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FIRST HOUR

PAIN MEDICATION – If instructed by your surgeon, you should take over-the-counter Motrin or Advil, 2 or 3 tablets
every 6 hours continuously for the first two days. Take the first dose before the local anesthesia has worn off. You may
use the prescription medication on top of and in-addition-to the Motrin/Advil tablets as needed.

PROTECTING THE BLOOD CLOT – Do not rinse, smoke, or drink with a straw for at least 48 hours after your
surgery. If you have been prescribed an antibiotic mouthwash, you may begin to rinse gently tomorrow morning.

THE CHEMICALS IN CIGARETTES ARE CAUSTIC AND WILL SIGNIFICANTLY DELAY HEALING, INCREASE
POST-OPERATIVE PAIN, RISK OF INFECTION AND DRY SOCKET.

GAUZE PRESSURE —Bite down firmly on the gauze packs that have been placed over the surgical areas, make
sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is heavy. After 30 minutes,
place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be
changed as necessary (typically every 20 to 30 minutes). It is best to slightly moisten the gauze with tap water and
loosely fluff for more comfortable positioning.

ICE PACKS – Swelling is often associated with oral surgery. Swelling can be minimized by using cold packs, or a bag
of frozen peas applied firmly to the cheek nearest to the surgical area. This should be applied fifteen minutes on and
fifteen minutes off during the first 3 hours after surgery. DO NOT USE ANY ICE AFTER THE FIRST 24 HOURS.
If you have been prescribed medicine to minimize swelling, be sure to take it as directed. You should take the first
group of pills at bedtime tonight.

DAY OF SURGERY

PERSISTENT BLEEDING – Mild bleeding or oozing is normal during the first 24 hours. If necessary reposition the
gauze packs directly over the surgical site. If bleeding persists or becomes heavy you may substitute a tea bag
(soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains
uncontrolled after a full hour of using the tea bags, call our office. Place an old towel over your pillow, as one drop of
blood will turn a mouth full of saliva red.

MOUTH OPENING EXERCISES – Jaw stiffness is common following oral surgery. You can reduce this stiffness by
stretching your mouth open with two fingers each hour.

MANAGING POST-OPERATIVE PAIN – Unfortunately, most oral surgery is accompanied by some degree of
discomfort and you may be given a prescription for pain medication. To best manage your discomfort, you should take
the first pill before the numbness has worn off. If you find you are taking large amounts of pain medicine at frequent
intervals, please call our office. You must call for a refill during normal weekday business hours, if you anticipate
needing more pain medication for the weekend.

NAUSEA —Nausea is not uncommon after anesthesia or surgery. It generally improves within 4-6 hours. Nausea
following anesthesia is best managed by avoiding all foods until you are feeling hungry. Try sipping small amounts of
clear liquids to prevent dehydration.

If the pain medication is the cause, try taking Maalox immediately before the medication and drink plenty of water. Try
to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca
Cola may also help with nausea.

POST-OPERATIVE DAY #2 AND BEYOND

ORAL HYGIENE – Keeping your mouth clean after surgery is essential. In addition to any prescription mouth washes
you may have been given, use 1 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 three
times a day. Avoid commercial mouthwashes, the alcohol they contain may irritate the surgical site. Avoid brushing the
surgical area for at least two weeks. However, we do encourage you to brush and floss all other areas.

HEALING – Normal healing after tooth extraction should be as follows: The first three days after surgery are generally
the most uncomfortable and there is usually some swelling. On the 4th day you should be more comfortable and,
although still swollen, can usually begin a more normal diet. The remainder of the post-operative course should be a
gradual, steady improvement. If you do not see continued improvement, please call our office.

DRY SOCKET – A dry socket is a painful condition that results from premature loss of the blood clot. Risk factors for
developing a dry socket are extracting painful or infected teeth, wisdom tooth surgery, females, smokers, and women
taking oral contraceptives. Symptoms of a dry socket typically occur on the 3rd or 4th post-operative day. Severe
throbbing pain, which is not responsive to pain medications and bad breath are the usual complaints. This condition
requires an office visit where your surgeon will gently place a medicated dressing into the tooth socket. Pain relief if
often immediate once the site is treated. A few visits are often necessary.

SHARP EDGES – If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the
bony walls which once supported the extracted teeth or the ends of the sutures. Occasionally small slivers of bone
may work themselves out during the following weeks. This is normal but if they cause concern or discomfort, please
call the office.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you,
but if you have questions about your progress, please call the office. Calling during office hours will result in a faster
response to your question or concern. A 24 hour live operator answering service is available to contact the doctor in
case of true after-hour emergencies. PLEASE NOTE: Telephone calls for renewing narcotic (pain killer) prescriptions
should be made during regular office hours.