POST- OP INSTRUCTIONS – ORAL SURGERY
Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for Clarification. Our number is: 301-468-9760.
DAY OF SURGERY
FIRST HOUR: Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. The packs may be gently removed after you reach home. Look at the gauze before you throw it away, if it is soaked in blood, you do need to replace with fresh gauze. Prior to replacing the gauze, drink a Milkshake/Ice cream or Yogurt with a spoon and then take your pain medications-One prescription strength Motrin and one extra strength Tylenol. Now take two pieces of gauze from the goody bag, roll it like a cigar and fold it and place it snugly in the area of extraction and bite down for 20 minutes. Redness in the center of the gauze is normal; the gauze needs to be replaced only if it soaked in blood. Intermittent bleeding or oozing overnight is normal
SWELLING: An external or an internal* ice pack will be given to you upon completion of the surgery. Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas placed inside a tube socks or stockings and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and 5 minutes off during the first 24 hours after surgery. *If an internal icepack is dispensed to you, those instructions will be given to you separately. If needed, a prescription for a steroid dose pack will also be given to you
.
FIRST 24 HOURS: Do not disturb the surgical area. Do NOT spit, rinse, brush your teeth at night, consume hot food or use a straw on the day of the surgery. PLEASE DO NOT SMOKE OR DRINK ALCOHOL FOR AT LEAST 48-72 HOURS, since this is very detrimental to healing and may cause a dry socket
.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are improperly placed. Relocate the gauze pack directly in the surgical area exert pressure on the surgical area(s) as you clench down. If bleeding still persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office to reach the doctor on call. Do not physically exert yourself for 5 days following surgery as this will cause unexpected bleeding.
PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for antibiotics and pain medication. If you take the pills before the anesthetic has worn off, you should be able to manage any discomfort better. We have found that the best combination is, taking 600-800 mg of Motrin (Ibuprofen) – which can be ONE-PILL by prescription, OR 3-4 over the counter tablets - which are 200 mg each, every SIX hours. You may additionally take TWO Extra Strength Tylenol (Acetaminophen) caplets (over the counter) THREE hours after your initial IBUPROFEN dose. This “staggering of medications”, will continuously keep some analgesic in your system and will keep you comfortable. You can repeat this cycle for the first 48 hours, as needed. Very seldom, does one need anything stronger. CAUTION: DO NOT EXCEED 3200 mg OF IBUPROFEN/24 HOURS. ADDITIONALLY, DO NOT EXCEED 4000 mg OF TYLENOL (ACETOMINOPHEN) /24 HOURS.
DIET: Eat soft nourishing food that can be tolerated without any discomfort. Avoid hot foods on day of surgery. Do not use a straw for the first day after surgery. It is advisable to confine the first day’s intake to liquids or pureed foods (soups (room temperature), puddings, yogurt, milk shakes, etc.) It is best to avoid foods like chips, nuts, sunflower seeds, popcorn etc. for two - three weeks, as they may get lodged in the socket areas. It is important, however, not to skip meals and stay nourished. If you stay nourished, you will feel better, gain strength, have less discomfort, and heal faster. If you are diabetic, maintain your normal eating habits or follow the instructions given by your physician. Nausea is not uncommon after surgery. Sometimes the pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food. Try to keep taking clear liquids and minimize dosing of pain medications, but call us if you do not feel better. Coca Cola or Sprite Soda may help with nausea.
SHARP EDGES: If you feel something hard, or some irregular sharp edges in the surgical areas, it is likely you are feeling bony walls which once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse only after the first 24 hours. Use 1/4 teaspoon of salt dissolved in an 8 ounces glass of warm water and gently rinse with the saline solution. Repeat the warm saline water rinse as often as you like, but certainly after every meal. A bottle of a prescription oral rinse might be dispensed to you with instructions, if needed.
BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. In the area of the surgery, exercise caution, especially if sutures have been placed. Soreness and swelling may make the area tender, but please make every effort to clean your teeth within the bounds of comfort.
HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable as there is usually some swelling. On the third day, you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual with steady daily noticeable improvement.
We will make every effort to call you the evening of the surgery (between 5:30 and 8:30 pm) to make sure you are doing well. Please try to have your phone with you. Following these instructions will assist you, but if you have questions about your progress, please call our office. You can contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern.