After Oral Surgery

The Day of Surgery

Pain – Some degree of discomfort is expected as the local anesthesia wears off. Depending on your procedure your pain can be moderate to severe in nature. We recommend beginning the prescribed oral pain medications or over the counter pain medications before the numbness wears off. Do not wait for the pain to become unbearable before using your pain medications as your pain will be more difficult to control at that point. Pain will usually begin to subside a few days after your procedure.

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every four to six hours (maximum daily dose of Tylenol should not exceed 3000mg). Ibuprofen, (Motrin or Advil) 200mg to 400mg may be taken every 4-6 hours.  Specific dosing of over-the-counter pain medication should be taken as per directions on the medication container. Dr. Bundy may prescribe a higher dose of Ibuprofen.  If so, this prescription Ibuprofen may be taken as directed for pain relief.

For more severe pain Dr. Bundy may prescribe other medications such as narcotics(i.e. Norco, Lortab, Vicodin, Percocet, Tylenol with Codeine, Ultram). Take these medications as prescribed and directed. Narcotic pain medicine may make you sleepy and will slow down your reflexes. Do not drive an automobile or work around dangerous machinery if you have been prescribed a narcotic medication. Avoid alcoholic beverages. You should also refrain from making any pertinent decisions regarding significant business or personal matters while taking these types of medications. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

If your pain is worsening 4-5 days after surgery this may be due to premature loss of the blood clot (dry socket) in the wound or infection. Should you have any concerns please call the office.

Any pain medication can cause nausea. It is important to take your medications after having consumed a small amount food.

Do not consume alcoholic beverages when taking narcotic pain medications.

Do not disturb the wound after your surgery – Attempting to inspect your wound may place tension on the wound an open it. This is best avoided. Allowing the tissues to rest will aid the early stages of healing. Avoid excessive chewing (eat soft foods for a 3 days), excessive spitting, and sucking on straws to consume fluids.

Bleeding – A small amount bleeding or oozing from the wound is expected for the first 24 hours following surgery. This is no cause for concern.

After your surgery it is important for a blood clot to form to stop the bleeding and begin the healing process. That is why we ask you to bite on a gauze pad for 30-45 minutes after the appointment.

If excessive bleeding or oozing still persists take the following steps:

  • Gently wipe excess blood from the mouth and around the wound or extraction site.
  • Place another clean gauze pad directly over the area that is bleeding and bite firmly for another 30 minutes. If this is not successful repeat the procedure using a moistened a tea bag instead of gauze. Bite with firm pressure on the tea bag directly over the site that is bleeding for 30 minutes.
  • Remain quiet, rest in an upright position and apply an cold pack to the face.
  • If these measures are not successful call our office.

After the blood clot forms it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 3 days (72 hours). These activities may dislodge the clot and retard the healing process.

Limit vigorous exercise for the 24 hours following your surgery as this will increase blood pressure and may cause more bleeding from the extraction site.

Physical Activity – Limit activities for 2 days following your surgery. Increased activity can lead to increased bleeding from the wound and increased pain in the area surgery was performed. It may also be helpful to rest in a semi-reclined position, not flat. Most patients can resume normal activities in 5-7 days.

Control of Swelling – After the tooth is extracted you may feel some pain and experience some swelling. Swelling usually develops in the first 24-48 hours following surgery. Swelling will usually reach its peak on the second or third post-operative day. An ice pack or an unopened bag of frozen peas or corn applied to the area will help to keep swelling to a minimum. Apply the cold pack to the face for 30-40 minutes every hour while awake. Application of ice to the surgical site for the first 36 hours will help to minimize swelling. To be most effective apply the ice pack as soon as possible following your surgery.

Control of Infection – If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are not present or have resolved.

* Antibiotics may decrease the effectiveness of oral contraceptives. If antibiotics are prescribed another form of contraception is advised for the remainder of your cycle.

Diet – It is important to drink plenty of fluid following your surgery. Start with clear liquids(water, sports drinks, etc.). Once you know your stomach is settled then you can advance to other fluids (tea, soda, broths, soups, supplement beverages such as Ensure, etc.). Avoid hot liquids until your numbness has worn off. Do not consume fluids with a straw for 3 days following your surgery.

In most cases you may advance to soft chew foods and then a normal diet as you feel able to do so, the day following surgery. Eat nutritious foods. Nutrition is an important component of your healing process. 

