Post-Op Instructions

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1. ACTIVITY: Patients who have received IV anesthesia should be assisted by a responsible adult during the day of surgery. Rest and recovery is recommended for 24-48 hours. Keep your head elevated when lying down. No smoking or drinking alcohol. IF YOU HAVE HAD A GENERAL ANESTHETIC OR IV SEDATION in conjunction with your surgery, you should not drive any vehicle or attempt any hazardous task for at least 24 hours. Similar recommendations apply if you are taking pain medication. When urinating, sit down on toilet (males and females) and do NOT void your entire bladder at one time (to avoid fainting).

2. BLEEDING: Do not disturb the surgical area for 24 hours. Do not rinse vigorously, brush the area or use a straw. A certain amount of bleeding is to be expected following the operation. Blood tinted saliva may be seen for about 36 hours. If bleeding occurs after you return home, place a small gauze pad (about the size of a tea bag) or a moistened tea bag directly over the socket for at least 30-60 minutes, holding it in place with moderate biting pressure. Repeat this procedure for the first day. This will reduce post-operative bleeding and swelling. If significant bleeding occurs, phone the office. If a dental prosthesis has been inserted, do not remove it for any reason for 24 hours or as you have been instructed by the office. Forceful spitting and excessive physical activity tend to increase and prolong bleeding as does bending over and picking up objects. A semi-reclining position and rest are recommended.

3. SWELLING: To help minimize ordinary postoperative swelling, apply an ice pack to the face over the operated area (20 minutes on-20 minutes off) FOR 24-48 HOURS. It is usual to have swelling the second and third day. On the FOURTH day start using warm moist heat pad to the swollen area. Use hydrocortisone cream on the corner of your lips to minimize swelling on the first day. Use Vaseline on following days.

4. PAIN: Discomfort is usually strongest during the first 72 hours. For severe pain, take your pain medicine as directed. For mild discomfort, Advil should suffice. We recommend that you take your first pain pill before the local anesthetic begins to wear off and as directed for the first 48 hours. Most pain medication can upset the stomach, especially if it is empty. You can prevent an upset stomach by drinking ginger ale or 7-Up (do not use a straw), or eating soft foods and then taking the first dose of pain medication 15 minutes later. Do not mix alcohol with medication.

5. NAUSEA: Nausea is not uncommon with strong pain medication (Vicodin, Codeine). Nausea may be reduced by eating a small amount of soft food prior to taking pain medication. A small amount of a “flat” carbonated drink (i.e. ginger ale or 7-Up; avoid caffeine) may also help eliminate nausea. Follow this with mild tea or clear soup, soft food, etc. If nausea continues, contact the office for further instruction or a prescription for medicine to help with nausea.

6. DIET: It is important to maintain a good diet. A liquid to soft diet high in vitamins and protein is advisable. You should drink PLENTY of fluids (8-10 glasses or more per day) and take a multivitamin daily. For the FIRST day after surgery, your diet should be soft and cold. Remove gauze before eating or drinking. Always finish your meal with cold water to clear food debris (do not rinse) and then replace gauze.

Some suggested foods are: soda and juice, baby foods, milkshakes / ice cream, blended fruits and vegetables, applesauce, mashed potatoes, & yogurt.
Your diet for the SECOND day and until your suture removal should be quite soft and include nutritious foods that are high in vitamins and minerals to aid in healing. Such foods are: milk, yogurt, soup, cooked cereals, plenty of fluids (especially water), blended fresh fruits/vegetables, ground beef, cheese, eggs, fish & pasta.

Please avoid foods that are hard, sticky or spicy during the week after surgery. Such foods are: popcorn, nuts, sesame seeds, pizza, candy, dried fruits, peanut butter, crackers, pastries & gum.
Patients who eat good nutritional soft foods feel better, heal faster, and remain more comfortable. The importance of a nutritious diet cannot be overly stressed!
• You have a normal calorie intake.
• There is no swelling or bleeding present.

7. MOUTH RINSING: Vigorous mouth washing may stimulate bleeding by breaking clots which have formed. Therefore DO NOT RINSE the mouth for 24 hours following extractions. You may then gently rinse the mouth with a warm salt water solution (1/4 teaspoon salt to an 8oz glass of warm water) 4 or 5 times a day for several days. If bleeding continues, stop all mouth rinsing and follow instructions in paragraph 2 regarding bleeding. Do not rinse with commercial mouth washes for the first week. After 24 hours you may gently brush the teeth which are not close to the area of surgery.

8. DO NOT DISTURB THE BLOOD CLOT: The grayish or yellowish appearance and slight odor does not indicate an infected condition. Keep fingers, toothpicks, or other matter that may cause infection out of the mouth. Keep your tongue away from the surgical area.

9. IRRIGATION: Begin gentle irrigation with salt water using the syringe on the FOURTH post-operative day and continue for two weeks. During the healing process, small sharp edges or fragments of bone may loosen and work through the gum. These fragments, which are not roots, usually work through of their own accord, but if they are annoying, return to the office so we can advise or treat you.

10. DRY SOCKET: Dry sockets or breakdown of the blood clot are possible on the 3rd-5th day. This will cause severe persistent pain in the jaw increasing each day. Call our office if this condition occurs.

11. APPOINTMENTS: Return to our office for follow-up appointments and suture removal as instructed (usually 7-10 days after surgery).

12. RESUMING NORMAL ACTIVITY: You may slowly resume your normal activity when all of the following have occurred:
• It has been three days since your surgery.
• You have not taken a narcotic medication for 24 hours.

13. UNUSUAL COMPLICATIONS: Feel free to contact us if any doubt arises as to your progress and recovery. Please call the office if you have any of the following symptoms:
• Excessive bleeding
• Redness, rash, skin eruption
• Difficulty swallowing or breathing
• Inability to open your mouth
• Fever and chills

14. YOU MAY EXPERIENCE:
• The first to third day may be uncomfortable but each day after should improve.
• Swelling that reaches its peak about 36-72 hours after surgery and should decrease over the next 36-72 hours. Trismus (tightness) of the muscles that may cause difficulty in opening the mouth.
• A slight earache or sore throat.
• Your other teeth may ache or feel pressure temporarily. We refer to this as referred pain and it is a temporary condition.
• Black and blue or yellow discoloration may occur on the outside of the face near the area of the surgery. This occurrence is not unusual and will gradually disappear within several days.
• There may be a slight elevation in temperature for 24 to 48 hours. If this continues, notify us.
Please call our office if you have a question or problem. After hours call the answering service at (831) 646-4569.