SURGICAL POST-OPERATIVE INSTRUCTIONS
You have undergone a surgical procedure. The quality of recovery highly depends on self-care. The after effects of oral surgery vary from person to person; therefore not all of these instructions will apply to you. Please feel free to call our office at any time if you feel you are experiencing any unusual symptoms following your treatment and/or if you have any questions.
CONDITIONS TO BE EXPECTED
PAIN AND MEDICATIONS
You may experience numbness (decreased feeling) for several hours after surgery. Discomfort (pain) usually peaks around the second or third day after surgery. Unfortunately, most oral surgical procedures are accompanied by some degree of discomfort that may last longer than a week. Normal surgical pain gradually subsides over the following week.
You will receive a prescription for pain control and should take them as directed. As soon as you get home and get comfortable we advise that you start taking your prescribed pain medication before the local anesthesia wears off. This will help minimize the discomfort of surgery. To help prevent upset stomach, it is recommended to stagger your prescribed medications (i.e. Norco and Motrin) approximately 45 minutes apart. Please remember to take your pain medication on a FULL STOMACH (soft, but SOLID foods) since an empty stomach will most likely cause nausea and possible vomiting.
BLEEDING AFTER SURGERY
Some bleeding is normal and should be expected, blood-tinged saliva may be present for 24 to 48 hours after surgery. Bleeding is best controlled with pressure. The gauze that was placed over the surgical site(s) helps to control your bleeding. Keep pressure on this gauze for 2 to 4 hours after surgery to allow a blood clot to form. If, after removing the first gauze pad, you are still bleeding, place the additional gauze provided over the surgical site(s) and continue with pressure for another 2 to 4 hours. If you run out of gauze, and bleeding persists, a moist tea bag can also be effective. Do not to fall asleep with the gauze in your mouth as this is a choking hazard.
SWELLING AND BRUISING
Swelling and bruising is normal and is to be expected. To help prevent swelling, ice packs should be applied to the outside of your face, next to the surgery sites for at least the first 24 to 48 hours. The ice should be applied for a period of 20 minutes on, 20 minutes off. Swelling usually reaches its maximum 24 to 48 hours after surgery. After 48 hours application of ice and/or warm moist heat is suggested. Bruising may occur up to one week after surgery. It is recommended that you apply heat packs and massage the area for a 5 to 10 day period or until swelling/bruising subsides.
THINGS TO DO:
- Take all medication as directed.
- Place sponges or gauze over, not into, extraction (surgical) site to control bleeding.
- Apply ice to face to control swelling.
- Sleep with your head elevated with an extra pillow or two. This will help to reduce or control swelling.
- Continue oral hygiene measures. (See oral hygiene suggestions).
- Eat and drink. Failure to drink at least 1 quart of fluids per day may lead to dehydration and temperature elevation. (See diet suggestions).
- Time of recovery is shortened by adequate rest.
THINGS TO AVOID FOR ONE WEEK:
- Avoid injuring the surgical site with coarse or hard food.
- Do Not suck on the extraction (surgical) site.
- Do Not Drive while taking pain medication.
- Do Not smoke.
- Do Not use a straw with any beverages.
- Do Not drink carbonated beverages.
- Do Not drink alcohol while taking any medication (pain medicine / antibiotics, etc.)
- Do Not use an electric Waterpic for oral hygiene until the socket (surgical) site is healed.
- Avoid heavy exercise or lifting for at least 4 to 7 days.
- Do not spit for the first 48 hours. This can contribute to clot dis-lodgment and dry socket formation.
After 24 hours rinse with warm salt water (1/2 teaspoon to 1 cup of water) every 4 to 6 hours and after meals. You may brush your teeth the following day, just remember to be very careful of the surgical site(s) and do not suck or spit vigorously. You may use commercial mouthwash (half strength) after the first 48 hours.
A plastic syringe also known as an irrigating syringe will be provided to you if you had your wisdom teeth (3rd molars) removed. You must begin using the irrigating syringe exactly 48 hours after surgery. This is to assist you in cleaning the lower surgical site(s) where food tends to accumulate. Use the syringe to rinse out the surgical site(s) by gently inserting the tip of the syringe into one of the small openings as demonstrated during recovery. You will continue this procedure following meals and before bed time. Using the irrigating syringe any earlier can flush out the blood clots and cause dry sockets.
It is CRITICAL that you use the irrigating syringe as directed in order to prevent infection.
Smoking can lead to dry socket with pain and will slow the healing process. Refrain from smoking for one week after surgery. Do not spit vigorously for the first 48 hours. This can contribute to clot dislodgment and dry socket formation.
The blood clot(s) in the surgical site may be dislodged, causing a condition known as dry socket. This condition starts 3 to 5 days following surgery, often radiating toward the ear or forward along the jaw area, which may cause other teeth to ache. If you do not see steady improvement with each passing day, or if severe pain persists, please call our office. Dry sockets are painful but can be easily treated. Factors that contribute to dry socket are vigorous sucking and spitting, smoking, using a straw or drinking carbonated beverages.
Depending upon the type of surgery you received often depends upon the type of sutures used and the need for follow-up care. Routine extractions usually do not require sutures and may or may not require a post-operative visit. With the removal of third molars (wisdom teeth) dissolvable sutures are generally used. These sutures usually will fall out in 3 to 5 days following the surgery. It is not unusual to visualize a hole in the bone where the tooth was removed. This surgical site (hole) will gradually heal from the bottom up. It is imperative to keep this area clean. If food debris is left in this hole and the tissue heals over the hole you will develop an infection (abscess), which will then need to be re-opened and cleaned out. Generally all patients who have had their third molars removed will be scheduled for a post-operative visit.
Patients undergoing multiple extractions or other extensive surgery may have non-dissolvable sutures placed. These sutures will need to be removed in one or two weeks following surgery. Generally all patients with multiple extractions or other more extensive surgery will require post-operative visits.
If you wear an orthodontic appliance, you may replace them immediately after surgery or the following day unless otherwise directed.
If you have any questions or concerns, please do not hesitate to call our office, 452-4101 between the hours of 8am – 5pm. For emergencies after hours you may call our “On Call Nurse” at # 907-978-5829.