Post-Operative Instructions

PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY.  The after effects of oral surgery vary per individual, so not all of these instructions may apply.  Please call our office any time should you have any questions or are experiencing any unusual symptoms following your treatment.

Immediately Following Surgery: Patents who received a general anesthetic should return home from the office immediately upon discharge and lie down with the head elevated until all the effects of the anesthetic have disappeared.  Anesthetic effects vary by individual and you may feel drowsy for a short period of time or for several hours.  You should not operate any mechanical equipment or drive a motor vehicle for at least 24 hours or longer if you feel any residual effect from the anesthetic.

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
  • Do not drink with a straw.  Do not rinse your mouth for the first 24 hours. 
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  • You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding persists, this may be due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site. If bleeding continues or becomes heavy, bite on a moistened tea bag (first soaked in hot water, squeezed dry and wrapped in moist gauze) for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, please call for further instructions.

Swelling

Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling may not become apparent until the day following surgery and usually reaches its maximum in 48 hours. To minimize swelling cold packs or ice bag wrapped in a towel should be applied to the face adjacent to the surgical . This should be applied 20 minutes on then removed for 20 minutes during the first 24-36 hours after surgery. Bruising may also occur. Tightness of the jaw muscles may cause difficulty in opening the mouth. This is a normal reaction to surgery and there is no cause for alarm.  This should disappear within 7 days.  Keep lips moist with cream or Vaseline to prevent cracking or chapping.

Pain and Medications

Unfortunately, most oral surgery is accompanied by some degree of discomfort. For severe pain, take the pain medicine prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. The local anesthetic administered during your surgery normally has a 3 hour duration and it may be difficult to control the pain once the anesthetic has worn off.  We advise you to take the pain medication as soon as possible after your surgery. If you do not achieve adequate pain relief, you may supplement each pill with an analgesic such as aspirin, ibuprofen or acetaminophen.  Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

For moderate pain, one or two tablets of an anaglesic such as aspirin, ibuprofen or acetaminophen may be taken every 3-4 hours.

 

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

 

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions. 

If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternative method of birth control for the remainder of this cycle.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Eat any nourishing food that can be taken with comfort.  It is advisable to confine the first day to cool and soft foods such as jello, yogurt, pudding, ice cream, applesauce. Avoid foods like nuts, sunflower seeds or popcorn which may get lodged in the socket areas.  Over the next several days, you may progress to more solid foods.  Proper nourishment aids in the healing process. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. If you are diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.

Oral Hygiene and Care

No rinsing of any kind should be performed until the day following surgery. You may brush your teeth gently that night, avoiding the surgical site. Do not smoke for at least 48 hours since it is detrimental to the healing process. The day after surgery you should begin rinsing your mouth with a warm salt water rinse at least 2-3 times a day especially after eating with a cup of warm water mixed with a 1/2 teaspoon of salt.  Continue this for the next 2 weeks.  It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.

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Skin Discoloration

In some cases, discoloration of the skin may be expected and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively and often takes a week to completely disappear.

Occasionally, the arm or hand near the site where the needle was placed to administer IV anesthesia drugs may remain inflamed and tender.  This is causedd by chemical irritation in the vein.  Analgesics and application of heat on the area will usually correct the symptoms.

Numbness

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months due to the close association of the roots of the teeth to the nerve that supplies sensation the these areas described.

 

Dry Sockets

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. There will be a noticeable, distinct, persistent pain in the jaw area often radiating toward the ear and forward along the jaw which may cause other teeth to ache. This may occur 2-3 days following surgery. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office.

 

Other Possible Post-Surgery Effects

  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Analgesics may be taken to reduce the fever.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Bieber.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures will dissolve in approximately 3-5 days.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur please call  for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

It is our desire that your recovery be as smooth and pleasant as possible.  If you have any questions about your progress or any symptoms you are experiencing please call our office.