***Please Read ALL of These Instructions Carefully***
The postoperative course following oral surgery can be quite minimal, so not all of the instructions may apply. Review the instructions to find the answer to your questions. When in doubt follow these guidelines or call our office for clarification. Our number is: (303)772-8870
Day of Surgery
Be Cautious
Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently at all non-surgical sites 24 hours after surgery. PLEASE DO NOT SMOKE for at least 48-72 hours, preferably 1 week, since this can be detrimental to healing and may cause a dry socket.
Bleeding
Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. You will be advised to remove the gauze packs once you arrive home so that you can eat/drink something and take over the counter pain medication. Please replace the gauze packs after you have done so and check the site(s) after one hour. If active bleeding persists, replace the gauze for another hour or as needed. The average patient uses gauze pressure for 3-4 hours after surgery. It is also important to note that the gauze packs will look bloody for a while due to the blood mixing with saliva. Therefore, to accurately assess the bleeding it is best to look directly at the extraction sites for active pooling or dripping of blood. If the sites are not actively dripping or pooling with blood it is advised to leave the gauze packs out.
Oozing
Intermittent bleeding or oozing overnight is normal and usually does not require gauze pressure. It is typical to have the taste of blood in your mouth intermittently for the first week. Do not sleep with gauze packs in your mouth in order to avoid the risk of choking.
Persistent Bleeding
Bleeding should never be severe. If so, it usually means that the gauze packs are being clenched between teeth only and are not exerting pressure on the surgical sites. Try repositioning the packs directly over the surgical sites. 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 1 hour. If bleeding remains uncontrolled, please call the office.
Swelling
Swelling is expected following oral surgery. Peak swelling will occur 48 to 72 hours after surgery. It can be minimized by using a cold pack or ice bag wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied 20 minutes on / 20 minutes off during the first 24 hours after surgery. Apply ice for first 24-48 hours after surgery and then apply heat after 48 hours.
Pain
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Pain often peaks 48-72 hours after surgery. If you take the first dose of pain medication before the local anesthetic has worn off, you will be able to manage the discomfort better. The local anesthesia may last from 1-12 hours after surgery depending on the type of local anesthesia administered. It is recommended that you use ibuprofen (Advil, Motrin) 600-800mg every 6-8 hours as the first option for pain relief, unless otherwise instructed. You may then supplement the narcotic pain medication with the ibuprofen. Some patients find that narcotic pain medications cause nausea/vomiting. However, if you precede each dose with food, the risk of nausea/vomiting will be reduced. The effects of pain medications vary widely among individuals. If you find you are taking large amounts of pain medicine at frequent intervals, please call the 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. Beyond the immediate post-op period, narcotic pain medications are often 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.
Diet
Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods the first few hours after surgery. Do not use a straw for the first week 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.) Avoid crunchy foods like nuts, seeds, rice, popcorn, etc. for at least one week. Over the next several days you may gradually progress to solid foods. It is important not to skip meals. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.
Instructions Following The First Day
Mouth Rinses
Keeping your mouth clean after surgery is essential. Use 1/2 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse by rocking your head side to side. Repeat as often as you like, but at least two or three times daily.
Brushing
Begin your normal oral hygiene routine the day after surgery. Gently brush the gum tissue and the teeth. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. Avoid vigorous swishing and spitting while brushing.
Hot Applications
You may apply warm compresses after 48 hours to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on / 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 2-3 days after surgery are generally the most uncomfortable and there is usually some swelling. On days 4 and 5 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 are given a plastic irrigating syringe, DO NOT use it for the first week or until advised. Then use it at least twice daily and before bed until you are certain the extraction site has closed. This can take up to 3-4 weeks and longer in some cases.
Activity
Plan to rest the first 24 hours. It is important to refrain from vigorous activity or heavy lifting for around 7 days following your procedure. If your head pounds when bending over to tie your shoe that is a sign to take things easy. Use overall caution and if you have questions call the office.
It is our desire that your surgery and recovery be as smooth and pleasant as possible. These instructions are intended to help in the process. Please remember that your case is individual, and no two mouths are alike. Use caution in accepting well-intended advice from friends. If you have questions or concerns, please discuss them with your doctor. Calling during office hours will afford a faster response to your question or concern. A doctor is available after hours, however, please be considerate and avoid non-emergent calls during these times.
Sharp Edges
If you feel something hard or sharp edges in the surgical areas, it is likely that you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may become dislodged and work themselves out through the opening or even through the gum tissue. If they cause concern or discomfort, please call the office.
