Your Guide to Surgical Instructions
from the Center for Oral Surgery + Dental Implants
To ensure the best possible outcome for your procedure, preparation and follow-up care are essential. On this page, you’ll find information on anesthesia preparation, as well as general post-operative surgical instructions. These are best-practice approaches to the care you will require for a comfortable, efficient recovery—but remember, these are general recommendations. Before your surgery, our team will also provide instructions specific to you and your upcoming procedure.
If you have questions about pre- or post-operative care, please reach out to our team.
Pre-Operative Instructions for Anesthesia
Proper preparation is vital for ensuring your safety and comfort when receiving IV sedation or general anesthesia. Please follow these instructions strictly.
Smoking: No smoking for at least 12 hours before surgery. Ideally, cut down or stop as soon as possible. Plan nicotine replacement after surgery with patches as directed by your surgeon.
Marijuana: No use for 24 hours prior to procedure. You may be asked to refrain entirely or substitute edibles for smoking or vaping for a period of time after surgery
Before Intravenous (IV) Anesthesia Sedation
Eating/Drinking: You may not eat or drink (including water) for 8 hours before the appointment. It is usually ok to take medication with a small sip of water, but ask your doctor first.
Companionship: A responsible adult must accompany you to the office, remain in the office during the procedure, and drive you home.
Activity Restriction: You should not drive a vehicle or operate any machinery for 24 hours following anesthesia.
Clothing/Jewelry: Please wear loose-fitting clothing with sleeves that can be rolled up past the elbow, and closed-toed, low-heeled shoes. Contact lenses, jewelry, and dentures must be removed.
Illness/Medication: If you have an illness (cold, sore throat, upset stomach), notify the office. If you take routine oral medications, check with the office before your surgical date for specific instructions.
Before Oral Conscious Sedation
If your doctor has prescribed you relaxation medication to take at home before surgery, and the anesthesia plan otherwise calls for local anesthesia only or local numbing with laughing gas/nitrous oxide (Oral Conscious Sedation without IV Anesthesia):
Eating/Drinking: Is ok before your surgery.
Driver/Escort: A responsible adult must drive you to and from the office. You should not drive or do activities where you could get hurt for 8-10 hours or longer until all the after-effects of the medication have worn off.
Clothing/Jewelry: Please wear loose-fitting clothing with sleeves that can be rolled up past the elbow, and closed-toed, low-heeled shoes. Contact lenses, jewelry, and dentures must be removed.
Illness/Medication: If you have an illness (cold, sore throat, upset stomach), notify the office. If you take routine oral medications, check with the office before your surgical date for specific instructions.
Before Local Anesthesia
With local anesthesia (numbing only), no special preparation is needed, and there are no food, drink, or driving restrictions.
Before Nitrous Oxide
Nitrous oxide (laughing gas) is available upon request. There are no food, drink, or driving restrictions that apply.
Oral Pre-Medication
When you take a medication to help you relax prior to your procedure, please make sure to have a driver accompany you to your appointment. You should eat a small meal before your appointment and bring headphones if you would like to listen to music during your procedure.
When to Call Our Office
Please discuss any concerns you have regarding the type of anesthesia during your consultation. If you experience unexpected reactions or problems related to sedation after your procedure, please call us immediately.
General Post-Operative Instructions
Our goal is to make your recovery as smooth and pleasant as possible. The following general instructions apply to most oral surgery procedures. It is critical to follow any specific instructions your surgeon provides for your unique case. Recovery time varies, but following these steps will significantly improve your healing process.
Bleeding Control
It is normal to have some bleeding for several hours after surgery.
Gauze: Bite firmly on rolled, moistened gauze for at least 30 minutes at a time. Only repeat this procedure if you continue to have bright red bleeding or blood collecting around the surgery area.
Protection: Do not lie down or go to sleep with gauze in your mouth. You may wish to use an old towel over your pillowcase. Sleeping with your head elevated above your heart for 24-48 hours can help lessen bleeding and swelling.
Prohibited Actions: You must not rinse, spit, or use a straw for 24 hours after your surgery. These actions can dislodge the crucial blood clot, leading to increased bleeding or complications (e.g., dry socket).
Duration: You may notice some oozing or minor bleeding for a few days after surgery when you wake up or brush your teeth; this is normal and will diminish daily.
Activity and Anesthesia Recovery
IV Anesthesia: If you received intravenous anesthesia, go directly home after your surgery and rest for the remainder of the day and evening. Do not operate a motorized vehicle, work, operate machinery, or make any legal decisions until 24 hours after I.V. anesthesia.
Assistance: Have a responsible adult remain with you for the first few hours at home and assist you with getting up and walking.
