Post-Operative Instructions

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Healing is a highly variable process in every individual and it depends on multiple factors including your health, age, your healing physiology, tissue health surrounding the surgical site, and proper post-operative care.

For Optimal Healing Please Follow These Instructions Carefully

Instructions Highlights

Bite firmly on gauze; Replace every 30-45 minutes until bleeding stops
Ice to face for 24 hours; 20 minutes on, 10 minutes off
Avoid spitting or using straws for 24 hours
No Strenuous activities for 48 hours
Do not rinse or brush on evening of surgery
On the following day after surgery, begin oral rinses with water or salt water (saline) every 2 hours; Continue for at least 10-14 days
Do not smoke for 7-10 days (First 24 hours for bleeding problems, thereafter to avoid healing complications such as dry socket, infections, poor closure)
Soft diet for 3-5 days; advance as you feel comfortable

Do Not Be Alarmed By ......

Slight bleeding up to 6-8 hours or very slight oozing into the next day
Increase in swelling 36-48 hours after surgery
Bruising of skin over neck or chest areas
Sutures loosening
Small openings of incision site
Radiating pain to different parts of head and neck

Call Us Immediately If ......

Pain increases after 3-5 days
Swelling increases 3-5 days after surgery with pain and drainage
Significant bleeding continues more that 8 hours after surgery
Any drainage or infection marked by swelling and increase in pain
Rashes, hives, itching following use of medications
Significant opening of incision lines over grafted regions

Swelling:

Swelling is expected for more invasive oral surgical procedures. Surgical swelling develops gradually reaching its maximum in 36-48 hours after surgery. It will then gradually resolve over the next 3-5 days. Apply ice to affected facial area as soon as possible. Place ice bag to the face for 20 minutes on and 10 minutes off. Do this for the next 24 hours following surgery. If swelling develops 3-5 days after surgery, this is most likely due to an infection. Continue antibiotics and call our office for more instructions.

Pain medication:

Best to start while local anesthesia is still in effect. Take medications with plenty of water. For additional pain relief, narcotic pain medication (Vicodin, Tylenol #3) may be supplemented with ibuprofen (200-400 mg), or tylenol, staggered every two hours. If nausea develops, discontinue the narcotic pain medication and take only ibuprofen (Advil, 2-3 tablets). It is normal for discomfort to last up to 5-7 days, gradually decreasing each day.

Increase in pain 2-3 days after surgery without swelling or pus drainage is most likely due to localized inflammation from inadequate oral rinses. Increase oral rinses aggressively every 1-2 hours Increase in pain 3-5 days after surgery with swelling or pus drainage is most likely signs of a developing infection. Continue your antibiotics and pain medications as prescribed; call our office for instructions.

Antibiotics:

Begin the prescribed antibiotics as soon as possible. Take with plenty of water and food. You must complete the course of antibiotics until finished. Follow the suggested dosage and frequency (at night while asleep, keep it as close as possible to your dosage time); If you develop any hives, rashes, or itching, discontinue antibiotics, take Benadryl (25-50 mg) and repeat every 6 hours till resolved. Call our office for additional instructions.

Diet:

Drink plenty of fluids such as orange or tomato juice, ginger ale, water, tea, etc. Drink at least 4 to 8 glasses of liquids daily to avoid dehydration. DO NOT USE A STRAW: This will cause bleeding by creating suction in the mouth. Soft diet is recommended for 3-5 days. Chew on opposite side of the surgical site if possible. A diet high in protein and carbohydrates is best. Homemade eggnog, using fresh milk, eggs, and a fresh fruit blended into it, is an excellent source of both. We also recommend soups, soft pasta, soft rice, jello, soft boiled eggs, yogurt, soft cereals, and mashed potatoes. Avoid hard or crispy foods for 5-7 days. If bowel habits are irregular, we suggest you take a mild laxative such as Milk of Magnesia.

