POST-OPERATIVE INSTRUCTIONS

Care of the mouth after surgery has an important effect on healing. Depending on the extent, nature, and location of surgery; swelling, discomfort, slight oozing of blood, and restricted jaw movement should be expected. These need not cause alarm and may be minimized if the following post-operative instructions are followed:

Bleeding

Folded gauze has been placed in the area of surgery prior to your leaving the office. Bite on this gauze with constant, firm pressure. After 20-30 minutes remove the gauze and if there is still heavy bleeding repeat as needed. It is not unusual to have slight oozing for 24 hours and periodic break through bleeding for 10 days after an oral surgical procedure. Remember, a drop or two of blood mixed with saliva may seem like more blood than there really is. The most effective means to stop bleeding is firm biting pressure on gauze correctly placed over the surgical site.

To minimize bleeding:

– Place folded gauze directly over the surgical site and bite down with firm pressure.
– Avoid spitting or rinsing your mouth on the day of surgery.
– Do not replace the gauze if there is only slight oozing, if there is continued bleeding: place new gauze over the surgical site and bite down for 1 hour…repeat as necessary. Bring any fluids forward with your tongue and wipe with a towel or gauze. If bleeding continues place a moistened tea bag over the area and bite down for 1 hour (place tea bag in a cup with warm water, remove from water, and squeeze out the excess water from the bag by hand).
– Do not place a large bulky gauze pack, for it will only put pressure on the nearby teeth and not in the area of bleeding.
– Do not drink thru a straw and avoid smoking.

Swelling

You may experience swelling after surgery. The swelling peaks in appearance in 2-3 days and take up to 10 days to return to normal. Applying ice packs for the first 24 hours, 10 minutes per side, and elevating your head may help decrease swelling. If you experience swelling several weeks after your surgery, please make an appointment to see your doctor.

To minimize swelling:

– Apply ice bag to the operated side of your face as soon as you arrive home.
– Wrap the ice bag in paper towel before applying to your face.
– Apply cold for 10 minutes on and 10 minutes off cycles for the first 24 hours.
– After 24 hours you should switch to warm moist heat packs and warm mouth rinses.

Discomfort

Pain should be expected and medication usually will be prescribed to make you comfortable. You will be numb (pain free) after your surgery for 1-2 hours. You should start taking your pain pills before the numbness wears off. Remember, after pain medication is swallowed it may take one hour to take effect. The discomfort may be greatest for most patients on the night of surgery. Some patients report greatest discomfort second or third day after surgery (coinciding with greatest swelling). All narcotic-containing medications may impair the mental and physical abilities required for performance of potentially hazardous tasks such as driving a car or operating machinery.

To minimize pain

– When you arrive home, remove gauze packs, eat soft food, and start taking your pain medication.
– If you have taken the prescribed pain medication and are still uncomfortable, you may take Ibuprofen (Advil or Motrin) if not already prescribed in between your prescription pain pill schedule.

Diet

Eat whatever is comfortable. You may require soft or liquid foods for 2-7 days. Avoid foods that require hard chewing. It is very important to maintain good dietary intake even if only liquids.

– Soft foods: soup, mashed potatoes, eggs, yogurt, pudding, Jell-O, ice cream, cooked fish…anything you can mash with a fork.
– Avoid chips, popcorn, and peanuts.
– Avoid drinking through a straw.
– Avoid alcohol while taking prescription pain medication.

Nausea

Nausea may be present during the initial post-operative period. Small sips of 7-UP, ginger ale, or broth may help. Sometimes nausea and vomiting are associated with narcotic pain medications. Taking your pain medication on a full stomach can alleviate this problem. If nausea continues you may want to stop the prescribed pain medication and switch to regular Tylenol or Ibuprofen.

Care of the mouth

– Do not rinse your mouth or brush your teeth until the day after your surgery.
– Resume routine brushing of teeth and oral care starting 24 hours after surgery. Every time you eat, rinse your mouth with warm water to flush out food particles.
– Avoid smoking, drinking through a straw, as these may disrupt the healing, may cause bleeding, and or pain.

Activity

– No heavy lifting or strenuous exercise for at least 2 days after surgery.
– Avoid over fatigue. Go to bed early at night and get adequate rest during the day.

Sutures

– Your stitches, if you have them, will usually dissolve in 2-10 days and fall out on their own.

Antibiotics

If you are given a prescription for an antibiotic, have it filled and take ALL of the medication according to the instructions on the label. Keep taking the antibiotic for the full treatment time even if you begin to feel better. If you develop an adverse reaction (i.e. rash or itching) discontinue the antibiotic and contact the office.

Female patients on antibiotics should be aware that oral contraceptive (birth control) pills might be less effective while taking antibiotics. You should use a second method of birth control while taking antibiotics.

Post-Operative Conditions

The following post-operative conditions may occur in some patients while healing is progressing normally:

– Swelling on one or both sides of the jaws/face
– Tightness of the muscles (Trismus) causing limited opening
– Earache or sore throat
– Discoloration (black/blue/yellow) of face and neck skin
– Other teeth may ache temporarily
– Cracking and soreness of the corners of the mouth – apply Vaseline
– There may be a “hole” in your gum after surgery. This is the tooth socket. It will fill with time
– If you are in doubt about your post-operative course, make an appointment to see your doctor.

