Oral Surgery FAQs

Frequently asked questions about oral surgery, wisdom teeth Removal & more

I had surgery this morning and my stitches came out already, is this ok?

Yes, in most instances, the stitches are placed at the time of surgery simply to assist with initial control of bleeding and clot formation. This is especially true with wisdom tooth surgery and other tooth extractions. Thus, loss of a stitch is not considered an emergency, even if it occurs on the day of surgery. If your surgeon has performed a bone-grafting procedure and the stitches are coming out prematurely, please contact our office so that the doctor may determine whether or not you need to be seen before your scheduled post-operative visit.

What kinds of food can I eat after having oral surgery?

On the day of the surgery, cool and soft food is recommended, such as applesauce, cottage cheese, or yogurt. Hot foods may disturb initial clot formation in the extraction sites. Following the day of the surgery, it’s best to avoid crunchy foods such as popcorn, nuts, and potato chips which break up into little pieces and can get packed down into the extraction sites. If you had dental implants placed, please avoid chewing hard foods with the implant itself for 6 weeks or the healing of the implant will be compromised.

I had my wisdom teeth removed yesterday and the pain medicine isn’t helping my pain. What should I do?

The best regimen for acute pain control after wisdom tooth removal is non-narcotic pain medication, specifically 800mg of Motrin or Ibuprofen every six hours used in combination with 1000mg of Tylenol (two Extra Strength pills) every six hours. If you put each medication on a separate schedule, you can take the Ibuprofen, then three hours later take the Tylenol, three hours later take the Ibuprofen, etc. Alternating between these medications every three hours allows you to maximize your pain control, minimize unwanted side effects of the medication (nausea), and prevent overdose of either medication. If you have medical problems such as kidney or liver disease, please consult with your surgeon or medical doctor before starting a regimen like this. Also, make sure you are well hydrated if you are taking Ibuprofen or Motrin for longer than 24 hours. Please contact our office if you have been on this pain control regimen for longer than 3 days.

What is a “Dry Socket” and how do I know if I have one?

The term “dry socket” refers to a condition called alveolar osteitis, or a premature breakdown of the blood clot present in an extraction site. Smoking, poor oral hygiene, and over-excursion in the post-operative period can contribute to this condition, but sometimes there is no obvious cause. Typically, “dry socket” presents itself 3-5 days after the surgery with increased pain, foul odor and taste, and bad breath. This condition is very easily treatable and requires that we place a medication into the extraction socket, which provides pain relief usually within an hour after placement. These medicated dressings typically are replaced every 2-3 days in our office until the condition subsides in one to two weeks. If you are experiencing symptoms consistent with “dry socket,” the best solution is to call our office when it opens in the morning at 7:30 am so we can arrange to have you seen that day for treatment.

I had my wisdom teeth removed this morning and I’m still bleeding, what should I do?

Believe it or not, some bleeding after tooth extractions is beneficial – good blood flow usually means good healing. The purpose of the gauze that you were given is to apply firm, consistent pressure to the extraction sites for 45-60 minutes at a time. If you have gauze in your mouth and you are not biting down firmly, the gauze is doing no good. Likewise, taking the gauze in and out every five minutes to look at it just tends to stir up more bleeding. Often, when patients are removing their gauze after surgery, they are surprised at how wet and red the gauze appears and this is often perceived as excessive bleeding. Most of the time, the gauze is saturated with saliva with a few drops of blood that give it the appearance of a lot of bleeding when it really isn’t. If you run out of gauze, most pharmacies sell it or you can bite on tea bags; the tannic acid in tea helps in clot formation. If your mouth is rapidly filling up with blood and the above measures are not helping to slow down the bleeding, call our office for assistance. Also, it is not unusual to notice small episodes of bleeding for several days after having teeth removed; simply bite on gauze again in the area of bleeding if you experience bleeding in the days after your surgery.

My son had his wisdom teeth removed today under IV sedation and he is experiencing a lot of nausea. What is causing it and what should I do?

