Surgical Instructions for Home Care After Oral Surgery

 

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

 

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 first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for one hour. The key to this is constant pressure.  Do not pull the guaze out every few minutes to check the status of the bleeding.  If bleeding does not subside, please give us a call.

 

Swelling

 Swelling around the mouth is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day after surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Most patients tend to like to apply bags of frozen vegetables to each side of the face as typically will stay frozen a bit longer.  Ice should be put on intermittently and not left in direct contact with the skin for more than 30 min at a time.  After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling

 

Pain

For moderate pain — Motrin 400 mg is a great medicine to control pre surgical and post surgical pain.  However check with your physician before taking NSAIDS.

For severe pain a narcotic pain medicine will be prescribed and used if needed. The narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. 

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.

 

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Once the numbness wears off do not use straws. Make sure to drink plenty of fluids after surgery.  Though we give fluids during surgery it is possible to get dehydrated easy causing light headedness and possibly fainting on standing quickly.  

Your food intake will be limited for the first few days due to soreness and limited opening.At least 5-6 glasses of liquid should be taken daily.  Make sure that you are eating enough food, not only for the calories to assist in the healing process but also to assist with the nausea that commonly is associated with the narcotic pain medicine.  

 

Keep the mouth clean.

Make sure to brush your teeth normally.  The pain from the extraction sites will make sure you are not too aggressive.  Gently rinsing with salt water the first night is also helpful.  We will supply you with an irrigation syringe with the extraction of lower teeth to assist in food/debris removal from these sites.  Make sure to direct a steady stream of water down into the ext sites starting at the 3rd post operative day until the hole fully closes to clear the debris and help prevent pain and infection.  

 

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This bruising is typically rare in young patients, but occasionally seen.  Our elderly patients will typically bruise easier due to increased skin laxity, but again every patient responds differently after surgery.

 

Antibiotics

If you have been placed on antibiotics, take the pills as directed. Antibiotics will be given to help prevent or manage an infection. Discontinue antibiotic use in the event of a rash, hives, swelling around the mouth and call the office for further instruction.  

 

Nausea and Vomiting

Some patients may experience nausea following surgery.  In most cases this is due to taking the narcotic pain medicine on an empty stomach.  Please make sure that you have some food on your stomach before you take the narcotic pain medicine.  If you experience difficulty managing the nausea post operatively don't hesitate to give us a call.

 

Other Issues

Numbness of the lips and/or chin after post operative day 1 is uncommon.  However, as explained at the consult appointment, this will usually completely resolve with time and is due to bruising of the nerve.  This sensation may take months to completely resolve and we will monitor you closely starting at your follow up appointment 1 week after surgery.  

Occasionally, patients may feel hard projections in the mouth with their tongue.  This is the bone that surrounded the teeth and held them in place.  In most cases these areas will smooth out with time requiring no additional treatment.

During extraction it is necessary to stretch your lips apart. In some cases the corners of your lips may become dry and crack.  We do our best to keep your lips moist during surgery, however if your lips are dry and cracked post operatively your lips should be kept moist with an ointment such as vaseline.

Swelling of the jaw muscles post operatively may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event due to inflammation which will resolve with the anti-inflammatory and time.  In addition application of the ice packs for the first 24 hours and elevation of the head while lying down will help decrease the swelling of the jaw muscles.

 

Finally

Occasionally sutures are placed after surgery.  Normally we place the ones that fall out on their own in a few days to a week.  If a suture happens to come out earlier than you expect, no worry just give us a call.  We will let you know if you have stitches that need to be removed at your follow up appointment.  

There will be a "hole" where the tooth was removed. The "hole" will gradually fill in with healthy tissue in up to a month or two depending on the age and health of the patient. In the mean time, the area should be kept clean.

Most importantly your case is individual, no two mouths are alike. Do not accept well intended advice from friends.  If you have questions please give us a call or ask your dentist.