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Home care is a very important part of treatment following oral surgery. The following instructions are recommended to keep you more comfortable and to shorten the healing period.
BLEEDING: Some bleeding is normal following surgery. Gauze packs will be provided to apply pressure to the area of surgery. Gentle, steady pressure should be maintained by biting on tightly rolled gauze packs for 2 hours. The gauze should be placed so that pressure is applied directly to the extraction site and not between the remaining teeth. Avoid spitting, smoking, swishing, or other actions that may dislodge the blood clot. If bleeding persists or should it resume at a later time, repeat the above procedure. If bleeding is not controlled after several such attempts, please contact the office.
SWELLING: Swelling is common following surgery, particularly after the removal of impacted teeth. Ice bags applied over the area of surgery during the first 48 hours help minimize swelling. After 48 hours, MOIST heat should be applied to the area to help reduce the swelling more rapidly. This is best accomplished by applying a hot-water bottle wrapped with a moist, hot towel or a heating pad. (Be careful not to scald area.)
REST: Adequate rest is necessary for healing to progress normally. Bed rest is recommended the evening following surgery with the head elevated on several pillows. No strenuous physical activity or exercise should be attempted for 48 hours.
DIET: No food or liquids should be consumed until the bleeding has been controlled. Avoid hard, irritating foods such as popcorn, peanuts, potato chips, etc., and extremely hot foods. Eat soft nourishing foods such as soups, jello, custards, ice cream, fruit juices, and milk. Foods that may be run through a blender are okay. Good fluid intake is essential. DO NOT TAKE FLUIDS THROUGH A STRAW. ALSO, AVOID SMOKING FOR AT LEAST 3-5 DAYS FOLLOWING SURGERY.
DISCOMFORT: A certain amount of discomfort is to be expected. Using the prescribed or recommended pain medications should effectively relieve this. On the day following surgery, begin rinsing gently 4 times daily with a warm saltwater solution (this solution should be made with ½ teaspoon of salt in 8 ounces of warm water) or a diluted mouth rinse. VIGOROUS RINSING AND ATTEMPTS TO CLEAN THE AREA OF SURGERY MUST BE AVOIDED TO PREVENT DISLODGING OF THE BLOOD CLOT, WHICH IS NECESSARY FOR HEALING.
OTHER CONDITIONS: Stiffness of face muscles and difficulty in opening the mouth may occur. Heat application and salt-water rinses as directed above will relieve this condition. Discoloration resembling a bruise may appear. This is due to slight hemorrhage into the tissues at the time of surgery. This should not cause alarm as it will disappear in several days.
In the event of a dry socket, there may be additional fees.
SENSITIVITY:
Sensitivity, especially to cold, is common following treatment. For the first few days avoid extremely hot or cold beverages.
Temporary: A temporary crown or bridge will be placed on the prepared teeth while the permanent restoration is being made. Please be aware that temporary material texture is more porous, thus it will not replicate the natural tooth structure as your permanent restoration will. The temporary serves several very important purposes. It protects the exposed dentin so it is not sensitive, prevents food and bacteria from collecting on the tooth preparation, and prevents the tooth from shifting or moving, which can make seating of the permanent restoration more difficult or even impossible. The temporary is placed with a cement that is designed to come off easily, so avoid chewing sticky foods such as gum or taffy or anything very crunchy. Use your toothbrush to clean the temporary as you normally do your other teeth. However, when flossing, it is best to slide the floss out below the contact rather than popping up through the contact between the temporary and the tooth next to it.
If your temporary comes off between appointments, even if there is no discomfort, slip it back on and call our office so that we can re-cement it for you. We cannot stress the importance of doing this as soon as possible. A little denture adhesive placed inside the crown can help to hold it in place in the interim.
Sensitivity: Sensitivity, especially to cold, is common while you are wearing the temporary. If you experience this, avoid extremely hot or cold foods and beverages. It is normal to have discomfort in the gums around the tooth after the anesthesia wears off. While there may be sensitivity to temperature and biting, any and all symptoms should only last anywhere from 2 days to 2 weeks. If symptoms persist and begin to increase in intensity, please call our office immediately. If you appear to be hitting the temporary before your other teeth, please call our office immediately as you may need to have an adjustment made. If you choose not to have the adjustment, root canal therapy may be necessary. If your gums are tender, rinse with warm salt water by dissolving 1/2 teaspoon of salt in an 8 oz. glass of warm water. An analgesic, such as the medication you would take for a headache, will help to increase your comfort.
Permanent Crown or Bridge: Typically, we will have your permanent crown or bridge approximately 2 weeks after the appointment during which the tooth or teeth were prepared. It may take a few days to get used to the new crown or bridge after your permanent restoration is finally cemented. If your bite feels high or unbalanced, please be sure to call our office for an appointment to make a simple adjustment. Normally no anesthetic is needed for this appointment.
Home Care after seating your Permanent Crown or Bridge: Although crowns and bridges are often the most durable of all restorations, the underlying tooth is still vulnerable to decay, especially at the interface between the tooth and crown. It is important to resume regular brushing and flossing immediately. Daily home care and regulating your intake of sugar-containing foods will increase the longevity of your new restorations.
ANESTHESIA: Your anesthesia will wear off in approximately 1 to 3 hours after the procedure. Avoid chewing and hot drinks until the numbness has subsided so as not to accidentally burn or bite your tongue or lips.
