POST OP CARE INSTRUCTIONS
POST OP CARE INSTRUCTIONS
FIRST HOUR AFTER SURGERY
PAIN MEDICATION – If instructed by your surgeon, take 800mg Ibuprofen (Motrin, Advil) and 1000mg Tylenol (Acetaminophen) together every 8 hours for the first two days after surgery. Take your pain medication as soon as possible after surgery and before the local anesthesia (numbing medicine) has worn off. If prescribed a narcotic medication, take it only for severe, break through pain in addition to the Ibuprofen/Tylenol combination. DO NOT exceed 3200mg Ibuprofen or 4000mg Tylenol per day.
GAUZE PRESSURE – Bite down firmly on the gauze packs that your surgical team has placed and make sure they remain in place for 30 minutes after surgery. Do not change them for 30 minutes unless the bleeding is heavy. If you encounter heavy bleeding or if when you remove the gauze after 30 minutes you are still oozing, place new gauze DIRECTLY over the extraction socket/surgical site to obtain complete coverage of the surgical site and bite down with FIRM PRESSURE for another 30 minutes. The gauze may then be changed as necessary (typically every 20 to 30 minutes). It is best to slightly moisten the gauze with tap water. Bleeding after oral surgery can take approximately 24 hours to fully stop. Bleeding or oozing can recur for around 3 days after it has stopped if the surgical site becomes aggravated by eating sharp or hard foods or by brushing the area. If this happens, place new gauze as directed above.
PROTECTING THE BLOOD CLOT – Do not rinse, smoke, or drink with a straw for at least 48 hours after your surgery. If you have been prescribed an antibiotic mouthwash, you may begin to use it gently at bedtime the night of your surgery unless directed otherwise by your surgeon. If taking blood thinners, do not rise for 72 hours after surgery, but gently brush your teeth (avoiding the surgical site) as you normally would.
The after-effects of oral surgery are sometimes quite minimal and every patient’s recovery course slightly different. The instructions below are not universal, and some will not apply for every patient. Common sense will often dictate what you should do. However, if you have a question, follow these guidelines, or please call us for clarification.
The chemicals in cigarettes are caustic and can significantly delay healing, increase post-operative pain, swelling, risk of infection, and “dry socket.”
SWELLING, BRUISING – Swelling and bruising is common following oral surgery. Normal post-operative swelling peaks 3 days after surgery and can take 2-4 weeks to completely resolve. The following can help to minimize post-operative swelling:
- Taking your medication as prescribed
- Applying cold packs, or a bag of frozen peas, firmly to the cheek nearest to the surgical area for twenty minutes on and twenty minutes off during the first 2-3 days after surgery.
- Sleep with your head elevated above the bed at 45 degrees for 3 days after surgery.
AFTER THE FIRST HOUR
PERSISTENT BLEEDING – Mild bleeding or oozing is normal during the first 24 hours. If necessary, place new gauze packs directly over the surgical site(s) as instructed earlier. If bleeding persists or becomes heavy you may substitute the gauze with a cool damp tea bag, used in the same manner as the gauze, for 20-30 minutes. Tea contains a beneficial chemical that locally constricts blood vessels. If bleeding remains heavy after a full hour of using the tea bags, please call our office. You do not need to replace the gauze once the bleeding stops. Remove the gauze while you eat and sleep. You may find that when you wake up after being asleep some saliva mixed with blood has drained onto your pillow. Do not be alarmed as this is quite common after oral surgery. One drop of blood will turn a mouth full of saliva red. We recommend placing an old towel over your pillow for the first night after surgery.
STEROIDS, ANTIBIOTICS – If you have been prescribed steroids or antibiotics, be sure to take them as directed by your surgeon.
MOUTH OPENING EXERCISES – Jaw stiffness is common following oral surgery and can sometimes take 2-3 weeks to totally resolve. You can reduce this stiffness by stretching your mouth open with two fingers each hour.
