Post Operative Instructions

Please read these instructions carefully--your comfort and welfare depend on them!

Instructions following surgery

Patients receiving a general anesthetic should return home from the office immediately upon discharge and lie down with the head elevated until all of the effects of the anesthetic have disappeared. Since these anesthetic effects are different for each person, you may feel drowsy for only a short period of time or for several hours. You should not operate mechanical equipment or drive a motor vehicle for at least 12 hours, or longer if you feel any residual effects from the anesthetic.

Bleeding

Some bleeding is to be expected following oral surgery and blood tinged saliva may be present for 48 hours. The gauze we place in the mouth should be left in place with firm pressure continuous for 30 minutes. If brisk bleeding persists, a 4x4 gauze or a tea bag may be soaked in ice water, rolled into a pack, and placed directly over the bleeding area. Firm pressure must again be applied for at least 30 minutes. It is the direct firm pressure over the bleeding area that controls bleeding. Rinsing, spitting and smoking cause bleeding by creating suction and should be avoided for 24 hours.

Swelling

To minimize swelling, ice packs should be applied to the face in the area of the surgery. These should be held on the face for 30 minutes, then removed for five minutes. This should continue for the first 48 hours. After the second day swelling will start down and return to normal by one week. If swelling would return or increase after the third day you should come in for a checkup.

Pain

During your surgery you received a local anesthetic which lasts for from 1-6 hours. After surgery you should have a light meal (milkshake), then take your pain medication prior to feeling pain when the numbness is wearing off. You may take your pain medication every 4-6 hours as needed. Our recommendation is not to take pain medication on an empty stomach as it may cause nausea or stomach upset. We also advise taking the pain prescription if you have pain. You may also use over the counter pain medication instead of your prescription if the pain is mild.

Diet and Oral Hygiene

It is advisable to begin your diet with liquids and progress to a soft diet as tolerated. Chewing hard food is to be avoided for the first 12 hours because bleeding is often initiated. Do not rinse or spit for the first 24 hours after surgery.

Start normal toothbrushing and rinses the following day. Mouthwash may be used, however we recommend you not use peroxide.

Warm salt rinses (1/2 teaspoon to a glass of water) is often helpful and can be continued for up to a week. It is important to keep your mouth clean, since an accumulation of food and debris promotes infection.

Smoking

We discourage smoking for at least 5 days after surgery. Smoking delays healing and is a leading cause of dry sockets.

Orthodontic Appliances

If you wear orthodontic appliances, replace them immediately after surgery unless instructed to do otherwise. If these appliances are left out of the mouth for any length of time, it Is often difficult or impossible to reinsert them.

Post Operative Sequelae

The most usual post-operative sequelae following oral surgery are bleeding and swelling. Other post-surgical effects may also be encountered. These may include difficulty opening the mouth for several days following surgery which is caused by irritation of the muscles.

Skin bruising may occur after surgery. This may be limited to the cheek area near the surgical site or may involve the cheeks and neck. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. It often takes over a week for this to completely disappear.

Numbness of the lip and chin may occur. This may follow the removal of the lower wisdom teeth. Most often, this is temporary and completely disappears within a few days or weeks. Occasionally, some numbness may persist for months, and in rare cases, may be permanent. This is caused by the close association of the roots of the teeth to the nerves in the area.

A blood clot may be dissolved following surgery. This is called a dry socket. This usually occurs 3 days after the procedure and causes the area to become painful. If this occurs, return to the office so the area can be treated and the pain eliminated.

Oral infections occur rarely and are a result of bacteria present in the oral cavity. Signs of infection are swelling, redness and pain. Should these symptoms develop, contact the office for a post-op checkup.

Occasionally, the arm or hand may remain inflamed and tender near the I.V. site. This is caused by chemical irritation in the vein. Anti-inflammatories and heat with rest of the extremity will usually correct these symptoms. Your doctor should be advised if this occurs.

Disability from Work

We assume you will be able to resume your occupation within 24 hours after your surgery unless otherwise advised. Anyone taking off work without prior approval will be doing so at their discretion and will be responsible to their employer for the consequences.

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© Chris Hlady 2001-2008