Surgical Instructions

Section 1: Before IV Anesthesia / Sedation

Download Printable Instructions (PDF)

Before Surgery

• Do not eat or drink anything after midnight the day of surgery (minimum 8 hrs unless told otherwise). This is essential for your safety under anesthesia.
• A responsible adult must stay in the office during your surgery, drive you home, and care for you the rest of the day
• Wear a short-sleeved shirt for monitor placement, plus comfortable clothes and shoes
• Do not wear contact lenses, facial makeup, nail polish, or jewelry
• Avoid smoking/vaping for at least two days before surgery. Cannabis should be avoided for at least 72 hours, and other illicit drugs 7 days prior to sedation.
• Call us if you start any new medications, or if you develop a cold, flu, chest congestion, or fever, we may need to reschedule. Other medications taken in the morning on a normal basis should be confirmed with your surgeon before your procedure.
• If you take morning blood pressure medication, take it the day of surgery with a small sip of water
• Cell phones are not permitted in the surgical operatory

Section 2: After Surgery — Care Instructions (All Patients)

Download Printable Instructions (PDF): “Post-Op — General Oral Surgery” and “Post-Op — Implants & Bone Grafting”

Bleeding

• Place a folded gauze compress directly over the surgical site and bite with moderate pressure. Replace the gauze every 20–30 minutes for 1–2 hours, then remove it. Do not leave gauze in place all day.
• A red tinge to the gauze or slow oozing is normal — for the first 12–24 hours it is common to have slow oozing and a red tinge in your saliva.
• Stay upright until bleeding has slowed. Bleeding can take longer to stop if you take blood thinners.
• If bleeding restarts, you may replace the gauze and hold sustained pressure for at least 20 minutes. If it does not stop and you have concerns please call our office.

Hygiene — After Extractions & General Oral Surgery

• Avoid rinsing rigorously or forcefully spitting for 48 hours. Resume brushing the day after surgery, but avoid the surgical sites for the first 3–5 days.
• After 48 hours, rinse with a 50/50 mixture of water and Peridex/Periogard after every meal and at bedtime for 7 days (warm salt water if no prescription was provided).
• If a syringe was provided: after 48 hours, gently flush lower surgical sites after meals and at bedtime with the 50/50 mixture until no food or debris remains. Do not use the syringe if bone graft material was placed. Do this until sites are completely closed.
• Avoid smoking, vaping, spitting, and straws for 7 days to prevent dry socket.

Hygiene — After Implant & Bone Grafting Surgery

• Begin gently rinsing the day of surgery with ½ oz Periogard/Peridex mixed with ½ oz water. For the first 48 hours don’t swish, hold the liquid in your mouth, tilt your head side to side, and let it fall into the sink. Rinse 4 times daily for 10 days.
• Brushing can resume immediately, but avoid the surgical sites, abutments, and adjacent teeth. Gentle brushing of the abutment(s) and surgical site can resume after 5–7 days.

Diet & Fluids

• Nutrition matters for healing, keep your calorie intake up with protein shakes, smoothies, or instant breakfast drinks (Ensure/Boost).
• Soft, room-temperature foods are best: anything soft enough to push through with a fork (Jello, yogurt, ice cream, applesauce, eggs, pasta, well-cooked vegetables, cool soup). Avoid hot, sharp, crunchy, or spicy foods and anything with grains or nuts that can lodge in surgical sites.
• As pain resolves over 3–5 days, advance your diet slowly — if a food causes pain, set it aside for a few days.
• Start fluids right away (remove gauze first); adults should drink 2–3 quarts daily, especially after IV sedation. No alcohol while taking prescription medication, and no straws or carbonated drinks for at least 48 hours.

Swelling, Bruising & Rest

• Swelling is expected and typically peaks 48–72 hours after surgery; bruising can appear in the same window and may extend to the face, chin, neck, or chest.
• Do not lie flat for 24 hours — sleep at 45 degrees in a recliner or with several pillows. Apply ice 20 minutes on / 20 minutes off for the first 24–48 hours, then switch to moist heat for muscle stiffness.
• Avoid rigorous activity for 2–3 days (5–7 days after more extensive procedures), then resume exercise gradually.
• Avoid swimming (pool or ocean) and submerging head under water for at least one week.

Sutures & Sinus Precautions

• Dissolving sutures fall out on their own within about a week; non-dissolving sutures are removed at an appointment in 1–2 weeks.
• If you were given sinus precautions, follow them strictly for two weeks: no nose blowing, forceful spitting, straws, smoking or vaping, swimming, heavy lifting, SCUBA, pressurized flights, or wind instruments — and always sneeze with your mouth open. A nasal decongestant may be prescribed.

Pain & Antibiotics

• Unless a medical condition or allergy prevents it, we generally recommend staggering ibuprofen and Tylenol around the clock for the first 48 hours (e.g., ibuprofen 600 mg at 8am/2pm/8pm/2am with Tylenol 500 mg at 11am/5pm/11pm/5am). Take a dose of ibuprofen before the numbness wears off.
• If a narcotic was prescribed, use it only as needed for severe pain, be mindful of side effects and do not drive while taking it. After 48 hours, use either medication as needed.
• If an antibiotic was prescribed and it upsets your stomach or causes a rash, it is OK to stop it as long as you continue the Periogard rinse, and please inform our office. If you miss a dose, simply continue with the next scheduled one.

Section 3: Additional Instructions — Implant & Bone Grafting Patients

Bone Graft Site

• It is normal to notice small granules of bone (like salt or sand) in your mouth for the first 1–2 days. It is also normal for stitches and a white sponge to come out 5–7 days after surgery, this is not the bone graft.

Denture, Partial, or Flipper (Prosthesis)

• A prosthesis can usually be worn if it does not interfere with the surgical site. The doctor will check it, relieve pressure points, and confirm whether it can be worn after surgery; it may need adjustments with your general dentist.
• If the prosthesis ever feels like it doesn’t fit properly or contacts an implant abutment, call our office or your general dentist.