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POST-OPERATIVE INSTRUCTIONS

PAIN - some degree of discomfort and pain may arise as numbness subsides. Take the prescribed pain medicine and/or ibuprofen before the numbness wears off after eating some food. Please read the pain medication insert for your maximum daily dose. Do not take ibuprofen if you cannot take aspirin products. Any pain medication can cause nausea and vomiting. It is very important that you have some food in your stomach before you take them.
RINSE - On the morning of the day following surgery, rinse your mouth carefully with the solution made by adding 1/2 teaspoon of salt to a large glass of warm water. Resume brushing teeth simply avoiding brushing the surgical sites for the first few days. You may also have been prescribed a mouthrinse called Peridex (chlorohexidine) that you should rinse with for 30 seconds after brushing your teeth, this will help keep the surgical sites clean. Please do not use a syringe or Water Pik® to aggressively rinse during the first week. This can dislodge the blood clot.
STITCHES. Stitches (also known as sutures) are usually placed to control bleeding, aid healing and help prevent food from collecting in the surgical site – – especially for lower teeth. The sutures we use dissolve in about 5-7 days but may fall out before this. They do not have to be removed and should be left alone as much as possible.
DO NOT DISTURB THE AREA OF SURGERY. The first stages of healing are aided by placing tissues at rest. Avoid vigorous chewing, excessive spitting, or rinsing as initial healing may be delayed, active bleeding restarted, or infection introduced.
BLEEDING - Expect minor bleeding or oozing from the operative site. This bleeding may continue throughout the first day or two. For the first hour, keep firm pressure on the area of surgery by biting on the gauze sponge placed in your mouth at the office. If bleeding persists, continue pressure on a fresh sponge for an additional 30 minutes to an hour. Biting on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site. Tea has an ingredient that promotes blood clotting. Do not sleep or eat with gauze in your mouth. If active bleeding should recur at any time, carefully rinse your mouth with cold water and apply a fresh gauze sponge to the bleeding site. Firm pressure for 15-30 minutes usually controls the problem. Should active bleeding persist, please call the office.
LIMIT PHYSICAL ACTIVITY during the first 24-48 hours after surgery. Over exertion may lead to postoperative bleeding and discomfort. When you lie down, keep your head elevated on a pillow.
SWELLING usually develops during the first 12-24 hours following surgery, often increasing on the second to third day. It should begin to subside by the third day. Swelling can be minimized a great deal by wearing an ice pack on the side of your face for 30-45 minutes every hour while you are awake during the first 24 hours following the surgery, unless you receive special instructions. Bags of frozen vegetables are very effective to use as ice bags. Anti-inflammatory medications, such as Motrin or Advil, also help decrease swelling. Keep your head elevated for the first 3 to 5 days to keep the swelling to a minimum. Swelling may be greater in the morning when you first awaken.
FLUID intake is important. We suggest you start with clear fluids. Once your stomach has settled, you can advance to other fluids such as broth, soups, or juices. Also avoid hot liquids until the numbness has worn off, and the bleeding has stopped. It is important to drink plenty of fluids.
STRAWS - avoid using straws for the first few days as it may cause the blood clot to dislodge and delay healing.
DIET - Eat soft, cool foods that require little or no chewing and will not disturb the surgical sites. A good rule of thumb is if the food is soft enough to cut with a spoon you can eat it. Do not chew anything until your numbness wears off. Avoid hard, crunchy foods (chips, nuts, seeds, popcorn) or very hot food/beverages for the first several days. After this time you can typically advance your diet as you tolerate. Since you will be taking medication, it is important to remember that eating can prevent nausea sometimes associated with certain medications.
ANTIBIOTICS - Take any special medication such as antibiotics we have prescribed on the specified dosing schedule. Yogurt with active cultures or acidophilus should be taken while on antibiotics to prevent diarrhea. It is important to take the antibiotics to completion. If you are given antibiotics and take birth control pills, you should be aware that the birth control pill may become ineffective, therefore take appropriate precautions.
MEDICATIONS - Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule unless advised to do otherwise.
SMOKING - try to limit or avoid smoking completely as it tends to slow the healing process and may also contribute to development of a dry socket.
DO NOT DRIVE OR OPERATE ANY VEHICLE OR DRINK ALCOHOL for 24 hours following surgery if you have had intravenous sedation or general anesthesia, or if you are taking prescription pain medication.
SINUS PRECAUTIONS - IF YOU WERE INFORMED THAT A SINUS COMMUNICATION OCCURRED DURING SURGERY, as a result of the close relationship between the roots of your upper teeth and your sinuses, or if you have had some surgery that involved work near your sinuses or in your sinuses, please follow these instructions:
- DO NOT blow your nose.
- DO NOT sneeze through your nose. If the urge to sneeze arises, sneeze with your mouth open.
- DO NOT smoke or use a straw.
- AVOID swimming and strenuous exercise for at least one week.
- It is not uncommon to have a slight amount of bleeding from the nose for several days.
- Please remember that occasionally a second procedure may be required if there is a persistent sinus communication.
IMPLANT - If you had a dental implant placed the same general post-operative instructions apply plus a few additional points
- For the first 48 hours dip a Q tip in the chlorohexidine mouthrinse and gently clean around the implant. After the first 48 hours brush the area very gently with a soft toothbrush. The metal part you can see is the abutment, not the implant itself. Do not avoid brushing the area altogether it is very important to keep this area clean
- It takes 3 months for the implant to integrate to the bone. The implant gets weaker before it gets stronger; if it has been a couple weeks since the implant has been placed do not start chewing on the implant at this time as it will be at its weakest point. Do not chew on the implant site directly as it heals.
BONE GRAFTING - Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. It’s normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:

Do not chew in the area of the bone graft until we have told you it is okay to do so
Do not vigorously rinse or spit for 3-5 days.
Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.