Patient Preoperative Instructions for Oral Surgery

Please follow our patient preoperative instructions before anesthesia for your oral and maxillofacial surgery to prevent cancellation of your procedure.

1 Week Prior to Anesthesia and Surgery

• Arrange for someone to drive and accompany you to your oral surgery.
• Fill your prescriptions and read the directions on each bottle.

Day Before Anesthesia and Surgery

• Start taking medications per the instructions on each bottle if prescribed by your oral surgeon.
• Remove nail polish and artificial nails from your fingernails (at least the index fingers).
• Stop smoking and drinking alcohol for 24 hours before surgery.
• Eat normally and get a good night’s rest.

Preoperative Instructions the Day of Anesthesia and Surgery

Guidelines for Preoperative Fasting

Midnight – Do not eat any solid food, milk, orange juice, candy or gum after midnight.

6 Hours Clear Liquids – Do not drink anything (that includes water, coffee etc.) for 6 hours before your appointment.

• Children may have small amounts of clear liquids (Water, Pedialyte, apple juice, Gatorade, Popsicles)  until 4 hours prior to the scheduled procedure, unless otherwise directed.

Medications

• Medications may be taken as prescribed with up to 30 ml (1 oz.) of water up to two hours before anesthesia.
• If you were prescribed an antibiotic, please take them as prescribed the night before your surgery and in the morning with a small sip of water and continue as directed.
• Please stop taking herbal medications (see herbal supplements warning below) and diet drugs at least one week prior to surgery.
• Do not drink any alcohol for 24 hours before surgery.

Tobacco and Alcohol

• Stop smoking and drinking alcohol for 24 hours before surgery.
• Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.

What to Wear

• Please wear comfortable, loose-fitting clothing with short sleeves that may be rolled up past the elbow and low-heeled shoes.
• Contact lenses, jewelry, and dentures must be removed at the time of surgery and avoid excessive makeup and nail polish.

How to Relax

• If you would like to listen to music during your anesthesia and oral surgery procedure, feel free to bring a portable music player to listen to your favorite music.

Ride Information – Transportation

• A responsible adult must be available and physically present in the office upon check-in to escort you home. Your ride must remain in the office during the procedure. This person must drive you home or accompany you by taxi only. You may not drive or take public transportation.

Driving After

• After your oral surgery, you should go home and rest there for the remainder of the day.
• Do not drive an automobile or operate any other machinery for 24 hours, nor should you plan to be responsible for children for 24 hours.
• Make arrangements to have someone home to assist you for the rest of the day and stay with you overnight.

Illness

• If you have an illness such as a cold, sore throat, stomach or bowel upset, severe allergies, or an upper respiratory infection before your surgery, please call the office to make sure it is safe to proceed with your surgery.

Pregnancy

• For women: If you are, might be, or trying to become pregnant, please be advised that surgery and anesthesia can cause potential problems during pregnancy. You should inform and consult with your doctor to rule out pregnancy before surgery.

If you have any questions about the preoperative instructions, please contact our office.

Fasting Guideline Information

Pulmonary (lung) aspiration of gastric (stomach) contents is a feared but largely preventable complication of anesthesia. For non-emergent surgeries, patients are asked to fast in order to allow for sufficient gastric emptying time to prevent aspiration. Our fasting guidelines are evidence-based ASA guidelines.

Herbal Supplement Risks for Preoperative Patients

The following is a summary taken from the Journal of American Medical Association on eight herbs that can potentially pose harm during and after surgery. We recommend that the following herbs should be stopped before surgery in order to avoid any potential complications from their use:

• St. John’s Wort can significantly increase the breakdown of other routinely administered drugs during surgery, some of which are vital to the care of patients after surgery. This should be discontinued at least 5 days before surgery.
• Echinacea should be used with caution in patients with asthma or allergic problems and should be discontinued as far in advance of surgery as possible.
• Ephedra causes a potential increase in blood pressure and heart rate. This herb has also been associated with sudden death under anesthesia. This should be discontinued at least 7 days before surgery.
• Garlic supplements have a potential for reducing clotting function and platelet function and should be stopped 7 days prior to surgery.
• Ginseng has also been shown to have effects on clotting pathways and should be discontinued approximately 7 days preoperatively.
• Ginkgo should be discontinued 7 days prior to surgery because it can inhibit platelet clotting factors.
• Kava should be discontinued 7 days preoperatively because it can increase the sedative effects of anesthetics.
• Valerian can increase the sedative effects of anesthetics. This should not be discontinued abruptly because there is risk of physical dependency to Valerian and withdrawal symptoms may develop. This should be tapered over several weeks before surgery.