DENTAL IMPLANT & BONE GRAFT PROCEDURE POST-OPERATIVE INSTRUCTIONS

Care of the mouth after surgery has an important effect on healing. Depending on the extent, nature, and the location of surgery; swelling, discomfort, slight oozing of blood, and restricted jaw movement should be expected. These need not cause alarm and may be minimized if the following post-operative instructions are followed:

Care of the mouth:

– Do not rinse, swab your mouth or brush your teeth on the day of the surgery.
– Starting on the second day, you may resume routine brushing of teeth and oral care avoiding the surgical site. Rinse your mouth gently with Chlorhexidine (Peridex) twice daily until your first post-operative appointment.
– DO NOT pull on lips or cheeks to view the surgical site. Avoid using a Waterpik or similar water flosser, and do not chew on surgical site, as these can open the surgical site and delay healing.
– Avoid smoking, drinking through a straw or using your tongue to feel surgical area, as these may disrupt the healing, cause bleeding, and or pain.

Bleeding:

It is not unusual to have slight oozing for 24 hours and periodic break-through bleeding for 10 days after an oral surgery procedure. Remember, a drop or two of blood mixed with saliva may seem like more blood than there really is. To minimize bleeding:

– Keep firm pressure with gauze on the area as instructed until bleeding is controlled.
– Avoid frequent spitting or rinsing your mouth on the day of the surgery.
– If you have been instructed to wear your dental appliance, keep it in place for the first 12 hours as it will help control the bleeding.

Swelling:

You may experience swelling after surgery. The swelling peaks in appearance in 2-3 days and take up to 10 days to return to normal. Applying ice packs for the first 24 hours, with 10 minutes on and off intervals and elevating your head may help decrease swelling. If you experience swelling several weeks after your surgery, please make an appointment to see the doctor. To minimize swelling:

– Apply an ice pack to the operated side of your face for the first 24 hours, with 10 minutes on and off intervals.
– Switch to warm moist heat packs after 24 hours and warm mouth rinses.

Discomfort:

A certain amount of discomfort must be expected with any surgery and medication usually will be prescribed to make you comfortable. You will be numb (pain free) after the surgery for the next few hours depending of how much anesthesia was administered during the surgery. You should start taking your pain medication before the numbness wears off. Remember, after the pain medication is swallowed it may take one hour to take effect. The discomfort may be the greatest for most patients on the night of the surgery. Some patients report greatest discomfort second or third day after surgery (coinciding with the greatest swelling). All narcotic-containing medications may impair the mental and physical abilities required for performance of potentially hazardous tasks such as driving a car or operating machinery. To minimize pain:

– 30 minutes after surgery, remove gauze packs (if placed on the surgical site), eat soft food, and start taking your pain medication.
– If you have taken the prescribed pain medication and are still uncomfortable, you may take Ibuprofen (Advil or Motrin) in between your prescription pain pill schedule.

Diet:

Eat whatever is comfortable but chew on non-operated side if possible. You may require soft or liquid foods for 2-7 days. Avoid foods that require hard chewing. It is very important to maintain good dietary intake even if only liquids.

– Soft foods: soup, mashed potatoes, eggs, yogurt, pudding, Jell-O, ice cream, cooked fish…anything you can mash with a fork.
– Avoid chips, popcorn, and peanuts.
– Avoid drinking through a straw as this may cause some bleeding.

Activity:

– No heavy lifting or strenuous exercise for at least 2-3 days after surgery.
– Avoid over fatigue. Go to bed early at night and get adequate rest during the day.

Nausea:

Nausea may be present during the initial post-operative period. Small sips of 7-UP, ginger ale, or broth may help. Sometimes nausea and vomiting are associated with narcotic pain medications. Taking your pain medication on a full stomach can alleviate this problem. If nausea continues, you may want to stop the prescribed pain medication and switch to regular Tylenol or Ibuprofen.

Antibiotics:

If an appropriate antibiotic has been prescribed for you. It is very important that your antibiotics be taken as directed until all are used to prevent the possibility of infection. If you develop an adverse reaction (i.e. rash or itching), discontinue the antibiotic and contact the office.

Female patients should be aware that oral contraceptive (birth control pills) may be less effective while taking antibiotics. You should use a second method of birth control while taking antibiotics.

Special Instructions:

– DO NOT touch the surgical area with tongue or fingers. It is best not eat directly on the surgical site for 2 weeks.
– Suture (stitches) if placed will dissolve and fall out if they are resorbable. Non-resorbable sutures will need removal by your doctor in about 2 weeks. DO NOT attempt to remove or play with your tongue.
– If bone graft material has been placed, you may experience more discomfort. It is important to prevent any pressure on the graft. It is normal to notice sand-like material in your mouth during the healing process.
– If you wear a denture or one was placed after surgery → Do not remove denture for 2 days. After 48 hours, it is best to wear your denture as little as possible during the day and not to wear it at night time.