General Post-Operative Instructions
Oral surgical wounds usually heal quickly and without complication if simple precautions are taken. Sometimes the after-effects of oral surgery are quite minimal, so not all of the following 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.
Day Of Surgery
THE FIRST FEW HOURS: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour or two unless the bleeding is not controlled. The packs may be gently removed after one hour (the greater the surgical procedure, the longer the packs should remain in place). If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30–60 minutes. The gauze may then be changed as necessary (typically every 30–45 minutes). It is best to moisten the gauze with tap water and loosely fluff it for more comfortable positioning.
WOUND CARE: A good blood clot will help healing, so do not disturb the surgical area today, and do not rinse vigorously or probe the area with any objects. You may brush your teeth gently, avoiding the surgical area. Avoid vigorous exercise for the first several days. If you smoke, please do not smoke for at least 48 hours, since this is detrimental to healing and may cause a dry socket. Avoid alcohol for the next several days.
OOZING: Intermittent bleeding or oozing overnight is normal. This may be controlled by placing fresh gauze over the areas and biting on the gauze for 30–45 minutes at a time.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between the teeth only and they are not exerting pressure on the surgical areas. Try repositioning the gauze packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp/dry and wrapped in a moist gauze) for 20–30 minutes. If bleeding remains uncontrolled, please call our office.
SWELLING: Oral surgery is often associated with post-operative swelling. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the cheek — twenty minutes on, twenty minutes off — during the first 24 hours after surgery. It is especially important to do this for the first few hours after surgery. In your instruction bag, you are provided a surgical glove which can be filled with ice and used as an ice pack if needed. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. Immediate and constant gauze compression on the wound and between the gum and cheek, firm, gentle pressure on the cheek with an ice pack, and elevation of the head are the best ways to minimize swelling.
PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort, depending on the procedure and patient. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage the discomfort better. The effects of pain medication vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as ibuprofen. Rarely, some patients may initially even require two pain pills at one time. It is best to limit as much as possible the use of pain medication, as overuse can lead to negative side effects, without any added beneficial effects.
Remember that the most severe pain is usually within 6 hours after the local anesthetic wears off; after that, your need for pain medication should lessen with time. If you find yourself needing to take large amounts of pain medicine at frequent intervals, please call our office. Also, do not drive while taking this medication.
DIET: Eat any nourishing food that can be taken with comfort. Avoid extremely hot or cold foods. Do not use a straw for the first few days after surgery. It is usually advisable to confine the first day’s intake to liquids or pureed foods (soups, pudding, yogurt, milk, fruit shakes, etc.). Avoid hard foods, which may be lodged in the socket areas. Over the next several days, you may gradually progress to solid foods. If you are diabetic, maintain your normal eating habits or follow instructions given by your doctor.
SHARP EDGES: If you feel something hard or a sharp edge in the surgical areas, it is likely you are feeling the 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 our office.
INSTRUCTION FOR THE NEXT FEW DAYS
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use ¼ teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse portions of this solution, taking 5 minutes to use the entire glassful. Repeat as often as you like, but at least 2 or 3 times daily, preferably after meals, for 1 week after surgery. Avoid commercial mouth rinses, as they contain a small amount of alcohol in them.
BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery, normally the day after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
HEALING: Normal healing after tooth extractions should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling and/or bruising in the affected area. 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 a gradual, steady improvement. If you don’t see continued improvement, please call our office.
DRY SOCKET: This is an occasional complication after tooth extraction, especially with third molars (wisdom teeth) and lower teeth. It is caused by the blood clot dissolving too early, and it is identified by increased pain/discomfort after the first few days of normal healing. While this process is self-limiting, it can be uncomfortable. Please call our office as soon as possible so we can treat you and relieve your pain.
Common temporary post-operative symptoms:
- Jaw stiffness with difficulty in opening
- A slight earache on the side of the surgery
- Your other teeth may ache. This is “sympathetic” pain.
- The corners of your mouth may be dried, cracked, or bruised. Use cream or ointment to keep the area moist and to promote healing.
- Black and blue discolorations or bruising may occur on the face in the area of surgery. This should resolve itself within several days.
- There may be an elevation of body temperature for 24–48 hours (up to 101° F). If temperature persists, please call our office.
Remember, you just had a surgical operation. Be kind to yourself.
It is our desire that your recovery is as smooth and pleasant as possible. Following these simple instructions will assist you in your recovery, but if you have any questions about your progress, please call our office at (484) 231-1177.