Post Operative Instructions

Instructions for Home Care Following Oral Surgery

• PAIN: After a tooth extraction, it is common to experience some pain. To manage it, be sure to fill all prescribed medications and take them as directed. You should contact our office immediately if you notice unusual symptoms or excessive pain. We recommend taking Ibuprofen (800 mg) every 6-8 hours. If ibuprofen does not work or is not tolerated, take with the prescribed pain reliever and/or add two 500mg Acetaminophen every 6-8 hours. It is important to note that taking the pain medication as directed is only for the first 3 to 4 days after surgery.
• BLEEDING: After a tooth extraction, it is normal to experience some bleeding. To control this, replace the gauze every 30 minutes until the bleeding stops. If bleeding is excessive, make sure gauze covers the area and bite down firmly, applying constant pressure for 30 minutes. Avoid rinsing your mouth for at least 24 hours after the procedure and until all bleeding has stopped. It is recommended to consume fluids as soon as possible, with a minimum of half a gallon on the day of surgery. To promote healing, remain upright and avoid exercise. If bleeding persists, please contact our office for assistance.
• SWELLING: After surgery, it is common to experience swelling, which can be reduced by applying an ice pack to the affected area of the face. Apply the ice pack for 20 minutes and then take a 20-minute break. Repeat this process for the first two days after surgery. The third day after surgery is when you may experience the most swelling and discoloration. You may also notice restricted jaw movements, which may be more severe on the second day after surgery. Swelling and discoloration of the face may continue for up to 72 hours after surgery, with the most noticeable effects on the third day. You may also experience a slight increase in temperature the day after surgery. It is important not to alter the grayish-white color of the blood clot, as this is normal. Consider sleeping at a 45 degree angle or place two or three pillows under your head and shoulders.
• NAUSEA: After receiving anesthesia, some people may experience nausea and vomiting, which are common side effects. To relieve these symptoms, it is recommended to consume only clear liquids such as tea, water, and Gatorade. If you were prescribed medication (Zofran/Ondansetron) to control nausea and vomiting during your visit, you can take it after surgery as directed.
• BONE FRAGMENTS: During the healing process, small sharp bone fragments may break off and work their way through the gums, which should resolve on their own. If they persist, please call the office for a post-operative evaluation.
• SKIN DISCOLORATION: It is common to see skin discoloration in the surgical area and where the intravenous injection was administered one or two days after the procedure. This is a natural reaction of the body and should resolve itself within a few days. It is also common to see skin discoloration on the face or neck.
• MOUTH RINSE: It is important to avoid vigorous mouthwashes after surgery to prevent bleeding. Refrain from rinsing your mouth for 24 hours. After this time, start brushing your teeth and gently rinse your mouth with a warm salt water solution (mix 1/2 teaspoon of common salt with a glass of warm water) after meals and before going to bed. Alternately, you may have been prescribed an antibacterial mouthwash (Peridex/Chlorhexidine) to use after surgery; follow the indicated instructions for 5 days. These rinses should be done after brushing your teeth. If bleeding continues, stop rinsing your mouth and refer to the instructions under "BLEEDING." Smoking, using straws and spitting should be avoided. Over-the-counter mouthwashes such as Listerine or Scope should not be used for 5 days. Keeping your mouth clean by brushing your teeth regularly will reduce the risk of infection.
• DIET: After a procedure, it is recommended to begin a diet consisting of clear liquids such as tea, apple juice, or clear broth. Once tolerated, light, soft foods that require minimal chewing can be slowly introduced. It is important to avoid chewing near the surgical area for 3 days. Fruit juices, ice cream, milk, yogurt, soups, and blended foods can provide the nutrition and calories needed for healing. When possible, resume your regular diet.
• SUTURES: After surgery, stitches (sutures) may have been used to reduce bleeding and facilitate healing. If deemed necessary, the stitches will be removed. Typically, absorbable stitches are used and will dissolve on their own within 2 to 10 days after surgery.
• DENTURES: Patients with immediate dentures should follow a soft diet and avoid removing the dentures for the first 48 hours after the procedure. The patient should make an appointment with the general dentist to consider adjustments to the dentures.

IMPACTIONS AND OTHER SURGICAL PROCEDURES:After undergoing surgical procedures to remove impacted teeth, it is important to note that this process of removing impacted teeth differs from removing erupted teeth. During the first 3 to 5 days after surgery, it is common to experience some or all of the following conditions:

1. The surgery area will swell and may become quite large, especially on the third day. This will normalize in several days.
2. Lockjaw (tightness) of the muscles can cause difficulty opening your mouth.
3. You may have a slight earache.
4. You may develop a sore throat.
5. Paresthesia (numbness and abnormal sensation of the lip or tongue) may occasionally occur after surgical removal of impacted teeth. This is a result of the proximity of the sensory nerves to the surgery area. This will usually resolve over time. If it continues, please contact our office.
6. Your other teeth may hurt. We refer to this as referred pain and it is a temporary condition.
7. When the lips and corners of the mouth stretch, they may crack. Using lip ointment or ice will help minimize this condition.
8. The cavity or space where the tooth was removed will gradually fill with new tissue, which may take up to 6 to 12 weeks to heal. Occasionally, healing complications may occur (dry socket) that requires the placement of a bandage to promote comfort and healing. This condition typically occurs after post-operative day 5.
9. There may be an elevation in temperature (98 to 100 degrees) during the first 48 hours after surgery. You may treat the fever with fever-reducing medication (Tylenol) and take it as indicated in the package directions. Be sure to drink adequate amounts of fluids. If the temperature is higher or continues, contact our office for a re-evaluation.
10. Alcoholic beverages should not be consumed while taking pain relievers. Do not drive a car while taking narcotic medications.
11. Follow General Instructions for a speedy recovery.
12. If the oral surgeon deems it necessary, a follow-up appointment will be scheduled.

PAIN AND SWELLING: If pain or swelling occurs after the wound appears to have healed, please call this office to schedule an appointment.

SMOKING: Do not smoke for 5 to 7 days after surgery.

In case of postoperative complications, please call the office. Our surgeons are available when the office is closed. You can call any office number to contact the surgeon on duty. On occasion, the oral surgeon will provide his or her personal number to patients. These calls must be exclusively for emergencies.