Surgery Information

Pre-Surgery Instructions

  1. If you will be taking a sedative medication, be sure that the prescription is filled as soon as you receive it from our office. Keep it in a safe place until the day of your surgery. You may be prescribed Peridex mouth rinse to start using one to two days prior to your surgical procedure. The use of this rinse has been shown to be effective in decreasing the risk for developing dry socket after lower tooth extractions; please use this mouth rinse as directed.
  2. The use of anti-inflammatory medications prior to surgery has been shown to decrease pain and swelling after your surgical procedure. Unless you have been told by your physician to avoid ibuprofen, or if you have had problems taking ibuprofen in the past, we recommend taking 600mg of ibuprofen (3 Advil or generic equivalent pills) every 6 hours starting 24 hours prior to surgery.
  3. If you will be taking sedative medication, you may NOT have solid foods or liquids for six hours prior to your appointment unless otherwise advised by Dr. Fleming. Take your sedative medication one hour before your appointment as directed. Do NOT take the medication if you might be pregnant.
  4. You should take your usual medications the morning of your surgery unless otherwise advised by Dr. Alex Fleming. If you start any new medications that Dr. Fleming is not presently aware of, please call and let us know prior to your surgery.
  5. If you are taking a sedative medication, have an adult act as an escort to bring you and drive you home.
  6. After surgery, if you are sedated, it is advisable to rest for the remainder of the day.
  7. Although you are likely to feel perfectly normal, you should NOT drive, operate dangerous machinery, make important business decisions or sign any legal documents for 24 hours after sedation or while taking prescription narcotic pain medication.
  8. On the day of surgery, wear loose-fitting and comfortable clothing. Do not wear tight-fitting clothes that may restrict your breathing.
  9. If for some reason you are unable to keep your surgery appointment, please let us know as soon as possible so that we may offer your appointment time to another patient.
  10. Please be prepared to complete your financial responsibility prior to your appointment by check or credit card. Following your surgery, you will be escorted directly to the car of your spouse, parent or companion to take you home.
  11. If you have any questions, please call us for further assistance.

Post-Op Instructions for Extractions

It is normal to experience some discomfort for several days after a tooth extraction, but call us if you have:

  • Heavy or increased bleeding
  • Pain or swelling that increases or continues beyond two or three days
  • A bad taste or odor in your mouth
  • A reaction to the medication

During the First 24 Hours

It is important that a blood clot forms on the extraction site to stop bleeding, reduce discomfort and speed healing. To protect the clot and avoid the pain of a dry socket:

  • Bite on the gauze pad firmly for 30 to 60 minutes, then remove the pad or let it drop out of your mouth into a trashcan. Blood and saliva mix in the mouth and make it look like there is more bleeding than there really is. Some oozing is normal; however, after one hour, if oozing is profuse, fold a gauze pad in quarters and place over the extraction site. The site may ooze for as long as 24 hours. You may also moisten a tea bag with warm water, squeeze out excess water and place it over the extraction site.
  • Do NOT spit, suck on candies or drink through a straw.
  • Do NOT rinse your mouth or brush or floss next to the site for 24 hours.
  • Do NOT use sedatives or stimulants or smoke or use tobacco for at least 72 hours. These may slow healing.
  • Do NOT sneeze or cough; have sinus or allergy medication on hand if needed.
  • Limit yourself to calm activities. When you lie down, elevate your head with pillows. Avoid heavy lifting.
  • Do NOT drink hot, carbonated or alcoholic drinks and avoid hot or spicy foods.
  • Stay hydrated. Drink water, juice or an energy drink.
  • If oral sedation was used, please do not drive for 24 hours. Do not go up and down stairs unattended.
  • When the numbness is completely worn off, drink fluids, eat soft foods and chew on the opposite side.
  • You will be instructed if ice packs are needed, 20 minutes on and 20 minutes off. To control discomfort in most cases, a regimen of three Advil (ibuprofen) and two Extra Strength Tylenol (acetaminophen) will be as effective as a narcotic, without the side effects. Take all five pills every four hours as needed for discomfort. If a narcotic was prescribed for you, follow the directions carefully.

After the First 24 Hours

  • Begin to eat normally as soon as you are comfortable.
  • Resume brushing and flossing, but clean gently around the site for about a week.
  • If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
  • To reduce soreness and swelling, apply moist heat. Swelling usually starts to go down after 48 hours.
  • Begin to rinse your mouth very gently with warm saltwater. Use about one teaspoon of salt per glass of warm water. Rinse two or three times a day for a week following the extraction.

If you have any questions about our oral surgeries in Durham, North Carolina, you may reach our dentist, Dr. Alex Fleming, and our team at 919-682-5327.


  • Monday - Wednesday 7:30 a.m. - 4:30 p.m.
  • Thursday 7:30 a.m. - 3:30 p.m.
  • Friday Closed


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