post operative instructions
It is our desire for your recovery to be as smooth and pleasant as possible. These instructions are provided to assist in making the post-operative period uneventful. Please follow them as closely as possible. If you have any questions regarding your progress, please do not hesitate to contact the office at Kingwood Office Phone Number 281-358-2002. A 24 hour answering service is available for reaching the doctor or staff after office hours.
DAY OF SURGERY – ALL PATIENTS
- Keep your head elevated above the level of your heart. Do not lay flat for 24 hours. This can cause increased swelling.
- Keep the ice or cold pack on the surgical site-30 minutes on, 30 minutes off.
- Take some nutritious liquids and start the prescribed medication before the local anesthesia wears off.
- Do not rinse vigorously. Gently rinse your mouth with room temperature water once or twice.
- Utilize the gauze sponges as instructed, changing as necessary. Once the gauze is only spotted with blood, they can be left out of the mouth.
- You can brush your teeth the night of surgery, exercising caution in the area(s) of surgery. Rinse gently.
- Do not probe or touch the surgical area with objects or fingers.
- Do not smoke or use smokeless tobacco for a minimum of 72 hours. Our recommendation is to permanently discontinue using tobacco for the benefit of your overall health.
- Do not use a drinking straw for 72 hours. This can dislodge the blood clot.
- Do not spit–wipe saliva from your lips with a tissue.
- Do not take any hot drinks or foods until all feeling has returned. One can easily scald oneself and not be aware of the injury.
- Avoid bending or leaning over due to increased risk of falling.
If gauze has been placed over the surgical area, bite down gently but firmly on the gauze, making sure it remains in place. Do not change gauze for the first 15-20 minutes unless gauze becomes thoroughly soaked with blood. If active bleeding persists, replace the gauze to obtain pressure over the surgical site for another 15-20 minutes. The gauze may be changed as necessary and should be dampened before placement. Intermittent, minimal bleeding is normal. Bleeding should never be severe. In the event it is, it could mean the gauze is being clenched between your teeth rather than exerting pressure on the surgical site(s). Try repositioning fresh gauze. If bleeding persists or gauze becomes heavily soaked, please call our office. Do not leave the gauze in any longer than necessary. ONCE BLEEDING STOPS, REMOVE GAUZE.
TO AVOID THE POSSIBILITY OF CROSS CONTAMINATION, BE SURE THE GAUZE IS SAFELY DISPOSED (IN A SELF-SEALING PLASTIC BAG) SO NO ONE COMES INTO CONTACT WITH ANY BLOOD OR BODY FLUID CONTAMINANT. WE HAVE PROVIDED A DISPOSABLE GLOVE TO REMOVE THE GAUZE & THE PLASTIC BAG. WE ALSO REQUEST THAT YOU THROUGHLY WASH YOUR HANDS AFTER TOUCHING GAUZE PACK EITHER TO ADJUST IT IN THE MOUTH OR TO PLACE IT IN A PLASTIC BAG.
Often there is swelling associated with oral surgery. You can help minimize swelling by using the ice bag supplied and applying it firmly to face or cheek adjacent to the surgical area. This should be applied 30 minutes on and 30 minutes off during the first 24 to 48 hours after surgery. It is not uncommon for the maximum amount of swelling and pain to occur 24 to 48 hours following surgery. If the swelling seems to be increased the day after surgery as compared to the day of surgery this is usually very normal.
Please use the prescribed medications as prescribed or directed; noting not to take medication on an empty stomach. If nausea, vomiting, diarrhea, or rash develops, discontinue all medications and contact the office immediately. DO NOT DRIVE AN AUTOMOBILE OR OPERATE MECHANICAL EQUIPMENT WHILE TAKING NARCOTIC PAIN MEDICATION. Also, the consumption of alcohol or other non-prescription drugs can be dangerous in combination with your medication.
Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication and if you take the first dose before the local anesthetic has worn off, you will be better able to manage any discomfort. Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as acetaminophen (Tylenol), if not allergic following the directions on the box. If the pain persists, please contact the office. Elevated temperature may occur after surgery. If the temperature is above 101 degrees orally, contact the office. Also the corners of the mouth may dry or crack. Your lips should be kept moist with a lip balm or Chap Stick. Your other teeth may ache temporarily. We refer to this as sympathetic pain and it is a temporary condition.
