Opening Hours : Mon - Thurs 8am-5pm and Fri 8am-3pm
  Contact : 843-762-9028

Surgical Instructions

Surgical Instructions

At Charleston Oral & Facial Surgery, we strive to provide the very best care in a healing and comfortable environment.
Our guide to surgery provides you with information about what to expect from the moment you schedule your surgery right up to the day of your procedure.

Pre-Op: Instructions

If you need to cancel your scheduled surgery time for any reason, please give our office a minimum of 24-hours notice. We appreciate your cooperation with this policy.

Please begin taking prescribed medications, if your doctor has given those to you, prior to your surgery date. Please arrive to your appointment 15 minutes early to allow time to read and sign necessary forms, make payments, and go over any final questions with the doctor and his staff.

A staff member will ask you at check in time if you would like a receipt mailed to you or handed to your driver. Please notify them of your decision.

Please wear comfortable, loose-fitting clothing. Tops/shirts should have sleeves that can be easily pulled up above the elbow. Females should remove nail polish before surgery and apply as little makeup as possible.

You will be given anesthesia for your surgery. The level of sedation for your procedure will depend on what you have decided with your doctor. Please follow these instructions exactly for your safety. If any questions arise, please do not hesitate to call our office.

LOCAL ANESTHESIA

Local anesthesia will be given to block pain pathways in a localized area. Local anesthesia can be administered without a driver present, and you may eat or drink whenever you like if you have chosen this form of anesthetic. This anesthetic may last for 2-4 hours depending on the patient and will create a “numbness” effect in the general area it was used in.

LOCAL ANESTHESIA WITH ORAL PREMEDICATION

A pill will be administered for relaxation prior to giving the local anesthesia. No driver needed and food or drink may be consumed at any time prior to surgery.

NITROUS OXIDE (Laughing Gas)

Helps to decrease uncomfortable sensations and offers some degree of relaxation before surgery. Local anesthesia will then be given after the relaxation effect has occurred.

INTRAVENOUS SEDATION

Medications are given through a vein in your arm or hand, which will cause total relaxation and, although you will not actually be unconscious, there will be very little recall (if any) of the events throughout the surgery. Local sedation will also be given to numb the site for surgery, so the effects will most commonly still be present even after IV sedation has worn off.

DO NOT eat or drink ANYTHING (including water) after midnight the night before your surgery. You may be instructed by our doctors to take your regular medications (high blood pressure, antibiotics, etc.) or any pre-medication prescription that we have provided, by taking only a SMALL sip of water the morning of your procedure.

You MUST have someone present during surgery that will be able to stay in our waiting room the entire length of your procedure, in case of an emergency. This person must also be able to DRIVE you home.

Plan to rest the remainder of the day. Do not operate a vehicle, power tools or machinery for 24 hours following surgery. Do not make any financial or legal decisions 24 hours following surgery.

We will require you to sign a consent form and make full payment arrangements before you are sedated.

Work and school excuses will be provided upon request. We are able to excuse you for up to three days, or the appropriate healing time. Please notify our staff if you need an excuse. We also ask that you refrain from strenuous physical activity for 5-7 days. Therefore, please notify our staff if you need a sports related excuse.

Our goal is to provide you with safe, pleasant and effective anesthetic. In order to do this, it is imperative that we have your full cooperation. Please feel free to call the office with any questions concerning your surgery or anesthetic.

General Post-Op Instructions

Sometimes the after effects of oral/facial surgery can be quite minimal, so not all of the following instructions will apply. It is important to remember that specific post-operative instructions will be given to you that pertain to your particular procedure. If you have any questions, call our office for clarification.

MEDICATION OVERVIEW

Oftentimes, pre-operative medications will be given depending on your particular procedure. They can include antibiotics, steroids, topical medicines, or supplements to aid in healing. Be sure to take them according to the instructions given to you by our surgeons or staff.

EXERCISE

Do not participate in strenuous physical activity/exercise for 5-7 days. Your doctor will advise you when it is safe to resume your exercise routine.

SMOKING

As with any surgical procedure, oral and facial surgery can be hindered by smoking or tobacco use. If you smoke or use tobacco, we ask that you refrain from its use for 5-7 days post-surgery as the agents can affect bleeding and healing significantly!

