INSTRUCTIONS After ALL PROCEDURES

Gauze: If you leave the office with gauze in your mouth, please discard it after one hour, unless otherwise instructed.

Bleeding: Some oozing of blood is to be expected for the first 24-48 hours. If bleeding is extensive or prolonged, apply a folded fresh piece of gauze to the site and bite down firmly maintaining pressure for at least 1 hour. Constant firm pressure will control the bleeding.

Swelling: Swelling after surgery is natural and to be expected for as long as 7 days after surgery. It is common for swelling to steadily increase within the first 48-72 hours and peaks 3 days after surgery. Applying an ice pack to the area of swelling during the first 24 hours will help.

Pain: Discomfort is common for 7-14 days following surgery. For severe pain, take the prescribed pain medications as directed. The prescribed medications might make you feel groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. If you are directed to take over the counter pain medications do not use Aspirin as it promotes bleeding.

Rinsing and Brushing: Do not rinse your mouth until 24 hours after your surgery. After 24 hours you can use a warm salt water solution or plain water to rinse every 6 hours. Do not rinse with mouthwash as it will burn healing gums. You can brush without toothpaste on the day of surgery but avoid surgical sites. Toothpaste can be used after 24 hours however avoid brushing the surgical site directly for 7 days.

Activity: Avoid over-exertion as it may initiate or intensify discomfort and bleeding.

Diet: Liquids can be taken freely after surgery however you should avoid carbonated beverages as the effervescence damages blood clots. Please remain on a soft diet for 7 days and be careful to avoid hot, hard, and spicy foods for 2 weeks. Avoid sucking through a straw as well as it can disrupt any clotting.

Wearing dentures and other appliances: If you have a denture or other appliance, you may have to visit your general dentist to have it adjusted after surgery. If the appliance presses on the surgical site, do not wear it until it has been appropriately adjusted.

Smoking: Smoking should be discontinued for the first week following surgery.

Stitches: Most stitches are designed to dissolve and fall out on their own, usually between 3-5 days after surgery. You do not need to return for stitch removal unless otherwise instructed.

Medications: Take any pain medications prescribed as well as any antibiotics or other prescriptions given until they are gone. Take all your regular medications as prescribed unless otherwise directed.

Dental Appointments: Unless instructed by our office or your general dentist, you should postpone any dental treatment for at least 4 weeks following surgery.

Other Complications: 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 them and not feel the sensation. Most numbness is gone after 24 hours, however some numbness can persist for up to 6 weeks.

Slight elevation in temperature immediately following surgery is not uncommon. If the temperature persists, contact our office.

Many patients feel dizzy following surgery. You should be careful going from lying down to standing. The prescribed pain medications may also make you feel dizzy. If you experience severe dizziness and vomiting or are unable to eat for 24 hours, please contact our office.

Occasionally, patients may feel hard projections in the mouth. The rough surface is not the roots of the tooth. They are usually the bony walls which supported the tooth and are typically smoothed out over time.

Sore throats and pain when swallowing are not uncommon. Since muscles are swollen, the normal act of swallowing can become painful. This pain will usually subside in 2-3 days.

Stiffness of the jaw muscles may cause difficulty in opening your mouth for several days following surgery. This stiffness usually gets worse over the first 4 days and can continue for up to 14 days.

Bruising of the face is not uncommon and may occur 2-3 days post operatively.

Bad breath or a bad taste in your mouth is not uncommon for up to 1 week following surgery.

Please be advised you should not attempt to conceive or breastfeed for at least 48 hours after any type of anesthesia. Birth control medications may also not be effective for one complete menstrual cycle after any anesthetic or medications given by our surgeons.

After Bone Grafting

In addition to the general postoperative instructions, we would like to emphasize a few points.

• Bone graft is made up of many particles, you may find some small particles in your mouth for the first several days.

• Do not vigorously rinse or spit for 3-5 days.

• Do not apply pressure with your tongue or fingers to the surgical site

• Do not lift or pull on the lip to look at the surgical site. This can cause damage and tear any sutures.

• Do not brush the surgical site directly for 14 days.

After Sinus Grafting

If you had sinus grafting performed, the general postoperative instructions still apply, but there are a few additional instructions.

• Do not blow your nose.

• If you sneeze, do so with your mouth open to avoid any unnecessary pressure on the sinuses.

• Do not smoke or use smokeless tobacco.

• Do not take liquids through a straw.

• Do not lift or pull on the lip to look at the surgical site.

• Take all medications as prescribed.

• You may have some bleeding from your nose. This is not uncommon and should pass quickly.

• You may be aware of small granules in your mouth for the next couple days.

• If you feel congested, use decongestants. Avoid nasal sprays unless they are saline. Most patients do fine without the need for any decongestants.

• Do not brush the surgical site directly for 14 days.

Sinus Precautions

If you were informed that a sinus communication occurred during surgery, please follow these instructions.

• Do not blow your nose

• If you sneeze, do so with your mouth open to avoid any unnecessary pressure on the sinuses.

• Do not smoke or use a straw

• It is not uncommon to have a slight amount of bleeding from the nose for several days.

• Occasionally a second procedure may be required if there is a persistent sinus communication.

• Do not brush the surgical site directly for 14 days.

General Instructions

If any of the following complications arise, please contact our office at any time, if after hours the Doctor on call will speak directly to you.

• Uncontrollable bleeding that fills the mouth within five minutes.

• Severe, uncontrollable pain.

• Swelling which worsens after the first 3 days.

• A temperature of greater than 101 F.

• Any skin eruptions, allergic reactions or difficulty breathing.

• Any situation not covered by these instructions which you feel should be brought to our attention.

What is a “Dry Socket”?

Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket and affect approximately one out of five patients. It occurs with greater frequency in people who smoke or are taking birth control pills. Dry sockets usually develop in the lower jaw and appear on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s).

Treatment involves placing a medicated dressing in the empty tooth socket. This will help to decrease the pain and protect the socket from food particles. The dressing doesn’t aid in healing, they are only placed to help control pain. Occasionally this requires you to return to our office for treatment multiple times to keep you comfortable.