After Surgery Care

GAUZE PACKS

The moistened gauze placed in your mouth after surgery should be held in place with firm biting pressure for two hours without changing to allow a blood clot to form. The patient should refrain from excessive talking which dislodges the gauze and encourages bleeding. The best time to stop the bleeding is while the area is still numb. It is also important if the patient is very sleepy to awaken them during this time to encourage them to bite firmly on the gauze. A small amount of oozing from the surgical site is normal. It is recommended your pillow be covered with a towel to prevent stains from blood seepage. Keep your head elevated, rest, avoid getting hot, and refrain from drinking through a straw or smoking for at least twenty-four {24} hours after surgery. Avoid swallowing bloody drainage to decrease the chance of nausea and vomiting. The drainage can be removed by leaning forward, allowing the fluid to drain out and wiping with a tissue. Rinsing your mouth or spitting should be avoided for 24 hours after surgery. This will make the bleeding worse, remove blood clots and cause dry sockets. If bleeding persists, following removal of the pressure gauze, bite firmly on another gauze sponge for one hour. Alternatively, moistening a gauze using liquid tea or a single-size moistened tea bag can be substituted. When changing the gauze or placing a tea bag in your mouth, use fingers to press the pack into the corner of the mouth as you bite down to apply pressure over the surgery site. If bleeding persists after using these additional methods, call our office.

MEDICATIONS

As soon as you remove the gauze pressure sponges, you should begin taking prescribed medication, unless otherwise instructed. Taking pain medication on an empty stomach should be avoided to prevent nausea. Swallow a small amount of Jell-O, pudding, or room temperature clear liquids before taking these medications. Swallowing with the mouth numb can be a challenge at times. This can be remedied by simply elevating the chin before attempting to swallow which will allow the medications and liquid to get into the back of the mouth where there is sensation present. Numbing the mouth does not prevent normal swallowing. Do not drive, operate machinery, or make decisions while under the influence of medications which can alter awareness. Do not take medications more frequently or in higher doses than prescribed. Do not take any other sedating drugs such as alcohol, tranquilizers, or sleeping pills while taking pain medications without first checking with our doctor or your regular physician. If our doctor does not prescribe pain medication for you and you are experiencing discomfort, you may take over- the- counter pain relievers such as Aspirin, Ibuprofen, or Tylenol according to the labeled instructions. Avoid taking Tylenol in conjunction with prescribed pain medicine which may also contain Tylenol and exceed safe levels of the medication. If pain persists and is not relieved by the provided medications, call our office. All patients should continue to take their regular medications after surgery unless otherwise instructed. If you are a diabetic, you may need to reduce your insulin dosage to allow for a change in your normal diet. If you have questions, it is always best to discuss these situations with your regular physician who monitors your diabetes. Women, please note that certain antibiotics may interfere with the effectiveness of birth control pills. You should check with your pharmacist or take appropriate precautions.

ICE PACKS

Keep your head elevated on at least two pillows at all times or rest and sleep in a recliner for at least 48 hours after surgery. Place an ice pack on the outside of your face over the surgical site continuously for no more than 30 hours after surgery. You can make an ice pack with ice cubes placed in a Zip-Loc bag, alternatively use small bags of frozen vegetables, or use commercially made gel packs. Ice should not come in direct contact with the skin for prolonged periods of time or skin damage can occur. Keep at least a single thickness of washcloth between the skin and ice at all times or use insulated ice packs. If the cold pack becomes uncomfortable, remove it for 20 minutes and then reapply. Velcro ice pack slings are available at our office to apply the cold therapy. You may make your own sling by cutting off one leg of a pair of pantyhose. Place a Zip-Loc ice bag or other cold alternative wrapped in a wash cloth in the inside of the hose just below the half-way point. Twist the hose to place under the chin and insert the second wrapped pack. The packs should then be aligned over the surgical site and the ends of the hose tied across the top of the head to secure it in position. If the packs are no longer cold, they should be replaced. Cold therapy should be followed continuously for 30 hours. Leaving cold packs on the face longer than 30 hours after surgery will cause increased swelling, delayed healing, and prolonged pain.

DIET

Do not chew anything until the feeling has returned to your lips and tongue.For at least 24 hours following surgery, you need to drink more fluid than normal.Initially, clear liquids at room temperature are recommended.Luke-warm, non-dairy soup such as broth-based chicken or vegetable is best. Carbonated beverages can help if nausea is present but are best not used in large amounts to avoid increased dry sockets.Milk products should be avoided for the first 12 hours to avoid nausea. Avoid eating foods with seeds, nuts, rice or popcorn for several weeks after surgery.Do not drink hot liquids or from a straw for 24 hours because it may make the bleeding worse. Once you have regained normal sensation, you may return to your normal diet as tolerated.Eat soft foods which are comfortable to chew and avoid chewing over the surgical area for a few days.

NUMBNESS

To avoid most of the severe postoperative pain, you will experience numbness in your mouth and face following surgery for up to 12 hours. Take care not to bite or chew your lip, tongue or cheeks during this time. Biting may cause severe damage to oral structures and you may be unaware until the sensation returns. If numbness persists for longer than 24 hours, you should notify our office. Such conditions are usually temporary and return to normal over a period of weeks to months. Our doctor will discuss the follow-up treatment of this condition with you. Swallowing liquids, food and medication may be difficult when you are numb. However, the back of the throat and base of the tongue will have normal sensation. Simply place the medication and liquids on the back of the tongue, hold up your chin and swallow.

ACTIVITY

Following a simple extraction or minor procedure, you should avoid strenuous activity or excessive heat for the first 12 hours. After extensive surgery or removal of impacted teeth, do not plan to do any activity for 48 hours after surgery and rest for at least 72 hours. Do not attempt to drive or operate machinery while under the influence of pain medication which can cause drowsiness or the affects of anesthesia. If you are undergoing general or modified general anesthesia, you may experience temporary amnesia for several hours after leaving the office. You should not be left unattended either in the car on the way home or at your home until you are able to recall the events after surgery and take care of yourself. Never move quickly from a reclining position to standing or walking. Medications can cause lack of coordination and unsteadiness. Sit on the side of the couch, bed or chair for a period of time before standing to avoid low blood pressure, nausea, fainting or falls. If you experience these situations, someone should assist you.

CARE OF MOUTH

Do not rinse you mouth for 24 hours after surgery. A bad odor or taste sometimes occurs after surgery and rinsing will help control the problem. On the second day, you should rinse with the prescribed mouthwash, diluted commercial mouthwash or saltwater after meals and at bedtime. Saltwater rinse can be made by thoroughly mixing ½ level teaspoon of table salt and ½ level teaspoon or baking soda {sodium bicarbonate} in 8 ounces of warm water. Avoid probing the surgical area with your finger or tongue. Avoid vigorous rinsing the first few days which may remove the blood clots, aggravate bleeding or cause dry sockets. Do not use undiluted commercial mouthwash or hydrogen peroxide. Do not brush in the area of surgery until the stitches have dissolved or are removed. You can clean the tops of the teeth in the area of surgery by wiping gently with a soft wash cloth. You can resume brushing the remainder of the teeth when you can comfortably open your mouth. You can resume wearing dentures, partial dentures or retainers when it is comfortable to do so. It is normal for healing wounds in the mouth to be covered with a yellowish film. This does not mean your wound is infected. Do not attempt to remove the film.