SWELLING

Swelling is often associated with oral/facial surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen vegetables wrapped in a towel and applied firmly to the check adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24 hours after surgery. If you notice swelling 3-5 days after surgery, you may apply warm compresses to the skin.

PAIN

Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the local anesthetic has worn off, you should be able to manage any discomfort better. Take your pain medication with food. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as acetaminophen or ibuprofen. Remember that the most severe pain usually occurs within six hours after the local anesthetic wears off. After this, your need for medication should lesson. If you find that you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medicine for the weekend, you must call for a refill during weekday business hours. By day three, you should notice more comfort and be able to decrease medication intake, although you still may be swollen.

DIET

Depending on your particular procedure, there may be diet limitations or restrictions such as a soft diet or low sodium diet. Please follow the instructions given to you based on the specific procedure.

WOUND CARE

You will be given specific instructions on how wound care and dressing changes as they apply to your procedure.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will greatly help you during your recovery, but if you have any questions about your progress, please call the office at 843-762-9014. Our answering service will contact the doctor for emergencies after hours.

Post-Operative Instructions: General Tooth Extraction

Sometimes the after effects of oral surgery can be quite minimal, so not all of the following instructions will apply. Specific post-operative instructions will be given to you that pertain to your procedure. If you have any questions about your progress, please call our office at 843-762-9028. Our answering service will contact the surgeon for emergencies after hours.

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. If bleeding is still occurring, then new gauze should be placed and held in place with firm biting pressure.  You may keep changing the gauze every 30 minutes for up to 2 hours, until the bleeding slows to a slight ooze or stops.The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3 to 4 hours, but a small amount of bleeding is common for up to 48 hours.
  • Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling typically peaks by the 4th or 5th day after surgery and then starts to resolve. If needed, for the first 24 hours after your procedure, apply an ice pack to your cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off. These measures will not eliminate swelling, but they will help to reduce its severity. It is normal for swelling or jaw stiffness to persist for several days after surgery.
  • To allow blood clots to form, do not eat for 2 hours after surgery. Start with clear liquids, such as apple juice, tea or broth. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours to room temperature. You should eat only soft food for the first 24 hours (soups, eggs, mashed potatoes, yogurt, etc.). You can eat normally as soon as you are comfortable. To help prevent dry socket, do not use a straw for the first 5-7 days after surgery.
  • Begin brushing your teeth the day after surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site will delay healing.
  • Do not smoke for at least a week. Smoking will increase your bleeding; the nicotine and tar in tobacco impairs healing and may cause a dry socket.
  • Do no vigorous physical activity for a minimum of four days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity, such as jogging or tennis 7 days after your surgery.
  • If placing a denture after surgery, it’s best to keep your new denture in place for the first 24-48 hours. This gives the tissue opportunity to heal into the shape of your denture, allowing for stability and minimal swelling. If this becomes uncomfortable or if you experience excessive bleeding, the denture can be removed for short periods of time – but should be reinserted as soon as tolerable. On the third day after surgery, the denture should be worn only during the day and left out through the night.  We recommend scheduling a follow up with your restorative dentist 3-5 days after surgery for any adjustments.

Medication Overview

  • Narcotic Pain Medication: To control discomfort, take your first dose of pain medication before the anesthetic has worn off or as recommended. Take one tablet every 4-6 hours or as directed with food to prevent nausea.
  • Antibiotic: If an antibiotic was prescribed, continue to take them for the indicated length of time, even if all symptoms are gone.
  • Ibuprofen: Rotate your narcotic pain medication with your ibuprofen prescription. Take one tablet as needed every 4 hours. If necessary, the ibuprofen can be taken with your narcotic.
  • Anti-Nausea (Zofran): To be taken as directed or with your narcotic pain medication to control nausea.

