HOME CARE INSTRUCTION AFTER ORAL SURGERY
It is normal to experience a number of symptoms following oral surgery. This information provides you with an outline of the normal things you may expect to feel after surgery, and some helpful hints for a speedy and complete recovery following your surgery.
Pain:
Pain following oral surgery is expected for several days. It is recommended that you take a pain pill before the local anesthesia (freezing) wears off, and continue to take the medication, as needed. If you have been prescribed narcotic pain medication, following the instructions for use as directed on the bottle. You may combine non-narcotic pain medications like ibuprofen (Advil, Motrin, Aleve) and acetaminophen (Tylenol) with or between your doses of narcotic pain medication. Common side effect of narcotic pain medication include constipation, nausea and vomiting. Constipation can be treated by eating prunes, drinking prune juice, or taking a mild laxative of your choice. Never drink alcohol or drive while using prescription pain medication. Nausea and/or vomiting may occur after surgery. This is due to swallowing small amounts of blood, the medications given to you during your anesthetic and those prescribed to you after surgery, and having an empty stomach. Gravol, which may be prescribed without prescription at any pharmacy, may be helpful to treat nausea. You may take a 25 - 50 milligram gravol pill together with your pain pill, or decrease the dose and/or frequency of the narcotic pain medication prescribed for you. Eating bland foods may be helpful. Avoid spicy and acidic foods while you are nauseated.
Bleeding:
Bleeding is normal and expected after oral surgery. Bleeding can be decreased by keeping your head elevated, limiting strenuous activity, and drinking cool fluids. Do not drink with a straw and do not smoke for 7-14 days after your surgery. Minor bleeding should be treated by applying gauze or an unused, moistened tea bag directly over the wound, and biting firmly for 30 to 60 minutes. Repeat as necessary. Do not eat or drink with the gauze pads or tea bags, as bleeding may increase and remember to remove them before sleeping as they are a potential choking hazzard.
Stiches:
Depending on the type of stitches placed during surgery, they may begin to unravel and/or dissolve and fall out 1-6 days after surgery or they may last longer, requiring removal 1-3 weeks after surgery.
Bruising:
Discoloration of the skin over the cheeks, chin, neck and chest is common following oral surgery. There is no specific treatment for bruising, and it will gradually fade away.
Swelling:
Swelling after surgery is normal and expected, and may occur inside the mouth and on the face. It can increase for tow to three days after surgery, and may persist for 7 to 14 days. The early stages of swelling may be controlled by applying ice packs to the face - 20 minutes on, 20 minutes off - for up to 48 hours after surgery. Do not place hot packs over the swollen areas of the face. The lips and corners of the mouth may be lubricated with Vaseline, or a bland cream, to minimize drying and cracking.
Trismus:
Trismus, or "difficulty opening the mouth" is very common after oral surgery and though it will resolve on its own, it may persist for several weeks. It may be decreased by doing regular jaw exercises, such as gently opening and closing the mouth, several dozen times daily, and by chewing soft, sugarless gum.
Mouth Rinsing and Tooth Brushing:
You may begin rinsing your mouth with a diluted mouth wash and water or mild salt and water solution right after your surgery. Combine an 1/8 - 1/4 tsp of salt in a glass of lukewarm water and stir until the salt is dissolved. On the day following surgery, begin gently brushing your teeth, while avoiding the surgical sites. When comfortable for you, begin brushing the surgical sites too. Do not use electric devises such as waterpik at the surgical sites for 4 weeks.
Socket Syringing:
To ensure excellent healing, socket irrigation is extremely important. If you have been given a plastic extraction socket cleaning tool (a syringe), start suing it to clean your lower jaw extraction sockets two days after your surgery. Irrigate the socket(s) when you awaken i the morning, after every meal and before you go to sleep, at least 4 - 6 times a day, for 4 - 6 weeks. Insert the tip of the syringe directly into the extraction socket and gently flush until the site is clean and the solution runs clear. Syringing prevents the painful collection of bacteria and food debris in the healing socket which can lead to delayed healing, infection and bad breathe. There is no need to syringe extraction sites in the upper jaw because they drain on their own, by gravity.
Fever:
A slight fever is common following oral surgery, and is not cause for concern. If safe for you to take, you may use plain aspirin, as directed on the bottle, to decrease fever.
Dehydration, dizziness and fainting:
Some patients may experience dizziness after surgery, which may lead to fainting. This is commonly due to the inadequate intake of fluids. You are urged to drink at least 1-2 liters of fluids each day. It is best to drink a combination of water and fruit juices.
Diarrhea:
Antibiotic drugs, such as penicillin, may cause diarrhea. If this occurs, you are advised to stop your antibiotics.
Recovering from Intravenous Anesthesia:
While recovering from intravenous sedation, you should remain under adult supervision for at least six hours after surgery or until awake and alert. It is helpful to rest on your side or stomach while recovering from the effect of the sedative drugs. Remove gauze before sleeping. Do not operate machinery, drive a car, or drink alcohol for at least 24 hours following your anesthetic, or while taking prescription pain medications.
Diet:
Adequate nutrition following surgery is important to encourage rapid healing. Some difficulty in chewing food is suggested. A soft, non-chewing diet of tepid soups, pasta, pudding, mashed potatoes, scrambled eggs and dairy products is suggested. Lukewarm and cool foods are preferred, while temperature hot foods should be avoided, as they may cause bleeding. Calorie-rich drinks such as Ensure or Boost may also be appropriate to supplement your diet.
Phlebitis:
Phlebitis is pain inside the vein where the intravenous medications were injected. Elevating the arm and placing hot compresses on the sore area for 10-15 minutes every hour for 1-2 days will decrease soreness. Symptoms may persist for several weeks after surgery. If your pain significantly worsens, please notify the office.
Drug Interactions:
Some of the medications prescribed to you after your surgery may interfere with the medications prescribed to you by other health care providers. Please be sure to inform Dr, Eidinger of any pills or medications that you are taking.
Smoking:
You are strongly advised not to smoke after surgery. Smoking delays healing by compromising the blood flow to the healing tissues leading to infection. If you have had implant surgery, there is a three-fold increased risk of implant and bone graft failure. Please consider visiting your local pharmacist or family doctor to help you explore the options available to help you stop smoking.
Antibiotics:
Take your prescribed antibiotic medications as instructed by Dr. Eidinger. If you develop an adverse reaction to your medication, such as a rash, stop taking your pills and contact the office.
Pressure at the Implant and/or Bone Graft Site:
It is imperative that absolutely no pressure be placed on the site of your bone graft or newly inserted implants or their abutments during the healing phase, for a four to six month period. If you have had a removable temporary denture made prior to your implant surgery, you must go to your dentist to have it adjusted at least one day after surgery. This is because the procedures that have been done for you may change the fit of the denture. Do not chew on the bone grafted side or on your implants. Premature loading of the graft site or implants may contribute to mobility, infection or failure.
Resuming Exercise and Physical Activity:
Plan to rest and relax after your surgery. It may take several days to 1-2 weeks for the body to fully recover from the effects of surgery, anesthesia, and the prescription medications. In most cases, it is normal to being very light activity three to four days after surgery. However, do not resume normal activity or vigorous exercising until you feel well enough to do so.