Opening Hours : Mon-Thurs 9am-4:30pm and Fri 9am-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.

Pre-Op: All-On-Four

Preparing for Surgery

Download a pdf of these instructions

Drs’ Strauss, Sarathy, Oliphant and their staff at Charleston Oral and Facial Surgery have compiled the information below to help you prepare for your surgery. In addition to following these important instructions, please also see Drugs To Avoid.

You will also receive additional information in your specific post-operative instructions.

THREE WEEKS BEFORE SURGERY

Stop smoking

In some cases, we may ask you to stop sooner. Smoking can interfere with healing by constricting and decreasing blood flow all over the body which may prevent the wound from healing properly. Do not resume smoking after surgery until you are given permission by your surgeon.
IMPORTANT: Smoking causes severe complications

Stop drinking

There should be no excessive alcohol consumption for a minimum of 5 days prior to your procedure. Alcohol causes increased bleeding, increases the chances of infection, depresses immune functions, and may interfere with wound healing.

Make a list of all medications (Over-the-counter and prescribed)

You will be instructed by your surgeon or patient counselor to temporarily discontinue certain medications in the weeks ahead.

Check your refrigerator

It is important that you maintain a healthy diet. You will be on a soft mechanical diet or some form of a modified diet tailored to your surgery. It is important that you follow these instructions!  It is a good idea to stock up on protein supplements like BOOST or Ensure. Various softer foods like well-cooked pastas, eggs, soup/broths, and yogurt are also good ideas. We will provide you with a list of dietary suggestions in your post-op packet as well.

TWO WEEKS BEFORE SURGERY

Stop 2 weeks BEFORE until 2 weeks AFTER surgery:

  • All Aspirin and Ibuprofen products including the drugs listed on the enclosed insert.
  • All anti-inflammatory drugs (i.e. Ibuprofen) used for arthritis. (Please consult your physician prior to discontinuing).
  • All anti-coagulants (Please consult your physician prior to discontinuing).
  • Vitamin E taken internally
  • If a medication is in question, please call our office.

These products may cause excessive bleeding.

START TWO WEEKS BEFORE UNTIL TWO WEEKS AFTER SURGERY(strongly recommended)

  • Take a Multivitamin tablet daily. Most multivitamins contain some form of vitamin E, which is acceptable to take prior to surgery. However, we do ask that you refrain from taking additional vitamin E.
  • Take Vitamin A – 8,000-10,000 units, twice a day. This has well-documented beneficial effects on surgical healing and will also fuel your immune system.
  • Take Vitamin C – 1,000 mg., twice a day. This is essential for collagen synthesis, which is part of normal wound healing. Your need for Vitamin C will increase after surgery.

ONE WEEK BEFORE SURGERY

GET PROPER NUTRITION AND REST: (1 week BEFORE until 2 weeks AFTER procedure):

  • Eat healthy, regular meals.
  • Eat 2 fruits and 3 green vegetables daily (per diet instructions)
  • Eat a small amount of protein at each meal.

IMPORTANT! Your diet can aid healing remarkably and reduce swelling and pain!

GET ALL PRESCRIPTIONS FILLED.

TWO DAYS BEFORE SURGERY

YOU MAY BEGIN TAKING ARNICA MONTANA

  • Take every 8 hours as directed and continue for 10 days.
  • Continue taking Bromelain as directed every 12 hours between meals. This anti-inflammatory promotes healing. As an alternative, eat fresh pineapple.

Arnica:  Arnica Montana is an herb that grows wild in the Swiss Alps. Also known simply as “Arnica,” it’s been used in Europe for hundreds of years for the reduction of bruising and swelling and to shorten the recovery period after a physical trauma such as an accident, surgery or injury.

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

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, insert another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and delay the healing process. Limit vigorous exercise for the next 48 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides quickly, usually peaking at around 2-3 days.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for two to three days, or a reaction to the medication, call the office immediately.

Post-Operative Instructions: Wisdom Tooth Removal

This video will cover important information regarding proper post-surgical care for Wisdom Teeth Extraction. If you have been scheduled to have your Wisdom teeth removed it will be important to follow these instructions exactly as we present them.

Discomfort is normal after the extraction of teeth. If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil or Motrin) as instructed by your Doctor at the time of your surgery. If your pain is not controlled by the ibuprofen alone, take your prescribed narcotic in addition. Ibuprofen and your prescribed narcotic can be taken together. Be certain to take your pain medicines with food as this will help prevent nausea. Remember, narcotic pain medicine will impair your judgment and reflexes.

