General Instructions After Oral Surgery

Useful Links:

• Medication
• Bleeding
• Swelling
• Pain
• Diet
• Oral Hygiene
• Activity
• Nausea
• Jaw Stiffness
• Smoking
• Stitches

Medication

We recommend that you consider taking some form of pain reliever within the first 45 minutes of leaving the office. By doing so, you have an easier transition as the local anesthetic (numbing medicine) wears off. For many simple procedures, over-the-counter pain relievers will be all that is necessary. Appropriate prescription pain relievers will be prescribed whenever indicated. Following the first dose, over-the-counter and/or prescription pain relievers should only be taken as needed, according to the directions on the bottle. If antibiotics were prescribed, please be sure to follow the directions that are on the bottle. Medications should be taken with juice or food to prevent an upset stomach. If you develop hives, rash, or any other reaction to the medication, stop taking them and call our office. Also, do not drive or operate machinery while on pain medication, this can be dangerous.

Bleeding

Following the removal of a tooth, gauze will be placed on the extraction site. Bite down firmly for 30 minutes, as this helps form a blood clot. You may apply a new gauze for another 30 minutes or so if bleeding has not slowed sufficiently or stopped. Mild, intermittent bleeding or oozing is normal for 24 hours or so following oral surgery. Be sure to remove the gauze before eating or drinking. Avoid spitting. The action of spitting encourages continued bleeding.

Swelling

Surgery of any type will be accompanied by swelling. The degree of swelling will vary widely between patients. Placing an ice pack on the outside of your face where the surgery took place can help minimize this. Ice packs are most effective during the first day or so after surgery, and should be and should be applied in 20-minute intervals. It is normal for swelling to increase for 3 to 4 days after your surgery. Occasionally, swelling can be accompanied by bruising, especially around the lower jaw. After the first 3 to 4 days, your swelling will gradually dissipate- about 75% of your swelling will be gone by the end of the first week.

Pain

Unfortunately, discomfort is normal after any type of surgery. It is impossible to predict the level of discomfort an individual will experience following a surgical procedure. Even when the same procedure is performed, there is wide variation in the level of discomfort experienced by patients. In fact, even when identical procedures are performed on different sides of the same patient (for example, wisdom teeth extractions) the level of discomfort may not be symmetrical. This does not necessarily mean that something is wrong. Many oral surgery procedures involve bone. Bone is a relatively slow healing tissue, and it is normal for discomfort to wax and wane for a week or so following surgery. Varying degrees of discomfort for the first 7 10 days following surgery is usually normal, especially with procedures involving bone surgery.

We recommend that you manage discomfort aggressively in the beginning: Take the first dose of the prescribed pain medication before the local anesthesia wears off. You may certainly start off with something over the counter if you prefer (e.g. Aleve, Motrin). Only take the pain medication when necessary, and do not exceed more than the prescribed amount. As time goes by and healing progresses, discomfort will decrease.

Diet

The first few days following oral surgery you should stay on a soft food diet. Some suggestions are: scrambled eggs, soup, cottage cheese, flakey fish, macaroni and cheese, etc. Avoid eating nuts, chips, and other foods that can be sharp and difficult to chew. You may gradually eat solid food as you become comfortable chewing again.

Oral Hygiene

A clean environment is very important for healing to progress quickly. Remember, it will take a day or so for blood clots at the surgical site to stabilize so it is important to be gentle with your oral hygiene during the initial period. Brush your teeth as thoroughly as possible while avoiding the surgery site. If you normally use a powered toothbrush (e.g., Sonicare or OralB) consider turning it off when brushing near the surgical site, or, switching to a manual brush for a few days. Start warm salt-water rinses late in the day or the day after surgery (give time for clotting to stabilize). Mix a teaspoon of salt with a glass of warm water, and swish gently for 30 seconds or so. Do this throughout the day and especially after you eat. You really can’t rinse too much. Avoid spitting as you rinse and brush. Instead, simply let gravity do the work. Continue rinsing frequently throughout the first week or so.

Activity

Following more involved surgical procedures you should get plenty of rest. Wait at least 2 – 3 days after surgery to resume exercise, sports, or other physical activities.

Nausea

Nausea can occur after surgery. Common causes include pain medications, anesthetic agents, the ingestion of blood, and changes in diet. Taking your pain medication with a little food and a full glass of water may help to decrease nausea. If nausea persists stop taking the pain medication and call our office.

Jaw Stiffness

Known as trismus, jaw stiffness is caused by muscles tightening up due to the inflammation and mild injury caused by surgery. It is a common occurrence following surgery at the back part of the upper and/or lower jaw. This is where your major chewing muscles are located. A way to relieve stiffness is to slowly open your mouth as wide as possible, holding that position for a few seconds, then slowly closing. Gently forcing your front teeth a little farther apart with your own fingers will also help improve your opening. Repeat as often as necessary. Moist heat (e.g., hot water bottle, warm washcloth, commercially available heat pack) will also help lessen the stiffness. You may notice a mild increase in swelling if you use moist heat therapy.

Smoking

Don’t smoke.

Smoking has too many negative effects to list on a single page. Smoking before surgery interferes with circulation and oxygen delivery to the tissues. This compromises your body’s ability to heal. Smoking causes airway and breathing irritability, and is a well-known risk factor for anesthesia complications. Smoking after surgery has a direct negative effect on healing. This fact applies to surgery anywhere on your body. The negative effects of smoking are magnified several times for oral surgery procedures because the toxin-containing smoke will have direct contact with the surgical sites. Cigarette smokers are five times more likely to suffer from dry sockets and other complications following simple procedures.

Stitches

For 95% of our procedures, we use dissolving stitches. They usually fall away within 7-10 days. If they have not fallen off by then, or are becoming annoying we can take them out for you. The stitches may be stiff and annoying in the beginning but will soften and become less noticeable with time.