POST-OPERATIVE INSTRUCTIONS for Oral Surgery
Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed 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. Calling during working hours will afford a faster response.
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 the first day. Do NOT rinse vigorously or probe the area with any objects. Do NOT spit excessively. You may brush your teeth gently the next day after surgery.
PLEASE DO NOT SMOKE: This is very detrimental to healing and may cause a dry socket. It is best to refrain from smoking entirely during the first week after surgery. It is also a great time to quit permanently!
BLEEDING: 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. Keep your head elevated. Excessive spitting can cause 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 re-positioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in 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 during the first 24 hours. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. It is common to have swelling for at least 3-4 days following oral surgery.
PAIN & OPIOIDS: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will 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. If you have no issues taking Ibuprofen or Tylenol, try to use these medications first. Your pain medication has been prescribed based on the extent of your procedure and your medical history. Medical professionals are trying to reduce opioid prescriptions. You or your family member may have been prescribed Ibuprofen to take as a scheduled pain medication. This should eliminate most if not all post-operative pain. If it does not, add Tylenol 500 mg (over the counter) and follow the instructions on the box. Studies have shown this combination is equally as effective as an opioid pain medication without as many risks. Lastly you or your family member may have been given oxycodone if the above combination does not work. Take according to the directions on the bottle. If you have been prescribed Norco or Percocet do not take Tylenol with these medications. They have Tylenol in them already.
NAUSEA: Nausea can occur 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. If you have a prescription for an anti-nausea medication, take it as directed.
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
IRRIGATE (RINSE): On the third or fourth day after your procedure, use the MONOJET syringe provided to irrigate the lower wisdom tooth extraction sockets. Place the tip of the syringe all the way in the extraction socket and flush. Adequate cleaning is important. Use salt water. If you had a bone graft placed DO NOT irrigate.
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use ¼ 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 the day after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth.
HOT APPLICATIONS: After the first 48 hours, you may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, and heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Your post-operative course should be gradual, with steady improvement. If you do not see continued improvement, please call our office.
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 our office. A 24-hour answering service is available to contact the doctor after hours.
Calling during office hours will afford a faster response to your question or concern.
Caroline M. Webber D.D.S.