Postop Instructions Extractions
Care of the mouth after surgery has an important effect on healing. Discomfort, swelling, and bleeding are normal after surgery. In addition, you may experience restricted jaw function for several days. These may be minimized by the following instructions.
Although most bleeding may slow down in a few hours following surgery, some minor bleeding or oozing may persist for up to 36 hours following surgery. It is important to remove the gauze pack that is in your mouth when you return home. If you notice bleeding in the region of the extraction sites, place a roll of the gauze you were given over the extraction site and bite firmly with CONSTANT pressure for 30-45 minutes. Removing the gauze more frequently than this will not allow a blood clot to form. Sleeping with your head elevated, avoiding sucking from straws, and avoiding vigorously rinsing your mouth after surgery will all help to minimize the bleeding. If you find that the gauze is becoming saturated within a few minutes of being in your mouth, take a moistened tea bag and place directly over the extraction site and bite with firm and constant pressure for 30 minutes. If you experience any excessive bleeding that is worrisome to you, please contact our office. One of our surgeons is on call 24/7 and will be able to provide you with assistance.
The local anesthesia that was administered prior to your surgery will wear off approximately 2-3 hours after surgery. It is important to take a pain reliever prior to this wearing off. When you are able to pick up the prescription or when you arrive home, remove the gauze from your mouth, have a little something to eat and take one of the prescribed pills or 1-2 tablets of Tylenol. These can be taken every 4-6 hours. In addition, we recommend taking Ibuprofen (Motrin or Advil) as this will dramatically improve the pain control and decrease swelling. It is safe to take two - four tablets of the 200mg strength Ibuprofen every 8 hours. If you are taking the prescription pain medication, it can make you groggy and it is very important to not drive for 8 hours after each dose.
The amount of swelling you experience is highly variable following surgery. In some cases, it can be very significant. Often, the swelling will continue to increase after surgery, until the third day and then should start to decrease. Applying ice to the jaw when you return home is important in minimizing the swelling. Apply for 20 minutes on and then remove for 5 minutes for the first 36 hours after surgery. After 36 hours, if swelling is present, apply heat to the face. This can be in the form of a warm, moist washcloth. If the swelling continues to increase after the third day, we will want to evaluate you to make sure you are not developing an infection. Other ways to decrease swelling: ibuprofen and sleeping with your head elevated.
Several factors can increase nausea and vomiting after oral surgery: bleeding, medications, and dehydration. If you experience nausea or vomiting and think it is from the bleeding, continue to keep gauze in your mouth as needed. If you find you experience it after taking the prescription medication, refrain from taking the mediation until it improves. One ounce of carbonated soda, every hour for 5-6 hours will usually terminate nausea.
Proper hygiene is important in minimizing your risk for infection and dry socket. You can brush your teeth gently the night of surgery with a soft bristled tooth brush and use caution in the region of the surgical site. After 24 hours you may gently rinse with luke warm salt water (1 tsp of salt in a large glass of water) after each meal and at bedtime. Avoid water picks, commercial mouth rinses, and hydrogen peroxide products.
It is very important to keep up with your intake of foods and fluids. A soft diet is recommended following surgery, but you may eat whatever is comfortable. It is recommended that foods with small particles (rice, seeds, nuts, etc.) be avoided as they can become trapped in the socket. Canned nutritional supplements (Ensure, Slimfast, or Carnation Instant Breakfast) may be helpful in maintaining adequate calories in the few days following surgery.
- Most sutures will dissolve within 5-7 days
- Some patients will experience bruising that can sometimes extend into the neck area. Moist heat can help speed the healing.
- Do not drive 24 hours after general anesthesia or while taking prescription pain medication.
- Smokers are advised to avoid smoking for as long as possible as smoking is detrimental to healing.
- Avoid vigorous exercise for 48-72 hours as this can increase bleeding and delay healing.
- Allow yourself adequate rest following surgery. Those who try to do too much too soon often develop more complications and take longer to heal.
Postop Instructions Implants
Most people find recovery following implant surgery to be easier than following a tooth extraction. However, there are several important instructions that must be followed to optimize implant success.
Take the prescribed medication or Tylenol when you arrive home and then as needed for pain. Ibuprofen can also be beneficial and can be taken with Tylenol.
The amount of swelling following implant surgery is considerably less than following an extraction. Swelling will usually subside by the third day, but if it extends beyond this, or is worrisome to you, please contact us right away.
Gently rinse your mouth starting the following day with luke warm salt water (1 tsp mixed in large glass of water) after you eat and in the evening. Be careful brushing this the area of the implant and avoid use of electronic/ultrasonic tooth brushes.
You were provided with gauze prior to leaving our office. If you have any bleeding, fold a piece of gauze and moisten it with water and place over the surgical site. It is important to softly bite down with constant pressure for 30 minutes prior to removing the gauze.
- Smoking is extremely detrimental to implant and graft healing. It is important to refrain from smoking as long as possible.
- Avoid any activities that can result in trauma to the face/jaw.
- Do not wear old dentures/partial dentures prior to having them adjusted by us or your dentist as they may cause too much pressure over the implant or graft.
- Sutures usually will dissolve on their own. Your surgeon will remove any sutures that are still present at your follow-up at that time.
Postop Instructions Sinus
Because of the close relationship between upper back teeth and the sinus, a communication between the sinus and mouth sometimes results from surgery. That communication has occurred in your case, which often heals slowly and with difficulty. Certain precautions will assist healing and will minimize the risk of a permanent opening developing between your sinus and your mouth. We ask that you faithfully follow these instructions:
- Take prescriptions as directed.
_____Augmentin 875mg One tablet by mouth twice a day for 7 days
_____Amoxicillin 500mg One tablet by mouth three times a day for 7 days
_____Clindamycin 300mg One tablet by mouth four times a day for 7 days
- Do not forcefully spit for several days.
- Do not smoke for several days.
- Do not use a straw for 14 days.
- Do not forcefully blow your nose for at least two weeks, even though your sinus may feel "stuffy" or there may be some nasal drainage. If you find that you are experiencing congestion, take an over-the-counter decongestant until symptoms improve.
- Try not to sneeze; it will cause undesired sinus pressure. If you must sneeze, keep your mouth open.
- Eat only soft foods for several days, always trying to chew on the opposite side of your mouth.
- Do not rinse vigorously for several days. Gentle salt water swishes may be used.
Slight bleeding from the nose is not uncommon for several days after surgery.
Please keep our office advised of any changes in your condition, especially if drainage or pain increases. It is important that you keep all future appointments until this complication has resolved.