Post Operative Instructions

Please read BOTH sides of these instructions carefully.

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions below may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification.

DAY OF SURGERY:

FIRST HOUR: Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough gauze to obtain pressure over the surgical site for an additional 30 minutes. The gauze may then be changed as necessary (typically every 45 minutes to an hour). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

CARE: Do not disturb the surgical area today. DO NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least one week, since this is very detrimental to healing and may cause a dry socket.

OOZING: Intermittent bleeding or oozing overnight is normal. It may be controlled by placing fresh gauze over the areas and gently biting on them for 45 minutes at a time. Remove gauze while eating or sleeping.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical area. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp dry and wrapped in a moist gauze) for twenty to thirty minutes. If bleeding remains uncontrolled, please call our office.

SWELLING: Swelling is often associated with oral surgery. It often increases for the first 2–3 days. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 48 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN: Oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off you will be able to manage the discomfort better. Some patients find that pain medicine may cause nausea but if you precede each pain pill with a small amount of food, chances for nausea are reduced. The effects of pain medication vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as ibuprofen, naprosyn or acetaminophen. Follow the dosing directions given by your doctor and do not take these medications if you have had an adverse reaction in the past. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within the first 2-3 days; after that your need for medication often lessens. Do not drive or operate dangerous equipment if taking a narcotic pain medication.

NAUSEA: Nausea sometimes occurs after surgery. Often, prescription pain medications are the cause. This can be reduced by preceding each pain pill with a small amount of soft food, and taking the medicine with a large volume of water. Try to keep taking clear fluids and minimize dosing of the pain medication, and call us if you do not feel better. Classic Coca Cola may help with nausea.

DIET: Eat any soft, nourishing food that can be taken with comfort. AVOID EXTREMELY HOT FOODS. DO NOT USE A STRAW for the first week after surgery. It is often advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, try to maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES:If you feel something hard or sharp (in the surgical areas) with your tongue, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. They are not pieces of teeth that were left in. If they cause concern or discomfort, please call the office.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS:

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1⁄4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. It is advisable to rinse after every meal.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. Do not use electric toothbrushes for the first week after surgery.

HOT APPLICATIONS: After 48 Hours, you may apply warm moist compresses to the skin over the areas of swelling, for twenty minutes on and twenty minutes off to help soothe tender areas. This will also help to decrease swelling and stiffness.

HEALING: Normal healing after wisdom tooth surgery should proceed as follows: The first two to three days after surgery are generally the most uncomfortable and there is usually some degree of swelling. By the fourth day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be GRADUAL, STEADY IMPROVEMENT. If you don’t see continued improvement, please call our office during business hours so we can assist you. If you are given a plastic irrigating syringe, DO NOT use it for the first five days; then use it daily according to instructions until you are certain that the tooth socket has closed completely and there is no chance of any food particles lodging in the socket.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office at 303-758-6850 (Denver office) or 720-452-2144 (Thornton office). Hours are Monday through Thursday from 8 to 4:30 and 8 to 3 on Friday. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern.

PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewal are ONLY accepted during office hours.