Immediately Following Surgery:
- The gauze pad placed over the surgical area should be kept in place for half an hour. After this time, the gauze pad should be removed and discarded.
- Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as soon as possible to avoid discomfort before the local anesthetic wears off.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable and are not taking prescription pain medication.
- Place ice packs to the sides of your face where surgery was performed (refer to the section on swelling for explanation).
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 wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. 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 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be used as often as possible (30 minutes on 30 minutes off) while you are awake. After 48 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. Forty eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling and relaxing the muscles. DO NOT OVER HEAT AS THE PACK MAY RUPTURE OR SCALD YOUR SKIN. If there was infectious swelling at the time of surgery you will need to start with HEAT not ice to help the area drain.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours. 48 hours after surgery you can use Tylenol or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours.
For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain may intensify (48hrs.) when swelling increases. The most important time to take pain medicine is when you arrive home after surgery before the local anesthetic wears off. Take your pain medication before the pain intensifies. If pain persists, it may require attention and you should call the office.
After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important (refer to the section on suggested diet instructions at the end of the brochure). 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 a single meal, you will feel better, have more strength, less discomfort 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 for one minute before standing.
Foods and liquids to be avoided include anything hot, hard, spicy, or citric.
Keep the mouth clean:
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. Forty eight hours after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt. Do not use mouth rinses/mouthwash for at least a week.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets as directed. Antibiotics will be given to help prevent infection. In the event of a rash or other unfavorable reaction call our office.
Women please not: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.
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 soda, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.
Syringe Use (if applicable):
In certain surgical procedures we may give you a special syringe to facilitate keeping your surgical site clean. In such cases you would use the syringe with warm water and/or a special rinse provided by our office starting a week after your surgical procedure. This is to be used nightly until the area is fully healed.
The pain and swelling should subside more and more each day following surgery although the 3rd and 4th day are typically the most uncomfortable. If your post-operative pain or swelling worsens or unusual symptoms occur call the office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Eisner or your family dentist.
Brushing your teeth is okay – just be gentle at the surgical sites.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 4-5 days following surgery, call the office if this occurs. The best method to avoid a dry socket is to avoid the sucking motion (Ex: Smoking, spitting, and the use of straws to drink).
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.
- If numbness of the lip, chin or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation, so be careful. Call our office if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If the 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 were not able to eat or drink prior to surgery; it was also difficult to take fluids. Taking pain medications can make you dizzy; you could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
- Occasionally, patients may feel hard projections in the mouth 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.
- 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 Vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful, this will subside in 2-3 days.
- Stiffness (Trimus) 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.
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