SENSITIVITY: Your tooth (or teeth) may be sensitive to hot, cold, or pressure from this procedure. This is COMPLETELY normal. These symptoms will gradually cease within a few days to a couple of weeks. In some instances, this sensitivity could last longer than a couple of weeks.
SORENESS: Your gum tissue may be sore, due to the workaround this area. As long as your teeth or gums are continuing to feel better, (not staying the same, or getting worse) everything is fine. Warm salt water rinses and/or ibuprofen will help with this inflammation.
We understand that different questions may arise after treatment. It is our intention to keep you as informed and as comfortable as possible. Please call our office with any questions or concerns that you may have.
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. This is normal.
BLEEDING: Small amounts of blood in the saliva can make your saliva appear quite red/pink the remainder of the day following surgery. If you wake up and see excessive blood, contact our office immediately. If we are unavailable, please go to the emergency room.
PAIN: Before the anesthetic wears off, it is recommended you take 400-800mg of ibuprofen/Advil or Motrin every 6 hours to relieve any post-op discomfort. If you are allergic or cannot take the above meds, you can take 1000 mg of Acetaminophen/Tylenol every 6 hours. There will be a pain medication sent home with you for any additional discomfort.
SWELLING: Some swelling of the lip or cheek may occur.
What to do following surgery:
After leaving the office, rest and avoid any strenuous activities for the rest of the day. This will help reduce bleeding and aid in the healing process.
Take your meds as described above. Be sure to take them before the anesthesia wears off. Nausea can occur and most often is due to taking your meds on an empty stomach. Take your meds with a large glass of water or with some soft food.
Eat soft foods for the first 2-4 days. Maintain a good, balanced diet. Drink plenty of water. Avoid chewing hard foods on the graft sites. Chewing forces during the healing phase can decrease the body’s ability to heal around the graft. DO NOT USE A STRAW. Avoid alcohol for 48 hours.
For the first day, it is advisable to let the blood clot stabilize by not rinsing your mouth. Following the first day, gentle rinsing would be advised; avoid vigorous rinsing. Do not rinse vigorously because you can disturb some of the bone graft granules. Do not use any mouthwash. Use only warm salt water or peridex as prescribed.
Smoking should be avoided for a minimum of 1 week as it delays the healing process.
Do not apply pressure with your tongue or fingers to the grafted area because the material is movable during the initial healing.
Do not avoid cleaning the area. You may gently rinse with warm salt water 24 hours following surgery and continue to do so 2 to 3 times daily for the next 5 days. AVOID VIGOROUS RINSING.
Do not avoid brushing your teeth but stay away from the site with a toothbrush. Let comfort be your guide.
If a partial denture or a flipper was placed, you will probably have to have it adjusted and learn how to remove and replace it appropriately. In some cases, you will be advised not to wear it during the healing process.
Sutures will be removed approximately 2 weeks after the surgery. The non-resorbable barrier membrane will be removed by the doctor at a later appointment. If the membrane comes out after the sutures have been removed, this is ok. The membrane looks like a white sheet and it wraps over the grafting site to aide in the healing process.
1. NO BRUSHING OR FLOSSING over surgical sites(s). (Water-Pik ONLY from tongue-side on low).
2. NO TOUCHING with finger, tongue, or any other device or object such as cotton swabs, cloth, etc.
3. Non-Alcohol based mouth rinse may be used, however, no vigorous swishing should be done. We recommend sloshing rinse from side to side with lips apart (NO extending of cheeks)
4. No manipulation of the lips or cheeks surrounding surgical sites (Example: pulling cheek to look at surgical sites)
5. Do not apply pressure to the surgical site, including sleep with hands under the cheek where surgery was done, facial massages or skin treatments
6. Absolutely NO spitting, blowing, etc. (Including wind instruments)
7. Do not keep mints, candy, throat lozenges, etc. on surgical sites.
8. No smoking, chewing tobacco, cigar, pipe, or recreational drugs.
9. Avoid all strenuous activity, high-intensity exercise, and heavy lifting for 3 weeks.
10. No snorkeling for 6 months
11. Continue to wear all prescribed bite appliances as instructed. Please be sure to notify us if you are currently wearing any Invisalign® or removable orthodontic retainers.
12. Avoid clenching and/or grinding teeth. If you begin to notice this happening, notify our office ASAP
13. Keep ice placed gently on the outside of cheek over surgical sites in ten-minute intervals for the first 48hours – This will help to minimize swelling.
14. Avoid crunchy and/or sticky foods that can get stuck on or in between your teeth and hinder healing.
Post-operative swelling and bruising is normal, but please notify us with any concerns
Cold sensitivity can be expected for the initial 6+ weeks after the procedure. Be sure to report sensitivity at follow up appointments.
It is recommended to take one tablet of Acetaminophen (Tylenol) in conjunction with NSAID (Ibuprofen/Motrin) to decrease post-operative pain and swelling. Other pain control regimens may be given by the doctor if needed.
Call our office IMMEDIATELY if you have significant pain, bleeding, or a feeling of heat/warmth from the surgical site.
The patient MUST return to our office for all follow up appointments. (24hr, 1 week, 3 weeks, 6 weeks, 3 months, 6 months). Further instructions for oral care will be given at your 6-month appointment.