Surgical Instructions

Before Anesthesia (General Anesthesia, Deep Sedation, or IV (Twilight) Sedation

  • Do NOT have anything to eat or drink (including water) for eight (8) hours prior to the surgery.
  • The day before surgery, drink plenty of fluids to keep yourself hydrated, which can help with IV placement on your surgery day.
  • An adult must accompany the patient to the office, remain in the office during the procedure and drive the patient home.
  • All minors under the age of 18 must be accompanied by a parent or legal guardian.
  • The patient should not drive a vehicle for 24 hours following anesthesia.
  • Please wear loose fitting clothing with short sleeves. Low heeled shoes or sneakers are best, please no flip flops or high heels.
  • No smoking at least twelve (12) hours before surgery. Please do not smoke the morning of surgery.
  • Please take all your normal oral medications with a small sip of water, unless otherwise directed. (Always take any blood pressure medication with a small sip of water)

After Tooth Removal

After your tooth extraction, it is important for a blood clot to stabilize. Please bite on a slightly moisten gauze for 20-30 minutes after the appointment and continue to change the gauze every 20-30 minutes until the bleeding stops.

Please NOTE – Biting on a moistened tea bag for 30 minutes also helps to slow the bleeding.

After the blood clot has formed, it is important not to disturb or dislodge the clot as it aids healing.

  • Do not rinse vigorously
  • Do not spit excessively
  • Do not use straws
  • Do not smoke
  • Do not drink carbonated beverages.
  • Do not exercise for the next 24-48 hours
  • Do not eat/drink anything HOT for 12 hours

After your tooth extraction you might have some pain and/or swelling. If directed please use an icepack to the area for the next 48 hours only, this keep swelling to a minimum. Take pain medications as prescribed by your surgeon. Add Ibuprofen if you were directed. It works best if taken at the same time as the prescription medication.

  • Do not exceed 3000mg of Tylenol in a 24-hour period.
  • Do not exceed 3200mg of Ibuprofen in a 24-hour period.

Any antibiotics that are prescribed, please take them for the time period prescribed.

Diet after extractions:

  • Drink plenty of fluids
  • Eat nutritious soft foods for the next 2-3 days
  • Do not eat any hard kernel foods
  • Resume a normally diet as soon as you are comfortable

Mouth care after your extractions.

  • Continue brushing and flossing your teeth at least once a day
  • Gentle rinsing with water or salt water after meals is recommened

What To Do After Wisdom Teeth Removal

Immediately After Wisdom Teeth Removal

  • Bite on moisten gauze for a half an hour. Remove and replaced if only if bleeding persists.
  • Do not rinse vigorously, as this may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • As soon as you can eat something take your prescribed pain medications before the local anesthetic effect is gone. This will allow you to stay ahead of the pain.
  • Restrict any strenuous activities for the day of surgery and resume normal activity only when you feel comfortable.
  • Place ice packs to the sides of your lower jaw where surgery was performed.

Keep your mouth clean

  • Brush your teeth the night of surgery and rinse gently by leaning over a sink, avoid spitting.

General Instructions

  • You will have numbness of the lip, chin, or tongue for up to 12 hours. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Please be careful. Parents should watch small children do not chew or bite their lip and or tongue.
  • You may have a slight temperature immediately following surgery. If the temperature persists, notify the office. Tylenol or ibuprofen can be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You could get lightheaded when you stand up suddenly.
  • Occasionally, patients may feel a hard area in the mouth with their tongue. This is not usually tooth or root fragments. Most often you will feel the bony walls which supported the tooth. This will usually smooth out with time.
  • The corners of your lips may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
  • Sore throats are normal and will subside in 2-3 days.
  • Stiffness in the jaw muscles may cause difficulty in opening your mouth for a few days. This can be a normal event following surgery. Heating pads and slow jaw stretches are recommended on day 3 and after.
  • Sutures may have been placed to minimize post-operative bleeding and to help healing. Sutures will normally dissolve within 7-10 days. If your sutures become dislodged, simply remove the suture from your mouth and discard it. It does not need to be replaced.
  • If your post-operative pain or swelling worsens or unusual symptoms occur, please call the doctors at 469-698-9800
  • Please brush your teeth. Just be gentle at the surgical sites.

