Post-Operative Instructions: General

Post-Operative Instructions at Oral Surgery Group

These are general instructions and not all of these instructions may apply to your recovery. Common sense will often dictate what you should do; however, when in doubt, follow these guidelines or call our office at any time for clarification.

The First Hour After Surgery

Bite down firmly but gently on the gauze packs that have been placed over the surgical area(s). Make sure that the gauze remains in place, undisturbed for 30 minutes, then reapply with clean gauze. You can also use a damp tea bag in place of the gauze. No eating, drinking, or sleeping with gauze in your mouth.

If you experience continued heavy bleeding while biting on the gauze, it means the gauze is in the wrong position and not pressing on the extraction site. Repeat the following steps:

1. Remove gauze.
2. Reposition gauze or tea bag so that pressure is applied to the bleeding site.
3. Bite on the gauze for 30 minutes to 1 hour.

Bleeding and Oozing

Intermittent oozing is normal for up to 24 hours and can last longer if you are taking blood thinners. The blood will mix with saliva, so it is important to determine if there is active bleeding. The above instructions can be repeated, and then the gauze can be discontinued when the bleeding has subsided. Do not go to sleep with any gauze in your mouth.

Pain

Unfortunately, most oral surgery procedures are accompanied by some degree of discomfort. There are many good strategies to get you through the process, though. Some form of pain reliever should be taken before the numbness goes away. Over-the-counter medications like ibuprofen (Advil^® or Motrin^®), acetaminophen (Tylenol^®), or aspirin are adequate if there are no allergies, they have been tolerated in the past, and they do not interfere with any other medications. For more involved procedures, a prescribed narcotic can be taken. The narcotic can also be alternated or taken in addition to ibuprofen if there are no allergies and has been tolerated in the past. Taking your medications with food will decrease the chance of nausea. Remember, narcotic pain medications will impair your judgment and reflexes, so driving and operating heavy machinery is to be avoided.

Antibiotics

Antibiotics are prescribed to treat or prevent infections, so take all of the medication as directed. If you experience any adverse reactions, such as nausea, rash, or itching, discontinue the medication. A rash or itching may indicate an allergic reaction to a medication. Antihistamines (Benadryl^®) will usually counteract the hives, rash, and itching. Swelling of the lips or tongue or difficulty breathing may represent a more severe allergic reaction, and you should seek medical attention immediately.

Swelling

Swelling from oral surgery is normal and reaches its maximum in 48 hours. Keeping the head elevated with 2 pillows when lying down can minimize facial swelling. Swelling can also be minimized by applying cold compresses to your face every hour (30 minutes on, 30 minutes off) for the first 48 hours. After 48 hours, warm compresses will help reduce the swelling. These should be continued (30 minutes on, 30 minutes off) until the swelling has subsided.

Rinsing

Avoid rinsing the mouth for 24 hours after surgery. It may disturb the clot. The following day, you may begin gently rinsing with warm (not hot) salt water. Dilute 1 teaspoon of salt in 8 ounces of warm water and rinse gently 3 or 4 times a day for 1 week.

Spitting

Do not spit because this action can disrupt the blood clot and/or promote bleeding.

Brushing

Avoid brushing near the surgical sites the day of surgery, since there may be stitches that can be disturbed, as well as some soreness and swelling. Begin your normal hygiene routine as soon as possible and gently brush the areas you are comfortable with.

Irrigation Syringe

If you have been given an irrigation syringe, start using 1 week after the procedure. Fill it with warm water and use gently to clean the socket. The socket will be closing up from the bottom and after 3 or 4 weeks will close up, and food will no longer get stuck. It is normal to feel a hole after the tooth is removed, and this will eventually heal completely, and bone will fill in the socket.

Diet

A nutritionally balanced diet is very important. During the first 24 hours, eat cool/room temperature soups and soft foods that are easily chewed and swallowed. You may gradually progress to solid foods over the next few days. Do not skip meals. By eating nutritious meals regularly, you will feel better, gain strength, have less discomfort, and heal faster. Take any prescribed food supplement as directed. If you are a diabetic, maintain your normal diet and take medication as usual.

Nausea

Drink a carbonated beverage, such as ginger ale or cola, every 30 minutes until nausea subsides. You may also eat saltine crackers to help alleviate symptoms. If nausea persists, please call our office.

Dry Socket

When a dry socket occurs, there is constant pain that radiates to other areas of the jaw, teeth, and ear. Symptoms of a dry socket will not occur until the third or fourth post-operative day, and it results from a loss of the blood clot in the socket. This is similar to a scab pulling off the skin. All the surrounding areas will look normal. If you do not have improvement after the first few days following the procedure, please call the office. A medicated dressing may need to be placed to resolve the discomfort.

Bruising

Sometimes bruising may occur 24 or 48 hours after surgery has been performed. Application of warm compresses to the involved area (30 minutes on, 30 minutes off) will expedite the healing process.

Smoking and Alcohol

Avoid smoking or chewing tobacco for 1 week after surgery. Alcohol should not be consumed while taking pain medication and/or antibiotics.

Sharp Bony Edges

If you feel something hard when you place your tongue on the surgical site, you may think it is part of your tooth. This is the hard, bony wall that originally supported the tooth. Leave it alone, and it will heal itself. Our interest in your care does not cease with the completion of the operation. If any difficulty arises at any time, please call us, and we will see you for treatment.

Soft Diet Instructions

Follow for the first 24 hours after surgery

• Colas, Ginger Ale, Cottage Cheese, Baby Food (no chunks)
• Milkshakes, Protein/Ensure Shakes, Mashed Potatoes, Soup (lukewarm)
• Yogurt (no chunks of fruit), Jell-O^® (no fruit pieces), Milk
• Ice Cream, Sherbet, Frozen Yogurt, Pudding, Custard, Apple Sauce, Homemade Pureed Food

Avoid any foods that contain nuts, seeds, popcorn, rice, corn, or chips.

All food and drink should be consumed chilled/cool until the numbness wears off.

Do not use a straw for 1 week as this may disturb the blood clot and/or promote bleeding.