POST-OPERATIVE INSTRUCTIONS FOR ORAL SURGERY PROCEDURES
Please review the following instructions on general care after oral and facial surgery. Sometimes the after-effects of oral surgery can be quite minimal, so not all of the instructions may apply. However, if you have questions or concerns, please call our office at 602-956-9560.
THE DAY OF SURGERY
Bite down firmly on the gauze packs that have been placed over the surgical areas. Do not change them for the first half-hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place a new folded gauze pack over the wound site and bite firmly for another 30 minutes. The pressure pack should be large enough so your teeth do not touch when biting firmly. The gauze pack may be changed as necessary (typically every 30 to 45 minutes).
Do not disturb the surgical area today. Do NOT swish vigorously or scrape or probe the area with any objects. You may brush your teeth gently in any untreated areas.
Please DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a painful irritation, problems with healing or a dry socket.
Oozing: Mild intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing a fresh gauze pack over the wound area and biting firmly for 30-45 minutes at a time.
Persistent Bleeding: Bleeding should never be severe. If so, it might mean that the packs are being clenched between the teeth only and are NOT correctly placed over the surgical areas with firm pressure. Try repositioning the packs over the wound sites. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) and apply firm bite pressure for 30 minutes. If bleeding remains uncontrolled, please call our office.
Swelling: Swelling is commonly seen with oral and facial surgery. It typically peaks by the 3rd or 4th day and can last for a week. It can be reduced by using an ice pack or a bag of frozen peas wrapped in a towel and applying firmly to the cheek adjacent to the surgical area. This may be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed a medication for the control of swelling, be sure to take it as directed.
Pain: Most oral and facial surgeries are accompanied by some degree of discomfort. Be sure to take any pain medications as prescribed. If you take your first dose before the numbing injections have worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you take the pain medications after eating a small amount of food, the incidence of nausea will be reduced. 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. Remember that the most severe discomfort is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find yourself taking large amounts of pain medicine at very frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, please call for a refill during weekday business hours.
Nausea: Nausea is not uncommon with some types of pain medications. Nausea can be reduced by preceding pain meds with a small amount of soft food and staying hydrated with water. Try to drink plenty of clear fluids and minimize the use of narcotic pain medications, but call us if you do not feel better. Sipping small amounts of ginger ale and cola may also help with nausea.
Diet: Stick with soft, nourishing foods that can be eaten comfortably. Avoid extremely hot foods and do NOT use a straw for the first week after surgery. It can be helpful, but not required, to eat liquid or pureed food like soup, pudding, yogurt, or milk shakes for the first day. You should avoid foods like nuts, seeds, or popcorn which may get lodged in the wound areas and sharp or crusty foods which can cut or irritate the wound areas. Over the course of the next week, you may gradually progress to solid foods. It is important not to skip meals! If you are able to nourish yourself regularly you will feel better, get stronger, and heal faster.
Sharp Edges: If you feel something hard or sharp along the wound areas, it is likely you are feeling the bony walls or edges which once supported the extracted teeth--like the edge of a wine bottle with the cork removed. Occasionally small fragments of bone may also work themselves out during the following week or so. These bony edges will remodel and smooth down with time, but 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. You may use salt water rinses to clean and condition the wound and tissues. Try about 1/4 teaspoon of salt dissolved in 8 ounces of warm water to gently rinse your mouth. You should avoid forceful or aggressive swishing because this may cause irritation or dislodge the healing clot over the wound. You may repeat as often as you like, but start slowly with 3 sessions per day.
Brushing: You may continue your usual oral hygiene regimen after surgery away from the wound areas. Soreness and swelling may not permit vigorous brushing, but please make an effort to clean your teeth within the bounds of comfort.
Heat: You may apply warm compresses to the skin over the areas of swelling using a hot water bottle, hot moist towels, or heating pad beginning on the second day. Apply for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
Healing: The progression of normal healing after dental surgery should be as follows: The first two days after surgery are generally the most uncomfortable and this is when swelling is most noticeable. By the third day, swelling usually peaks and you should be feeling more comfortable. Swelling and discomfort typically improves from this point forward. If you do not experience steady and progressive improvement, please call the office. If you are given a plastic irrigating syringe, i.e. "squirt gun", DO NOT use it for the first week after surgery. Then it should be used daily or as instructed until you are certain the tooth socket has closed completely and that there is no chance of any food particles staying lodged in the socket.
It is our hope that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions or concerns about your progress, please call the office. If you anticipate the need for additional narcotic pain medications, please call for a refill during weekday business hours.
