Post Surgery Instructions
DAY OF SURGERY:
WOUND CARE. Do not disturb the surgical area today. Bite down gently but firmly on the gauze that was placed in the office, making sure that the gauze remains in place. Leave the gauze in place for one hour and change it every hour until the bleeding stops. This can take 4-6 hours.
It is important to allow a blood clot to form in the socket therefore, DO NOT rinse or brush your teeth for the first 24 hours and DO NOT SMOKE for at least 48 hours, since it is detrimental to the healing process. Do not use straws for the first week. This may dislodge the blood clot from the socket.
Start rinsing your mouth with warm salt water no sooner than 24 hours after surgery. Use ½ teaspoon of salt per cup of warm water. Continue this for several days. You may start normal tooth brushing the day after the surgery or after bleeding is controlled. It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.
BLEEDING. Some bleeding is normal, and blood-tinged saliva may be present for 24 hours. This may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes.
STEADY BLEEDING. Bleeding should not be severe. If bleeding persists, this may due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site. Try repositioning the gauze to the cheek side of the surgical area. If bleeding persists or becomes heavy, use a moist non herbal tea bag (first soaked in hot water, squeezed dry and wrapped in moist gauze). Bite gently on the tea bag, place on the surgical site for 20-30 minutes. If bleeding continues, please call our office.
SWELLING OR BRUISING. Swelling is to be expected, and usually reaches it’s maximum in 48 hours. To minimize swelling, cold packs or an ice bag wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied 20 minutes on then removed for 20 minutes during the first 12-24 hours after surgery.
After 24 hours, it is usually best to switch from using the cold pack to applying moist heat or heating pad to the same area, until swelling has receded. Bruising may also occur, but should disappear soon. Tightness of the jaw muscles may cause difficulty in opening the mouth. This should disappear within 7 days. Keep lips moist with cream or Vaseline to prevent cracking or chapping.
DIET. Eat any nourishing food that can be taken with comfort. It is advisable to confine the first day’s food intake to bland liquids or pureed or soft foods. Avoid foods like nuts, sunflower seeds or popcorn, which may get lodged in the socket areas. Over the next several days, you may progress to more solid foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.
MEDICATIONS. Unfortunately, most oral surgery is accompanied by some degree of discomfort. We therefore, advise you to take the pain medication on schedule as directed by Dr. Stern and staff.
You should take Ibuprofen, 600 mg (three tablets of Advil or the equivalent) every six hours as needed for the first 3 days following surgery. This is an excellent painkiller.
Dr. Stern or Dr. Swanson may have prescribed an additional narcotic painkiller. If you do not achieve adequate pain relief with the ibuprofen, you may supplement the ibuprofen with this with the narcotic painkiller. Taking the prescription narcotic pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset.
If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
INSTRUCTIONS FOR THE FOLLOWING DAYS:
ORAL HYGIENE. Keeping your mouth clean after oral surgery is essential. Keep using warm salt water rinses to rinse your mouth at least 2-3 times daily for the first week. Do not start rinsing or brushing until 24 hours after surgery. Then begin rinsing with warm salt water. Use ½ teaspoon of salt per cup of water.
CARE OF SURGICAL AREA. Apply warm compresses to the skin overlying areas of swelling for 20 minutes on and 20 minutes off to help soothe these tender areas. This will also aid in reducing swelling and stiffness. Sutures will dissolve on their own after 3-14 days unless you were instructed otherwise.
OTHER POSSIBLE POST-SURGERY EFFECTS
DRY SOCKETS. The blood clot on the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office to report these symptoms.
SKIN DISCOLORATION. This may be expected, and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week for this to completely disappear. Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. Aspirin and application of heat on the area will usually correct these symptoms.
NUMBNESS. Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.
It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at 739-8611. Dr. Stern or Dr Swanson can be reached after hours by calling this number as it is transferred to their cell phones.
After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately at (307) 739-8611.