MANAGING POST-OPERATIVE PAIN – Unfortunately, most oral surgery is accompanied by some degree of discomfort. To make your recovery as smooth and comfortable as possible, be sure to take your pain medication as directed above or otherwise by your surgeon. Do not miss a dose of your pain medication for 48 hours after surgery; this means setting an alarm while you are sleeping to wake up and take your medicine at your scheduled intervals. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. You must call for a refill during normal weekday business hours if you anticipate needing more pain medication for the weekend. Avoiding strenuous exercise or physical activity for 5 days after surgery is recommended to help lessen post-operative discomfort.
NAUSEA – Nausea can occur after anesthesia or surgery. It usually improves within 4-6 hours. Nausea following anesthesia is best managed by avoiding all foods until you are feeling hungry. If the pain medication is the cause, try taking Maalox immediately before the medication and drink plenty of water. Classic Coca Cola, ginger ale, or over the counter medications like Pepto-Bismol or Dramamine can also help to reduce nausea.
PAIN MEDICATION PRECAUTIONS – Prescription narcotics can cause drowsiness, decreased reaction time, blurred vision and change in mental status. Do not drive a vehicle or operate machinery, make important legal/financial decisions, or perform strenuous exercises while taking these medications. Failure to follow these instructions increases your risk of causing injury to yourself and others.
POST-OP DAY #2 AND BEYOND
ORAL HYGIENE – Keeping your mouth clean after surgery, free from food debris and plaque, is
CRITICAL in the healing process and will help to minimize your discomfort, recovery period, and chance of developing infections. Unless directed otherwise, swish and spit with 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water after every meal (Patients that are taking blood thinners wait 72 hours after surgery to begin rinsing). Repeat as often as you like. Brush and floss as you normally would, being sure to be gentle around the surgical site. Avoid commercial alcohol-based mouthwashes, or rinsing with hydrogen peroxide, as these can irritate the surgical site.
HEALING TIMES – Healing times are different for every patient and vary based on a variety of factors including but not limited to age, pre-existing medical conditions, the type of surgery performed, and hygiene practices at and around the site. Generally, the first 3 days after surgery is when most of the discomfort is experienced as this is when swelling peaks. 4-5 days after surgery, most patients start to become more comfortable and, although still swollen, can usually begin to eat a more normal diet. The remainder of the post-operative course is generally experienced as gradual but steady improvement. If you do not see continued improvement, please call our office.
DRY SOCKET – A dry socket is a painful condition that results from premature loss of a blood clot. Risk factors for developing a dry socket are extracting painful or infected teeth, wisdom tooth surgery, females, smokers, and oral contraceptives. Symptoms of a dry socket typically occur on the 3rd or 4th post-operative day. Severe throbbing pain, which is not responsive to pain medications and bad breath, are the usual complaints. This condition requires an office visit where your surgeon will gently place a medicated dressing into the tooth socket. Pain relief is often soon once the site is treated. A few visits may be necessary in some cases.
SHARP EDGES/SUTURES – If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the bony walls, which once supported the extracted teeth, or the ends of the sutures (stitches). Occasionally small slivers of bone may work themselves out during the following weeks. This is normal but if they cause concern or discomfort, please call the office. Dissolvable stitches begin to melt away as you heal. Loose ends may be cut short with clean sharp scissors or gently pulled.
MEDICATIONS:
You were probably given one or more prescriptions for medications. Take all as directed on the bottle. Call us if you experience severe nausea or diarrhea, or cannot swallow your pills.
Antibiotics: Continue until the bottle is empty. Do not quit halfway.
Pain Medicine: If instructed by your surgeon, take 800mg Ibuprofen (Motrin, Advil) and 650mg Tylenol (Acetaminophen) together every 8 hours for the first two days after surgery. Take your pain medication as soon as possible after surgery and before the local anesthesia (numbing medicine) has worn off. If prescribed a narcotic medication, take it only for severe, break through pain in addition to the Ibuprofen/Tylenol combination. DO NOT exceed 3200mg Ibuprofen or 4000mg Tylenol per day.
We are here for you. If you would like to speak to a member of our surgical team, please contact us at any time.
During business hours, please call our office. After hours, please call our office, and our answering service will page a member of our surgical team. We’ll get back to you as soon as possible.
If you would like to speak to a member of our surgical team, please contact us at any time.
During business hours, please call our office. After hours, please call our office, and our answering service will page a surgeon.
We’ll get back to you as soon as possible.
