Post-operative care is very important. Unnecessary pain and swelling can be minimized and the chance of complications can be diminished if the instructions are followed carefully. Although you will be given specific instructions for your particular procedure, here are some general guidelines.
Immediately Following Surgery:
- The gauze pad placed over the surgical area should be kept in place for one half to one hour. After this time, the gauze pad should be removed and discarded. Additional moist gauze pads may be placed as needed for any persistent oozing or bleeding.
- Vigorous mouth rinsing or touching the surgical site following surgery should be avoided. This may initiate bleeding by dislodging the blood clot that has formed.
- Take the prescribed pain medication before you begin to feel discomfort or just as the local anesthesia begins to wear off.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs on the outside of your face next to where surgery was performed. Refer to the section on swelling for explanation.
Caution: If you suddenly sit up or stand from a lying position you may become dizzy. Therefore, immediately following surgery, if you are lying down, make sure you sit for one minute before standing.
Bleeding
A certain amount of bleeding, oozing or red-tinged saliva is to be expected following surgery and is not uncommon. Excessive bleeding may be controlled by first gently rinsing any blood from your mouth, placing a moist gauze pad over the surgical site, biting firmly for thirty to sixty minutes, and repeating as necessary. If despite these instructions bleeding continues, bite on a moistened plain tea bag for thirty minutes. Tannic acid contained in tea helps blood to clot. To minimize further bleeding, remain calm, sit upright, and avoid activity. If bleeding still persists, call the office for further instructions.
Swelling
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 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously 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 size of the swelling.
Pain
For mild discomfort, over-the-counter acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) may be taken. Please carefully read and follow all instructions on the bottle.
For moderate to severe discomfort, take the prescribed pain medication as directed. The prescribed pain medication may make you groggy and may slow down your reflexes. Do not drive an automobile, work around or operate machinery, or attempt to make important decisions while you are taking the prescription pain medication. Avoid mixing any prescribed pain medications with alcoholic beverages. Discomfort following surgery may increase on the second or third day following the procedure and then should improve each day thereafter. If pain persists or worsens after this timeframe, it may require attention and you should call the office.
Diet
After general anesthesia or I.V. sedation, start with clear liquids first. Drink from a glass and do not use straws. The sucking motion and pressure of using a straw can cause more bleeding by dislodging the blood clot. You may eat anything soft by avoiding the surgical sites when chewing. High calorie, high protein intake is very important. Nourishment should be taken regularly. You can prevent dehydration by drinking plenty of fluids. Since, your solid food intake will be limited for the first few days, 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.
Keep the mouth clean
No rinsing of any kind should be done until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day 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.
Discoloration
In some cases, discoloration or bruising of the skin may follow swelling. The development of black, blue, green, or yellow discoloration is due to bleeding or oozing below the surface of the tissues during and after surgery. This can be a normal post-operative occurrence, which may not be noticeable until two or three days following the procedure. Moist heat applied to the affected areas may speed up the resolution of the discoloration.
Antibiotics
If you are placed on an antibiotic, make sure to take the tablets or liquid as directed. Antibiotics are sometimes given to help prevent or cure an infection. If a rash or other unfavorable reaction would occur, stop taking the antibiotic and contact the office immediately for further instructions.
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 any prescribed medication. Sitting still in a dark room and placing a cold compress on one’s forehead may also help. After an hour, one should try sipping on bland liquids such as water, tea, or 7-Up over a fifteen-minute period. When the nausea subsides begin taking solid foods and the prescribed medication again. Anti-nausea medication can easily be prescribed if nausea or vomiting would persist despite these efforts.
Good Things to Know
- If numbness of the lip, chin, or tongue occurs this is usually temporarily due to the local anesthesia and no cause for alarm. Be very cautious while attempting to eat if your lip or tongue is numb so that you don’t accidentally bite or hurt yourself. Should any numbness or tingling persist after 24 hours, please notify the office.
- Slight elevation of temperature immediately following surgery is not uncommon. If a temperature or fever persists, please notify the office. Tylenol or ibuprofen sometimes is recommended to help reduce a temperature or fever.
- You should be careful going suddenly from a lying down position to a standing, upright position. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up slowly.
- Occasionally, patients may feel hard projections in their mouth with their tongue near the surgical site. These projections are not forgotten tooth roots but the bony walls of the empty tooth socket. These projections usually smooth themselves out as the surgical site heals. If not, they can be smoothed by your surgeon.
- During oral surgery, it is necessary to retract the lips and cheeks which may sometimes cause the corners of the mouth and lips to dry out and crack. Your lips should be kept moist with an ointment such as Vaseline to help prevent this.
- A mild sore throat and pain when swallowing are not uncommon for a day or two after surgery. This can sometimes be due to some of the anesthesia medications or swollen muscles.
- Stiffness (trimus) of the jaw muscles may cause difficulty in opening one’s mouth or limited opening for a few days following surgery. This is a normal post-operative event which will resolve over the first week after surgery. Taking an anti-inflammatory medication such as ibuprofen (Advil/Motrin) can be helpful.
Finally
- Sutures are sometimes placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, and this is no cause for alarm. Just remove the loose suture form your mouth and discard it. When possible, dissolvable sutures are placed to avoid the inconvenience of having them removed a week later. If your doctor places sutures that do require removal, this process is very easy and requires no anesthesia or needles. It takes only a minute or so, and there is typically no discomfort.
- There will be a hollow space where a tooth is removed. This area gradually, over the next several weeks and months, heals and fills in with the new tissue. In the meantime, the area should be kept clean with salt water rinses and normal brushing. Brushing your teeth is okay -- just be gentle at the surgical sites.
- Your case is individual; no two mouths are alike. Do not take seriously well intended advice from friends or family that is different from the information and instructions provided by our office.
- If you are involved in regular exercise, be aware that your normal caloric intake is reduced after surgery and exercise may further weaken you. It is best to avoid strenuous activity for two to three days following surgery.