POST-OPERATIVE INSTRUCTIONS

 

***PLEASE READ THESE INSTRUCTIONS CAREFULLY***

***DO NOT DRIVE OR OPERATE MACHINARY WHILE ON PRESCRIBED MEDICATION***

 

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply.  Common sense will often dictate what you should do.  However, when in doubt follow these guidelines or call our office for clarification.  Our number is 512-372-6230.

 

DAY OF THE SURGERY

FIRST HOUR:Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place.  Do not change them for the first hour unless the bleeding is not controlled.  The packs may be gently removed after one hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes.  The gauze may then be changed as necessary (typically every 30 to 45 minutes).  It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

 

EXERCISE CARE: Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with any objects.  You may brush your teeth gently.  PLEASE DO NOT SMOKE for at least 10 days, since this is very detrimental to healing and may cause a dry socket.  If sutures were placed, they will dissolve on their own.  This will take place anytime within the next few weeks. 

 

OOZING: intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

 

PERSISTENT BLEEDING: bleeding should never be severe.  If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas.  Try repositioning the packs.  If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes.  If bleeding remains uncontrolled, please call our office. It is expected that the patient will have blood in their saliva for the next few days, although it should not be non-stop oozing blood.

 

SWELLING: swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.  After the first 24 hours after surgery, it is suggested that you use moist heat instead of ice.  A warm, wet towel should be placed on each cheek in 20-minute intervals.  If you have been prescribed medicine for the control of swelling, be sure to take it as directed.  The swelling will be the worst 3-4 days after surgery.  If the swelling is present with a fever or oozing from the surgical area, please call our office for a follow up appointment

 

PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to better manage any discomfort.   Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced.  The effects of pain medications vary widely among individuals.  If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen.  Ibuprofen is taken to help control swelling and will help with some discomfort.  As long as you have no allergies or other problems with ibuprofen, take it as described on the label.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

 

NAUSEA: nausea is not uncommon after surgery.  Sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better.  Classic Coca Cola may help with nausea.

 

DIET: Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, pudding, yogurt, milk shakes, etc.)  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas.  Over the next several days you may gradually progress to solid foods.  It is important not to skip meals!  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

 

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls that once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office.

 

INTRUCTIONS FOR THE SECOND AND THIRD DAYS

 

MOUTH RINSES: Keeping your mouth clean after surgery is essential.  Use ¼ teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.  Repeat as often as you like, but at least two or three times daily.

 

BRUSHING: begin your normal oral hygiene routine the day after surgery.  It is important to keep your teeth clean while you are healing.  Although it may be uncomfortable, gentle brushing is necessary.

 

HOT APPLICATIONS: You may apply warm compresses to the skin over the areas of swelling 24 hours after the surgery (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will also help decrease swelling and stiffness.

 

HEALING: Normal healing after tooth extraction should be as follows: The first two days after surgery are uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet.  The remainder of the post-operative course should be a gradual, steady improvement. If you don’t see continued improvement, please call our office.  Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

 

Follow Up:  Routine follow-up appointments are generally not needed.  If the doctor feels that there is any reason that the patient must return after surgery, an appointment will be made before the patient leaves the office.  If you feel that you are not healing like you should, feel free to contact our office and we will make a follow-up appointment for you.

 

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office during business hours (M-F 8-3).  If you have an emergency situation after business hours, you may contact our office and leave a message for Dr. Marcantoni. Calling during our business hours will afford a faster response to your questions or concerns.

 

PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewal are ONLY accepted during office hours and a POST-OP visit will be needed.  Please do not call the pharmacy for refills.