Gauze pad(s) should be placed directly over the extraction site(s) and held in place with firm biting pressure; proper placement will help you not swallow blood, which can make you nauseated. Replace the gauze pad(s) every 20 to 40 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3 to 4 hours, but small amount of bleeding is common for up to 48 hours.

Do not rinse on the day of surgery, it may prolong your bleeding. Begin salt-water rinses the day after surgery and continue for 1 week. Rinse with warm salt water 6 to 8 times each day. To make the salt-water solution, dissolve 1/2 teaspoon of salt in a small glass of warm tap water.

If you have been given an irrigating syringe, start irrigation on the third day following surgery. Fill the syringe with warm salt water and place the tip of the syringe into the extraction site to clean. Do this 3-4 times a day for 2 weeks and lessen this amount as the surgical site heals.

Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling typically peaks by the 3rd or 4th day and then starts to resolve; it can be reduced by the use of an ice pack. Apply the ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Continue icing the face for the first 24 hours. Do not freeze the skin. Ice packs are useful for the first 24 hours only. Also, keep your head elevated on 2 pillows for 3 to 4 days. These measures will not eliminate swelling, but they help to reduce its severity.

To allow blood clots to form undisturbed, 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. If you were sedated for surgery, do not eat fatty, creamy or oily foods; these foods may cause nausea. You should eat only soft food for the first week: for example, soups, eggs, mashed potatoes and meatloaf are fine. For 2 weeks (8 weeks if you had lower wisdom teeth extracted), do not eat hard, crunchy or very chewy foods, such as European breads, pizza crust, steak or jerky, nuts, or popcorn. To help prevent dry socket, do not use a straw for the first 3 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.

Unless told otherwise, do no vigorous physical activity for three 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 5 to 7 days after your surgery.

Post-Operative Instructions: Impacted Tooth Exposure

This page will cover important post-operative information for adherence after the exposure of an impacted tooth. If you are undergoing this procedure, it is important to follow these instructions exactly to ensure optimal healing and quick recovery.

After your surgery, do not disturb the wound or any packing that is placed inside of your mouth. This packing is in place to keep the tooth exposed; however, do not be alarmed if this packing falls out or moves from its original positioning. If your surgeon has attached a small gold chain to the impacted tooth, it is essential that your orthodontist activate the chain as soon as possible prior to your surgery. If this chain becomes dislodged from the tooth, please contact our office immediately to have the chain replaced.

A small amount of bleeding is common for up to 24-48 hours. If you experience excessive bleeding (your mouth fills up rapidly with blood), place a gauze pad directly over the extraction site and hold it in place with firm biting pressure for around 30 minutes or until the bleeding can be controlled. If your bleeding does not slow, please call our office.

Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling can be reduced by applying an ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Continue icing the face as much as possible for the first 36 hours. Do not freeze the skin. These measures will not eliminate swelling, but they help to reduce its severity.

It is important to drink fluids after your surgery. Start with clear liquids, such as apple juice, tea, or broth. Always cool down any hot foods or liquids during the first 24 hours. You should eat only soft food on the day of your surgery, for example, soups, eggs, and mashed potatoes. Gradually build your appetite back up to normal eating habits as soon as possible unless otherwise directed.

Discomfort is normal after any surgery. If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil or Motrin) or Tylenol as soon as you feel the local anesthetic wearing off. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. If your pain is not controlled by the ibuprofen alone, take your prescribed narcotic in addition. Ibuprofen and your prescribed narcotic can be taken together. Be certain to take your pain medicines with food; this will help prevent nausea. Remember, narcotic pain medicine will impair your judgment and reflexes.

Begin brushing your teeth and cleaning your mouth 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. Begin salt water rinses the day after surgery and continue until the surgical site heals. Rinse with warm salt water 6 times each day. To make the salt water solution, dissolve 1/2 teaspoon of salt in a small glass of warm tap water.

Post-Operative Instructions: Dental Implants

This video will cover important information regarding proper post-surgical care for Dental Implants. 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 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 straining. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

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 3 to 5 days. If swelling begins to increase after the 3rd 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 6 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 4 to 6 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 4 to 5 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 7 days. After 7 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.

Post-Operative Instructions: Sinus Lift

This page will cover important information regarding proper post-surgical care after a Sinus Lift for Dental Implants.

This treatment is 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.