Post Operative Instructions
Avoid using straws and smoking for at least 72 hours after your procedure. This will lower the risk of post-operative bleeding and dry socket. A dry socket is early loss of the blood clot that exposed the surgical site. Pain will usually increase from post-operative days 3-4 with a dry socket. You will need to see the doctor to assess and treat as needed if this occurs.
IMMEDIATELY FOLLOWING SURGERY
- The gauze pad placed over the surgical area should be kept in place for at least thirty minutes. After this time, the gauze pad should be removed and discarded. If there is more oozing from the surgical sites, new gauze pads can be placed for an additional thirty minutes. Avoid taking the gauze in and out of the mouth to check prior to the recommended time, this will cause increased bleeding. You may stop using gauze when it is light pink, not red.
- Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may prolong bleeding by causing the blood clot that has formed to become dislodged.
- Prior to the local anesthesia (numbing medicine) wearing off, take the recommended pain medicine. The numbness associated with the local anesthetic typically wears off about four to eight hours after the procedure. Please see the “Pain” section below for detailed instructions.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable, typically avoiding strenuous exercise until one week after your procedure.
- Place ice packs on the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.
BLEEDING
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or gently wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Sit upright while performing this attempt, as lying flat may cause Increased bleeding. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. If bleeding does not subside, call our office for further instructions.
Diet
After general anesthesia only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot and cause a dry socket. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. Recommended first meals after surgery include soft, clear, foods such as Jell-O or soup broth (warm, not hot). Gradually progress to other soft foods such as scrambled eggs, mashed potatoes, and macaroni and cheese. Dairy products should not be started until the day after surgery. You will feel better, have more strength, and heal faster if you continue to eat. CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.
KEEP THE MOUTH CLEAN/MOUTH RINSE
No rinsing of any kind should be performed until the day following surgery. Gentle rinsing may be performed after meals with a teaspoon of salt mixed into one cup of warm water. Resume brushing your teeth the day after surgery. It is ok to gently brush over the surgical sites to help keep them clean.
ANTIBIOTICS
Antibiotics may be given to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.
SWELLING
The swelling that is normally expected is proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is common. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. The swelling may be minimized by the immediate use of ice packs. Ice packs, or baggies filled with ice, should be applied to the sides of the face where surgery was performed. The ice packs should be on for 20 minutes, off for 20 minutes while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the amount of swelling.
PAIN
For moderate pain, over-the-counter medications such as Tylenol (acetaminophen) or Motrin (ibuprofen) can be taken. As strengths vary, please consult the medication bottle for amounts and timing. Please note some stronger pain medications (if prescribed by your doctor) may have acetaminophen or ibuprofen as a co-ingredient. Be careful not to take above the recommended amounts of this over-the-counter medicine if it is already in the prescribed medication. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery while taking prescribed pain medication. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. Please call the office if the pain persists and is not diminishing in intensity by the third or fourth day after surgery.
DISCOLORATION
In some cases, discoloration (bruising) of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissue. This is a normal
post-operative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may decrease the duration of the discoloration.
NAUSEA AND VOMITING
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on clear liquids (sports drinks, tea, or ginger ale.) You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking soft foods and the prescribed medicine.
SPECIFIC PROCEDURES
Sinus Precautions
learn more >>
Sinus Precautions
If you had a procedure in which the sinus was involved, there may be a communication from the extraction site into the sinus cavity. In most cases this will heal on its own, very rarely will there need to be a second procedure to correct this. It is important to follow the specific instructions for this condition to decrease the need for additional procedures.
- Take all medications as directed. This may include a nasal spray, antibiotic and/or decongestant. These medications are prescribed on an as needed basis by your doctor.
- Do not bend below your waist to lift anything greater than 10 pounds. Refrain from heavy exercise until instructed to resume by your doctor.
- Refrain from forceful nose blowing, as this will cause the communication into the sinus to become worse.
- Do not use a straw for at least 14 days after the procedure.
Please refer to the general instructions listed in this handout for additional information.
