Patient Instructions

• Have NOTHING TO EAT OR DRINK 6 hour before scheduled appointment.
• A RESPONSIBLE ADULT to DRIVE YOU HOME. An adult must remain with you at home for the rest of the day.
• DO NOT SMOKE 6 hours before scheduled appointment.
• DO NOT TAKE ANY ASPRIN PRODUCTS for at least 7 days before surgery. If you do not know if a product has aspirin in it, call us or your pharmacy before taking it.
• DO NOT WEAR EARRINGS OR TONGUE RINGS.
• Wear SHORT SLEEVE SHIRTS and LOOSE CLOTHING.
• Remove CONTACT LENSES before appointment.
• Call if you have DEVELOPED A COLD before surgery.
• Surgery appointments with general anesthesia or I.V. Sedation are scheduled very tightly. Please NOTIFY US OF CANCELLATION AS EARLY AS POSSIBLE.
• If you are under 18 years of age, you must have a parent bring you here. They will be expected to stay here during the entire procedure.
• Please take your blood pressure medication with a sip of water in the A.M.

1. Dressing
   • Keep the gauze that was placed over the surgical site for 30 minutes and then gently remove it. If there is still active bleeding, replace it with a fresh rolled up gauze and bite down gently but firmly for another 30-45 minutes. Please be sure that the gauze is placed over the surgical site and not just between the teeth. This helps a blood clot to form in the socket. Repeat every 30-45 minutes as necessary until bleeding is minimal. You may see blood tinged saliva for a day or two. This is normal and is no cause for alarm. If bleeding persists, see #6 below.
2. Diet
   • Please follow any dietary guidelines provided after treatment. You may eat as soon as you get home, being very careful if any area of the mouth is still numb. Do not chew on hard, sticky or chewy foods for a least 24 hours. Never chew on ice.
   • Do not suck on a straw for 5 DAYS!  Avoid hot and spicy foods, carbonated and alcoholic beverages. During the first few days after surgery, restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies. Try to maintain good nutrition, especially if you are a diabetic.
3. Medications
   • If any prescriptions were given, please have them filled promptly and take as directed. If no prescriptions were given and you are not allergic, you can take over the counter pain medication as directed by Dr. Erakat. Taking an anti-inflammatory medication before the local anesthesia wears off can help better manage discomfort. Nausea is not uncommon after surgery, anesthesia or strong pain medicines. Taking at least one cup of food or liquid prior to taking any prescribed pain medication (unless otherwise specified) may help avoid stomach upset. Antibiotics, if prescribed, should be taken to completion unless drug complications develop.
4. Swelling
   • Swelling is a normal part of healing and, if significant, tends to peak 2 days after surgery. If you were instructed to apply ice to your cheek, apply for 20 minutes with a 20 minute break and repeat for the first 48 hours only, but do not apply ice when sleeping. Propping yourself up with a few pillows for the first 2 nights may also help reduce facial swelling. Applying ice beyond the recommended time could delay normal healing. Do not apply ice if the swelling you have is due to an infection.
5. Hygiene
   • Do not brush your teeth or rinse your mouth for the first 12 hours. Carefully follow all guidelines provided by the doctor and their staff, and most importantly practice good oral hygiene. Afterward, you may brush the non-surgical area and also rinse your mouth with a salt water rinse 4 times a day for one week.
6. Bleeding
   • After some procedures, a certain amount of bleeding is normal. If bleeding persists in spite of following the above instructions, try the following: keep the head elevated and roll a moist tea bag in a piece of gauze. Place it over the socket and bite down gently, undisturbed, for 30-45 minutes. If bleeding persists, please call the office.
7. Smoking
   • Please refrain from smoking. It delays healing and causes irritation.
8. Dry Socket
   • Healing can be delayed if the blood clot filling the socket dissolves or is washed away, exposing the bone. This may lead to a constant deep or throbbing pain, which can be easily treated with a medicated dressing. “Dry Sockets” generally occur 3-5 days extraction. If you suspect you have a dry socket, call the office so that we can assist you.
9. Bone Spur
   • Occasionally after surgery small edges of bone may become exposed. Usually they are unattached. If these occur, please call the office in which you were seen and make an appointment for their simple removal.

• Immediately following surgery, maintain pressure on the surgical area by biting down on the provided gauze pad or roll until the bleeding stops. A certain amount of bleeding is to be expected following a surgical procedure. Placing the gauze pad over the area and biting firmly will help prevent excessive bleeding. Replace the gauze as necessary until the bleeding stops.
• For a few days following surgery, you may become dizzy when getting up. Sit up slowly, and give yourself a minute to adjust before getting up and walking.
• Avoid vigorous activities for three to four days after surgery. You may go back to your normal routine as tolerated.
• Please fill any prescriptions you have been given and take as directed. If you have been prescribed pain medication other than aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools, or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication. Antibiotics may be prescribed to help prevent infection. If you have been placed on antibiotics, take the medicine as directed.
• Swelling and stiffness are to be expected the first 24 hours after surgery. Swelling around the face, eyes, and surgical site is not uncommon and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the extraction site will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times.  You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed. After 36 hours the cold compress will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling.
• For 24-48 hours following your surgery, do not suck on a straw, drink from a bottle, rinse, spit, or smoke. Avoid hot and spicy foods, carbonated and alcoholic beverages.
• During the first few days after surgery, restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
• Do not rinse, spit, or brush your teeth on the day of surgery. Resume brushing the day after surgery, avoiding surgical sites with the toothbrush.
• After brushing, rinse gently with warm salt water (1/2 teaspoon of salt mixed with eight ounces of warm water). Start the salt water rinse the day after surgery and repeat 3 times a day for 7-10 days. This will help keep the surgical areas clean and will also help dissolve the sutures.
• Please do not use the irrigating syringe for the first five days. After five days, fill the syringe with warm salt water and flush out the socket. This will flush out any food or debris.
• If you are experiencing numbness of the lip, chin, or tongue, be aware that this is usually temporary in nature and normal feeling should return after a few days. Until then, please be cautious while eating and chewing in order to avoid accidentally biting your tongue, cheek or lip.
• A dry socket can develop when blood clot gets dislodged prematurely from the walls of the tooth socket. Symptoms of a dry socket include throbbing pain at the surgical site, the ear, chin, adjacent teeth, and/or jaw. These symptoms indicate a dry socket when they occur three to four days following surgery and do not respond to pain medication.
• Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

