Pre & Post Sedation Instructions
Pain & Swelling-Related Questions
Pre & Post Sedation Instructions
Steps to a successful sedation/anaesthesia appointment:
1. Do not have any meals or solid food for 8 hours before your appointment.
2. Water only permitted up to 2 hours before your appointment.
3. If you are taking medications or you are diabetic, please ask for special rules.
4. Please empty your bladder before your appointment.
5. Wear loose, comfortable clothing with sleeves that can be rolled up easily.
6. Avoid smoking for at least 48 hours before surgery.
7. Remove fingernail polish to allow for oxygen monitoring.
8. Cough and colds can interfere with anesthesia. Please call if you (or your child) are sick in the days immediately preceding an appointment.
After your sedation/anesthesia appointment:
1. YOU MUST HAVE A RESPONSIBLE ADULT drive you to your appointment and back home and stay with you for the first few hours following your anesthetic appointment.
2. The medication give can remain in your system for up to 24 hours. You must not drive or operate any machinery for this period of time. It is not uncommon to feel sedated a few hours after your appointment.
3. Please do not drink alcohol for 24 hours before and following sedation/anesthetic appointment.
4. In order to aid your recovery, you should drink plenty of fluids. You may eat as soon as you are comfortable. Light easily digested foods (e.g. breads, pasta) are often best at first.
5. “Freezing” or numbness wears off in 2-4 hours. While frozen, avoid hot foods and hot beverages. Also, be careful not to bite your lip or tongue as this could cause injury.
6. If you or a family member has any concern regarding your level of consciousness after your appointment, call us or your family doctor. If it is after hours and you are unable to reach us, you can visit a hospital emergency department.
7. Pain medication can be taken as prescribed, but do not exceed the instructed dose. If you have any questions about your medication, please call us.
8. It is not unusual for the IV site to be tender for a short period of time afterwards. It is important to avoid heavy lifting or overuse of that arm for about 48 hours. You should keep the IV site clean and covered for 24 hours.
9. If you use a sleep apnea device (CPAP), please use it after your appointment.
How much pain is there after dental surgery?
Level and duration of pain depends on the complexity of the surgery, technique, and patient’s tolerance. Most patients experience two to three days of elevated pain, commonly managed with pain medications such as Tylenol 3 or Percocet. As pain gradually diminishes over the next two to three days, Ibuprofen (Advil) or Acetaminophen (Tylenol) can be used. After seven to ten days, most patients no longer have pain and may stop their medications.
Pain management following your surgery:
It is best to start pain medications while local anesthesia is still in effect. Take medications with plenty of water. For additional pain relief, the narcotic pain medication already prescribed (Percocet or Tylenol #3) may be supplemented with Ibuprofen (200-400 mg), or Tylenol, staggered every two hours.
Pain persisting even after initial dose of pain medications:
Once you take 2-3 continuous dosages of the pain medications, the pain generally subsides. If you do not feel too drowsy from on tablet of pain medication, you may take an additional half to one tablet. But please be cautious. Follow the prescriptions on the bottle and only increase dosage if pain is not relieved and you are not feeling too sleepy or drowsy. Most narcotic pain medications may be taken every 4-6 hours although it may be increased to one every 3-5 hours depending on your tolerance, weight, and clinical effect.
Nausea from pain medications:
If nausea develops, discontinue the narcotic pain medication and take only ibuprofen (Advil, two to three tablets). It is normal for discomfort to last up to five to seven days, gradually decreasing each day.
Increase in pain:
An increase in pain three to five days after surgery without swelling is most likely due to localized inflammation from inadequate oral rinses. Increase oral rinses aggressively every two to three hours. However an increase in pain with swelling may be a sign of developing infection. Continue your antibiotics and pain medications as prescribed, rinse with salt water every two hours, and call Dr. Rami El Sebai for more instructions.