Resuming Activity: Your activity 24 hours after surgery can be as tolerated. For wisdom teeth or complex procedures, you may need up to 5 days to resume regular activity.
Pain Medication Protocols
Start your over-the-counter or prescribed pain medication while you are still numb from the local anesthesia to prevent pain from setting in.
Ibuprofen (Motrin/Advil): Take the prescribed dose (often 600mg or 800mg) every 6–8 hours. This is the first line of defense for pain and swelling.
Tylenol (Acetaminophen): Take the recommended dose (often 1 or 2 Regular 325mg or Extra Strength 500mg) every 6–8 hours. Tylenol may be taken along with Ibuprofen, or staggered 3–4 hours later.
Narcotics (If Prescribed): Use only for severe pain not managed by non-narcotics combined with good local care. You must limit all activity (no driving, exercise, water activities) while taking the drug due to side effects (drowsiness, dizziness, nausea). Reduce use or switch to a clear liquid diet if these symptoms occur, and call our office if they do not improve.
Difficulty Swallowing Meds: If you have difficulty swallowing, you may use liquid medications. In some cases (when directed by your surgeon or pharmacist), you may crush tablets or open capsules and mix them with liquid, applesauce, or Jell-O.
Antibiotics: Take antibiotics only if prescribed. Discontinue use and call our office immediately if you experience allergic reactions, such as hives.
Swelling and Stiffness Management
Ice Packs (Day 1): Apply ice packs to the cheek near the surgical site continuously for the first 36 hours only, using a 20-minute-on, 20-minute-off schedule.
Moist Heat (Days 2 & 3): Transition to moist heat applied to swollen areas (20 minutes on, 20 minutes off) to loosen muscles. Use a warm, damp cloth (check temperature first).
Duration: Swelling typically begins to improve around 3-4 days after surgery, but may take several days to resolve fully.
Jaw Stiffness: Soreness and stiffness are common. Begin slowly stretching and moving your jaw, neck, and shoulder muscles in the hours after surgery. Gradually resume your regular diet within three to four days or as directed to help exercise the jaw muscles. Use moist heat and gentle massage. If stiff muscles are not improving after 4-5 days, please call our office.
Liquids and Food Progression
Avoid chewing near the surgical area. If it hurts to chew something, it’s too complicated and should be avoided.
1–6 Hours Post-Surgery: Start a cool liquid diet as tolerated (water, juice without pulp, iced tea, Gatorade). Avoid hot beverages and chewing. Jell-O, applesauce, milkshakes, pudding, and ice cream are acceptable (no chunks/hard pieces). Do not use a straw.
Day of Surgery (After Numbing Wears Off): Add foods that do not require chewing, such as scrambled eggs, mashed potatoes, pasta, broth soups, and cooked cereals. Foods should be warm, not hot.
1st & 2nd Full Days: A soft, chewable diet is permitted. Choose foods that can be easily swallowed after chewing only once or twice. Increase diet as tolerated thereafter.
Oral Hygiene
A clean surgical site heals better and faster.
Brushing: Continue brushing your teeth as best as possible, beginning once the numbness from your surgery has resolved.
Rinsing + Flushing: Do not rinse for the first 24 hours. Starting 24 hours after surgery, rinse with the prescribed mouth rinse (if given) or a saltwater rinse (1 teaspoon of salt in 1 cup of warm water). If provided, use the syringe to gently insert the tip directly into the socket and gently flush. Use 3 times daily until the socket is completely healed (about one month).
Electric toothbrushes and Waterpicks (oral irrigation tools) are often too aggressive for use around a new surgical site. Turn off these devices 1-2 teeth away from the area of surgery until your surgeon says it’s ok to resume your usual routine. This is especially true around bone grafts and new dental implants. Do not use a Waterpik near a fresh graft or implant until instructed to do so by your surgeon.
Healing Notes and Restrictions
Stitches: Stitches will soften, break, and come out on their own within five to ten days. Early loss is usually not a concern unless increased bleeding occurs.
Sinus Precautions (Upper Teeth): If upper teeth were removed with a sinus exposure, avoid nose blowing for three to seven days. Some slight nose bleeding may occur.
Smoking/Alcohol: Do not smoke for one week. Alcoholic beverages are not permitted within 24 hours of I.V. anesthesia or while using prescription pain medication.
Sensitivity: Temporary hot/cold sensitivity in adjacent teeth is common and usually disappears after several weeks.
When to Call Our Office
Please call us right away if you experience any of the following:
Heavy bleeding that persists despite firm pressure.
Severe pain that is not relieved by prescribed medication, or pain that increases after two to three days.
Swelling that is not improving after 3-4 days, or continued elevation of temperature after 48 hours.
A reaction to the prescribed medication.