After Oral Surgery

Printable Version of these instructions

BLEEDING: Place a gauze compress directly over the surgical site and bite down. Replace the gauze every 15 minutes or as needed for 1–2 hours. After two hours of biting of using gauze pads, TAKE THEM OUT AND LEAVE THEM OUT! They will usually still be red—THAT’S NORMAL. The rate of bleeding or degree of clotting cannot be inferred from the redness of the gauze. A small, steady trickle of blood from the site(s) is perfectly acceptable and continued use of the gauze for more than two hours SHOULD NOT BE NECESSARY. It may make the bleeding worse. Do not resume using the gauze unless the mouth is filling up with profuse amounts of blood. Place moist tea bag(s) over the surgical site(s) or wedge in place between the teeth and bite for 20–30 minutes. This may help slow the bleeding but, if you insist on putting the gauze back in, do it for only 20–30 more minutes at the most—NOT ALL DAY LONG. If you have any concerns then call our office.

HYGIENE: Avoid rinsing your mouth rigorously for two days after surgery. You may brush your teeth; however, you should avoid brushing aggressively over the surgical site(s) until it is less tender. For those NOT provided with an irrigating syringe, after 48 hours, vigorously rinse with 50/50 mixture of water and Peridex/Periogard after every meal and bedtime for 10 days. For those NOT provided with a prescription rinse please use warm salt water or gold Listerine as a substitute. If your prescription rinse runs out, you may substitute it with warm salt water or gold Listerine. If you have any questions, or are not sure you are doing this procedure properly, please call the office for assistance.

SYRINGE/PERIOGARD RINSE: In some cases a syringe will be provided to flush food debris out of the tooth socket(s). Food debris will tend to collect in the area of lower tooth sockets. This step is extremely important to prevent infections and promote healing. To minimize food accumulation, begin the procedure described below two days after surgery and continue until the sites are healed (usually 2–3 weeks).

FLUSHING: We will provide instructions when to start carefully but thoroughly flush all lower surgical sites after every meal and at bedtime using a 50/50 mixture of water and Peridex/Periogard (when prescribed). Place the tip of the syringe into the mixture, and pull back on the syringe to load. Position the plastic tip of the syringe slightly into the opening or incision above the extraction site. Slowly flush each lower socket with one or two full syringes of the liquid. This is best accomplished initially by looking in a mirror with your mouth well lighted (a flashlight helps!). Be sure to continue the irrigation of each site until the areas look clean, and further attempts yield no more food particles or other debris.

DIET: It may be necessary to eat soft foods for several days or weeks after surgery (soup that is cooled to room temperature, Jello, cereal, eggs, yogurt, ice cream, applesauce, pasta, well-cooked vegetables, etc.) Some of the liquid diet preparations are helpful as well, such as Ensure, Carnation Instant Breakfast, or Protein shakes/smoothies. You will feel better, have more strength, less pain, and heal faster if you continue to eat a healthy diet. You may return to your normal diet as comfort allows.

FLUIDS: You may start drinking right away (take the gauze out of your mouth before doing so). Fluids are very important, especially after intravenous anesthesia, even though it may be uncomfortable. An adult should consume two to three quarts of fluids every day. Children should have a proportional amount. Avoid alcoholic beverages for the entire time you are on prescription medicationand avoid using straws and drinking carbonated beverages for at least 48 hours. Hot beverages may promote bleeding, so room temperature or colder beverages are recommended the first day after surgery. Drinking iced tea may assist in slowing down the bleeding the first few days after surgery. Other good beverages include milk, juice, Gatorade, Instant Breakfast, Ensure, smoothies, milkshakes, and water.

REST: It is always important to get plenty of rest with any surgery or illness. Avoid rigorous activity such as exercising and lifting heavy objects for the first two days (for wisdom teeth surgery, 5–7 days.) Resume exercise only if you are not experiencing symptoms.
SUTURES: In some cases, sutures have been placed. Certain types are designed to dissolve on their own, but if it is necessary to remove the sutures, an appointment will be made for this.

SWELLING/BRUISING: Some swelling is to be expected following surgery, sometimes up to one week after surgery. To help control this, apply an ice pack on the outside of your face near the area of the surgery for 20 minutes, remove for 20 minutes. Repeat this alternating process for the first 24–48 hours. To be most effective, the application of ice packs should begin as soon as possible after surgery. After 48 hours ice packs should be discontinued and moist heat (i.e., warm moist wash cloth) should be applied at 20 minutes intervals. Continue this until swelling has subsided. Please remember not to lie flat for 24 hours. Stay propped up at a 45-degree angle in a recliner or by use of pillows. This will help reduce swelling, bruising and bleeding.

You can expect bruising to appear 2–3 days after surgery, the amount of bruising depends on the extent of the surgical procedure. Areas of probable bruising would include the face, chin, neck, and chest. Use ice packs on the day of surgery and the day following surgery. After 48 hours use warm, moist heat every day until the bruising dissipates (may take up to a week). This process will help reduce the amount and duration of bruising.

MOUTH APPLIANCES: Usually can be worn if it does not interfere with the surgical site(s). The doctor will check the prosthesis, relieve any pressure points, and determine whether it can be worn after surgery. When comfortable, return to wearing your retainer as soon as possible.

PAIN: The amount and duration of pain varies per patient. It is not uncommon to still need OTC pain medication (ibuprofen, Tylenol) for several weeks after oral surgery. If you are having more pain than can be controlled with ibuprofen (or similar over-the-counter pain medications) or with the prescription pain reliever your doctor gave you, you should call the office.

MEDICATION: Depending on your procedure, you may need antibiotics and/or prescription pain medication.  Follow all instructions provided with those medications and call us with any questions.

SINUS PRECAUTIONS: for highly impacted upper teeth only, please follow sinus precautions for two weeks. Avoid blowing your nose, try to sneeze with your mouth open, do not spit or cough forcefully, do not drink through a straw. SCUBA diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided. Avoid bearing down during exertion, lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action, or any other activity that increases nasal or oral pressure. There is a possibility that you may develop slight nose bleeds. Please do not blow. Instead, simply dab it. This is temporary and should not persist past 3 or 4 days. The doctor may also recommend a nasal decongestant to help drain and reduce pressure in the sinuses (e.g., Mucinex, Sudafed, or Coricidin).

FEVER: A low grade fever is not unusual even after a simple procedure. Fever may be caused by inadequate fluid intake as well. If your temperature exceeds 101° F, do not hesitate to phone the office.

Lastly, DO NOT SMOKE at all for a minimum of 7 days to avoid a painful dry socket.

IN CASE OF EMERGENCY, PLEASE CALL
(603) 883-4008