Dry Socket

  • A dry socket can occur when a blood clot gets dislodged prematurely from the tooth socket.
  • You may experience symptoms of pain at the surgical site and even pain may radiate to your ear. Most dry sockets occur 2-3 days following surgery. If this occurs, please call our office for further instructions.


  • Bleeding is normal and be expected following surgery.
  • Excessive bleeding is not normal. To help control first rinsing or wiping any old clots from your mouth, then placing a gauze over the extraction site and biting firmly for 20-30 minutes. Do not keep changing gauze during this time.
  • If bleeding continues, bite on a moistened tea bag for thirty minutes.
  • No straws and no spitting.


  • Some swelling that is normally and to be expected.
  • Maximum swelling will not become apparent until the 2-3 days following surgery
  • To help limit the amount of swelling immediate use of ice packs will help. The ice packs should be placed on and off, every 20 minutes while you are awake.
  • DO NOT use ice after 48 hours. After the 48 hours transitioning to heating pads or warm towels. This will continue to help reduce the swelling and help with muscle soreness/jaw stiffness.


  • Please take a pain medication prior to the local anesthetic wearing off. Within 2 hours is best.
  • For mild to moderate pain, Tylenol or Extra Strength Tylenol may be taken every 4-6 hours as directed.
  • Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, over the counter comes in 200 mg tablets: 3-4 tablets may be taken every 6-8 hours as needed for pain.
  • Do NOT exceed 3000mg of Tylenol in a 24-hour period.
  • Do NOT exceed 3200mg of Ibuprofen in a 24-hour period.
  • For severe pain, use the prescribed medication as directed.


  • It is very important to stay hydrated. Drink plenty of fluids. Prevent dehydration by taking fluids regularly. Drink at least 5-6 glasses daily
  • No straws please
  • Eat soft foods by chewing opposite the surgical sites.
  • If you had multiple teeth removed, foods that are soft, cold, and do not require chewing are best.


  • In some cases, bruising of the skin may happen after teeth removal. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively.
  • Moist heat to the area may speed up the removal.


  • If you have been prescribed antibiotics, take the tablets or liquid as directed.
  • Antibiotics are given to help prevent or treat an infection.
  • Immediately discontinue antibiotic use in the event of a rash or other unfavorable reaction.
  • Call 469-698-9800 (phone is answered after hours) if you have any questions or concerns

Nausea & Vomiting

  • You should then sip sprite or ginger ale. Sip slowly over a fifteen-minute period. When the nausea improves you may begin taking slowing trying solid foods.
  • If nausea does not improve, call the office and anti-nausea medicine may be prescribed.

After Placement Of Your Dental Implant

Oral Hygiene

  • Oral hygiene is essential to good healing and dental implant success.
  • Brushing your teeth around the implant is recommended.


  • Keep strenuous activities to a minimum immediately following surgery.
  • If you exercise intensely, throbbing or bleeding may occur. If this occurs, you should discontinue exercising.

Wearing Your Denture or Artificial Tooth Prosthesis

  • Partial dentures, flippers, or full dentures can be worn only if they have been adjusted prior to by your surgeon or restorative doctor.


  • Slight bleeding and/or redness in the saliva is normal for up to 48 hours.
  • Excessive bleeding can be controlled by biting on moist gauze directly over the site for 20-30 minutes. Firm, consistent mild pressure is best.
  • If bleeding continues please call 469-698-9800


  • Swelling is a normal and to be expected after surgery.
  • To minimize swelling, apply an ice bag on the outside of your face for 20 mins on and off. It is not necessary to apply ice while sleeping.


  • You should begin taking pain medication as soon as you feel the local anesthetic wearing off.
  • For mild to moderate pain, Tylenol or Ibuprofen may be taken every 4-6 hours as directed.
  • Do not exceed 3000 mg of Tylenol in a 24-hour period
  • Do not exceed 3200 mg of Ibuprofen in a 24-hour period.
  • For severe pain, the prescribed medication should be taken as directed. Do not take any medication if you have an allergic reaction, or if you have been instructed by your doctor not to take it.


  • Drink plenty of fluids and avoid hot liquids or hot food until all numbness is gone.
  • Return to a normal diet as soon as possible unless otherwise directed.


  • Be sure to take all the prescribed antibiotics as directed.

Two Locations Conveniently Near You

3014 Ridge Rd, Rockwall, TX 75032

(469) 698-9800

804 Gilmer St, Sulphur Springs, TX 75482

(469) 698-9800