortable, loose clothing with sleeves that can be rolled up past the elbow.
Do not wear lipstick, makeup or nail polish on the day of the surgery.
If you have any current illnesses prior to your appointment, please notify the office immediately.

Please consult with Dr. Payne on directions of current medications taken. He will direct you on how to manage your current medications.

Post Operative Instructions

***PLEASE READ ALL OF THESE INSTRUCTIONS CAREFULLY***

After your surgery, it is important to follow certain guidelines to ensure a successful healing process and minimize pain and discomfort. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. If you have questions about your progress, please call the office at 719-542-4546.

You can contact Dr. Payne after hours by calling the office and following the emergency prompts. However, calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: telephone calls for narcotic (pain killer) prescription renewal are ONLY accepted during office hours.

Day of Surgery

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after two hours. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another two hours. The gauze may then be changed as necessary (typically every 1-2 hours). It is best to roll the gauze and moisten with tap water to apply pressure to the surgical site.

EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently.

PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.

OOZING: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 1-2 hours at a time.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry) for 1-2 hours. If bleeding remains uncontrolled, please call our office.

SWELLING: Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has completely worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as ibuprofen. Some patients may even require two of the pain pills at one time but should never be taken more than prescribed. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Stay in a cool area, reclined, and minimize movement. Ginger ale or Classic Coca Cola may help with nausea.

DIET: Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

Instructions for Second & Third Days

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily. If you were prescribed a mouth rinse, use it instead of, or after the salt water rinses.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement or if your condition worsens after this time, please call our office. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.