Home medication – Take any and all regularly prescribed medication as directed by your physician.

Oral Hygiene – Do not rinse your mouth vigorously on the day of surgery.  The day following surgery you should rinse your surgical sites with warm salt water solution (1/2 tsp of salt in a cup of water). It is important to resume your normal dental hygiene routine for your other teeth after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

Nausea – Small amounts of a carbonated beverage (i.e 7-UP) every few hours may aid in terminating nausea.  Follow this with clear liquids or a mild soup (broth).  If your nausea persist contact our office for more assistance.

Smoking – Smokers are advised not to smoke for one week following surgery.  Smoking will slow the healing process and promote the development of a “dry socket.”

Driving an Automobile – Do not drive an automobile, or undertake any significant business matters for 24 hours following your surgery if IV sedation was used. Do not drive an automobile if you are taking narcotic pain medication (Norco, Vicodin, Lortab, Hydrocodone, Percocet, Oxycodone, Tylenol with Codeine, Ultram, Tramadol, etc.).

Sinus Communications – At times the roots of teeth are very close or lie within the maxillary sinus cavity. Or you may have undergone a surgery near to or within your sinus. If you were informed that a sinus communication occurred during your surgery it is not uncommon to have a small amount of bleeding from the nose on side your surgery was performed. On occasion a second surgical procedure may be needed to close the opening.

The following instructions should also be followed:

  • Do not blow your nose.
  • Do not sneeze through your nose…sneeze with your mouth open.
  • Do not smoke or use a straw.
  • Avoid swimming and strenuous exercise for at least one week.

 

 

The Day Following Your Surgery

Oral Hygiene – The day after surgery start rinsing your mouth and surgical site with a mild salt water solution (one tsp of salt in one cup of water). Perform rinses each meal and at other times throughout the day to keep the wound clean.

You may brush your remaining teeth as normal. As you approach the teeth adjacent to your surgical site while brushing be gentle, brush lightly and slowly, and stay on the hard tooth surface. Do not floss adjacent to an extraction site for 6 weeks following your surgery.

Sutures/Stiches – Do not worry about your sutures. Sutures are placed to aid soft tissue healing. They will be removed at your postoperative visit if they are not of the dissolving type. Dissolvable sutures may fall out in 4-10 days depending upon they type of resorbable suture placed.

Swelling – For several days after most invasive oral surgical procedures the soft tissues of the cheeks and face will swell.  Your jaws can also become very stiff as this swelling irritates muscle groups in the area that surgery was performed. Application of a warm moist compress to the swollen tissues beginning 2 days after surgery will help to resolve swelling.

* If swelling begins to worsen on day 4 or beyond following surgery this may a sign of infection…and you should call our office to schedule an appointment for evaluation.

Bruising – Discoloration of the skin overlying the surgical area may begin to appear during the first few days following surgery. This is no cause for alarm. Bruising is a normal reaction to surgery…not an indication of infection. Bruising is caused by pigments being released from blood cells that collect in and move through the tissue planes around the surgical site. Bruising often is visualized below the surgical area as well, and can extend far down the front or side of the neck. Bruising is often more extensive in the elderly population and in those patients that take blood thinners (Aspirin, Coumadin, Warfarin, Ticlid, and Anti-inflammatory medications).

 

Compliance with these instructions will optimize your post-surgical recovery. Be sure to follow the instructions carefully. After a few days you will feel begin to feel better and can resume your normal activities. Should any undue reaction or concern arise please contact our office.

If you have heavy bleeding, severe pain, worsening swelling  4-5 days after surgery, or a reaction to the prescribed medications such as nausea, rash or breathing problems develops… call our office immediately at Littleton Office Phone Number 303-932-7458. After hours calls will be forwarded to Dr. Bundy by our answering service. Dr. Bundy will make every attempt to return your call within 30 minutes. Occasionally messages do not reach the pager. If you do not receive a call back within that time frame please call again.

Dr. Bundy is in a call group for weekend coverage.  Call coverage on the weekends is shared by the doctors in this call group. All of the doctors in the call group are Board Certified Oral and Maxillofacial Surgeons. If you try to reach Dr. Bundy on Friday evening, Saturday or Sunday the call may be returned by one of the call group member doctors.