Post Operative Instructions for Oral Surgery

FIRST HOUR: 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 unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 60 minutes. The gauze may then be changed as needed (typically every 60 to 90 minutes).

EXERCISE CARE: Do not disturb the surgical area today. You may rinse GENTLY prior to going to bed. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is detrimental to healing and may cause a dry socket.

OOZING: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 60-90 minutes at a time. Do not leave the gauze in overnight.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the 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 60 or 90 minutes. If bleeding remains uncontrolled, please call our office.

SWELLING: Swelling is often associated with oral surgery. 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 adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.

PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. 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 better manage any discomfort. Some patients find that narcotic pain medication causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually experienced within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

• Do not rinse or spit for 24 hours after surgery.
• Keep fingers and tongue away from socket or surgical area.
• Use ice packs on surgical area (side of face) for first 48 hours, apply ice 20 minutes on — 20 minutes off. Bags of frozen peas and corn work well.
• For mild discomfort take Tylenol or Ibuprofen every three to four hours.
• For severe pain use the medication prescribed to you.
• Drink plenty of fluids. (Do not use a straw)
• If the muscles of the jaw become stiff, chewing gum at intervals will help relax the muscles, as well as the use of warm, moist heat to the outside of your face over these muscles.
• After the first post-operative day, use a warm salt-water rinse following meals for the first week to flush out particles of food and debris which may lodge in the surgical area. (1/4 teaspoon of salt in a glass of warm water. Mouthwash can be added for better taste.)
• Diet may consist of soft foods which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
• A certain amount of bleeding is to be expected following surgery. Bleeding is controlled by applying pressure to the surgical area using small rolled gauze for 90 minutes. After that time remove the gauze and then you may eat or drink. If bleeding persists, a moist tea bag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists call our office.
• We suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a “dry-socket”.

Feel free to contact us at 603-595-8889 if any doubt arises as to your progress and recovery.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily. Also, if you were prescribed Peridex, use it as directed twice daily.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. 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 gradual, steady improvement. If you don’t see continued improvement, please call our office. If you are given a plastic irrigating syringe, DO NOT use it for the first three days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.