There are several causes of post-operative nausea and vomiting. First, if you were sedated with IV medications, nausea is a side-effect of nearly all the medications used for sedation. The best treatment is to start out with clear liquids (water or Gatorade) on the day of the surgery. The goal is to maintain good hydration and prevent dehydration. After holding down clear liquids for several hours without nausea, your diet can progress to soft foods. Dairy products (milkshakes) are not the best food on the day of the surgery and may contribute to nausea and vomiting.  Second, and most importantly, dehydration is a cause of post-operative nausea and vomiting. Again, the best treatment is prevention. Clear liquids are very important in maintaining an adequate level of hydration. If you are simply not able to hold anything down and your condition is worsening, call us and we can arrange for you to receive IV fluids for rehydration, most likely done at the nearest emergency room or urgent care center. If you are diabetic and are experiencing post-operative nausea and vomiting, this could potentially be a serious condition, so please contact our office immediately.

What are common procedures performed by an oral surgeon?

Oral surgeons commonly do the following procedures:

  • Wisdom teeth removal
  • Surgical tooth extraction
  • Placement of dental implants
  • Bone grafting
  • Oral pathology
  • Treatment of facial trauma or pain
  • Correct problems with the bite

What is the difference between an Oral Surgeon and a General Dentist?

General dentists serve as primary care providers for dental medicine. At the general dentist’s office, you will receive teeth cleaning, X-rays, and a comprehensive screening for dental problems. General dentists most often provide gum care, dental fillings, root canals, veneers, bridges, and crowns. They also make recommendations for how to prevent common dental problems. Although a general dentist may perform simple tooth extractions, more complex surgeries may be outside of the scope of a general dentist.

Oral and maxillofacial surgeons receive specialized training to treat a variety of conditions affecting the face, mouth, and jaw. Patients are typically referred to an oral surgeon when a problem is beyond the scope of a general dentist’s expertise. Oral surgeons perform simple and complex tooth extractions, including wisdom tooth extraction. They also provide care to accident victims who need reconstructive dental surgery. Oral surgeons may also perform soft tissue biopsies, tumor removal, jaw realignment surgery, soft tissue repair, or positioning of implants. Oral surgeons go through extra schooling and are certified to administer general anesthesia.

Do I need a referral to make an appointment?

We do not require referrals to make appointments at our office. Some treatment plans require that you are established with a general dentist, but we can still see you for a consultation to start the process. We can also refer you to a dentist that participates with your insurance.

What types of anesthesia do we offer at our office?

Local Anesthesia 

Local anesthetics are those that affect only a small portion of the body. They work locally to numb the area and ensure the patient doesn’t feel any pain. Lidocaine is a common numbing medication that is injected directly into the affected area and takes effect quickly. Patients are conscious and aware during local anesthesia, but should not feel any discomfort. It is typically used in simple tooth extractions or placement of dental implant(s). The patient is able to drive home after the procedure.

Minimal Sedation

This method of anesthesia combines the localization of an anesthetic with the calming effects of nitrous oxide (also known as “laughing gas”). A mixture of nitrous oxide and oxygen is breathed through a mask or nosepiece, allowing a patient to be aware during the procedure while remaining relaxed. This method also may include a sedative agent. Patients with anxiety about dental care might prefer moderate or general sedation as you can still hear drills and removal of teeth. This type of anesthesia for simple procedures and you can drive yourself home.

Moderate Sedation

Sometimes referred to as “twilight sedation,” intravenous (IV) moderate sedation places a patient in a state between awake and asleep, drifting in and out of consciousness. Although patients are partially conscious, few remember anything from the procedure other than feeling sleepy and relaxed. Moderate sedation often can be used instead of minimal sedation for procedures such as removal of impacted wisdom teeth. Moderate sedation may use the same types of medication as general anesthesia, and generally leads to a quick recovery from sedation and a minimization of anesthesia side effects. We require you to have someone drive you home after this type of sedation.

How long do the holes in my jaw stay after extractions?

The “holes” or “extraction sockets” will generally close within 6 weeks. It will take several months for the sockets to actually fill with bone. If food gets trapped in the socket area, be sure to clean it with the Peridex if prescribed for you or warm salt water.

I have terrible bad breath after the surgery, does this mean I have an infection?

The bad breath may be caused by food getting into the socket area. Be sure to keep the surgery site clean and this should resolve.

What will the recovery look like?

Oral surgery might sound scary, but most procedures are fast, simple, and effective. You will, however, want to ask your oral surgeon what to expect during the recovery process. The staff or the surgeon will inform you about how many days you’ll need to take off work, what you will be able to eat, and the post-op pain level you can expect.

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