POSTOPERATIVE INSTRUCTIONS FOLLOWING DENTAL IMPLANT AND PERIODONTAL SURGERY
1. Medications/Prescriptions:
If an antibiotic is prescribed, it is to be taken until finished. It is important to take your pain medication prior to discomfort. Pain medication is to be taken as instructed on the bottle. Be sure to eat prior to taking pain medication. Not eating can result in nausea and vomiting. No driving when taking narcotic pain medication. After the first 24-72 hours you may switch to over the counter pain medication. If you should develop a rash, itching, difficulty breathing, wheezing, nasal congestion or swelling around the eyes not related to the surgery stop taking all pain medications and notify our office immediately.
ATTENTION: All female patients utilizing birth control pills, please be advised that if the doctor prescribes the use of antibiotics an alternative form of birth control must be utilized during that period of time.
2. Bleeding:
Gauze was placed over the surgical site so that it serves as a pressure bandage when you bite down. Replace the gauze hourly to control the bleeding if necessary. Remove the gauze when eating or taking medications. Placing a moistened tea bag over the surgical site for one hour while applying pressure is another method of controlling excessive bleeding. A small amount of oozing is normal. Pink or blood tinged saliva may be present for 12-48 hours. You may wish to cover your pillow with a towel to avoid any staining that may occur. For the first 24-48 hours it’s a good idea to keep your head elevated with two or more pillows.
3. Eating:
For the first 24 hours it is recommended that you eat cold/soft foods. Suggestions: ice cream, jello, puddings, yogurt, cottage cheese, milkshakes, applesauce. For the next four days, follow a soft diet (eggs, mashed potatoes, pasta). Drink more fluids than you usually would. This is not the time to lose weight; proper nutrition is very necessary for healing.
4. Swelling:
Some swelling after surgery is normal; don’t be alarmed. It takes three days for surgical swelling to reach its peak before subsiding. Ice packs are used to reduce swelling and produce a local numbness immediately after surgery. Ice packs should be applied the first 24 hours after surgery. Plastic bags filled with crushed ice and wrapped in a damp towel or commercial ice bags are convenient forms of application. Apply for 20 minutes then leave off for 10 minutes. If swelling occurs after 48 hours switch to moist heat (hot water bottles or a warm washcloth), alternating between hot and cold “ten minutes on ten minutes off”. Keeping note that you must avoid heat for the first 24 hours.
5. Rinsing:
Avoid rinsing, spitting, drinking through a straw and mouthwashes that contain alcohol for the first 24 hours as it may prematurely dissolve the blood clot. A gentle rinsing with warm salt water (½ teaspoon of salt in a large glass of water) after meals and at bedtime is important after this period. After 72 hours a more vigorous rinsing is encouraged after meals and at bedtime for the next two weeks.
6. Bruising:
Bruising may present to varying degrees. It will subside over a period of 5 to 10 days.
7. Smoking:
We advise that you do not smoke at all during the first 72 hours following surgery. Smoking can increase pain and lead to poor healing. The longer you refrain from smoking the less chance you have of postoperative problems.
8. Activity:
Avoid excessive physical exertion and fatigue during the immediate postoperative period. Obtain adequate sleep.
9. Tooth Brushing:
NO BRUSHING THE DAY OF SURGERY. Brushing of the immediate surgical site should be discontinued for about a week after surgery to prevent disruption of the blood clot, healing tissues and or sutures. The remainder of the mouth may be brushed normally. When you resume brushing at the surgical site you may experience a small amount of bleeding or discomfort, but this is normal.
10. Sutures/Dressings:
A variety of sutures and dressings may have been used as a part of your treatment and you may feel them with your tongue. They will either dissolve on their own or be removed at the appropriate postoperative appointment.
IMMEDIATE DENTURE INSTRUCTIONS
The denture placed in your mouth immediately after surgery will serve as a surgical bandage. Leave the denture in place for 24-hours. If the denture is removed to early, the oral tissues may continue to swell, and you will not be able to replace the denture. After 24 hours, remove as needed to clean or rinse your mouth. After the initial 24-hour period, it is important to keep the denture out at night to allow adequate healing.
POSSIBLE CONDITIONS AFTER SURGERY
1. Antibiotics:
May cause diarrhea or upset stomach. Eating active culture yogurt may help decrease the incidence by restoring normal gastrointestinal flora.
