We are committed to providing the same quality of care following procedures that began during your initial visit. To that end, please refer to some general postoperative guidelines below, and by all means, CALL at any hour of any day to report any continuing problem.
- Some degree of discomfort and pain may arise as numbness subsides. Take the prescribed pain medicine and/or ibuprofen or Tylenol before the numbness wears off after eating some food. Do not take ibuprofen if you cannot take aspirin products. Any pain medication can cause nausea and vomiting. It is very important that you have some food in your stomach before you take them.
- DO NOT DISTURB THE AREA OF SURGERY. The first stages of healing are aided by placing tissues at rest. Avoid vigorous chewing, excessive spitting, or rinsing as initial healing may be delayed, active bleeding restarted, or infection introduced.
- Expect minor bleeding or OOZING from the operative site. This bleeding may continue throughout the first day or two. For the first hour, keep firm pressure on the area of surgery by biting on the gauze sponge placed in your mouth at the office. If bleeding persists, continue pressure on a fresh sponge for an additional 30 minutes to an hour. Biting on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site. Tea has an ingredient that promotes blood clotting. Do not sleep or eat with gauze in your mouth.
- If active bleeding should recur at any time, carefully rinse your mouth with cold water and apply a fresh gauze sponge to the bleeding site. Firm pressure for 20-30 minutes usually controls the problem. Should active bleeding persist, please call the office.
- LIMIT PHYSICAL ACTIVITY during the first 48-72 hours after surgery. No bending or lifting anything heavy, no exercise for at least 7 days, over exertion may lead to post-operative bleeding and discomfort. When you lie down, keep your head elevated on a pillow.
- SWELLING RELATED TO THE SURGICAL PROCEDURE usually develops during the first 12-24 hours following surgery, often increasing on the second to third day. It should begin to subside by the third day. Swelling can be minimized a great deal by using the ice pack on the side of your face for 20-30 minutes on and off while you are awake during the first 24-48 hours following the surgery, then please switch to warm compress on the 3rd day, it is the same as ice, on and off every 20-30 minutes. We would like you to keep using warm until you return for your follow-up appointment. Anti-inflammatory medications, such as Motrin or Advil, also help decrease swelling. Keep your head elevated for the first 3 to 5 days to keep the swelling to a minimum. Swelling may be greater in the morning when you first awaken.
- FLUID INTAKE IS IMPORTANT. We suggest you start with clear fluids. Once your stomach has settled, you can advance to other fluids such as smoothies (fruits w/out seeds), protein shakes, broth, soups, or juices. Also avoid hot liquids until the numbness has worn off, and the bleeding has stopped. It is important to drink plenty of fluids.
- AVOID USING A STRAW FOR SEVERAL DAYS as it may cause the blood clot to dislodge and delay healing.
- FOOD SELECTION the first 3-5 days will be limited to liquids only. At your post op appointment, the Doctor will advance your diet depending on your healing, unless otherwise instructed. Soft, cool foods that require little or no chewing are most easily tolerated at this time. A nutritious diet throughout your healing process is most important to your comfort and temperament. Hungry people become irritable and less able to deal with the discomfort which can follow surgery. Since you will be taking medication, it is important to remember that eating can prevent nausea sometimes associated with certain medications. Once cleared to advance your diet we recommend soups, broiled fish, stewed chicken, mashed potatoes, macaroni and cheese, and cooked vegetables can be added to your diet as your comfort indicates. Ensure, Carnation Instant Breakfast and/or yogurt supply excellent added nutrition. Do not chew anything until the numbness wears off. Avoid nuts, popcorn, and any foods with seeds for at least 6-8 weeks.
- Take any special medication such as ANTIBIOTICS we have prescribed on the specified dosing schedule. Yogurt with active cultures or acidophilus should be taken while on antibiotics to prevent diarrhea. It is important to take the antibiotics to completion. If you are given antibiotics and take birth control pills, you should be aware that the birth control pill may become ineffective, therefore take appropriate precautions.
- Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule unless advised to do otherwise.
- TRY TO AVOID SMOKING COMPLETELY, as it tends to slow the healing process and may also contribute to development of a dry socket. This includes vaping.
- DO NOT DRIVE OR OPERATE ANY VEHICLE OR DRINK ALCOHOL for 24 hours following surgery if you have had intravenous sedation or general anesthesia, or if you are taking prescription pain medication.
- IF YOU WERE INFORMED THAT A SINUS COMMUNICATION OCCURRED DURING SURGERY, as a result of the close relationship between the roots of your upper teeth and your sinuses, or if you have had some surgery that involved work near your sinuses or in your sinuses, please follow these instructions:
- DO NOT blow your nose.
