Post-Operative Instructions: Bone and Soft Tissue Grafting

After a Bone Graft Procedure

After a bone graft procedure: Do not disturb the wound. Avoid vigorous rinsing, spitting, or touching the wound on the day of surgery. There may be multiple sutures present at the surgical site. Do not attempt to remove or alter the sutures. If sutures become dislodged, or if you feel strange contours around the surgical site, do not panic. Call our office for instructions.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding should not occur, but can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues, please call for further instructions.

Swelling

A mild to moderate amount of swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag or towel filled with ice, on the cheek over the area of surgery. Apply the ice continuously, as much as possible, for the first 48 hours.

Diet

Drink plenty of fluids. Avoid hot liquids or foods. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. Acute pain management should always start with over-the-counter pain medications, such as acetaminophen (Tylenol^®) or ibuprofen (Motrin^®, Advil^®). If your surgeon approves these medications for you, you should take them as directed on the pill bottles, or by your surgeon. If you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Precede each pain pill with a small amount of food, and chances for nausea will be reduced.

The effects of pain medications vary widely among individuals. For severe pain, you may take your prescription opioid (narcotic). Do not take more opioid pills, or more often, than prescribed by your surgeon. If prescribed, Vicodin^®/Norco^® may be taken every 4–6 hours for pain. DO NOT USE TYLENOL. If you notice that the pain medication is not providing comfort for long enough, alternate the Vicodin/Norco and ibuprofen throughout the day (ex: take one Vicodin, then 2 hours later, take ibuprofen…2 hours later another Vicodin/Norco). If you are unable to achieve a comfortable state, please call us for further advice. Do not drive or drink alcohol while you are taking opioids. Do not use opioids with benzodiazepines, sleeping medications, or other depressants. If you have any questions, ask your surgeon or any pharmacist before using these medications together, as they can increase your risk of an accidental overdose.

Antibiotics

If you are given antibiotics, be sure to take the prescribed medications as directed to help prevent infection. If you are not given post-operative antibiotics, it is most likely because one was not required or you were given the appropriate intravenous dose during your procedure.

Oral Hygiene

Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex oral rinse before bed. The day after surgery, Peridex should be used three times daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds before you spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4–5 times a day, as well, especially after meals. Brush your teeth using Peridex instead of toothpaste for the first 3–4 days. Use a cotton swab (Q-tip^®) moistened with Peridex to gently clean the teeth surrounding the graft three times a day. Do not use electric toothbrushes or a Waterpik^® until you have gotten clearance from your surgeon.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, be aware that throbbing or bleeding may occur. If this happens, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Give us a call with any questions or concerns.

Wearing Your Prosthesis

In some cases, partial dentures, provisionals, or full dentures may not be used immediately after surgery and for at least 10 days. Make sure to receive instructions regarding your temporary appliance from your surgeon following your procedure. If you are unclear about what to do regarding your temporary, please call our office.

Sinus Bone Graft

If you have had a sinus bone graft, please note the following additional comments:

• Intermittent bleeding from the nose is not unusual.
• You may experience sinus congestion for a few days.
• Do not blow your nose or otherwise create blowing or sucking motions for at least one week following your procedure. These actions will prevent normal healing.
• If you have to sneeze, do it with your mouth and nose open.
• If you are given medications such as decongestants or antibiotics, take them as directed.