Nausea is not an uncommon event after surgery and it is sometimes caused by the stronger pain medications. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem. Non-diet carbonated beverages may be of benefit with the nausea present.
Bruising may appear on the outside of the face near the area of surgery. This will resolve within several days.
Eat any nourishing food that can be taken comfortably. Temperature of the food doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or pureed foods (creamed soups, puddings, yogurt, milkshakes, etc.).
Avoid foods like nuts, sunflower seeds, popcorn, etc. that may get lodged in the surgical sites. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort, and heal faster. (If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.) Avoid hot or spicy foods for 24 hours.
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS – ALL PATIENTS
The second day, continue applying ice packs and keep head elevated while resting. On the third day, it is usually best to switch from ice to warm heat to the same areas. Apply warm compresses to the skin overlying areas of swelling (hot water bottle, moist hot towels, and heating pad) for 30 minutes on and 30 minutes off to help soothe those tender areas. This will also help decrease swelling and stiffness.
Over the next several days you can advance your diet, but always soft foods (pasta, cooked vegetables, etc.).
You may rinse with your favorite mouth rinse, but dilute it 50/50 with water for the first week.
Following the day of surgery, start your normal oral hygiene routine as soon as possible. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.
Please avoid strenuous activities, i.e. jogging, tennis, etc. for 3 to 5 days.
ADDITIONAL SPECIAL INSTRUCTIONS
Initially utilize a soft/liquid diet.
- Keep denture in place for 24 hours (If possible).
- After 24 hours you should remove your denture after meals, rinse your mouth with warm salt water, clean your denture, and replace.
- Maximum swelling generally occurs at 48 hours, so if your denture is not in place, you may not be able to get it back in. During the first few days only remove the denture to cleanse.
- You will more than likely develop “denture sores.” Your denture will need to be adjusted by your general dentist. If you do not have an appointment at this time, be sure to schedule one as soon as possible.
- We will see you in 5-7 days to check surgical sites and remove sutures if needed
DENTAL IMPLANT PATIENTS:
Mouth Rinses – On the day after surgery, start twice daily rinses with Peridex during the early phase of healing – the first 2 weeks.
Exposed Area of Implant – Use Q-Tip moistened in Peridex to gently swab the exposed areas of the implants.
MAXILLARY SINUS GRAFT PATIENTS:
Absolutely, avoid cigarette smoking or the use of smokeless tobacco throughout entire healing process.
- DO NOT perform any Valsalva (straining) procedures. If you must clear your nose, do so gently and with your mouth open.
- DO NOT blow your nose. You may use a tissue to wipe your nose.
- DO NOT sniff vigorously.
- If you sneeze, do so with your mouth open to avoid any pressure in the sinus area.
- It is best to avoid air travel for 5-7 days after your surgery. However, if unavoidable and you are on an airplane, you must not clear your ears by holding your nose.
- If nose bleeds occur, gently, with mouth open, clear your nose. If the bleeding persists, contact this office.
- You may be aware of some granules in your mouth for the next few days. This is not unusual.
- A small amount of oozing of blood through the nose is not unusual.
- Notify us if you feel granules in your nose.
- Notify us if you have any swelling after 2 weeks.
- It is recommended that the following over-the-counter medications be used as directed on the package:
- It is recommended that the following over-the-counter medications. be used as directed on the package or as noted below until your next appointment:
- DO NOT play musical instruments that require blowing with your mouth for at least 6 weeks after the surgery. This will cause pressure in the sinuses and may cause damage to your surgical site.
1. Saline Nasal Spray to assist with keeping nasal passages open.
2. Sinus Decongestant/Antihistamine such as Claritin to assist with reducing swelling in the sinuses and nasal passages.
3. Nasal Spray such as Afrin to help reduce secretions and shrink nasal passages. Use 2 times a day for a maximum of 5 days.
MANDIBULAR GRAFT PATIENTS:
Take only mechanical soft diet until your next scheduled appointment.
- Rinse mouth frequently.
- IN THE EVENT YOU WEAR A DENTURE, DO NOT PLACE DENTURE OVER GRAFT UNTIL INSTRUCTED TO DO SO BY THE DOCTOR.