Commonly Asked Questions- English

How is pain handled after surgery?

We use the Pain Pack Protocol.  Go to painpack.co for reference.

Can I eat right after surgery and what can I eat?

    1. Yes, patients should eat right after surgery since they have been fasting.
    2. Patients will have gauze in their mouth to help keep the car ride home clean and soak up any residual bleeding after surgery.
      • Once the patient is ready to eat, take the absorbent gauze pads out of the mouth and leave them out.
        • Most patients are done bleeding before they leave the office or soon thereafter.
        • Extra absorbent gauze is given to take home and can be used if extra bleeding occurs.
    3. The best food to have immediately after surgery is soft-serve ice cream in a bowl, not a cone.  If ice cream is not an option, a good alternative is plain yogurt.
      • The patient is to spoon-feed the ice cream or yogurt into their mouth with small portions at a time.
      • DO NOT SIP THROUGH A STRAW. This could cause the removal of the blood clot that is forming at the surgical sites.
    4. Take the first dose of pain medicine soon after eating.

What can I eat the subsequent days after surgery?

    1. Swallowable food diet for 3 days.
      • Some ideas of swallowable foods are Ensure or Boost, Lipton chicken noodle soup, Jello, pudding, yogurt, ice cream, smoothies, mash potatoes, soups that are blenderized, cottage cheese, or any food item that has gone through a blender.
    2. On the 4th day, the patient can start chewing soft foods.
      • The patient will need to cut the soft food into small pieces.  Those small pieces of food will need to be chewed in the front of the mouth and every effort is taken to avoid chewing food over the surgical sites.
    3. Once the surgery area is no longer sore, the patient can start advancing the diet to more solid foods and chewing on their back teeth.
      • It may take up to a week after surgery or longer to comfortably chew on the back molars without pain.

How long will cheek swelling last?

    1. The average swelling time is 4 days.  This is an average.  Half will have swell less than 4 days and a half will swell more than 4 days.
      • It is not unusual to have swelling for up to a week after surgery but it is also not unusual to have no swelling at all.
    2. Sometimes swelling can be un-proportional with more swelling on one side over the other.  This does not mean that there is something wrong.
    3. Icing the face in the first 24 hours helps in reducing swelling.

How long will jaw stiffness last?

    1. Jaw stiffness usually lasts 48 hours and then goes away.
    2. It is not helpful to force the jaw open during that 48 hours.
    3. Because of jaw stiffness, you will be on a swallowable diet until you can open your mouth comfortably.

How do I keep the surgery area clean?

    1. The patient should not brush the surgery area with a toothbrush.  Brushing the surgery area will hurt, make the area bleed, and may disrupt stitches.
    2. The patient should be diligent in brushing their teeth and tongue after each major meal to make sure no food is left behind for the oral bacteria to grow in numbers.
    3. It is up to the mouth rinsing to keep the surgery area clean
      • The patient will be given a prescription mouth rinse that will be used first thing in the morning and the last thing at night.  This mouth rinse will kill a lot of the oral bacteria to help aid healing.
        • The prescription mouth rinse can be used for up to 2 weeks after surgery but at a minimum, it should be used for at least a week.
        • The prescription mouth rinse is called Peridex or Chlorhexidine.
        • The directions are to swish for 30 seconds 1/2 oz. when you wake up in the morning and 1/2 oz. before bedtime.  Do not swallow the mouth rinse.
          1. 10 minutes after rinsing with the Peridex, it is advised to brush your teeth and tongue with toothpaste.  It has been known to stain the teeth and tongue a shade of brown if you do not do this.
        • During the day time, the patient needs to mouth rinse with salt water as often as possible. Mouth rinsing needs to occur after breakfast, lunch, dinner, snacking, and whenever you feel like it.
          • Rinsing with salt water will make the mouth feel better and help it heal faster.
          • Salt Water Mouth Rinse Mixing Directions.
            1. 1/2 teaspoon of salt to a cup of water.
            2. Swish the saltwater around the mouth for 15 seconds and then spit it out.  Do not swallow the saltwater
          • For convenience, most patients make a large quantity of saltwater and put it in a sports bottle with a stopper on top.  This way they can re-mix the settled salt by shaking the sports bottle.

How do I use the irrigation syringe that was given after surgery?

    1. 3 days after surgery the irrigation syringe can be used to clean the surgery site.  The syringe should not be used any earlier.
    2. The irrigation syringe is only used where the bottom wisdom teeth were removed.
      • The top wisdom teeth have gravity in its favor that helps pull the food out of the extraction sockets, unlike the bottom wisdom teeth.
    3. It is suggested that a parent or friend help irrigate the surgical site for the first couple of times since it is hard to see.
      • It is helpful to use a flashlight or the light on your smartphone to see the extraction sites better.
      • It is helpful for the patient to open the mouth wide and to use his/her index finger to hold their cheek out of the way for better visualization.
    4. Every night after the 3rd-day post-surgery, the bottom surgical sites need to be water-washed with the irrigating syringe and evaluated for possible food entrapment.
    5. If a hole is present, where food could accumulate, the tip of the irrigating syringe needs to be placed in the hole, past the gum tissue, with gentle force, water from the syringe is pushed into the hole.  This pressure will float out any food that may have found its way into the healing extraction socket.
      • If food is not irrigated out, it will eventually turn into an infection that may require the Doctor to open the surgical site to flush the trapped food out.

When can I get back to normal activities after surgery?

    1. It is advised to take it easy for the first 24 hours.
    2. It is advised to avoid heavy lifting or sports activities for the first 48 hours.
    3. Patients can go back to school and work as soon as they are feeling up to it.
    4. Patients can take Ibuprofen and/or Tylenol while at school and work but a narcotic is not advised since it can alter the judgment and make you drowsy.
      • If you need a narcotic for pain management, it is best to stay home until you can transfer over to the over-the-counter type of pain management during school and work time.

When will my stitches go away?

    1. The type of stitches placed is the type that rapidly dissolves away and generally does not need to be removed.
    2. The longevity of the stitches varies for everyone.  On average, the stitches last 5 days before dissolving away.
    3. At first, the stitches may seem to poke into the cheek but after 24 hours, the stitches will soften and be less noticeable.

What do I need to do before surgery?

    1. The patient cannot have any food or water 5 hours prior to surgery.
      • Exceptions are for diabetics and those that take morning medications that cannot be skipped.
        • This will need to be discussed with the Doctor or his staff 48 hours before surgery for special instructions.
      • If your surgery is from 8:00 AM to 12:00 PM stop eating food or drinking water after midnight the night prior to surgery. No food can be eaten or water drank before surgery.
      • If your surgery is from 1:00 PM to 3:00 PM you can have breakfast but it needs to be eaten before 8:00 AM.  No food can be eaten or water drank after 8:00 AM before surgery.
    2. If the patient takes blood thinners, they will need to be discontinued prior to surgery
      • If the patient is on a prescribed blood thinner, please call the office for special instructions at least 4 days before surgery.
    3. It is advised to brush the teeth and tongue with toothpaste before surgery.
    4. Choose comfortable clothing you can go home after surgery and lounge in.
    5. Short sleeves or a long sleeve shirt, that can be rolled up, is best.
    6. Makeup is not advised.
    7. Tongue and lip jewelry will need to be removed before surgery.
    8. The patient cannot drive home after surgery and will need a responsible adult driver.
      • Since the patient will be drowsy and may have altered judgment the patient will need a responsible and capable adult that can help escort the patient out of the office and take care of them for the drive home.
      • It is advised to engage the child door locks in your car for safety.