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Post-Operative Instructions:
General

Immediately Following Surgery

  • Keep the gauze pad in place over the surgical site(s) with firm biting pressure for 1 hour. After this time, remove and discard the gauze pad. A new moist gauze pad does not need to be placed unless bleeding continues or recurs.
  • Avoid vigorous mouth rinsing, sucking on straws, smoking, and touching the surgical sites. These may cause continued bleeding by dislodging the blood clot.
  • Restrict your activities the day of surgery and avoid exercise. Lie down with your head elevated on 2 or 3 pillows or sit in a recliner and take it easy.
  • Place an ice pack on the outside of your face over the area where surgery was performed for the first 24–48 hours to help minimize swelling.
  • Do not use straws as this may encourage more bleeding. Do not drink hot fluids or eat hot food the first day. Very soft food for the first several days is recommended, as it can be chewed and swallowed easily.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight oozing or blood-tinged saliva is not uncommon for the first 12–24 hours. Excessive or continued bleeding may be controlled by first rinsing or wiping any old clots from your mouth and then placing a new moist gauze pad over the area with firm biting pressure for an additional hour and repeating as necessary. If bleeding continues, you may bite on a moistened tea bag in the same manner. Tannic acid in tea helps blood to clot. If bleeding does not subside, please call our office for further instructions.

Sutures

Sutures may be placed to minimize post-operative bleeding and to help healing. The sutures will be removed approximately 1 week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. If 1 or 2 become dislodged early, there is no cause for alarm. Remove the loose suture from your mouth and discard it.

Swelling

Swelling is normally expected after most surgical procedures and is usually proportional to the extent of surgery performed. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal and healthy reaction to surgery. Most swelling will not become apparent until the day following surgery and will not reach its maximum until 48–72 hours postoperatively. However, swelling and discomfort may be minimized by the immediate use of ice packs. Ice packs should be applied to the outside of the face over the area where surgery was performed for the first 24–48 hours. Ice packs should be placed on for 20 minutes, then removed for 20 minutes. After 48 hours, ice has no beneficial effect. Instead, the application of heat may be helpful in reducing the size of swelling more quickly. On occasion, some residual swelling may last a week or longer.

Pain

If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs, start taking Tylenol® along with Aleve® every 6 hours as needed for pain, or as instructed by your doctor at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. Be sure to take your pain medicines with food; this will help prevent nausea. We are a narcotic-free practice, and narcotic pain medications are not indicated after routine oral surgical procedures. For long-lasting pain relief, we offer EXPAREL®, which is an opioid-free pain control medication that numbs the surgical area for several days following surgery. If EXPAREL is a part of your treatment plan, we will administer this single-dose medication during surgery. If pain persists or worsens after 4 days, please notify our office as it may require attention.

Bruising

In some cases, bruising of the skin may follow swelling. The development of black, blue, green, or yellow discoloration is due to blood oozing and spreading beneath the tissues of the mouth and face. This is a normal post-operative occurrence that may occur 2–3 days after the procedure and take 1–2 weeks to gradually fade away.

Diet

It is best to wait until after the local anesthetic has completely worn off before beginning to eat. You may eat anything soft and cool the first day by chewing away from the extraction site. Do not use straws, as this may encourage more bleeding by dislodging the blood clot. Do not drink hot fluids or eat hot food the first day. Avoid hard, crunchy foods that may disturb the area. It’s best to progress to more solid foods and return to your normal diet as soon as possible.

Oral Hygiene

Begin gentle, warm salt water rinses (1/2 teaspoon of salt in a glass of warm water) the morning after your surgery. Rinsing 4–5 times a day for several days, especially after meals, will help to gently flush away food particles. Continue to brush your teeth as best as you can, remembering to stay away from the surgical site(s) for several days. Be sure to keep the surgical area(s) clean to promote better healing.

Antibiotics

Antibiotics may be prescribed for certain patients after a surgical procedure to help prevent or cure an infection. If you have been placed on an antibiotic, take the tablets or liquid as directed until gone. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and notify our office immediately.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least 30 minutes, including prescribed medicines. Sitting in a darkened environment, limiting movement, and applying a cold compress to your forehead may be helpful. Taking an over-the-counter diphenhydramine (Benadryl®) may stave off mild nausea. Start again with bland fluids (water, ginger ale, 7UP®, Sprite®), sipping them slowly over a 15-minute period. When nausea subsides, begin taking solid foods again. If nausea persists or you have trouble keeping anything down, notify the office, as an anti-nausea medication may be necessary.

Activities

It is best to avoid strenuous activity for a day or two following your extraction, as this may cause the extraction site to start bleeding again. After a few days, you should feel fine to resume your normal routine.

The use of tobacco products slows down the healing process and may lead to developing other complications. We strongly recommend avoiding tobacco products for at least 7 days following surgery.

If This Happens…

Dry Socket

Please notify our office if severe pain develops between the fourth and sixth day following your procedure which is unrelieved by pain medication, radiates to your ear, or wakes you up at night. Dry sockets are easily and effectively treated and should not cause undue alarm.

Numbness

If persistent numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated during your consultation, this is almost always temporary in nature. It may persist for a few days to several months but rarely is permanent. Should any numbness or altered sensation persist after the first 24 hours, please notify the office.

Fever

A slight elevation of temperature immediately following surgery is not uncommon. If an elevated temperature persists or a fever develops, please notify the office.

Dryness

Keep your lips moist with a lip ointment. Due to stretching of the mouth during surgery, your lips may dry out and crack, especially at the corners.

Stiffness

Stiffness of the jaw muscles (trismus) may occur and cause difficulty when opening your mouth and during chewing for several days following surgery. This is a normal post-operative event that resolves on its own in 5–10 days. Chewing gum may help relax muscle tension and bring relief. Taking an anti-inflammatory medication such as ibuprofen (Advil®/Motrin®) may also help.

Bony Projections

You may feel hard projections in your mouth with your tongue near the surgical sites. These projections are not forgotten tooth roots but the bony walls from the procedure site(s). These projections usually smooth themselves out on their own. If not, your surgeon will smooth them off for you.

Please notify our office if you have:

  • Increased pain after 4 days.
  • Increased swelling after the third day.
  • An elevated temperature or fever after 2 days.
  • Excessive or uncontrollable bleeding.
  • A bad reaction to any of your medications.
  • Any questions or concerns.