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Post-Op Instructions.

Often the after-effects of oral surgery are quite minimal, so not all of these -instructions may apply.

The surgical area will swell. This peaks around 48 hours following surgery.  So expect to wake up more swollen the second morning after surgery than the first. You may have a slight earache.  

It is NOT unusual to develop bruising in the area of extractions.

 

Your main goal is to avoid disruption of the blood clots for the first 48-72 hours, and then keep the sockets/area as clean as possible from that point forward.

Bleeding

  • Bite on the gauze firmly for at least 45 minutes after you leave the office.

  • If bleeding persists, rinse mouth with ice cold water and reapply gauze in a tight roll & place ice on the outside of your face, cooling the area will diminish the blood flow. 

  • Avoid removing the gauze too early! A common mistake is to remove the gauze 10 minutes after placing it to “check” the bleeding.  Keep it in for at least 30-45 min to establish a good clot.

  • It is normal to expect a small/scant amount of bleeding for the first 24-36 hours.

Pain Management

  • Stay ahead of the pain for the first 24h. This is important!!  Take your first pain pill before the anesthetic has worn off, and then repeat as directed. After 48h, you can move to less frequent dosing as needed until you are able to wean yourself onto over-the-counter (OTC) meds.

  • Always take the pain medicine with at least a small amount of food and/or water.  This will prevent most instances of nausea.  Use the anti-nausea medicine if needed for nausea with the pain meds.

  • Supplement pain meds when awake with an OTC anti-inflammatory between pain med dosing (600mg of Ibuprofen/Advil every 6 hours, or 440mg of Naproxen/Aleve every 12 hours).  Most prescribed pain meds already contain Acetaminophen/Tylenol.  Do NOT supplement your pain med dosing with Acetaminophen/Tylenol to avoid overdose.

Swelling

  • Some swelling is normal and can be minimized (not necessarily eliminated) with the following:

  • Ice Pack: Apply 20 min on and 20 min off during the first 12 – 24 hours after surgery. AFTER 24 hours, you may switch to WARM applications (20 min on and 20 min off). The warmth will help decrease soreness and stiffness.

Sutures/Stitches

  • Most sutures will dissolve or fall out on their own after 2-7 days. Depending on the procedure and the number of stitches required will determine how long they will take to dissolve. Different types of sutures may take up to two weeks or more to dissolve.

Irrigating Syringe

  • This is the most important thing to do following extractions in order to heal properly, (for wisdom teeth extractions and other extractions without grafting). Grafted sockets should not be directly irrigated.

  • The lower sockets (and upper sockets if necessary) should be kept clean using an irrigating syringe (which we will provide to you) beginning on the 3rd day after surgery.

  • This means flushing the sockets to remove all food particles from the sockets anytime after eating.  A common mistake is ineffective irrigating.  Irrigating should cause some discomfort (for the first few days) and a little bleeding (first few days).  If not, then you probably need to be more aggressive with your irrigating.  Allowing food to remain in extraction sockets is by far the most common cause of infection after surgery.

  • Irrigate with room temperature water.

6 Things to Avoid - 1st 72 Hours

  • DO NOT use a straw.  This can dislodge the clot (suction) and promote dry socket & prolong bleeding.

  • DO NOT smoke, as it is compromises blood supply and can promote dry socket.

  • DO NOT rinse vigorously with mouthwash or water for the first 48h (mild swishing with peridex is okay). It can dislodge the clot and promote dry socket.  After 48-72h, you can rinse with Peridex!

  • NO hot liquids (lukewarm coffee, tea or soup is fine) while numb.  Don’t burn yourself!

  • NO spitting; Just swallow normally.  

  • NO carbonated beverages. These can dissolve the clot and promote dry socket.

Diet

  • Be sure to eat nutritious food and drink plenty of liquids.  Do not skip meals, if you eat nutritious foods, you will feel better, gain strength, have less discomfort and heal faster.

  • Avoid foods that will be difficult to irrigate out of the sockets (small things such as nuts, sunflower seeds, popcorn, potato chips, rice, etc.) that may get lodged in the socket areas.

  • Softer foods (mashed potatoes, pasta, scrambled eggs, etc.) are OK for the first 48 hours (since the swelling and discomfort will gradually increase and peak at 48h).