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FOLLOWING ORAL SURGERY

Following Oral Surgery

Instructions Following Oral Surgery

Oral surgical wounds usually heal quickly and without complication, if simple precautions are taken.  Sometimes the after effects of oral surgery are quite minimal, so not all the following instructions may apply.  Common sense will often dictate what you should do.  However, when in doubt these guidelines or call our office for clarification.

DAY OF SURGERY:

THE FIRST FEW HOURS: 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 or two unless the bleeding is not controlled.  The packs may be gently removed after the first hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 to 60 minutes.  The gauze may then be changed as needed.  It is best to moisten the gauze with tap water and loosely fluff it for more comfortable positioning.

WOUND CARE: A good blood clot will help healing, so do not disturb the surgical area today.  Do not rise vigorously or probe the area with any objects.  You may brush your teeth gently, avoiding the surgical area.  Avoid exercise for the first several days.  If you smoke, please refrain from smoking for 48 hours since this is detrimental to healing and may cause a dry socket.  Also avoid alcohol and spitting for the next several days.

OOZING: Intermittent bleeding or oozing overnight is normal.  This may be controlled by placing fresh gauze over the areas and biting on the gauze for 30 to 45 minutes at a time.

SWELLING: Oral surgery is often associated with post-operative swelling.  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 20 minutes on and 20 minutes off during the first 24 hours after surgery.

PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort depending on the procedure and patient.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic wears off, you should be able to manage the discomfort better.  The effects of pain medication vary widely among individuals.  If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as ibuprofen.  It is best to limit as much as possible the use of pain medication, as overuse can lead to negative side effects without any added beneficial effects. Remember that the most severe pain is usually within the first six hours after local anesthetic wears off; after that, your need for pain medication should lessen with time.  If you find yourself taking large amounts of pain medicine at frequent intervals, please call our office.  Also, do not drive with this medication.

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 pain pill with a large amount of water.

DIET: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot or cold foods.  Do not use a straw for the first few days after surgery.  It is usually advisable to confine the first day’s intake to liquids or pureed foods (soups, pudding, yogurt, milk, fruit shakes, etc).  Avoid hard foods, which may be lodged in the socket areas.  Over the next several days you may gradually progress to solid foods.  If you are diabetic, your normal eating habits or follow instructions given by your medical doctor.

SHARP EDGES: If you feel something hard or sharp edge in surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers or bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call our office.

INSTRUCTIONS FOR THE NEXT FEW DAYS:

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 portions of this solution, taking five minutes to use the entire glassful.  Do not spit salt rinse out, but rather let it fall out of your mouth.  Spitting may cause the blood clot to dislodge, resulting in a dry socket, which may be painful.  Repeat as often as you like, but as least two or three times daily preferably after meals for one week after surgery.  Avoid commercial mouth rinses, as they contain a small amount of alcohol in them, which is harmful to the surgical site.

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

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 and/or bruising in the affected area.
  • 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.

DRY SOCKET: This is an occasional complication after tooth extraction, especially with 3rd molars (wisdom teeth) and lower teeth.  It is caused by the blood clot dissolving too early, and it is identified by increased pain and/or discomfort after the first few days of normal healing.  While this process is self-limiting, it can be uncomfortable.  Please call our office as soon as possible so we can treat you and relieve your pain.

COMMON TEMPORARY POST-OPERATIVE SYMPTOMS:

  • Jaw stiffness with difficulty in opening
  • A slight earache on the side of the surgery
  • Aching of other teeth, which is called “sympathetic” pain
  • The corners of your mouth may have dried, cracked, or bruised.  Use cream or ointment to keep the area moist and to promote healing.
  • Black and blue discolorations or bruising may occur on the face in the area of surgery.  This should resolve itself within several days.
  • There may be elevation of body temperature for 24 to 48 hours (up to 101°F).  If temperature persists, please call our office.

Remember, you just had a surgical operation.  Be kind to yourself.

It is our desire that your recovery is as smooth and pleasant as possible.  Following these simple instructions will assist you in your recovery, but is you have any questions about your progress, please call our office at 253-759-7941.

Call Dr. Sioda if you have any of the following conditions:

  • You have uncontrollable pain that continues after taking a pain pill or you develop a constant, dull ache that is not getting better four days after surgery.
  • Facial swelling develops suddenly more than 1 day after surgery.
  • A fever of 100°F develops.
  • You develop itching and/or a rash.

Instructions:

  • Bite down on the cotton for 30 minutes until the bleeding stops. If you run out of cotton use a tea bag (ex: Lipton brand). It is normal to have a slight amount of blood in your saliva for one week.
  • Take the medication that was prescribed to you by the dentist.
  • If medication was not prescribed to you, you may take analgesics such as Advil, Tylenol, or Motrin in case of pain.
  • For the first 24 hours, you should avoid rinsing your mouth.
  • On the second day you may rinse with warm salt water. Mix ½ teaspoon salt with 8 oz of warm water. Rinse 3-5 times a day, especially after eating.
  • Only eat cold foods for the first 24 hours. You may eat warm foods on the second day following surgery.
  • To slow any bleeding, apply ice on your cheek for 20 minutes, stop for 10 minutes, and reapply for 20 more minutes.

AVOID CIGARETTE SMOKING, ALCOHOL, AND USE OF STRAWS FOR DRINKING

If you have any problems or questions, please do not hesitate to call us.

If you have an emergency after hours, please call Dr. Sioda’s cell phone (253) 278-7648
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