Instructions Following Exposure

Sometimes the after-effects of oral surgery are quite minimal, so not all of the 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

FIRST HOUR: Bite down 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 saturates the gauze.  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 45-60 minutes.  The gauze may then be changed as needed (typically every 60 to 90 minutes).  Frequent talking or checking the gauze will only delay the bleeding from stopping. 

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 two weeks after the surgery, since this is detrimental to healing.

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.

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 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 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.  If possible, pain management should start with ibuprofen.  Some patients require additional medication for pain control in the form of a narcotic.  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. 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.  Please note that narcotic pain medication can be addictive and should be taken responsibility.  Do not drive operate heavy machinery while taking narcotic pain medication.  If you have any questions about responsible use of narcotic pain medication please call our office.  

NAUSEA:  Nausea is not uncommon after surgery.  Sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and avoid or minimize dosing of narcotic pain medications.  If your nausea/vomiting persists please contact our office. 

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first three days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.).  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical areas.  Over the next several days you may gradually progress to solid foods.  It is important not to skip meals!  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.   

ORTHODONTIC APPLIANCES:  When a tooth is exposed for orthodontic reasons we will often attach a special bracket and chain.  The chain is secured to the adjacent braces with a small wire or black suture.  Do not disturb the bracket or attempt to remove the wire or suture.  If the bracket and chain become dislodged please call the office immediately.  You will likely need to be scheduled to have the bracket re-attached.   If you are given a plastic irrigating syringe, you can start to irrigate the exposed tooth immediately.  Use the syringe after meals by filling the syringe with warm salt water and aim directly into exposure site. Use the syringe daily for at least one week.  When replacing the gauze it is common for the gauze to get caught in the braces.  Carefully and slowly remove the gauze to prevent damage to orthodontic appliances.  If a wire is bent and causes irritation to the lips or cheeks, apply a small amount of wax to wire until you can see your orthodontist.  You can and should wear your retainers after surgery.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

ANTIBIOTICS:  Continue taking your antibiotics as directed for one week until finished. 

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 for one week only.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. (This includes brushing right over the extraction areas.) 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, a 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 implant placement 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.  

DIET:  You may resume a normal diet as tolerated but a soft diet is typically more comfortable for the first 5-7 days.

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.  Calling during office hours will afford a faster response to your question or concern.