What to expect after surgery:
Facial swelling is expected for more invasive dental procedures. These include deeply impacted wisdom teeth and bone and gum grafting procedures. Surgical swelling reaches its maximum in 36-48 hours after surgery. Most people feel great the day following surgery and then notice increase in swelling the following day. This is absolutely normal and there is no need to be alarmed. The swelling will gradually resolve over the next three to five days. No or minimal swelling is expected if the surgical procedure was performed in a conservative fashion. These include most extractions and dental implant procedures.
How to minimize swelling:
To minimize surgical swelling, apply ice to affected facial area for 24 hours. Use the ice pack provided with your instructions and packet. Place the ice bag over the face for 20 minutes on and 10 minutes off. The ice packs are reusable. Simply place it in your freezer for about 15-20 minutes and restart using it.
Swelling after 3-5 days after surgery:
If swelling develops three to five days after surgery, this is most likely due to infection. In this case, continue with prescribed antibiotics and call your dentist for instructions. Do not put ice or heat over the area.
Gum tissue swelling:
Your gum tissue around the surgical site may also be swollen for a few days. It is normal. It gradually resolves in 5-7 days after surgery. Make sure to continue rinsing and be gentle with your diet.
What to expect immediately after surgery:
Bleeding gradually diminishes in three to four hours after surgery and often stops completely in four to six hours. Occasionally, it may ooze until the next day. One hour after surgery, remove the gauze sponges that have been placed in your mouth. Replace with a clean gauze and bite or press down with pressure. Repeat every 30 to 45 minutes until bleeding stops.
Important instructions to stop the bleeding:
- Rest with your head elevated
- Do not spit. If there is any saliva / blood, gently wipe it with a tissue
- Bite down firmly on the gauze
- Do not use straw to drink- Simply sip from a glass
- Do not smoke
When to stop using gauze?
As bleeding decreases, the gauze will be less and less red and saturated with blood. Eventually become pink and then only small amounts of blood is visible when you change it. Keep using the gauze until all the bleeding has stopped. When the gauze is completely white 30 minutes after changing (no blood on it) then you can stop using them. Gauze may be used cautiously during sleep.
Bleeding persisting beyond 6-8 hours:
If there is continued bleeding after six to eight hours, continue using the gauze directly over the extraction socket and bite down firmly and hold for 30 minutes. Sit upright and remain quiet. Repeat every 30 to 45 minutes as necessary. If bleeding continues, dip a caffeinated tea bag in cold water and place directly over the extraction site. Avoid spitting or using straws as that causes bleeding by creating suction in the mouth. If you are still unable to control the bleeding, call us.
Bleeding continuing 1-2 days after surgery:
Rarely, small amount of blood oozing may continue day or two after surgery. This may occur if you have taken Aspirin or perhaps blood thinning medications. Continue with gauze and firm pressure as instructed. Avoid rinsing until the bleeding completely stops.
Key dietary recommendations following surgery:
As soon as you get home, you can start liquids or a very soft diet. Drink plenty of fluids such as orange or tomato juice, ginger ale, water, tea, etc. Drink at least six to eight glasses of liquids daily to avoid dehydration. Soups, yogurt, mashed potato, eggs, and puree foods are great for immediately following surgery. Avoid hot liquids or food for the first 24 hours.
Diet in the next 2-3 days:
Continue on soft / liquid diet only. A diet high in protein and carbohydrates is best. We also recommend soups, soft pasta, soft rice, Jello, soft boiled eggs, yogurt, soft cereals, and mashed potatoes. Avoid hard or crispy foods at this time.
Diet 5-7 days after surgery:
Don’t change your diet yet. Many people make the mistake of starting harder food, which can cause irritation and pain. Continue on the same diet and consistency
Diet after 7 days:
You might be ready to gradually advance to a more normal diet but only if you feel comfortable. Advance slowly over the next few days as the surgical site continues to heal and is less tender. It is still too early for really hard foods like bagels, meats, chicken, or pizza. You should be able to try your regular diet in 10-14 days after surgery.