POST-OPERATIVE INSTRUCTIONS FOLLOWING ORAL SURGERY
SWELLING
Swelling of the face following oral surgery is normal. Apply ice packs during the first 24 hours. Swelling will usually reach its peak during the first 48-72 hours. After 38 hours, if swelling or jaw stiffness has occurred, apply heat on the outside of the face, using a warm, moist dressing. If you use a hot water bottle or heating pad, protect the skin with a moisturizing lotion and place a thin towel the between the heat source and the skin. Do not use heat continually. Apply it for about 20 minutes, then remove for an equal interval. If swelling appears to be increasing rather than decreasing on your 4TH day from surgery, you should call the office. This may be an indication of infection.
PAIN
• It is expected to have pain/discomfort of various intensity following dental surgery. Do not take pain medication on an empty stomach. You can swallow some milk prior to taking pain pills to reduce the potential of nausea. Take your pain medication as prescribed. Take the first dose of prescribed pain medication within approximately an hour following surgery. This will allow the pain medication to get into the blood stream by the time the local anesthetic has started to wear off. If pain persists or causes you undue concern on your 4th day from surgery, please notify the office. Prolonged pain may be a sign of infection.
• If you have been prescribed antibiotics, take all of the tablets or liquid as directed.
• You may be given additional medications to minimize swelling, reduce discomfort, prevent infection, and promote healing. Always take medications as directed and double check with your pharmacist for any potential drug interactions with any of the other medications you may be on. If any potential interactions are identified or occur notify our office and in case of an emergency call 911.
• Although most patients benefit from the prescribed drugs, occasional side effects (such as dizziness, rash, nausea, excitement, constipation, diarrhea and other) can occur. Should you experience any of these side effects, stop the drug immediately and notify the office.
BLEEDING: TRY NOT TO SPEAK AND KEEP HEAD ELEVATED AT ALL TIMES:
• After your teeth were extracted, gauze sponges were placed on the extraction and you were asked to keep your jaws closed tightly for 15 to 20 minutes. This will help stop the bleeding and keep saliva away from the open tooth socket. You may discard the gauze sponges in about 15 to 20 minutes.
• Should slight bleeding continue, fold two gauze sponges in half and place over the bleeding area and close your jaws tightly for 15 to 20 minutes to apply pressure. This may have to be repeated 4 or 5 times. Slight oozing may continue into the next 1-2 days and is normal.
• It also helps to stop bleeding if you will lie down, with the head raised on pillows. Apply your ice pack to that side of cheek. Use moistened tea bag (regular caffeinated, not herbal teas) compress.
• Do not spit or suck through a straw.
• Do not “play” with or disturb your stitches. They will dissolve on their own. Do not be alarmed if you swallow them, it is OK.
• Refrain from strenuous labor, exercise, swimming in a pool or the ocean, or being out in the heat.
DIET
• You must guard against dehydration after oral surgery. Follow a liquid diet on the first day. Drink at least the equivalent of eight glasses of water, orange juice, tomato juice, soups, milk shakes, ginger ale, or milk the first day. Avoid using a straw, or spiting since the pressures involved may dislodge the blood clot. Avoid chewing tobacco, smoking and vaping as the hot smoke will easily irritate the fresh oral wound and increase chance of infection. Return to a normal diet within two or three days. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
NOTE: If you are diabetic, maintain your normal caloric requirements and take your medication as usual. NOTE: Diabetics are more prone to infections.
HYGIENE
DO NOT RINSE your mouth until the morning after surgery. On the day following the surgery, brush as many teeth as best you can as soon as you can. Brush very lightly over the stitches. On the day after surgery commence rinsing with a glass of warm water with 1/4 teaspoon of salt 3-4 times per day, or after every meal for 3-4 days. Good hygiene is imperative to good wound healing.
OTHER PRECAUTIONS
• Do not use straws, blow up balloons, play a wind instrument (trumpet, flute, etc.) or exercise in the immediate postoperative period, and refrain from excessive pressures within the mouth for two weeks.
• If an opening into your maxillary sinus was noted at the time of this surgery (you will be advised of this), do not blow your nose, and if you sneeze, open your mouth. The object is to avoid forcing pressure back through the sinus and out into the wound -this will cause the soft tissue closure over the socket to open up.
• 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.
PRESENCE OR ABSENCE OF SIDE EFFECTS VARIES FROM PATIENT TO PATIENT AND CERTAINLY VARIES WITH THE DIFFICULTY OF THE SURGICAL PROCEDURE. THE FOLLOWING CONDITIONS MAY OCCUR, ALL OF WHICH ARE CONSIDERED NORMAL.
POSSIBLE SIDE EFFECTS TO EXPECT
• The face and jaw will probably swell. Swelling is most marked within the first 48-72 hours. Swelling may take a week, or longer, to disappear.
• Stiffness (trismus) of the jaws or difficulty in opening wide may occur. Prolonged or recurrent stiffness may be a warning of underlying infection. Please notify the office of stiffness if it seems prolonged or recurrent.
• Numbness and /or tingling sensation of the lower lip and chin and on the side of the tongue may occur on the day of the surgery. This is called “paresthesia,”. It is generally a temporary condition which will correct itself. It may remain anywhere from a few days to several months. In some rare instances it may be permanent.
• Black and blue marks (ecchymosis) on the face are caused by seepage of blood beneath the cheeks, chin or under the eye (black eye). This may appear initially as a swelling, but often by the second or third day it may discolor the face. The color may progress from black-and blue to yellow-and-green, and the color may progress down your face onto your neck. It will gradually disappear over a 1-2 weeks. Moist external heat will assist in resolving the surgically created bruise.
• You may have a slight earache and/or headache.
• You may have a sore throat and/or discomfort when swallowing.
• Other teeth may ache temporarily. This is called sympathetic or referred pain, and is only temporary.
• Your “bite” may seem to have shifted. This also resolves quickly.
• If the corners of the mouth are stretched, they may dry out and become cracked. The lips should be kept moist with a cream or ointment.
• During the healing process, small sharp fragments of bone may work up through the gum tissue. This is especially true after multiple extractions. This process of “shedding” slivers of bone may last anywhere from 2-4 weeks. If there is difficulty with some of these slivers, please call the office and arrange for an appointment.
• Rarely, a localized abscess occurs in the surgery site 2, 3, or even 4 weeks after the surgery. If you have a sensation of pain, swelling, stiffening of the jaw or fever, please contact the office.