2. Dry Socket:
A dry socket may occur 3-5 days after surgery. It is usually characterized by an ear ache like throbbing pain, and a foul taste as well an odor. This is the result of the blood clot coming out of the tooth socket. A dry socket does not require treatment, however it will result in a slower recovery. Treatment of dry socket is based on the amount of discomfort you are having. Treatment is simple involving irrigation and dressing placement to alleviate the discomfort.
3. Muscle Stiffness:
Tenderness and stiffness within the chewing muscles may develop during the postoperative period and should not alarm you. It is usually due to swelling in the area of the jaw muscles and is best treated with moist heat therapy. It will slowly resolve over a 5-10 period.
4. Nausea/vomiting:
Nausea following surgery is usually due to taking medications on an empty stomach. Keep eating and take as few pain pills as possible. Sipping on flat 7-UP, ginger ale, or coca cola may help. Call our office if severe nausea or vomiting persists.
5. Numbness:
The local anesthetic will wear off within ½ an hour to 4 hours following surgery. Sensations will slowly return although it may be difficult for you perceive the change. Sensations of “burning”, “tingling”, or “electric shocks” in the numb areas indicate that feeling is returning. Call any numbness to our attention at your first postoperative visit.
6. Sharp Bony Edges:
Small pieces of bone may work out of the surgical area as long as 5-6 weeks after the surgery. This may resolve on its own in a period of a few weeks. If necessary, removal of bone particles is a simple and routine process.
7. Sore Lip/Cheeks:
The corners of your mouth may be dry and cracked after surgery. This is best treated by gently applying Vaseline.
Download these Post Operative Instructions for Dental Implants and Periodontal Surgery as an Adobe PDF
POSTOPERATIVE INSTRUCTIONS FOLLOWING BONE GRAFTING
You may find some small granules in you mouth for the first several days. Do not be alarmed by these. It is normal to have some of them come out of the graft site and into your mouth.
Do not vigorously rinse or spit for 3-5 days
Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
First Day: let the blood clot stabilize, do not even rinse your mouth.
Following the first day: gentle rinsing would be advised but not too vigorously. ABSOLUTELY NO WATER PIK’S.
Download these Post Operative Instructions for Bone Grafting as an Adobe PDF
ACTIVITY:
Reduce your physical activity to keep blood pressure down.
SMOKING:
Please do not smoke following surgery. Tobacco smoke is an irritant to healing tissue and may dislodge blood clot.
BLEEDING:
Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over the bleeding area and bite down firmly to apply pressure for one-half hour. Repeat if necessary. A tea bag may also be used.
RINSING:
Do not rinse your mouth for two days. On the third day rinse mouth with one teaspoon of salt to a glass of warm water (8 oz.),
and gently rinse two times a day.
SWELLING:
In some cases swelling is to be expected. Use ice pack for swelling in the first 24 hours. If you have excessive swelling in treated areas, or in the neck, call the office.
DISCOMFORT:
Some discomfort is to be expected when the anesthesia wears off, and some truth sensitivity to cold and/or hot foods and drinks. If you have been given a prescription fps discomfort, take medication as directed on the container. If you have not been given a prescription, take 2 Tylenol, aspirin, or Ibuprofen. If discomfort continues, call the office.
EATING:
Limit yourself to a soft diet immediately after the procedure and avoid chewing in the treated area(s). Do not drink out of a straw or rinse mouth vigorously and avoid excessive spitting. Omit foods that are highly seasoned, spicy, or hot. Attempt to resume your regular diet as soon as possible. Cold foods and drinks are highly suggested.
BONY EDGES:
Small sharp bone fragments may work up through the gums during healing. These are not roots. lf they are annoying return to this office for their simple removal.
POSTOPERATIVE INSTRUCTIONS FOLLOWING SINUS LIFTS
1. Do not blow your nose.
2. If you must sneeze, do so with your mouth open to avoid any unnecessary pressure.
3. Do not smoke or use smokeless tobacco. Smoking greatly inhibits the healing,especially in the sinus graft.
4. Do not take liquids in through a straw.
5. Do not lift or pull up on your lip to look at the stitches, as this may actually create damage and tear the stitches.
6. Take your antibiotics as directed and until finished.
7. You may have some bleeding from the nose. This is not uncommon and should pass quickly.
8. You may be aware of small granules in your mouth for the next few days. This is not unusual, as your graft is mainly made of particles and some excess particles will be lost.
9. If you feel congested, you may need to use antihistamines or decongestants. If you do, Use over the counter products such as Sudafed, Tavist-D or Dimetapp. I would also suggest that you avoid nasal sprays unless they are saline.
Download these Postoperative Instructions For Sinus Lifts as an Adobe PDF
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