Smoking

Avoid smoking for at least 72 hours after surgery to avoid immediate complications such as bleeding. For proper healing, avoid smoking all together for 10-14 days to prevent healing complications such as infection, dry socket, or incomplete closure of the surgical site. Smoking significantly decreases success of dental implants and bone grafting procedures.

Bleeding:

Bleeding gradually diminishes in 3-4 hours after surgery and often stops completely in 4-6 hours. Occasionally, it may ooze until the next day. Remove the gauze sponges that have been placed in your mouth one hour after surgery. Replace with a clean gauze and bite or press down with pressure. Repeat every 30-45 minutes until bleeding stops.

If there is continued bleeding after 6 hours, do the following: Place a folded gauze pad directly over the extraction socket. Bite down firmly and hold for 30 minutes. Sit upright and remain quiet. Repeat every 30-45 minutes as necessary. If bleeding continues, dip a caffeinated tea bag in cold water and place directly over the extraction site. AVOID SPITTING OR USING STRAWS that causes bleeding by creating suction in the mouth. If you are still unable to control the bleeding, call our office.

Nausea:

One ounce of carbonated water every hour for 4-5 hours will usually terminate nausea. Coca-cola syrup may also be taken, two tablespoons every 4-6 hours. Follow this with mild tea or clear soup. If nausea persists, antihistamines or a Compazine suppository may be helpful. Call our office for more information.

Oral Hygiene:

For extractions, do not rinse or brush on the evening of surgery; For dental implants or bone grafting procedures, you may perform gentle rinses with salt water on the evening of surgery. The next day begin frequent oral rinses with warm salt water or regular water, every 2 hours, especially after meals. Continue this for 7-10 days. You can brush your teeth as usual, but avoid the site of surgery or be very gentle in that area. After first 24 hours, you may be more aggressive with oral rinses. A special irrigating syringe may be used to improve cleansing if necessary. The key benefit of rinsing is washing away of plaque and food, therefore salt or regular water equally work well. Avoid use of alcohol containing mouth washes for 7 days.

Dentures:

If you have had an immediate denture placed following extractions, do not remove it for 12 hours. You may remove the denture during oral rinsing. Your dentist may reline them for better and more comfortable fit in 3-5 days after surgery.

DO NOT BE ALARMED WITH THE FOLLOWING:

Loose sutures:

If sutures become loose after the surgery, DO NOT BE ALARMED. This is expected in 5-7 days but occasionally may occur in 2-3 days after surgery. Continue with aggressive oral rinses and medications as prescribed and further evaluation is done in your routine 5-7 day post operative visit.

Bruising:

Bruising after surgery may occur and will present itself as purplish, bluish skin color, gradually changing itself to brown and yellowish. It gradually resolves in 5-7 days as it moves down the neck and chest area.

Opening of incision site:

If you notice a small opening at incision site (example: over extraction socket, implant site, biopsy site, grafted site, etc.) DO NOT BE ALARMED. Continue with aggressive oral rinses and medications as prescribed. Continue with soft or liquid diet and treat the site very gently.

Bone graft material:

If a site has been grafted, on occasion,you might notice loose small granules in the area. This is not a problem. Continue with oral rinses and gentle, soft diet.

Whitish tissue:

White ?film? over the surgical site might be either plaque or variation of healing tissue color. Continue with aggressive oral rinses to remove plaque build up.

Bleeding:

Bleeding decreases gradually over 3-4 hours after surgery and often stops completely in 4-6 hours. Apply pressure by biting down or finger pressure on gauze. Tea bag can also be applied over the surgical site with pressure. Occasionally some slight bleeding may occur up to 12 hours after surgery; continue with the same instructions. If bleeding increases after 6-8 hours after surgery call our office for more instructions.

Drowsiness:

Drowsiness is often the result of IV sedation or narcotic pain medications. On occasion it may last several days along with weakness. DO NOT BE ALARMED. You might decide to change pain medication to non-narcotic, over the counter medications such as Advil or Tylenol.

Emergency Contact After-hours

Call (301) 654-7070; Press 2

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For more non-emergency related information or questions, please contact us.