Dr. Johnson's Patient Instructions

Anesthesia Pre-Operative Instructions

IV Sedation and General Anesthesia

• Please check in 20 minutes prior to your scheduled procedure.
• A responsible adult is required to attend your appointment with you to either drive you home or accompany you in a ride service (patients under 18 years old must be accompanied by parent or legal guardian).
• You must not have anything to eat or drink for 8 hours prior to your procedure, except for water, which you may have until 2 hours prior to your procedure. If needed to take approved medication prior to your surgery, a small (2 oz or less) sip of water may be allowed.
• Please wear a short-sleeved shirt as a base layer in order to allow for comfortable IV placement.
• Please refrain from using marijuana for more than 7 days prior to your sedation.
• Please remove nail polish or acrylic nails from your right index finger.

Parking

On the day of surgery, please park in the surface lot at the front of the building as close to the first-floor entrance as possible.

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Oral Surgery Medication Instructions

Please make sure you have ibuprofen (Advil) and acetaminophen (Extra Strength Tylenol) at home prior to your procedure. It is best to start these medications when you get home after surgery before the local anesthesia wears off. If needed, your antibiotic and narcotic pain prescriptions will be available on the day of your procedure.

Antibiotics

• Amoxicillin - Start after the procedure. Take 1 pill 3 times daily until gone. Take with food to avoid nausea.
• Clindamycin (if allergic to penicillin or amoxicillin) - Start after the procedure. Take 1 pill 3 times daily until gone.

Pain Medication

• Ibuprofen (common brand name: Advil) - Start after the procedure. Take 600 mg every 6 hours for pain.
• Acetaminophen (common brand name: Extra Strength Tylenol) - Start after the procedure. Take 1,000 mg every 6 hours as needed for pain.
• Hydrocodone/Acetaminophen (common brand name: Norco) - Start if ibuprofen and acetaminophen are not adequately controlling your pain. Discontinue use once pain is manageable with ibuprofen and/or acetaminophen.
• Norco has both hydrocodone, which is an opioid narcotic, and acetaminophen (Tylenol). Do not exceed 4,000 mg of Tylenol in 24 hours, do not operate machinery or drive, and do not mix with alcohol.
• Unused medications can be returned at any Walgreens location and most other pharmacies.

How to Take Your Pain Medications

• Advil and Tylenol can each be taken every 6 hours, but they work best if you stagger the medications every 3 hours (if you start Advil at 9am, then take Tylenol at 12pm, and Advil again at 3pm, etc.).
• Take Advil and Tylenol consistently for the first 3 days for best pain management and to limit swelling. After 3 days, you can take Advil and Tylenol as needed. It is better to stay ahead of pain with regular use of medication than to allow the pain to increase and then have to treat it with medication.
• It is best to start Advil or Tylenol as soon as you get home after surgery before the local anesthesia wears off.
• If taking Advil and Tylenol does not adequately control your pain, stop taking the Tylenol and replace it with Norco (which has both hydrocodone and Tylenol) until your pain is better controlled. Then stop taking the Norco and restart Tylenol.

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Oral Surgery Post-Operative Instructions

Bleeding

Minor bleeding or blood-tinged saliva may occur for the first 24-48 hours following surgery. Keep gauze packs in place over the surgical site or sites using firm pressure for the first 30-45 minutes. Remove gauze after 30-45 minutes if the surgical site is not actively bleeding.

• Do not replace gauze if there is only slight oozing. If heavy bleeding still occurs, replace it with new gauze and bite firmly for an additional 30 minutes. If heavy bleeding continues, place a dry black or green tea bag on the extraction site for 30-45 minutes; the tannins promote blood clotting.
• Do not smoke for 10 days.
• Do not drink through a straw or suck on candy for one week.
• Exercise should be minimal in the first 3 days after surgery to avoid increasing blood pressure. Try to avoid vigorous activity or heavy lifting.

Swelling

Swelling is the body's normal response to surgery and the beginning of the healing process. It will vary among patients and procedures. Swelling will increase over the first 48 hours and subside over the next 5-7 days.

• Apply ice packs for 20 minutes on and 20 minutes off for the first 24-48 hours.
• For bruising, switch to warm moist heat for 20 minutes on and 20 minutes off starting after the first 48 hours.
• Keep your head elevated for 72 hours. Use 2 pillows while sleeping.

Diet

You can eat as soon as you would like; a soft diet is recommended. Cool foods, iced beverages, smoothies, soup, and protein shakes are best. Protein is essential for wound healing.

• Avoid hot beverages until the numbness wears off.
• Avoid dairy after the first few hours if you had IV sedation or general anesthesia.
• Avoid drinking carbonated drinks, alcohol, and mouthwash (Listerine).

Rinsing

You may begin gentle salt-water rinses the next morning and will need to continue rinsing for 2 weeks.

• Rinse 3-5 times daily using 1/2 teaspoon of salt and a large glass of warm water.
• You can brush and floss as normal, keeping the areas as clean as possible and being gentle when brushing toward the back areas.
• Avoid excessive or hard spitting.

Sutures

If sutures are placed, they will dissolve without having to be removed within approximately 3-5 days after surgery. Do not be concerned if they loosen or come out on their own.

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