Post Operative Instructions

Surgery of the mouth is similar to surgery in other parts of the body and requires careful attention to post-operative instructions.  Only by doing so, can you help to ensure normal healing after surgery.

1. Smoking

Amongst the many negative effects of smoking, it is known to cause poor healing of wounds. You should not smoke during the initial 5-7 days post-operatively and longer if possible.  The effect of nicotine will decrease tissue circulation and slow healing.

2. Wound Care

Do not disturb the wound with the fingers or by sucking on it.
Bite on gauze with firm pressure for 45 minutes without changing it unless it becomes soaked. 
Remove the gauze after 45 minutes.  If there is continued bleeding, apply pressure to the area for an additional 45 minutes.    Often there is more bleeding from the site as the local anesthetic wears off.  This may last for one or two hours and is generally not a cause for concern.    Take care not to bite lips or tongue while eating as local anesthesia is wearing off.  Especially young children should be monitored to insure that they are not chewing on a numb lip or tongue which will lead to a painful ulcer and possibly infection.  The saliva may be tinged with blood for 24-48 hours.  However, excessive bleeding should be controlled.  Place sterile gauze, a piece of clean white cloth, or a moist tea bag wrapped in gauze over the wound and bite on the gauze holding firm pressure for 30-45 minutes if possible.  Do not use tissue paper.      If bleeding persists, continue to maintain pressure on the wound for another 45 minutes.  If bleeding does not subside after a reasonable length of time, or if it is severe, call us for  further instructions.   Do not swallow blood as this may cause upset stomach.      Dab blood stained saliva away with a tissue, do not spit.   When applying pressure to extraction sites ensure gauze is directly on the site.      Stitches will generally be of a dissolving kind and may begin to fall out within the first  36 hours.  Do not be concerned about this unless you are bleeding actively.  At night, you may be better to place a towel on your pillow before going to bed.


3.   Medications

Non-prescription pain medications and prescription medications should be taken as directed on the label. Ideally these should be started before the effects of the local anesthetic disappear.  Avoid heavy meals for 12 hours post operatively.  It sometimes helps to consume a clear broth with crackers or tea with toast before taking any medications, as this helps to prevent an upset stomach.  Even if you do not feel like eating, you should drink plenty of fluids to avoid dehydration. 

Antibiotics should be taken as directed until the entire prescription is gone, unless you are having a problem with them.  If you experience problems with your medication, please inform us.          

Certain medications including antibiotics such as penicillin can render the birth control pill ineffective.  Therefore, other methods of birth control should be used.   If you take coumadin or any other medications, resume taking them the night of surgery or as otherwise directed by the prescribing M.D..

 

4.  Swelling   

Some swelling is normal after oral surgery and the degree of swelling experienced varies greatly between individual patients and with the types of surgery performed. Swelling typically peaks between 48-72 hours after surgery.

In an attempt to minimize post-operative swelling, use an ice pack on the skin over the operative site; five minutes on, five minutes off, for the first 24-36 hours following a surgical procedure. Swelling post operatively can take 7-10 days to resolve.

 

5. Diet

Following extractions a soft diet such as soup and blended foods should be consumed for the first day.  After that, unless otherwise specified, a normal diet may be resumed.  However, some patients may experience nausea and vomiting following oral surgery and/or intravenous anesthesia.  Make sure to rehydrate if you are vomiting.  If the symptoms persist for 12 hours, call us for further instructions.

 

6. Oral Hygiene

Do not rinse the area of surgery for 24 hours.  After 24 hours, brushing of all teeth should be resumed, preferably with a soft brush.  For one week following surgery rinse gently with warm salt water 4 times a day.  Healing will occur more rapidly when good oral hygiene is observed.

 

7.  Immediate Dentures

Patients who have dentures inserted immediately after surgery should not remove their dentures until they have seen their dentist, which usually occurs within the first 48 hours, or unless otherwise instructed.

 

8.  Activities

Keep physical activity  to a minimum for the first 24 hours.  Active sports should be avoided for 3-4 days unless otherwise instructed.  Avoid playing wind instruments for 4-5 days.

9. Pain control

You will be provided with advice and/or prescriptions for pain control after surgery.  Even with all reasonably available pain medications there is often post operative pain after surgery. Take any medications as recommended/prescribed by your doctor. If pain persists or is severe in spite of taking the recommended medications, please let your doctor know. Please try to notify our office if you are having pain management problems during normal working hours as we may be limited in what is prescribed to you after hours.

Post operative pain that fails to improve steadily over 4-5 days post operatively MAY indicate a healing problem. In this case it is best to contact or return to the office for evaluation and treatment if necessary. 

10.  Miscellaneous

Pain in the operative area; difficulty swallowing; difficulty opening and closing the jaw, and some local bruising are additional symptoms which occur with varying frequency.  These symptoms are usually temporary, and should disappear during the normal healing period (7-10 days) If pain, redness or swelling develop at the intravenous site, call the office for instructions.

IN THE EVENT OF AN EMERGENCY … CALL 911 OR GO TO YOUR NEAREST EMERGENCY ROOM.

IN THE EVENT OF AN URGENT ( NON-EMERGENCY) PROBLEM,

the doctor on-call can be reached at (708) 423-5990, 24 hours a day.  

This service is only for urgent issues.