GENERALIZED ORAL SURGERY POST-OPERATIVE INSTRUCTIONS
***PLEASE READ ALL OF THESE INSTRUCTIONS CAREFULLY***
Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, if you have a question, follow these guidelines or call our office for clarification.
Our number is: 410 268 7790
DAY OF SURGERY
FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.
EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.
OOZING: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.
SWELLING: Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen vegetables (such as peas) wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.
PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea (prescribed narcotics), but if you precede each pain pill with a small amount of food, it will reduce the chance that nausea will occur. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.
NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.
DIET: Eat any nourishing food that can be eaten with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.
SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1⁄4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.
BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
INSTRUCTIONS FOR FOURTH DAY AND BEYOND
HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Normal healing after tooth extraction should be as follows: The first two to three days after surgery are generally the most uncomfortable and there is usually some swelling. On the fourth day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office where you had surgery. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern.
POST-OPERATIVE INSTRUCTIONS FOR DENTAL IMPLANTS
In additional to the generalized oral surgery instructions:
Single or Multiple Dental Implants: Dental implant placement requires meticulous homecare to ensure successful results. Metal buttons called “abutments” area often secured on top of the dental implant at the time of implant placement. They can be visualized at the surgical site protruding through the gum tissue.
IF AN IMPLANT ABUTMENTMENT WAS PLACED, DO NO DISTURB IT. You must chew as much as possible on the opposite side of your mouth for the first eight weeks after implant placement. Chewing on the same side of the dental implant can cause the implant to fail.
IF AN IMPLANT ABUTMENT WAS NOT PLACED, YOU WILL NOT SEE A METAL BUTTON PROTRUDING THROUGH THE GUMS. The gum tissue adjacent to the implant will appear normal, with the addition of sutures to close the surgical site. Normal chewing can resume once the swelling and discomfort have subsided.
If your dentist provided you with a temporary prosthesis to wear (flipper), ensure that it is adjusted by you general dentist so that it does not touch the gums in the area of the dental implant. Excess pressure on the surgical site can cause the wound margin to break down and subsequent exposure of the dental implant.
POST-OPERATIVE INSTRUCTIONS – SINUS COMMUNICATION/SINUS SURGERY
Because of the close relationship between upper back teeth and the sinus, a communication between the sinus and mouth sometimes results from surgery. That complication has occurred in your case, which often heals slowly and with difficulty.
Certain precautions will assist healing and we ask that you faithfully follow these instructions:
1. Take prescriptions as directed.
2. Do not forcefully spit for several days.
3. Do not smoke for 10-14 days.
4. Do not use a straw for several days.
5. Do not forcefully blow your nose for at least two weeks, even though your sinus may feel “stuffy” or there may be some nasal drainage.
6. Try not to sneeze; it will cause undesired sinus pressure. If you must sneeze, keep your mouth open.
7. Eat only soft foods for several days, always trying to chew on the opposite side of your mouth.
8. Do not rinse vigorously for several days. Gentle salt water swishes may be used. Slight bleeding from the nose is not uncommon for several days after surgery. Please keep our office advised of any changes in your condition, especially if drainage or pain increases. It is important to keep all follow up appointments as directed by your surgeon.