Surgical Information

At Santarelli & Tiboris Oral and Facial Surgery, we believe that patient care is just as important before and after surgery as it is during surgery.

Please select one of the categories below to learn more about the steps you should take regarding your procedure.

Pre-Op Information

At Santarelli & Tiboris Oral & Facial Surgery, we believe that patient care is just as important before and after surgery as it is during surgery. Please select one of the categories on the right to learn more about the steps you should take regarding your procedure.

Important reminders for the day of your surgery.
  • Do not eat or drink for 6 (six) hours before your scheduled surgery appointment however you can drink WATER up to 2 (two) hours prior to your surgery.
  • Take your regularly prescribed medications as you would routinely with sips of water unless directed differently by your doctor.
  • Please have your prescriptions filled prior to your surgery. If prescribed an antibiotic take one dose with a sip of water before going to our office on the day of surgery.
  • You must be accompanied by another adult at your appointment. They should not drop you off and come back to pick you up; they must wait until your surgery is completed. They will sit with you while you recover and then drive you home. A responsible adult will need to stay with you for the remainder of the day.
  • If you need to cancel your appointment, please provide 48 hour notice to avoid a $180 cancellation fee.
  • If we are billing your insurance company, the co-payment is due prior to your surgery. If you do not have insurance the final balance is due prior to your surgery.
  • If you are being sedated for your procedure or surgery, please park your car near the side door (employee entrance) and enter the office through the main door.
  • For the first 2-3 days after surgery, soft foods are recommended with the diet gradually increasing each successive day. Examples of soft foods are: Jell-O, pudding, mashed foods, nutritional supplements such as Boost and Ensure.
  • Please call Santarelli & Tiboris Oral & Facial Surgery with any questions or concerns prior to your surgery. 262-654-6770

Post-Op Instructions

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our telephone number is: 262-654-6770.

General Instructions

Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first 45 minutes unless the bleeding is not controlled. The packs may be gently removed after 45 minutes. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. No nose blowing should be done and open mouth sneezing (if necessary) for the first 3-5 days if upper teeth were removed. If you feel congested you can take any variety of over the counter decongestants to help congestion. Do not rinse your mouth or spit out today. Starting the day after your surgery and continuing for one week rinsing your mouth gently every 3 to 4 hours with warm salt water. If a mouth rinse was prescribed use it as directed. Start brushing your teeth with a soft toothbrush the day after surgery. Small sharp bone fragments may work through the gums during the healing process. These are not roots and if they are bothersome, please return to the office for evaluation.

Surgical Site Care

Do not disturb the surgical area today. Do not rinse vigorously or probe the area with any objects. Please Do Not Smoke for at least 5-7 days, since this is very detrimental to healing and may cause a dry socket. We do not advise smoking at all, but if you must do not do so until the site is completely healed and feels normal and you are no longer having any pain or sensitivity.

Oozing

Intermittent bleeding or oozing overnight is normal. Placing fresh, moist gauze over the areas and biting on the gauze for 20-40 minutes at a time control any bleeding. If bleeding remains uncontrolled, please call our office. If you have had sutures placed they most likely will dissolve on their own in approximately 4-6 days. Occasionally Dr. Santarelli or Dr. Tiboris will place sutures that do not dissolve and will need to be removed on your post-operative visit.

Swelling

Swelling is often associated with oral surgical procedures. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 48 hours after surgery. After this, use moist heat. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

Pain

Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take a dose of pain medication before the anesthetic has worn off, you should be able to manage any discomfort much better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. Take your medication as prescribed, you should never exceed the prescribed dosage. Remember that the most severe pain is usually within six to eight hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

Diet

Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor. If you were sedated or “put to sleep” for your procedure it is advisable to confine your diet to 1 to 1½ hours of clear liquids [apple juice, cranberry juice, water, etc.] before beginning any soft foods and a responsible adult should be present with you for 24 hours after the procedure.

Post-Op Instructions After Removing Multiple Teeth

  • A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes.  To do this place a tea bag (any kind) in 3-4 ounces of warm water and let sit for one minute.  Then place the tea bag directly over the bleeding site and apply firm biting pressure of 30 minutes.  If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
  • Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 36 hours only. Apply ice in twenty minute intervals (removing for 20 minutes and then reapplying) while you are awake.
  • For mild discomfort use aspirin, Tylenol or any similar medication; two tablets every 6 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 3 tablets every 6 hours.  These can be taken as long as you do not have a medical condition that does not allow their use.
  • For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
  • Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
  • Do not rinse your mouth the day of surgery, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.
  • Restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
  • The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
    • The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only).
    • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.
    • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.
    • If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Post-Op Instructions After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery
  • 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.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.
Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To do this place a tea bag (any kind) in 3-4 ounces of warm water and let sit for one minute.  Then place the tea bag directly over the bleeding site and apply firm biting pressure of 30 minutes. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 6 hours or Ibuprofen, (Motrin or Advil) three 200 mg tablets may be taken every 6 hours. These can be taken as long as you do not have a medical condition that does not allow their use.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications
  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful, and contact us if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by your doctor.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
Finally…
  • Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. Most of the time absorbable sutures will be placed and do not have to be removed however if non-absorbable sutures were placed they will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.
  • The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call the office for instructions.
  • There will be a cavity or hole where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
  • Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: your doctor or your family dentist.
  • Brushing your teeth is okay – just be gentle at the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.
  • If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

“The attitude of the staff here is outstanding! I could not have asked for better service.”

Gene B., Lake Geneva

Schedule your consultation: 262.654.6770