Wisdom Tooth Smoothie

• 2 bananas (or strawberries)
• 1 tsp. honey
• ice
• Orange juice
• Yogurt 6 oz size (regular or soy)
• Place ice in blender with bananas and set to crush
• Add honey, the yogurt (peach works nicely) and
• Orange juice for consistency. Blend till smooth.
• NO Straws Please.
• ENJOY!

Other foods you can shop for and enjoy: (use as a guide) Avoid foods that are too spicy or hot in temperature.
Select foods that do not require chewing for the first 3-5 days until you feel ready.

• Yogurt
• Ice Cream
• Cottage cheese
• Scramble or soft-boiled eggs
• Oatmeal-Cream of Wheat
• Mashed potatoes
• Soups and Broth
• Applesauce
• Puddings/jello
• Pasta well done
• Vegetables well cooked
• Filet of Flounder
• Meatloaf
• Any beverage non-carbonated, non-alcoholic and non-acidic
• Canned fruits and bananas

FOLLOW-UP CARE

If you have any questions about the instructions below, please call the office. IMPORTANT: If you Have Caller Block/Caller ID, be sure to turn it off before calling the service for a return call from Dr. Erakat.

1. Rest at home, keep quiet and generally take it easy for the first 72 hrs. following surgery. It is not necessary to stay in bed, however, it is important that you rest. Keep your head elevated with 1-2 extra pillows to help prevent swelling of the surgical site.
2. You may experience lightheadedness, dizziness, or sleepiness after surgery. DO NOT STAY ALONE. A responsible adult should stay with you 24 hrs. following surgery
3. Do not climb stairs or ladders without someone assisting you for the first 24 hours, ESPECIALLY IF YOU ARE TAKING PRESCRIPTION MEDICATION FOR PAIN.
4. Rinse your mouth very gently in the first 48 hours or you might tear stitches and impair healing.
   Rinse with ½ teaspoon salt in 8 oz. warm water after meals and before bed, until the stitches are removed.
5. Avoid all alcoholic beverages for the first 3 days following surgery and when taking medication for pain.
6. You may be eager to see the surgery site… PLEASE DO NOT PULL YOUR LIPS OR CHEEKS ASIDE, since this can tear stitches and delay healing.
7. Apply ice packs to the outside of your face against the surgical site, alternating for 20 minute intervals with 20 minutes of no ice applied. This should be done for the first 36 hrs.(except when sleeping) Moist heat will aid in healing after the 36 hrs.
8. Slight bleeding or spotting of the saliva is normal for the first 2 days, as is a slight elevation in temperature up to 101.0 degrees, taken orally. Please report any fever over 101.0 degrees.
9. DO NOT SMOKE!!! Smoking dries out the tissues and delays healing. Please consult the doctor prior to resuming smoking.
10. Following sedation anesthesia, you may not drive, operate machinery or attempt to cook for 24 hrs. Do not make any important decisions or sign any legal documents for 24 hrs. following sedation anesthesia.
11. Please continue to take prescribed medication as directed.
12. You may engage in normal activities (including exercise) after 1 week.

IMPLANT POST-OPERATIVE INSTRUCTIONS

You can expect to be uncomfortable the first day after surgery; the second day may be more uncomfortable with more swelling. The third day is generally better, with rapid improvement thereafter.

We are genuinely concerned with your well-being. Please report immediately any difficulty in breathing, excessive bleeding, persistent nausea or vomiting, any pain that is unusual. If you feel that your signs and symptoms warrant a doctor’s attention, and you have been unable to reach Dr. Erakat, go to the emergency room closest to you.

DIET

IMPORTANT: It is very important that you maintain a nutritious diet during the weeks of healing. The patient who maintains a good diet of soft foods generally feels better, has less discomfort and heals faster. Since you will be taking medication, it is very important that you eat to prevent nausea.

DIETARY RECOMMENDATIONS: Mildly “hot” chocolate along with cereal such as oatmeal or cream of wheat. Soft boiled or scrambled eggs, milk, toast and pastas are all excellent.

Soups along with broiled fish or stewed chicken will taste good to you. Baked potatoes, peas, asparagus, cooked carrots, cottage cheese, and baked apples will add to your diet. Soup alone is not enough.

Boost, Ensure, or Sustacal added to meals or as an in-between snack are good for added nutrition. Yogurt is excellent.

Foods containing tomatoes, onions, lemon juice, or spices of any kind will be irritating and should be avoided.

You may eat soft foods that do not irritate. You may chew if it is not too uncomfortable to do so.

Dietary Supplements of Vitamin C, D and Calcium are important.

EAT WELL AND YOU WILL FEEL WELL!!!!

NO STRAWS!