Patient Care Before/After

Preoperative Instructions for Patients Undergoing Intravenous Anesthesia

1. If you have an AM appointment, you may not have anything to eat or drink (including water) for six (6) hours prior to the appointment. If you have a PM appointment, you may have a light breakfast before 7AM-absolutely nothing else.
2. A responsible adult must accompany the patient to the office, remain in the office during the procedure, and be able to drive the patient home.
3. The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
4. Please wear loose fitting clothing with short sleeves, low-heeled shoes, and no higher than ankle-heigtth socks . No contact lenses, jewelry, excessive make-up or lipstick, and no nail polish or product on either index finger. Dentures must be removed at the time of surgery.

The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

1. The surgical area will swell.
2. Swelling peaks on the 2nd or 3rd post -operative day
3. Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
4. You may have a slight earache.
5. A sore throat may develop.
6. Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
7. If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
8. There will be a space where the tooth was removed. After 24 hours this area should be rinsed following meals with warm salt water until it is healed. This cavity will gradually fill in with new tissue.
9. There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
10. It is not unusual to develop bruising in the area of an extraction.

Please take all prescriptions as directed.

Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

YOUR CARE AFTER SURGERY (IMPORTANT, PLEASE READ)

What to do after extraction of a tooth

Extractions usually heal quickly and without complications if simple precautions are taken. However, they should not be neglected, and they should be given certain attention. Cooperation with your Oral Surgeon is important.

Remember, you have just had an operation. Treat yourself with due care: don't over-exert yourself; eat regular meals. You should reduce your activity as much as possible for several hours after an extraction. This helps reduce bleeding and permits the formation of a clot in the tooth socket, which is necessary for healing.

AFTER YOU LEAVE THE OFFICE

1. Continue applying pressure by simply biting together on the gauze in your mouth.

2. After about 20 minutes, remove gauze, eat something soft yet substantial (see food suggestions below), replace gauze as follows(if necessary for excessive bleeding: Take 2 gauze pieces; fold them in half, and in half again. Place them directly over the extraction site, or all the way back behind the existing teeth if you had wisdom teeth extracted; bite together firmly. About 30 minutes after eating, remove gauze again and take the prescribed pain medication, then replace gauze.

   Keep your head elevated with an extra pillow for the first 24 hours.

   It is normal to have bleeding for two days following the surgery, so use the gauze and change as needed. Once the bleeding stops, there's is no need for gauze.

3. The surgical area will swell and sometimes have discoloration. This usually peaks on the 2nd or 3rd day post-operatively. Apply an ice pack to the outside of your face, alternating sides, about every 30 minutes as much as possible for the first 24 hours following your surgery.
4. Remember to have an adequate amount of food in your stomach before taking your pain pills. Do not take pain medication on an empty stomach. Allow food to digest, about 30 minutes before taking medication. You will be more comfortable if you take them on a regular schedule as directed by your doctor.

Food suggestions:

• Oatmeal
• Eggs
• Mashed potatoes
• Refried beans
• Pasta
• any soft food that will create a good base for the pain pills

Oral Hygiene:

Brush your teeth as normally as possible and rinse very gently with warm, salt-water (1/2 tsp salt in glass of warm water) beginning the next day.

Other Complications:

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 Dr. VanHoose and Dr. Orzel's office if you have any questions.

Occasionally, patients may feel hard projections in the mouth with their tongues. They are not roots, rather the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. VanHoose and Dr.Orzel.

Remember your follow-up visit

INSTRUCTIONS FOR PATIENTS, IF YOU ENCOUNTER NAUSEA AND/OR VOMITING

1. DO NOT TAKE PAIN PILLS ON AN EMPTY STOMACH. You must have food in your stomach prior to taking pain pills.
2. STOP taking the pain pills.
3. Doctor can prescribe an additional medication to counteract nausea. Also, a different pain medication can be considered. Please contact our office (616) 891-1700 so that we can be aware of your needs.
4. Please be able to tell us if you have any allergies to anti-nausea medications such as Phenergan or Zofran. Also, have available the phone number of a pharmacy you would like us to contact.
5. Stop taking the pain pills
   • As soon as possible, use the anti-nausea medication that the doctor will prescribe.
   • When the nausea is under control, then take clear liquids (7-Up, Jello, GAtorade, All Sport, etc.)
   • Once the nausea is under control, use Extra-Strength Tylenol for pain.
   • Next, try eating soft foods (Cream of Wheat, oatmeal, yogurt, soup, cottage cheese, soft-cooked vegetables, etc.)
   • Only after nausea is controlled and you have food/liquid intake, you can try pain medication.
   • If pain meds cause further nausea, do not use them. Rather, use Extra Strength Tylenol per the package directions. Do not exceed the package recommended amount.
6. Please let us know of your situation and request a prescription for anti-nausea medication and/or an alternate pain medication.
7. Remember, pain pills have narcotics in them and narcotics frequently cause nausea. It is not an allergy, but a common side effect. Some people are very sensitive to this side effect and cannot tolerate some pain pills. We don't know which pain pills you will tolerate the best unless you are able to tell us from any prior experiences. Thank you for your attention to the above items.