General Surgical Information
Use gauze directly on top of bleeding sites with continuous biting pressure. Keep your head elevated until active bleeding stops. Change gauze as needed when it becomes saturated with blood and saliva. If you run out of gauze, a clean piece of cloth or paper towel will work well. The primary purpose of the gauze is to put pressure on the wound, not to soak up the blood. It is common for mild bleeding to continue overnight however it is not recommended to continue gauze overnight due to safety concerns.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling may not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Use ice packs the day of surgery only. Zip-lock bags filled with ice and a small amount of water wrapped in a thin towel, or commercial ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. At that point moist heat to face is beneficial to speed the reduction of swelling. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
For moderate pain, ibuprofen (Motrin or Advil) two to four over the counter (200 mg) tablets may be taken every 6 hours for up to three (3) days. Do not take Tylenol with your prescription pain medication.
For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office. You may have a dry socket.
A dry socket occurs due to a poorly formed blood clot in the extraction site. Ten percent of patients will get a dry socket. Dry sockets typically present as constant pain that begins the second to the fourth day. There is usually a bad taste and/or bad odor. It is not necessary to hurt with dry socket pain. Contact our office and we will medicate the socket to stop the pain.
While your lower jaw, lip and tongue are numb, have nothing to eat or drink that is hot or requires chewing. This will help prevent burning or biting your lip or tongue during this period. Milk shakes, ice cream, and yogurt are okay during this period. Drinking through straws should be strictly avoided for the first 48 hours to help avoid dry socket. After the numbness is gone, you may have whatever food you are able to eat, although you may prefer soft foods for the first two or three days after surgery.
High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
Keep the Mouth Clean
Starting the morning after your procedure, begin rinsing your mouth at least four times per day with warm water. Also, start brushing your teeth, being careful to avoid vigorous brushing in the surgical areas.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid until all taken as directed. Antibiotics may be given to help prevent or treat infection. Discontinue antibiotic use and notify our office in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
Nausea & Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, tea, or ginger ale. Ginger is a natural anti-nausea substance. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful.
- A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It is also difficult to take fluids after surgery. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth with healing of the socket. If not, they can be removed.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles in the throat may become swollen causing the normal act of swallowing to become painful. This will subside in two to three days.
- Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time. You should attempt to slowly increase this opening by gently stretching your mouth wider and wider progressively over the first postoperative week.