Implant Procedure
learn more >>Implant Procedure
The post-operative instructions for implant placement are similar to the information for tooth extractions. There may have been a custom healing abutment, temporary tooth, or other attachment placed on the implant to allow for optimal healing of the tissues. If there is a temporary attachment, do not chew with it. It may cause the implant to fail. The temporary component’s purpose is to provide an esthetic solution and to help shape the gum tissue during healing. Occasionally, there may be post-operative bleeding and swelling from the site. Swelling can be improved by placing an ice pack to the area. The bleeding should lessen by placing a folded piece of gauze to control the bleeding for at least thirty minutes. Sutures may have been placed to allow for the site to heal, most of the time they are dissolvable. In some instances, there may have been non-resorbable sutures placed, and these will need to be removed by the doctor at a later visit. Typically, the temporary is removed in 3 months and a new x-ray is taken to evaluate the healing of the implant. After the implant is integrated/healed, you will be instructed to return to your dentist to have the final tooth fabricated and placed.
Please refer to the general instructions listed in this handout for additional information.
Bone Grafting Procedure
learn more >>
Bone Grafting Procedure
The post-operative instructions for bone graft placement are similar to the information for tooth extractions. In addition, please follow these instructions carefully. Bone grafting material and various other materials were used to regenerate bone to improve the area for dental implant placement in the future. The surgical site is very delicate and should be undisturbed as much as possible for the initial weeks following surgery. The site may appear swollen and discolored, this is normal after the procedure and should improve after 3-4 days and will continue to improve with time. There may be a white-yellow appearance of the surgical site, this is normal and represents healing of the site or a membrane barrier placed that promotes healing. If there is persistent pain or swelling greater than 5 days and or discharge from the site, please call and inform the office. You may need to be evaluated sooner than your scheduled appointment. Sutures have been placed to allow for the site to heal, most of the time they are dissolvable. In some instances, there may have been non-resorbable sutures placed, these will need to be removed by the doctor at a later visit. If there are small particles that resemble grains of sand expressed from the surgical site, this is normal. A small amount of the graft material usually is lost from the site. This is not an indication of failed graft and the site will typically heal and produce the bone needed for future implant placement.
Post-Anesthesia Care
learn more >>Post-Anesthesia Care
- Do not drive a vehicle, operate machinery or return to work for at least 24 hours. Avoid making important decisions that require full cognition such as financial, home, work or related topics during this time.
- Increase fluid intake after the surgery and anesthesia. Good fluids to drink include water, Gatorade, juice, and other clear liquids. For the initial few hours after anesthesia, avoid dairy products as they may cause excess thick secretions and/or nausea.
- If an IV was placed, keep the site covered with a bandage for 24 hours. The site may have bruising for several days after an IV was placed and this is normal. If the area appears red and swollen after 24 hours, call the office to notify the surgical team.
OTHER COMPLICATIONS
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. This is usually temporary. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Call the office if the numbness persists the day after surgery.
- Slight elevation of temperature immediately following surgery is not uncommon. If the elevated temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- You should be careful going from the lying down position to standing. You could get light headed from dehydration, low blood sugar, or medications. You should remain seated for one minute before standing.
- Occasionally, patients may feel hard projections in the surgical site with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by the doctor.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as lip balm.
- Sore throat and pain when swallowing is not uncommon. There may be facial discomfort after surgery. Muscles become swollen, and the normal act of swallowing can then become painful. This will subside in two to three days.
- Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
- Sutures are often placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve approximately one week after surgery.
- The pain and swelling should begin to improve after the third day after surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.
- There will be a void where the tooth was removed. This will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush. Brushing your teeth is okay – just be gentle at the surgical sites.
- A dry socket can occur when the blood clot gets dislodged prematurely from the tooth socket. Worsening pain 5-7 days following surgery is usually an indication of a dry socket occurring. Call the office if this happens.
- If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
Do not hesitate to call the office at 717-766-7697 if you have any questions or concerns.
101 Old Schoolhouse Lane • Mechanicsburg, PA 17055