***DEA regulations do not allow providers to call in Schedule II narcotics such as Hydrocodone or Percocet. If you require additional narcotic pain medication, a post-operative appointment in the office will be required. There are no additional fees for post-operative visits.***

Post-Operative Instructions: Wisdom Tooth Removal

  • Discomfort up to 7 days is normal after the extraction of wisdom teeth.
  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. If bleeding is still occurring, then new gauze should be placed and held in place with firm biting pressure.  You may keep changing the gauze every 30 minutes, up to 2-3 hours, until the bleeding slows to a slight ooze or stops.The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3 to 4 hours, but a small amount of bleeding is common for up to 48 hours.
  • Begin salt-water rinses the day after surgery and continue for 1 week. Rinse with warm salt water gently 6 to 8 times each day. To make the salt-water solution, dissolve 1/2 teaspoon of salt in a small glass of warm water.
  • Swelling is normal after surgery and is a major cause of post-extraction discomfort. Pain and swelling typically peaks by the 4th or 5th day and then starts to resolve. For the first 24 hours after surgery, apply an ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Keep your head elevated on 2 pillows for 3 to 4 days. These measures will not eliminate swelling, but they will help to reduce its severity. It is normal for swelling or jaw stiffness to persist for several days after surgery.
  • To allow blood clots to form, do not eat for 2 hours after surgery. Start with clear liquids, such as apple juice, tea or broth. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours to room temperature. You should eat only soft food for the first week (soups, eggs, mashed potatoes, yogurt, etc.).  For 2 weeks (3-4 weeks if you had lower wisdom teeth extracted), do not eat hard, crunchy or very chewy foods (chips, popcorn, grits, etc.). To help prevent dry socket, do not use a straw for the first 5-7 days after surgery.
  • Begin brushing your teeth the day after surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site will delay healing. No swishing or spitting, even when brushing teeth. When rinsing mouth, move head from side to side and lean over sink to allow water to flow out (like drool).
  • Do not smoke for at least a week. Smoking will increase your bleeding; the nicotine and tar in tobacco impairs healing and may cause a dry socket.
  • Do no vigorous physical activity for a minimum of four days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity, such as jogging or tennis 7 days after your surgery.

Medication Overview

  • Narcotic Pain Medication: To control discomfort, take your first dose of pain medication before the anesthetic has worn off or as recommended. Take one tablet every 4-6 hours or as directed with food to prevent nausea.
  • Antibiotic: If an antibiotic was prescribed, continue to take them for the indicated length of time, even if all symptoms are gone.
  • Ibuprofen: Rotate your narcotic pain medication with your ibuprofen prescription. Take one tablet as needed every 4 hours. If necessary, the ibuprofen can be taken with your narcotic.
  • Anti-Nausea (Zofran): To be taken as directed or with your narcotic pain medication to control nausea.

***DEA regulations do not allow providers to call in Schedule II narcotics such as Hydrocodone or Percocet. If you require additional narcotic pain medication, a post-operative appointment in the office will be required. There are no additional fees for post-operative visits.***

Post-Operative Instructions: Dental Implants

Do NOT disturb the wound. Avoid spitting, or touching the wound for a few days after surgery. There may be a metal portion slightly protruding through the gum tissue.

Some bleeding or redness is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad paced directly on the bleeding wound for 30 minutes. If bleeding continues, please call the office for further instructions.

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours.

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids can be eaten on the day of surgery. You may return to a normal diet 1-2 days after surgery unless otherwise directed.

Warm salt water rinses can be made by mixing ½ teaspoon of salt in a cup of warm water and should be used at least 4-5 times a day, especially after meals.

Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.

Keep physical activities to a minimum for several days following surgery. Avoid bending over, heavy lifting or strain. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Medication Overview

  • Narcotic Pain Medication: To control discomfort, take your first dose of pain medication before the anesthetic has worn off or as recommended. Take one tablet every 4-6 hours or as directed with food to prevent nausea.
  • Antibiotic: If an antibiotic was prescribed, continue to take them for the indicated length of time, even if all symptoms are gone.
  • Ibuprofen: Rotate your narcotic pain medication with your ibuprofen prescription. Take one tablet as needed every 4 hours. If necessary, the ibuprofen can be taken with your narcotic.
  • Anti-Nausea (Zofran): To be taken as directed or with your narcotic pain medication to control nausea.

***DEA regulations do not allow providers to call in Schedule II narcotics such as Hydrocodone or Percocet. If you require additional narcotic pain medication, a post-operative appointment in the office will be required. There are no additional fees for post-operative visits.***

Post-Operative Instructions: Bone Grafting

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Be as gentle as you can around the bone grafting area. Avoid pressure at the graft site.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. Change the gauze pad every 30 minutes as needed. If excessive bleeding continues, please call for further instructions. (In general, use as little pressure as is needed.) Remove gauze when it is no longer needed.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or a plastic bag or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 24-36 hours. Swelling generally reaches a peak in 36-72 hours, and then subsides over the next three to five days. If swelling begins to increase after the third post-operative day, please contact your doctor immediately.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Keep all solid food away from the surgical site.

