Post-Surgical Instructions

MEDICATIONS: Please begin the medications within a couple of hours to minimize the discomfort as the effects of the anesthetics begin to lessen. Try to drink milk and eat soft food before taking the narcotic pain medication(s). Lying down may also minimize nausea. Restrict your activity if the pain medication causes drowsiness and follow label directions. Do not take aspirin-containing products for 72 hours. Avoid alcohol for 72 hours and while taking narcotic medications. If prescribed by your doctor, it is important to continue taking the antibiotic medication until it is all gone.

GAUZE PACKING: In some cases, our office will provide extra gauze to be used after surgery. Gauze is to be placed over the surgical site to serve as a pressure bandage. It may be removed after 30 minutes and then replaced with moistened gauze changing every 1-2 hours. Bite down firmly. Continue to use the gauze until bleeding subsides. Some oozing of blood can be expected for 24-48 hours following the procedure. Biting on a moistened tea bag may also control bleeding. Avoid spitting as this can intensify the bleeding. If BLEEDING persists, please call the office. NOTE: If you received any bone grafting or an implant, gauze may not have been given and is not necessary to use after surgery.

ICE/HEAT PACKS: When you return home, apply an ice bag over the affected area. Use for 15 minutes on and 15 minutes off to minimize swelling and discomfort. If an ice bag is not available, use a heavy plastic bag filled with crushed ice. Cover it with a soft cloth to prevent skin irritation. Use ice for up to 48 hours. Warm, moist packs should be used after this initial period.

ACTIVITY: Reduce your activity level during the immediate post-operative period. Depending on the surgical procedure performed, we may request that you avoid physical activity and fatigue for 48-72 hours following the procedure. The medications may alter your ability for rational thought and you should not execute any major personal or business decisions for a minimum of 48 hours or while on narcotic medications.

ORAL HYGIENE: The evening of your surgery you may brush your teeth as you normally would but avoid the surgical sites. The following morning again brush your teeth avoiding the surgery sites. At that time, begin rinsing gently with warm salt water (1/4 -1/2 teaspoon of salt in an 8-ounce glass of water) after meals and at bedtime. This rinsing serves to remove the food particles and debris from the surgical sites helping to prevent infection and promote healing. Continue these rinses for the next 7-10 days. If Peridex was prescribed, use twice a day until all of the bottle is used.

For implants: Do not brush the area of the implant for one week!

IRRIGATION SYRINGE: DO NOT USE the syringe for 5 days after your procedure. Use with warm salt water to irrigate out the sockets. DO NOT USE the syringe if you have had a bone graft or implant placed.

SUTURES AND DRESSING: Some sutures placed are absorbable and do not need to be removed. You will be told if they are absorbable. The absorbable sutures will be gone in within 2-3 weeks. If non-absorbable sutures or a “stent” have been placed, you will be scheduled for an appointment for their removal.

EATING: Have your meals at the usual times. Eat soft, nutritious foods and drink plenty of liquids. Do not drink liquids with a straw as this will create a vacuum that could dislodge the blood clot. Add solid food to your diet as soon as you feel comfortable doing so.

NOSE BLOWING: If back teeth in your upper jaw have been removed, avoid blowing your nose for one week following the surgery. If you develop a cold, with congestion, please call the office.

TOBACCO: DO NOT SMOKE OR USE TOBACCO PRODUCTS OF ANY KIND for at least the first 72 hours following surgery. You should realize that whenever tobacco products are used, they may greatly decrease the chances of success of your surgery.

IMMEDIATE DENTURES, IMPLANTS OR STENTS: If you have an immediate denture placed at the time of surgery this will serve as a surgical bandage. DO NOT remove the denture until after you have returned to your dentist for your first post-operative visit (or are instructed to do so by our office). At this appointment, your dentist will remove the denture. If the denture is removed too early, the tissues may continue to swell and you may not be able to replace the denture. If implant was placed plan to use it for the first 4-6 weeks for esthetic purposes only. The use of excessive pressure on the implant may cause it to fail.

BARRIER: In some cases your surgeon will place a barrier over the site where bone grafting was placed. This is a protective barrier that needs to remain on for 2-4 weeks. If barrier comes off, do not be alarmed. Please keep it and call the office for further instructions. The surgeon will need to see you 2-4 weeks post-op, which will be scheduled at time of surgery.   

SENSATION RETURN: Local anesthesia results in a loss of sensation to the tongue, lips, cheeks, gums and teeth. Following your surgical procedure, and until the sensation returns, be careful concerning: hot drinks that may burn the tissues; chewing your lips, tongue, or cheeks; and eating utensils or other sharp objects that may cause damage. Parents need to observe their child during this time of sensation return and ensure trauma does not occur.                                                                                                                                    

POST-INTRAVENOUS ANESTHESIA INSTRUCTIONS (If Applicable)

You may have received intravenous drugs to make your surgical procedure comfortable for you. Although the major effects of these drugs wear off rapidly, there may be residual effects that can alter your judgment and physical abilities. To ensure that your post-anesthesia treatment will be uneventful:

You are to go directly home after your surgery and rest quietly the remainder of the day. The residual effect of your intravenous medications may cause you to be drowsy. Your pain medications (pills issued for post-operative pain reduction) may also cause drowsiness. The combined effect may make you feel lightheaded or dizzy, so do not use stairs at home, etc. without assistance for the remainder of the day.

  1. A gentle flow of oxygen was used during your surgery, and, for some patients this may “dry” the nasal mucosa. This can result in sneezing episodes or a “runny” nose that will subside in 12 hours.
  2. No driving of motor vehicles or operating machinery for 24 hours or while taking narcotic medications.
  3. Do not schedule major decisions while taking narcotic medications.

 ITEMS OF CONCERN

NAUSEA AND VOMITING: Following surgery in the mouth, the combination of narcotic medication and the swallowing of blood can cause an upset stomach and nausea. If this occurs, try over-the-counter medications (PeptoBismol, etc.),take only clear liquids and being as quiet as possible. If vomiting does occur, oral medications can be prescribed. With vomiting, suppositories may need to be prescribed.

SWELLING: Swelling after surgery is normal. It takes about 24-48 hours for surgical swelling to reach its peak. Swelling that increases after this time, especially if accompanied by fever and pain should IMMEDIATELY be brought to the attention of this office.

FEVER: Your temperature may rise slightly for a day or two after surgery and this is usually of no concern. However, a persistent elevated temperature of 100 degrees F or higher should be reported to this office at once!

ALLERGIC REACTIONS: Rash, itching, difficulty breathing, wheezing, or swelling about the eyes and face not associated with the surgery – if you should develop any of these symptoms during your post-operative course, STOP TAKING ALL MEDICATIONS AND NOTIFY THE OFFICE IMMEDIATELY!

SKIN IRRITATIONS: Be aware that prolonged or continuous use of ice in contact with the skin may cause frostbite. Additionally, if in 48 hours you use a moist towel warmed in the microwave oven, warm for only 20 seconds or less to avoid a burn on the skin.

IF YOU HAVE ANY QUESTIONS OR CONCERNS, PLEASE CALL THE SILVERDALE OFFICE AT 698-9335 OR THE POULSBO OFFICE AT 779-2339 AT ANYTIME. AFTER BUSINESS HOURS, THE ANSWERING SERVICE WILL CONTACT ONE OF OUR DOCTORS.