- DO NOT sneeze through your nose. If the urge to sneeze arises, sneeze with your mouth open.
- DO NOT smoke or use a straw.
- AVOID swimming and strenuous exercise for at least one week.
- It is not uncommon to have a slight amount of bleeding from the nose for several days.
- Please remember that occasionally a second procedure may be required if there is a persistent sinus communication.
- No bending or lifting anything heavy, no exercise for at least 7 days.
The Day Following Surgery and Thereafter
On the morning of the day following surgery, rinse your mouth carefully with the solution made by adding 1/2 teaspoon of salt to a large glass of warm water. Repeat three times a day until remaining soreness subsides. Resume brushing any remaining teeth and your regular oral hygiene as soon as possible. Do not avoid brushing the area as this will cause more inflammation in the area. Please do not use a syringe or Water Pik® to aggressively rinse during the first week. This can dislodge the blood clot.
DO NOT WORRY ABOUT STITCHES. Stitches (also known as sutures) are usually placed to control bleeding, aid healing and help prevent food from collecting in the surgical site – – especially for lower teeth. Most times the sutures we use dissolve in 5 to 7 days and DO NOT HAVE TO BE REMOVED.
ANY SWELLING, SORENESS, OR STIFFNESS IN THE JAW MUSCLES that is present 1 week after surgery can be relieved by applying a warm moist towel to the affected side of the face several times a day. Moist heat should only be used 1 week following surgery.
In most cases a liquid diet may be necessary for the first few days following surgery. Most patient’s diets will be advanced once you have been cleared and seen at your 7-10 day follow up appointment.
Bruising marks may appear on the skin of the face during the first few days after surgery. Moist heat application will help relieve this condition once again. An antibiotic cream may be used on the lips to promote healing.
Post-Operative Instructions for Socket Bone Grafting
In addition to the general postoperative instructions, we would like to emphasize a few points.
Your bone graft is made up of many particles. You may find some small granules in your 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. There are some things you could do to minimize the amount of particles that become dislodged:
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 cause damage to the wound site and tear the sutures.
For the first day, we would suggest letting the blood clot stabilize and not even rinse your mouth. Following the first day, gentle rinsing would be advised but not too vigorously as you can again disturb some of the bone graft granules. If a partial denture or a flipper was placed in your mouth, you will probably have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.
Post-Operative Instructions Following Sinus Grafting
If you had a sinus grafting procedure performed, the general postoperative instructions still apply, but I would like to emphasize a few important points about your procedure and remind you of some instructions:
- Do not blow your nose.
- If you must sneeze, do so with your mouth open to avoid any unnecessary pressure on the sinus area.
- Do not smoke or use smokeless tobacco. Smoking greatly inhibits the healing, especially in the sinus graft. This includes
- Do not take liquids in through a straw.
- No bending or lifting anything heavy, no exercise for at least 7 days.
- Do not lift or pull up on your lip to look at the stitches, as this may create damage and tear the stitches.
- Take your antibiotics as directed and until finished.
- You may have some bleeding from the nose. This is not uncommon and should pass quickly.
- 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 small particles and some of these are lost in the healing process.
- If you feel congested, you may need to use antihistamines or decongestants. If you do, use over-the-counter products such as Sudafed or Afrin nasal spray. Most of the time, patients do fine without any nasal sprays, antihistamines, or decongestants.
Post-Operative Instructions for Endosteal Implants
If you had dental implants placed, our general postoperative instructions apply, but we would like to emphasize a few things:
Placement of endosteal dental implants usually do not create a great deal of pain. In most cases over the counter pain relievers can be utilized.
You should brush the area very gently after the first 48 hours with a soft toothbrush. Do not avoid brushing the area all together. Most times the sutures that are placed are dissolvable sutures, which will dissolve on their own in 8-12 days.
If a one-stage implant was placed so that you can see the metal part protruding from the gum tissue, it is very important for you to keep this area clean. You may start brushing the metal cap with a soft toothbrush the following day. Just clean the metal part protruding from the tissue. Avoid chewing hard foods on the implant sites. Chewing forces during the healing phase can decrease the body’s ability to heal around the implant. The most crucial time for your implant integration is between the 4-6th week after surgery.
If you are traveling to see us from out of town or out of the country, please allow 10-14 days extra stay. This information will be specific to each case/procedure and will be discussed in detail during consultation with your surgeon.
Please contact us should you have any other questions, or you experience any adverse events. We are here to help you in any way possible if you experience any complications.
We thank you for choosing our office for your procedure and we look forward to seeing you at your post op appointment.
Dr. Kroum Dimitrov and Team