General Post-operative Instructions

Care of the Mouth Following Oral Surgical Procedures

It is natural that temporary changes will occur in the mouth following a surgical procedure. You should be functioning normally in just a few days. In the meantime, you should follow a few simple rules to help promote healing, prevent complications, and make yourself more comfortable.

Anesthetics

The length of time you experience numbness varies, depending on the type of anesthetic youve received. While your mouth is numb, youll want to be careful not to bite your cheek, lip or tongue. The numbness should subside within a 24-hour period.

Bleeding

The surgeon will place a gauze pack on the surgical site to limit bleeding and confine the blood while clotting takes place. This gauze pack should be left in place for 30 minutes after you leave the doctors office. Do not chew on the pack. There may be some bleeding or oozing after the pack is removed. If so follow this procedure:

  • Fold a piece of clean gauze into a pad thick enough to bite on. Dampen the pad and place it directly on the surgical site.
  • Apply moderate pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes; replace the pad with a clean one as necessary.

A slight amount of blood may leak at the surgical site until a clot forms. However, if heavy bleeding continues, please call our office at Salem Office Phone Number 503-581-0223.

The Blood Clot

The clot that forms in the surgical site is an important part of the normal healing process. You should therefore avoid activities that might disturb the clot. Heres how to protect it:

  • Do not smoke, rinse your mouth vigorously, spit or drink through a straw for 24 hours. These activities create suction in the mouth which could dislodge the clot and delay healing.
  • Do not clean the teeth next to the surgical site for the rest of the day. However you should brush and floss your other teeth as tolerated. Gently rinse your mouth afterward.
  • Limit strenuous activity for 24 hours after surgery. This will reduce bleeding and help the clot to form.
  • If you have sutures, our staff will instruct you when to return to have them removed if necessary.

Swelling

Swelling is expected following oral surgery and is likely to peak about 48 hours post-surgery before resolving. To minimize swelling and discomfort, apply an ice bag or cold moist cloth immediately following surgery over the affected area30 minutes on and 30 minutes offfor eight hours. When using an ice bag, cover it with a soft cloth to avoid skin irritation. After 24 hours, application of cold compresses offers little benefit. However, if swelling persists after four days or a fever develops, call our office.

Medication

The surgeon may prescribe medication to control pain and infection. Be sure to take some fluids or food prior to taking pain medication. Use medication only as directed; if the pain medication does not seem to be working for you, do not increase the dosage. If you have prolonged or severe pain, swelling, bleeding, or fever, call the office for further assistance at (503) 581-0223.

Diet

After oral surgery, begin taking clear liquids slowly then progress to soft nutritious foods as tolerated. Avoid alcoholic beverages and hot liquids. Do not use straws; do not skip meals. Take any prescribed food supplements as directed. If you are a diabetic, maintain your diet and take medication as usual. If you are troubled by nausea and vomiting, call our office for advice. Food suggestions:

Food

  • Soups cooled
  • Eggs
  • Cottage Cheese
  • Yogurt or Ice Cream
  • Pasta
  • Potato mashed or baked
  • Macaroni and Cheese
  • Applesauce

Drinks

  • Fruit Juice: apple or grape (NO citrus)
  • Sodas
  • Milk shakes NO straws
  • Iced tea
  • Gatorade
  • Water
  • Protein Drinks

Oral Hygiene

The day following surgery, rinse your mouth gently with a solution of one half teaspoon of salt dissolved in a glass of lukewarm water. Repeat this after each meal for several days in order to remove food debris from the surgical site. It is important to brush and floss after surgery; however, be careful not to disturb the clot forming in the surgical site. Brushing the tongue with a soft bristled brush will help to eliminate the bad breath and unpleasant taste that is common after oral surgery.

Irrigating Syringe Instructions

The syringe is to aid you in cleaning your surgical wound, thereby assisting nature’s healing process. You may start this care on the fifth day after your surgery. To begin, place the curved tip in a glass of plain water and draw back on the plunger until syringe is full. Insert into wound and empty the warm water from the syringe. Do this exercise at least twice a day. You may wish to do it more often. There is no set number of days this must be done. You will begin to notice when food and debris no longer collect in the wound. This will guide you in knowing when to stop.

Rest

Keep your head elevated by using pillows or a reclining chair for 24 hours post-operatively. It is also important to get 8 10 hours of sleep a night to promote healing and well-being.

Remember.

  • Severity of post-operative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed by our staff.
  • Healing is slower for the removal of impacted teeth.
  • Swelling can be expected. Be sure to apply ice/cold compress as directed.
  • Difficulty in opening your mouth widely and discomfort upon swallowing can be anticipated.
  • Numbness of the lips and/or tongue on the affected side may be experienced for a variable period of time.

Complications

If any of the following complications occur, please notify our office:

  • Uncontrolled pain or if discomfort persists after 36 hours
  • Severe bleeding
  • Marked temperature rise
  • Continued inability to open mouth
  • Swelling that persists after the fourth day or excessive swelling that begins several days after surgery
  • Any irritation at the area of the IV
  • Persistent nausea or vomiting

Localized Osteitis (Dry Socket)

What is it?

Dry socket is an occasional unpleasant complication following the removal of a tooth. It occurs when the blood clot fails to organize and disintegrates from the wound, producing increasing pain and an unpleasant odor with drainage. Bone will be exposed in the wound. Dry socket is an inflammatory process and is most often not infectious. It typically develops two to five days post-operatively, most commonly after the removal of lower molar teeth and impacted teeth.

Who gets it?

Even after following the home care instructions, dry socket can develop. The causes of this condition are not completely known. Increased frequency is associated with:

  • Use of tobacco products
  • Presence of gum disease or infections
  • Use of oral contraceptives

If your surgeon feels you may be at risk, a medicated surgical dressing will be placed at the time of surgery.

How is it treated?

The surgeon inserts a medicated surgical dressing into the affected area to promote both pain relief and healing. This dressing will be changed and/or removed when appropriate. Healing of the wound usually begins three to five days following onset of symptoms. It is uncommon for dry sockets to persist longer than five days. Antibiotics will be prescribed if an infection occurs.

Outcome?

When dry socket occurs its important to know that the wound will ultimately heal properly.