Pain

You should begin taking pain medication prior to the local anesthetic wearing off. For moderate pain, one or two Regular Strength Tylenol (325 mg) may be taken every six hours (no more than 2600 mg/24 hour period). Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 3-4 tablets may be taken every four to six hours as needed for pain (no more than 3200 mg/24 hour period). For severe pain, the prescribed medication should be taken as directed (please note if this prescription has Tylenol [APAP] in it, see the above comments). Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take it. This may include patients with liver or kidney disease.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection.

Oral Hygiene

Good oral hygiene is essential to good healing. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least four to five times a day, especially after meals. If you are given a prescription for Peridex Oral Rinse, rinse for 30 seconds and spit twice per day. Do not brush the two adjacent teeth on either side of the graft site for the first seven days. After seven days, you may gently brush the tooth surfaces of the adjacent teeth, as long as the bristles don’t disturb the graft site. You may floss normally, starting the day of surgery, if comfortable.

Activity

Keep physical activities to a minimum immediately following surgery. If you are exercising, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures should not be used immediately after surgery. You may wear these prostheses as soon as it is comfortable, but only if the prosthesis doesn’t touch the graft site.

Medication Overview

  • Narcotic Pain Medication: To control discomfort, take your first dose of pain medication before the anesthetic has worn off or as recommended. Take one tablet every 4-6 hours or as directed with food to prevent nausea.
  • Antibiotic: If an antibiotic was prescribed, continue to take them for the indicated length of time, even if all symptoms are gone.
  • Ibuprofen: Rotate your narcotic pain medication with your ibuprofen prescription. Take one tablet as needed every 4 hours. If necessary, the ibuprofen can be taken with your narcotic.
  • Anti-Nausea (Zofran): To be taken as directed or with your narcotic pain medication to control nausea.

***DEA regulations do not allow providers to call in Schedule II narcotics such as Hydrocodone or Percocet. If you require additional narcotic pain medication, a post-operative appointment in the office will be required. There are no additional fees for post-operative visits.***

Post-Operative Instructions: Sinus Lift

The treatment performed to increase the height of bone available for your implant(s). It is imperative that you follow the instructions listed below carefully, to maximize your healing and improve the long-term outcome of your dental implant(s).

Do NOT blow your nose for at least 7 days, as the pressure will delay or damage your sinus healing. If you have to sneeze, do NOT hold it back – sneeze out. Open your mouth and try to minimize the pressure in your nasal/sinus passages.

You may use nasal decongestants, such as over-the-counter Sudafed tablets or Afrin nasal spray, to keep your passages dry, especially if you have noticed continued drainage or feel the need to blow your nose.

Take the antibiotics prescribed by your doctor until they are finished, even if you feel fine. They protect the surgical site from infection. Also, 1 or 2 servings of yogurt or an acidophilus pro-biotic tablet are recommended daily to reduce gastrointestinal complications (like diarrhea).

Do not drink through a straw. This creates suction, which may damage a healing clot. You may drink out of a cup, bowl or use a spoon.

Do not smoke because smoking reduces the blood flow, contaminates the healing wound, and frequently leads to infections.

Medication Overview

  • Narcotic Pain Medication: To control discomfort, take your first dose of pain medication before the anesthetic has worn off or as recommended. Take one tablet every 4-6 hours or as directed with food to prevent nausea.
  • Antibiotic: If an antibiotic was prescribed, continue to take them for the indicated length of time, even if all symptoms are gone.
  • Ibuprofen: Rotate your narcotic pain medication with your ibuprofen prescription. Take one tablet as needed every 4 hours. If necessary, the ibuprofen can be taken with your narcotic.
  • Anti-Nausea (Zofran): To be taken as directed or with your narcotic pain medication to control nausea.

***DEA regulations do not allow providers to call in Schedule II narcotics such as Hydrocodone or Percocet. If you require additional narcotic pain medication, a post-operative appointment in the office will be required. There are no additional fees for post-operative visits.***