Post-Operative Instructions: General

Keep the Mouth Clean

Beginning the day after surgery, begin gently rinsing. You can use warm salt water, diluted mouthwash, or simply water. Tooth brushing can resume the day after surgery as well. Avoid the areas of surgery and use a soft toothbrush. As healing progresses, normal brushing techniques may be resumed.

Bleeding

Gauze pressure is the most effective way to control bleeding. When you leave the office you will most likely be biting on a piece of gauze. This piece should be left in place for at least 60 minutes before removing it. After 60 minutes, the gauze should be removed. It is common to have slight bleeding or oozing for several days. If heavy bleeding continues, replace the gauze with a fresh, folded piece. Be sure of proper placement of the gauze over the site of bleeding. Leave this piece in place under steady pressure, undisturbed for one hour. Resting, with the head elevated on a couple of pillows, is also helpful. Do not get excited. If bleeding does not subside, call for further instructions.

No spitting, sucking on straws, or vigorous rinsing for 24 hours. This may cause persistent bleeding or dislodge the clot. Smokers should be aware that smoking could impair healing. It is recommended that patients recovering from oral surgery should no longer smoke.

Pain

The local anesthetic wears off in 1 to 3 hours. Some form of pain reliever should be taken before the numbness goes away. Tylenol^® (acetaminophen), aspirin, or ibuprofen (Motrin^®, Advil^®) is usually adequate. For more involved surgery, such as removal of impacted teeth, the doctor may prescribe stronger pain relievers. Take these medications as prescribed. Do not drive or operate machinery while on this medication.

Antibiotics

If you have been prescribed antibiotics, take all of the medication as directed. This drug is meant to treat or prevent infection.

If you experience any adverse reaction to the medication, such as nausea, rash or itching, discontinue the medication. A rash or itching may indicate an allergic reaction to a medication. Antihistamines (Benadryl^®) will usually counteract the hives, rash, and itching. Swelling of the lips or tongue or difficulty breathing may represent a more severe allergic reaction, and you should seek medical attention immediately.

Sutures

In most cases, dissolvable sutures are used. These sutures will come out on their own in 2 days to 2 weeks. If any sutures are bothering you, or you have concerns regarding your sutures, please contact the office during normal office hours. If the surgeon elects to use sutures that require removal, we will schedule a return appointment for you.

Discoloration

You may develop black, blue, green, or yellow discoloration resembling a bruise to the tissue. This is due to a slight oozing of blood beneath the tissue and is of little significance. This is a normal post-operative event and will resolve in a few days to a week.

Swelling

Swelling is common with oral surgery. It usually takes about 48 to 96 hours for swelling to peak. The use of ice packs to the side of the jaw, where the surgery was, may help prevent swelling. The ice packs should be used regularly, 30 minutes on and 30 minutes off, for the first 48 hours. After 48 hours, heat can be applied to the swollen area to speed the reduction of the swelling. Heating pads, hot water bottles, and warm washcloths are all acceptable heat sources. If swelling continues to increase in size after 3 days, it may require attention, and you should call the office.

Diet

After the local anesthetic (numbness) has worn off, you may eat anything soft you wish by chewing in an unoperated area. A nutritious high-calorie, high-protein diet is important for rapid healing. Soft nutritious foods such as soft-boiled eggs, chopped meats, custards, Jell-O^®, pudding, thick soups, milk, milkshakes, or liquid dietary supplements are examples of acceptable foods. Nourishment should be taken regularly. Try not to miss a single meal and stay well hydrated. You will feel better, have more strength, have less discomfort, and heal faster if you continue to eat.

Impacted or Buried Teeth

After the removal of impacted teeth, it is possible to encounter any one of the following:

Jaw Stiffness: This will resolve in one to two weeks with healing and increased use of the jaw.

Numbness: You may experience numbness of the lower lip, chin, tongue, and gum tissue. This is almost always a temporary condition. It may last for a few days or many months. Contact the office if this condition persists for more than a week.

Shifting of Teeth: Teeth adjacent to the extraction site may shift slightly, causing some discomfort. This is usually temporary and will resolve itself.

Irritation: Sores or cracking of the lips and corners of the mouth. This is due to chapped lips or stretching of the lips during surgery. It is best treated by keeping the lips well lubricated with a mild ointment.

Sharp Bony Edges: Occasionally, patients will detect hard substances with their tongue in the area of the extraction. This is the bony wall that surrounded the tooth. In most cases, this is a temporary condition; contact the office if it persists.

Dry Sockets: Dry socket refers to a condition which may arise after the removal of teeth. Symptoms include a throbbing, radiating pain. This pain may travel to the ear, jaw, teeth, head, or throat. This condition will resolve without treatment; however, the pain can be managed through the use of over-the-counter pain relievers and/or with medicated dressings placed in the extraction socket. If you think you may have this condition, please call the office so that we can help you.