Post-Operative Instructions

Sometimes, the aftereffects of oral surgery are quite minimal, so not all instructions apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office for clarification. Our number is (208) 232-2807.

DAY OF SURGERY

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. The gauze pads need to remain over surgical sites to apply correct pressure. Do not change them for the first hour unless bleeding is not controlled. The packs may be gently removed after 1 hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30–45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

EXERCISE CARE: Do not disturb the surgical area today. Do not rinse vigorously or probe the area with any objects. You may brush your teeth gently. Please do not smoke for 1 week, since this is very detrimental to healing and may cause a dry socket.

OOZING: Intermittent bleeding or oozing for the first two to three days is normal. Remember, blood mixed with saliva appears worse than it is. Bleeding may be controlled by placing fresh gauze over the areas and biting with firm pressure on the gauze for 30–45 minutes at a time.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp/dry, and wrapped in moist gauze) for 20–30 minutes. If bleeding remains uncontrolled, and the gauze pads appear dark red, please call our office.

SWELLING: Swelling is often associated with oral surgery and will increase slowly until the third or fourth day after surgery. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24-48 hours after surgery. If you have been prescribed medicine to control swelling (most commonly Ibuprofen), ensure you take it as directed.

PAIN: Unfortunately, most oral surgery is accompanied by some discomfort. You will usually have a prescription for pain medication. Initially, you should start by taking the prescribed pill for pain and swelling, which is most commonly Ibuprofen. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. The effects of pain medications vary widely among individuals. If you do not find adequate relief at first, you may supplement each pill with the stronger option you have been given, most commonly Hydrocodone or Tramadol. Some patients may even require two of the stronger pain pills at one time. Remember that the most severe pain is usually on days three and four after the surgery, so saving most of the stronger pain medication for these days is suggested. If you have been prescribed medication for nausea and vomiting, take this 30 minutes before the pain medication. Your need for medicine should lessen around day seven. If you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, please call for a refill during weekday business hours.

NAUSEA: Nausea is not uncommon after surgery. Sometimes, pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food and taking the pill with a large volume of water. If you vomit, rinse gently but thoroughly with salt water multiple times and please contact our office as we may want to prescribe antibiotics. Try to keep drinking clear fluids and minimize the dosing of pain medications. This can be done by cutting the stronger pain medication in half. If nausea persists, please contact our office. Carbonated soda may help with nausea as well.

DIET: Eat any nourishing food that can be chewed with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to limit the first day's intake to liquids or pureed foods (soups, puddings, yogurt, milkshakes, etc.). It is best to avoid foods such as nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days, you may gradually progress to solid foods. It is important not to skip meals! If you nourish yourself regularly, you will feel better, gain strength, have less discomfort, and heal faster. If you are a diabetic, maintain your normal eating habits and follow instructions given by your doctor.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

INSTRUCTIONS FOR THE THIRD AND FOURTH DAYS (Not counting day of surgery)

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Dissolve ¼ teaspoon of salt in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking 5 minutes to rinse gently with the entire glass. Repeat as often as you like but, at least 4 or 5 times daily.

HEALING: Normal healing after tooth extraction should be as follows: The first 3 days after surgery are generally uncomfortable, and there is usually some swelling. On the third and fourth day, you will feel the worst because the swelling and pain usually peak on day 3. These are the days when stronger pain medicine may be necessary. The remainder of the postoperative course should be a gradual, steady improvement. If you don't see continued improvement, please call our office. If you are given a plastic irrigating syringe, do not use it for the first 5-7 days. Then, use it three times a day, making sure to place the tip of the syringe inside the socket for irrigation with salt water. You will continue irrigation with the syringe until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket. We want your recovery to be as smooth and pleasant as possible. Following these instructions will assist you, but if you have any questions about your progress, please call the office. A 24-hour answering service is available to contact the doctors on call after hours. Calling during office hours will result in a faster response to your questions or concerns.