This information will reinforce the verbal instructions which you have been given following your surgery. If questions arise after reading this information, please do not hesitate to call our office at any time. Our answering machine has our after-hours information.
1. MEDICATIONS
Take pain medication within one hour after treatment with milk, fruit juice or a full glass of water. Never take pain medication on an empty stomach. If you have been given a prescription, use it as directed and as necessary. If your prescribed medication is not adequate, or you are experiencing side effects, please call our office immediately. Pain following surgery is normal after the local anesthetic has worn off. For mild pain, and/or if you were not given a prescription, you may take up to 400mg OF IBUPROFEN (Advil/Motrin) and I 000mg OF ACETAMINOPHEN (Tylenol) every 6 (six) hrs. for the first 24 hrs.
FOLLOWING EXTRACTION, INCREASING PAIN THAT DEVELOPS AND RADIATES FROM THE EXTRACTION SITE ON THE THIRD OR FOURTH DAY FOLLOWING SURGERY MAY INDICATE SLOW HEALING. PLEASE CALL OUR OFFICE IF THIS DEVELOPS.
2. BLEEDING
A certain amount of bleeding and oozing is normal. Due to the increase in salivary output because of oral surgery, this can seem worse than it really is. Gauze has been provided to you for the control of bleeding. Place it over the surgery wound and apply pressure, either by holding the gauze in place by biting down, or by applying tongue or finger pressure. Following extractions make sure that the gauze is directly over the extraction site and not wedged between the adjacent teeth. After biting on the gauze for I hour, take the gauze out and replace it with fresh gauze that has been moistened with a small amount of water. Replace the gauze as needed every 30 minutes until the gauze is only slightly streaked with blood.
If persistent heavy bleeding develops, biting on a moistened tea bag is a method which often accelerates clotting and stops the bleeding. If bleeding persists, elevate your head, and avoid unnecessary movement, talking, chewing, and spitting. If you are unsuccessful in controlling your bleeding within three to four hours please call us.
3. SWELLING
Swelling is a normal side effect after oral surgery. To control this, THINK COLD FOR 24 HOURS ONLY! Apply an ice pack to the face over the operated area, leaving it on for 15-20 minutes and off for 30-40 minutes. Continue this during the waking hours for the first 24 hours. Sleeping with the head elevated with several pillows also helps lessen swelling. A “hoodie” sweatshirt can be helpful to hold the ice packs in place. After 24 hours, if swelling persists, apply warm moist dressings to the swollen area.
4. CARE OF THE MOUTH
Keep your fingers and tongue away from the extraction site(s). Wait until the day after surgery, and then begin GENTLY rinsing with a WARM salt water solution of 1 teaspoon of salt per glass of water {about 8 ounces}. Be sure to spit gently. Continue 3-5 times a day for I week. Vigorous mouth washing and forceful spitting may stimulate bleeding if clots are not formed. If bleeding occurs, stop all mouth rinsing and follow the bleeding instructions in paragraph 2. Avoid alcohol rinses and peroxide. After surgery you may resume normal brushing, letting comfort to be your guide. You may continue to floss all areas EXCEPT surgical site, which you will be able to resume AFTER your post-op exam in 2 weeks.
5. DIET
Following oral surgery, adequate nutrition is essential for normal healing. Your diet should consist of cold soft foods (e.g. egg salad, yogurt, protein drinks, smoothies… etc.) AVOID SUCKING THROUGH A STRAW, hot liquids and hot foods during the first 24 hours. Following 24 hours, a warm soft diet which is easy to chew and swallow is advisable in conjunction with the warm oral rinses. Avoid foods that are difficult to chew. DRINK PLENTY OF FLUIDS following your surgery. Even if you do not feel hungry, make sure that you have food in your stomach prior to taking any pain medication. You may resume your normal diet after your oral discomfort has passed, unless otherwise instructed.
6. SUTURES
You will be told if your sutures require removal. If so, they will be removed at your Post-Op Appointment, two weeks from the day of surgery.
7. ANESTHESIA
If SEDATION has been administered for your surgical procedure, do not drive or operate machinery that could cause injury for 24 hours. Drink plenty of water to help eliminate the medicine from your system. Dizziness, headache, and nausea may occur, but should pass within the first 12 hours. Please contact us immediately if you encounter any unexpected difficulties. Children should be observed until the local anesthetic “numbness” has worn off to prevent accidental lip and tongue biting.
8. PRECAUTIONS
If any negative reactions develop to your prescribed medication, such as itching, rashes, nausea, or difficulty breathing or swallowing, discontinue the medications and call our office immediately for instructions. If you suspect an allergic reaction may be developing rapidly, call for emergency transportation to the nearest emergency room and notify our office.
**TO PATIENTS TAKING ORAL CONTRACEPTIVES** – Antibiotics and pain medication have been shown to decrease the effectiveness of oral contraceptives. It is advisable to use an additional means of birth control to avoid pregnancy during the oral contraceptive cycle in which the prescriptions are taken.
9. POST-OP APPOINTMENTS
Please adhere to your post-operative appointments and notify us if rescheduling is necessary.
10. ACTIVITIES
Do not leave the house for 24 hours. You may read, watch TV or work at your desk at home. After 24 hours you may return to normal daily routine, but avoid strenuous activities such as heavy lifting, or exercise programs which elevate your heart rate for one week following surgery. Day 3 of recovery is usually the most uncomfortable, the better care you receive in the first 24hours, the better you will feel on day 3 of recovery.
11. Other Post-Op Conditions
Numbness
If your surgery has occurred near the sensory nerves of the jaws, numbness of the cheeks, lips, gums, chin, and tongue may occur. This is usually a temporary condition that will correct itself as the healing progresses.
Jaw and Temporomandibular Joint Stiffness and Discomfort
Stiffness and discomfort involving the muscles and joints of the lower jaw is normal following some types of oral surgery, especially the removal of impacted wisdom teeth. This is a temporary condition that normally corrects itself within a few days, although it may last one to two weeks. After the surgical pain has resolved, moist warm packs over the muscles, and maintenance of a soft diet will help relax the tension and-relieve the stiffness and pain.
Bone Fragments
Following extractions and other surgical procedures of the jaws, it is common for small fragments of bone to loosen and work through the gum. These fragments, which are not dental roots, usually work out on their own accord. If a fragment is causing pain or swelling, please notify the office and return for its removal.
Sinus Complications
The sinus cavities lie above the upper jaw and teeth. Following the removal of upper teeth or surgery in that area, openings into the sinus may persist and can cause sinus drainage, nasal bleeding, congestion, and pain. If any of these symptoms occur following your surgery, please notify us immediately.
Phlebitis (Inflammation of the veins)
If you have received IV sedation, temporary inflammation of the vein may develop post operatively. If this happens elevate the involved hand or arm above the level of your heart and place cold packs over the affected area for the first 48 hours. Following 48 hours, warm packs and elevation will aid in the relief of the problem. If the inflammation persists, or the swelling is excessive or painful, please notify our office immediately.
Infection
Infection of oral surgical wounds can occur due to the normal bacteria which reside in the oral cavity. Maintain good post-operative oral hygiene by using the recommended mouth rinsing instructions in section 4. Resume normal brushing and flossing after the majority of the gum tenderness has resolved. This will prevent food debris from entering extraction sockets and other wounds. If antibiotics have been prescribed, please take these exactly as you have been directed and until they are finished. If a foul taste or odor, and/or unusual drainage or swelling develops, call us immediately.
Elevated Temperature
A body temperature up to 100° is normal during the first 48 hours fol1owing oral surgery. If your temperature exceeds I 00° or persists, please notify us.