HOME CARE INSTRUCTIONS AFTER ORAL SURGERY
It is normal to experience any number of symptoms as you recover from oral surgery. The following information provides you with an outline of what you may expect to feel after surgery, and some helpful hints for a speedy and complete recovery after your surgery.
Pain:
Pain after oral surgery should be expected and may continue for one to two weeks. 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 should be expected after oral surgery. Bleeding can be decreased by keeping your head elevated, limiting strenuous activity, and drinking cool fluids. Refrain from lifting weights or exercising for one to two weeks after your surgery. 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 in your mouth, as bleeding may increase. Remember to remove them before sleeping as they are a potential choking hazard.
Stiches:
Depending on the type of stitches or sutures used during surgery, they may begin to unravel and/or dissolve and fall out 1-6 days after surgery. If needed for your surgery, some stitches may be made of a material that may last much longer or not dissolve at all. These stitches may require 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 two 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. Though it will resolve on its own, return to normal opening may take some time to resolve and may persist for several weeks. Regular jaw exercises, such as gently opening and closing the mouth, several dozen times daily, and chewing soft, sugarless gum may loosen up the jaw and speed up return to normal jaw movement.
Mouth Rinsing and Tooth Brushing:
You may begin rinsing your mouth with a diluted mouthwash and water solution or mild salt and water solution right after your surgery. If you are using a salt water solution, combine an 1/8 tsp - 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 being careful to avoid the surgical sites. When comfortable, you may begin brushing the surgical sites as well. Do not use an electric toothbrush or a waterpik at the surgical sites for at least 3 - 4 weeks following your oral surgery.
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 using it to clean your lower jaw extraction sockets two days after your surgery. Plan to irrigate the socket(s) when you awaken in the morning, after every meal and before you go to sleep, at least 4 - 6 times a day for 4 - 6 weeks. Be sure to 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 four to 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, drink alcohol, use recreational drugs and refrain from making any important decisions 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. 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 spicy foods and 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 in your arm where the intravenous medications were injected. Elevating the arm and placing hot compresses on the sore area for 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. So that you may receive the best care possible, please be provide Dr.Eidinger or her staff with an up-to-date list of all of the prescription and non-prescription 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, you may plan to begin very light activity five to seven days after surgery. However, do not resume normal activity or vigorous exercise until you feel well enough to do so.