After Surgery Care
Care after Surgery
Sometimes the after-effects of oral surgery are quite minimal, so not all 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. Our number is: (505)892-9010
1st Day After Surgery
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 unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45). It is best to moisten the gauze with tap water and loosely fluff for the more comfortable positioning.
Intermittent bleeding, “oozing” or ”weeping” overnight is normal. In most cases, oozing or weeping may cause the saliva to appear light red, as the majority of the content is saliva and very little blood (this is normal). Strong bleeding appears dark red and the majority if the content is blood and very little is saliva. Placing fresh gauze over the areas and biting in the gauze for 30-45 minutes at a time may control bleeding. Remember to cover your pillow with a towel or rag so as not to drool blood on your pillowcase or bed sheet.
Bleeding should never be severe. If so, it usually means that packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 30 to 90 minutes. If bleeding remains uncontrolled, please call our office.
Unfortunately, most oral surgery is accompanied by some degree of discomfort. When given a prescription pain medication, take it as directed. You should be able to manage discomfort better when you take the first pill before the anesthetic wears off. Some patients find the stronger pain medicine causes nausea, but if you precede each pain pill with small amount of food, chances for nausea will be reduced. The effects of pain medication vary widely among individuals. If you do not achieve adequate relief at first, and there are no contraindications, you may supplement each pain pill with an analgesic NSAID such as aspirin, ibuprofen (Advil and Motrin) or naproxen (Aleve and Anaprox). Adults may take 600-800 mg ibuprofen every 6-8 hours (do not exceed 2400 mg/24 hours). If you desire not to use the prescribed narcotic medication, you may take acetaminophen (up to 1000 mg total, not to exceed 4000 mg/24 hours) every 6 hours. You may start with a dose of ibuprofen, followed two hours later by another dose of acetaminophen and repeated to effect. Remember that the most severe pain is usually 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. Narcotics containing Tylenol include: Tylenol #3, Vicodin, Lortab and Percocet (please AVOID Tylenol overdose!)
Antibiotics: If you received antibiotics, take the full amount prescribed course as directed.
Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Preceding each pain pill with a small amount of soft food, and taking the pill with large volume of water can reduce nausea. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.
Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or 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. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. Swelling will be as its peak the second or third day following surgery.
Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently, avoiding surgical site.
Do not smoke for at least 72 hours, since this is very detrimental to healing and may cause a dry socket (preferably, stop smoking permanently).
Do not drink alcohol for at least 72 hours post-operatively or during the use if over-the-counter or prescription drugs.
Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Avoid spitting, swishing or drinking through a straw for 48-72 hours post-operatively. You may gather the saliva to the front of your mouth and wipe it away with a napkin or tissue. It is sometime advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods. Remember to drink plenty of water and keep hydrated. It is best to avoid foods like nuts, chips, sunflower seeds, popcorn pretzels, etc., which may get lodged in the socket 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. Here are a few items you may want to get from the store to make your healing process a bit more comfortable after surgery:
Cream of Wheat
Smoothies-no seeds (with a spoon)
Macaroni & Cheese
Salt (for rinses)
Tea Bags (to use in place of gauze. This helps the healing process. Use with NO spice or Caffeine)
While pureed food and drinks are easy to swallow, it is important to strive for a balance of protein and fiber after having Oral Surgery since the temptation is to stick with juices which do not provide the necessary nutrition.
If you feel something hard or sharp edges in the surgical areas it is likely you are feeling the bony walls that once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call our office.
2nd and 3rd DAYS OF SURGERY
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.
Brushing: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, or a heating pad) for 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
Normal healing after the tooth extraction 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. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.
In most cases, if used, the sutures are resorbable (dissolvable) and will resorb (dissolve) within 7-14 days. Do not disrupt the sutures in place. If non-resorbable sutures were used, the surgeon will advise you to return for their removal within approximately 7-14 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 question about your progress, please call the number written above during business hours. Calling during office hours will afford a faster response to your question(s) concern(s).