BLEEDING:  Active bleeding usually lasts for about 2-3 hours and can be controlled by placing tightly folded gauze directly over the surgical site and maintaining firm biting pressure. Check gauze every 20-30 minutes and change it as needed.  Discontinue using gauze when it is pink in color.

NOTE: If heavy bleeding persists longer then 4 hours try biting on a moistened tea bag for at least an hour (black tea is best). If heavy bleeding continues then call our office or the Doctor directly.

DISCOMFORT/MEDICATIONS:  A moderate degree of discomfort is expected following surgery. Initially, the local anesthetic will keep patients comfortable, but it will wear off around 4-6hrs after the surgery. Start taking the prescription strength Ibuprofen right away. Once the local anesthetic has worn off you may start taking the higher strength pain medication make sure to alternate medications every 3 hours. It should look like this:

Ibuprofen, wait 3 hours, higher strength pain medication, wait 3 hours, Ibuprofen

• Sometimes the higher strength pain medication can cause nausea, prior to taking this medication each time it is suggested that a small amount of food is consumed. If you are experiencing nausea prior to taking the higher strength pain medication a clear liquid diet is encouraged, if nausea persists longer than a few hours, notify your doctor.

Take all medications as prescribed.  If side effects occur, please call us with any questions or concerns.

NOTE: Because antibiotics may lessen the effectiveness of oral contraceptives during the cycle in which they are taken, additional contraceptive means should be considered.

DIET:  It is important to take in plenty of fluids and maintain a high caloric intake (juices, soups, milk shakes, etc.) after surgery.  You may eat as soon as you arrive home, if biting on gauze please remove and replace with clean gauze when finished. A soft, cool diet is encouraged for the first 24 hours after surgery; avoid hot foods/liquids as these can encourage bleeding and swelling. You may reintroduce warm foods after the local anesthetic has worn off and bleeding is under control. The goal is to resume a normal diet as soon as possible unless instructed otherwise.  Avoid temperature extremes and chewing while numbness persists.

Do NOT use a straw for at least 24 hours post operatively.

NON-CHEWING/ SOFT DIET:

Jello, yogurt, applesauce, pudding, ice cream, milkshakes (no straws),mashed potatoes, scrambled eggs, cottage cheese, soups, canned fruit, soft noodles/pasta, well cooked/ steamed vegetables.

FOOD TO AVOID:

Chips, nuts, seeds, or anything that could get stuck in the surgical site.

ORAL HYGIENE: Avoid brushing, rinsing, spiting and swishing for the first 24 hours following surgery. Continued good oral hygiene following oral surgery is important to normal healing and should be resumed the day after your procedure. Avoid the surgical site the first few days, when re-introducing a toothbrush to the area you may experience a pink-tinge to the saliva and that is normal.

 RINSING: Rinsing may be resumed the day following surgery.  Rinse with saltwater (1/8-1/4 tsp. salt in 4 oz. warm water) 4 times per day or use an oral rinse if prescribed. More frequent rinsing will soothe the oral wound.  Continue rinses for at least 7 days post-operatively unless otherwise advised. Please refrain from using over the counter mouthwashes until healing is complete especially with implant, bone grafting and any other tissue graft procedures. Use ONLY prescription rinses for these procedures.

**For lower wisdom tooth extractions begin rinsing extraction sites with the curved tip syringe that has been provided, this should be started 5-7 days after surgery.  Slip the tip of the syringe under the flap of gum tissue covering the extraction site (if present).  Do this after each meal until the tissue completely heals over, usually 2-4 weeks.

 SWELLING/STIFFNESS: Apply ice packs externally to the surgical areas as soon as possible. Rotate ice packs from side to side, switching every 20 minutes for the first 12-24 hours following your procedure. Switch to warm, moist heat after the first 24 hours for swelling, bruising and stiff sore muscles. Continue taking the prescription strength Ibuprofen to assist with this. Some difficulty in swallowing, restricted jaw motion, pain near the ear, and bruising of the skin may also be experienced following oral surgery.

**Sleeping/resting at a slight incline, with your head elevated, will help minimize bleeding and swelling as well.  Swelling usually reaches its peak on the second or third day and then subsides over the next several days. You may notice that these days tend to be the most uncomfortable days during the healing period.

SMOKING: Refrain from smoking for several days following surgery. Not only does smoking delay healing it can possibly increase the chance of dry socket.

IV SEDATION: If intravenous sedation has been administered, initially remain in a reclining position and limit activity for the rest of the day.  Someone should remain with you for the remainder of the day or until you are fully recovered from the sedation.  The performance of potentially hazardous tasks, such as use of stairs, driving a car, operating machinery, or the intake of alcoholic beverages should be avoided for at least 24 hours.  It is also recommended that the same precautions be taken while taking any narcotic pain medications.

 PHYSICAL ACTIVITY: Keep all physical activity to a minimum for the first few days. Avoid strenuous activity or exercising for the first week after surgery and ease back into your exercise routine.

ARM PAIN: Occasional discomfort may develop at the site where intravenous medication is administered.  If this should occur bring this to our attention.

IMPLANTS

Take any prescribed medications as directed.  Avoid brushing the surgical site for 24 hours, when brushing is resumed run tooth brush under hot water to soften bristles and make cleaning the site more comfortable.  It is important to keep the area clean to promote healing. DO NOT SMOKE – smoking increases the chance of implant failure. Avoid any chewing in the area where the implant was placed for at least 3 weeks.  If stitches are present they will dissolve and come out on their own usually within 5-10 days, do not pull or cut them out. If a denture or flipper is used during the healing process, you may need to see your dentist to have it adjusted to fit the implant site.  Please call to make a follow up appointment for 2-3 weeks after your implant has been placed if one was not scheduled at the time.

BONE GRAFTING

The grafting material is made up of small particles, it is normal for some of these granules to come out of the graft site during the first week of healing. Do not apply pressure to the area with your tongue or fingers as the material is movable during the initial healing process.

SINUS PRECAUTIONS

(For sinus grafting or perforations)

1. Do not blow your nose.
2. If you must sneeze, do so with your mouth open to avoid pressure in the sinus. Do not stifle the sneeze.
3. Do not smoke or use chewing tobacco, this inhibits healing.
4. Do not use a straw.
5. Take antibiotics as directed
6. A small amount of bleeding from the nose is normal, but shouldn’t last for long.
7. If you feel congested, an over-the-counter antihistamine may be used.

 

DRY SOCKET:  Symptoms of a dry socket can include; severe pain, usually within 5-7 days after the extraction, pain radiating to the ear, eye, temple or neck, and an unpleasant taste or odor. This is a treatable condition; please call to schedule an appointment.

24 HOUR TELEPHONE SERVICE

(nights and weekends)

The above serves only as a guide for post-operative care.  Should you have any questions or problems, please call your doctor.  Their number can be found on your post operative instructions sheet.

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