Post-operative care is important following oral surgery and recovery may be delayed if this care is neglected. Some swelling, stiffness, oozing of blood and discomfort is expected after surgery. It is helpful to have the patient observed by a responsible adult for the duration of the day of the surgery. The following includes our post-operative instructions and events, which may take place following this kind of surgery.
The gauze pad which was placed after surgery acts as a protective dressing that helps bleeding to diminish and also helps a good blood clot to form within the extraction site. Some oozing is to be expected, but gentle pressure on the gauze directly over the surgical site should control this. Gauze should not be changed more frequently than every 1 1/2 to 2 hours. Gauze pressure for a total of 4-5 hours after surgery should be adequate to control most bleeding. During this time period it is important to rest quietly and limit talking. If excessive bleeding is noticed or the bleeding continues, this is not normal and you should call the office number.
If it is necessary, you will be provided with a prescription for medication. This can be filled at any drugstore and should be used as directed. Pain may be expected soon after the surgery and will reach its maximum during the first few hours. It is recommended that the prescription be started approximately 1-2 hours after the surgery and continued as directed. It is helpful to take the pain medication approximately1/2 hour after surgery with 7-Up or suitable substitute to decrease the possibility of nausea.
If nausea is encountered in the immediate post-operative period, it is often increased by taking the pain medication. Remember not to take the pain medication without something in your stomach. The post-operative nausea may be relieved by taking 1-oz. of a carbonated drink such as Ginger Ale or 7-Up every hour for 5-6 hours. This can be followed with mild tea, broth, and soft foods before resuming your regular diet.
Swelling and stiffness are to be expected. This swelling may increase over the first 2 days, and then it should start to subside. Elevation of the head by resting in a recliner or in bed with 2 to 3 pillows may help lessen the amount of swelling that may occur. Swelling can also be managed by the use of ice and heat as follows:
a) ICE: Use ice for the first 12-24 hours applying it to the cheeks for 20 minutes and removing it for 20 minutes alternately.
b) HEAT: Swelling and stiffness may be relieved by warm, moist heat applied to the jaws on the 2nd and 3rd days following the surgery. The stiffness which can sometimes occur will usually be relieved by the heat application, the use of chewing gum at intervals, and gentle stretching exercises beginning the day after surgery.
Nourishment should not be neglected. On the day of surgery, a liquid diet is recommended (Instant Breakfast, Jello, soups, milk shakes, broth, etc.). The following day, a soft to a regular diet as tolerated may be started. The patient should not use a straw for several days, since this may dislodge the blood clot.
6. Oral Hygiene
Rinsing, spitting, and tooth brushing should be avoided on the day of the surgery. Starting on the day after surgery, frequent gentle rinsing with mild, warm salt water is encouraged. Brushing should also be resumed, being careful to avoid the surgical site for the first two days. Good oral hygiene is important to normal wound healing.
Activities for the first 24 hours should be minimal. Rest quietly with head elevated. Smoking should be discontinued for at least 3 days. Do not expect to return to work or normal activities immediately. Two to three days rest is recommended and subsequently resuming activities as they are tolerated. Vigorous physical activities and sports should not be resumed until the surgical areas are comfortable, swelling is resolved and a normal diet is possible. Usually contact sports should not be resumed for approximately 1 week postoperatively. Musical wind instruments should not be played for at least 1 week to 10 days after most oral surgery.
Depending on the nature of the surgery which was performed and the nature of the person, some discoloring on the face may be seen for 3-5 days after the surgery. If this happens, do not be alarmed.
Many times the roots of the lower teeth are adjacent to the nerve in the lower jaw. When the tooth is removed, the nerve may be slightly disturbed which may lead to a numbness of your chin, lower lip, and your lower teeth on that side. No one can determine exactly how long this will remain, but it is rarely permanent.
10. Taste and Odor
After the surgery, a bad taste and odor may occur. This is usually secondary to a lack of appropriate cleaning in the area. Commercial mouthwash may be used along with normal rinsing and brushing.
11. Occasional Occurrences
Many people fear the possibility of a dry socket, which is a very unusual complication. If you have pain, however, that is not relieved by the pain medication or aspirin, this may be the case. Please contact our office so that we can schedule a follow up visit for you. Pain in the ear, difficulty in swallowing, and difficulty in opening and closing the jaws are symptoms which can occur with varying frequency, and usually are not significant. Swelling at a later date is uncommon, but if the swelling increases after 5-7 days, please contact our office.
During antibiotic use there has been a reduced effectiveness of birth control pills. Women who are using oral contraceptives should be cautioned to use an additional means of contraception during the period of antibiotic use and for the remainder of the menstrual cycle affected.
If there is any difficulty in breathing, fever, excessive bleeding or any other disturbing problems following the surgery, you should call the office immediately. There is a 24-hour answering service after office hours that can reach the doctor.