Home Care After Surgery

Oral surgery, whether extensive or limited, requires proper post-operative care.  If sutures (stitches) are used to close the surgical wound, you will be scheduled for a post-operative office visit.  During this visit, your sutures will be removed and your general healing progress will be evaluated.

Your understanding of proper home care following oral surgery is a very important part of a successful recovery.  These detailed instructions will guide you in caring for yourself or for others who have had surgery.  Please read this carefully and refer to it throughout your post-operative period.

If you have any questions concerning post-operative home care, please feel free to call our office.  Our answering service can reach us even if the office is closed.

BLEEDING

Maintain the gauze pressure packs in your mouth for at least one hour after surgery.  These packs should place pressure directly over the surgical site.  Replace and maintain a gauze pack over the surgical area for the next few hours.  This will help to minimize bleeding and will also help readapt the gum tissues that have been manipulated during surgery.

Some mild oozing of blood is to be expected following surgery and may continue for as long as 24 hours.  The oozing, combined with saliva, can often appear as noticeable bleeding.  Keeping gauze in place will minimize this oozing.  Using a straw post-operatively, as well as spitting should be avoided since these may dislodge the blood clot.  When you are resting and sleeping do so with your head elevated by two pillows and place an old towel over the pillows to protect them.

Do not become alarmed or excited if there is persistent bleeding.  This can usually be stopped by placing a moistened tea bag directly over the surgery area and applying pressure by biting firmly with constant pressure.  The tannic acid in the tea bag helps to form a blood clot by contracting blood vessels.  Apply an ice bag or cold compress to the cheek in the area of surgery.  If these measure do not seem to be working, please call our office.

SWELLING

Facial swelling following oral surgery is quite normal and will usually reach its peak during the first 48-72 hours.  To minimize such swelling, apply ice packs during the first 24 hours, 20 minutes on and 5 minutes off.

Three days after surgery heat applied to the jaw will probably increase comfort and reduce stiffness.  Use a hot water bottle or heating pad on the cheek.  You should protect the skin with a moisturizing lotion and with a thin towel between the heat source and the skin.  Do not use the heat continually, but apply it for about 20 minutes, then remove for an equal interval.  If swelling appears to be increasing rather than decreasing after the third day, you should call our office.

PAIN

Ordinarily the use of acetaminophen (Tylenol) or aspirin should be sufficient to keep you comfortable when taken in doses of two tablets every four hours.  However, occasionally prescription pain medications are needed during the first day or two following surgery.  Do not drive or operate mechanical machinery while taking prescription pain medication.

We recommend that you take the first dose of pain medication within an hour following surgery.  This will allow the medication to dissolve and be absorbed into the bloodstream by the time the local anesthetic wears off.  To avoid nausea, take pain medication with meals or with a glass of milk.

MEDICATIONS

If prior to your oral surgery, you had been taking medication prescribed by another physician or dentist, continue to take that medication unless you are advised otherwise.

Antibiotic medication may be prescribed after your surgery.  If you are given such a prescription, be sure to take all of the medication, as directed.  Caution:  Antibiotics may alter the effectiveness of oral contraceptives.

Although most patients benefit from such prescription drugs, occasional side effects such as dizziness, rash, nausea, excitement, constipation or diarrhea can occur.  Should you experience any of these side effects, stop the medication immediately and notify our office.

DIET

You must guard against dehydration following oral surgery.  Increase your fluid intake, drinking several glasses of water, juices, milkshakes, or soda on the first day.  Avoid hot drinks during the first day after surgery, although warm soups or mashed potatoes are suitable.

You might have nausea during the first few hours after surgery.  A small amount of a carbonated drink such as Coca-Cola or 7-up every hour will usually relieve nausea.  Avoid using a straw since the pressure of sucking through a straw may dislodge the blood clot.

A soft diet, high in vitamins and protein, is recommended for the second and third day after surgery.  You will feel better, have more strength, and heal faster if you continue to eat.

If you are a diabetic, maintain your normal caloric requirements and take your medication as usual.

ORAL HYGIENE

Good oral hygiene is essential for wound healing.  Food left in the wound slows healing and invites infection.  However, do not rinse your mouth for the first 12 hours.  The day after surgery, gently rinse with a solution of 1/4 teaspoon of salt in a glass of warm water.  Occasionally we will prescribe an antibiotic rinse which should be used as directed.

If you have had an extraction, there will be a cavity where the tooth was removed.  During the course of normal healing, this will fill with new bone tissue.  In a few cases rinsing is not totally effective in keeping this area clean.  We may provide a small syringe to help you gently rinse this area.

On the day following surgery, you may brush your teeth.  Do not be intimidated by the presence of the stitches, but take care to avoid them.  After two to three days, brush over the stitches lightly.

ACTIVITIES

Avoid becoming fatigued.  Rest as much as possible during the day and go to bed early.

Avoid smoking for at least 24 hours after surgery as the smoke will easily irritate the fresh oral wound and delay healing.

You should not drive a car, operate any machinery or undertake any responsible business matters for at least 24 hours after a general anesthetic or while taking pain medication.

Possible Side Effects Associated with Oral Surgery

Side effects may vary with the complexity of the surgical procedure.  In addition to swelling, bleeding and other conditions discussed above, the following may occur:

STIFFNESS

Stiffness of the jaw muscles may cause difficulty in opening your mouth.  This should resolve within a few days.

EARACHE, HEADACHE OR SORE THROAT

You may experience any of these conditions temporarily as a result of your surgery.  Your other teeth may also ache.  This is called sympathetic or referred pain and is also a temporary condition.

NUMBNESS

Numbness of the lower lip, chin, and/or tongue on the side of surgery may develop.  This is called "paresthesia" and though in rare cases it may be permanent, it is usually a temporary condition that will correct itself within a few days to several months.

BRUISING

Black and blue marks may occur on the cheeks and chin, or under the eye, near the area of surgery.  This may begin as swelling, before resulting in discoloration by the second or third day.  The color may progress from black and blue to yellow and green and may progress down your face onto your neck.  It will gradually disappear over a week or two and may be helped by moist external heat.

FEVER

Your body temperature may be elevated during the first day or two.  Be sure to drink plenty of fluids.  If fever persists, call our office.

CHAPPING

If the corners of the mouth are stretched, they may dry and crack.  Use a lip balm or other ointment to keep your lips moist.

PHLEBITIS

Occasionally the vein in your arm used to administer the anesthesia during surgery becomes tender.  This indicates an irritation of the vein and usually responds well to applied heat.  Should the area become swollen, red, warm and very tender, call our office.

INFECTION

Rarely, a localized infection may occur in the surgical site in the weeks following surgery.  If you have a sensation of increased pain, fever, increased swelling or stiffening of the jaw after the first 48 to 72 hours after surgery, call our office.

BONE FRAGMENTS

Occasionally, small sharp fragments of bone may work up through the gum tissue during the healing process.  This is more common after multiple extractions and is nature's way of reshaping the ridge.  This process of "shredding" slivers of bone may last anywhere from one to four months.  Impressions for bridges, partial dentures or full dentures should be postponed until the ridge is well healed, usually six weeks.

Be sure to contact us if you have any concerns about your progress or recovery.  Our 24-hour answering service informs us of any emergencies.