Oral Surgery Post-Op Instructions

• Almost all oral surgery causes swelling. Don’t be too worried about the swelling it should be gone or greatly reduced in three to four days. If the swelling persists please call for a follow up examination.
• An ice pack during the first 8 hours of surgery may be used to help keep the swelling to a minimum (on for 20 minutes, off 20 minutes).
• You may rinse out your mouth gently with warm salt water several times a day starting the following morning.
• Avoid very hot or very cold foods and liquids.
• To minimize the pain when eating, avoid foods that require strenuous chewing. Liquids and soft foods cause less pain and minimize the chance of damage to tender areas. Please take plenty of fluids.
• Take the medication your doctor has prescribed for pain but do not take it more often then necessary. If an antibiotic has been prescribed, it must be taken regularly to be effective.
• Call your doctor immediately if you begin to bleed more than a small amount. A little bleeding is to be expected, especially on the first day. Gauze pads should be applied for a full 15 minutes.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

• Almost all oral surgery causes swelling. Don’t be too worried about the swelling – it should be gone or greatly reduced in three to four days. If the swelling persists, please call for a follow-up examination.
• An ice pack during the first 8 hours of surgery may be used to help keep the swelling to a minimum (on for 20 minutes, off 20 minutes).
• You may rinse out your mouth gently with warm salt water several times a day starting the following morning.
• Avoid very hot or very cold foods and liquids.
• To minimize the pain when eating, avoid foods that require strenuous chewing. Liquids and soft foods cause less pain and minimize the chance of damage to tender areas. Please take plenty of fluids.
• Take the medication your doctor has prescribed for pain but do not take it more often then necessary. If an antibiotic has been prescribed, it must be taken regularly to be effective.
• Call your doctor immediately if you begin to bleed more than a small amount. A little bleeding is to be expected, especially on the first day. Gauze pads should be applied for a full 15 minutes.

• Treat with ice for the first 48 hours (20 minutes on/ 20 minutes off)
• NO NOSE BLOWING.  Sniff back only and wipe end of nose.  Continue this until your surgeon directs you otherwise.
• Nosebleeds are normal and may occur for several days following surgery. Treat by leaning head back, and direct pressure.
• Some drainage from the nose and mouth are normal, just wipe away.
• Don’t be alarmed by the presence of small bone granules.
• Try to avoid sneezing, but if it comes on, sneeze through the mouth. Do not pinch the nose or hold your breath.
• Severe cheek swelling is also normal following this procedure. If the eyes swell shut, please call our office immediately.
• Use over the counter Actifed, Sudafed or Claritin D for one week.

• Typically corrective jaw surgery will not be a major painful procedure.  Your pain medication requirements will include Tylenol (acetaminophen), Motrin (Advil or ibuprofen), and if needed Oxycodone.  Manage the pain by alternating the Tylenol and Motrin every 3 hours.  For example if Tylenol is taken at 9am, Advil would be taken at 12pm, Motrin at 3pm etc.  Repeat this process for 5 days from the day of surgery.  If your pain is more severe, 7 out of 10 on a pain scale, then you can take the Oxycodone.  Often the pain experienced is from sinus pressure, which will be better managed with decongestants.  This will be reviewed below.
• Although not a lot of pain, there will be a fair amount of swelling.  Do not be alarmed, this is the body’s natural response and is part of the healing process.  Your swelling will peak 3 days after surgery and then will gradually begin to go away.  You will be icing while in the hospital and we recommend that you ice for the first 48 hours from the end of you surgery.  After the 48-hour period, discontinue the ice and switch to moist heat. It is not imperative to use moist heat.  If you like the way it feels and/or prefer to use it then do so.  It is ok to not use moist heat as well.
• Most patients 4-5 days after surgery may experience what we refer to as “the post-op blues.”  There are medications that you will be given that produce feelings of euphoria.  As these medications leave your body one can experience feelings of being “down in the dumps.”  Stay mentally focused during this time. These feelings will pass in a day or two.
• As a result of your upper jaw surgery, you will experience sinus congestion (pressure), some mild nasal bleeding and muffled hearing.  This is typical of patients who have upper jaw surgery.  You have been prescribed several different decongestants (both oral and topical) to help with these symptoms.   The decongestant is one of the most important medications to take to help you in the post-operative period.  Dimetapp or Sudafed is typically the medication prescribed.
• Your skin will be very sensitive after surgery as a result of the swelling.  It is important to protect your face by wearing sunblock and a hat until the swelling has subsided.

After your surgery, we encourage you to get back into your normal life as quickly as possible.  You can ease your recovery process by actively partaking in the following:

• Opening your jaws after surgery is important.  You will not harm yourself by opening your mouth; in fact, we encourage you to stretch your muscles without inflicting pain.
• We cannot emphasize enough the importance of doing your facial exercises “kiss and smile.”  Doing these exercises routinely (2-3 times per hour) on a daily basis will only speed up your recovery. Regaining facial muscle control will help get you back into your normal routine.  Pushing your lips forward in a kissing motion will make drinking and swallowing easier.  Pulling your lips back in a smiling motion will help you with your speech.  Drooling can also occur post-operatively due to swelling and loss of muscle control, this will be regained by performing these exercises frequently.
• You are not required to be on a liquid diet but rather a full mush, soft non-chew diet.  You can have whatever you desire as long as it does not require you to chew it.  Try to use your tongue against the roof of your mouth to help mush your food up.  You will likely be eating around five meals a day.  Your muscles will be too tired to get through normal sized meals.  It is critical that your body gets the calories via carbohydrates, fats, and proteins to carry you through your recovery.  Every time you eat you should brush your teeth.
• You will have rubber bands on your teeth after your surgery.  When they are in place you will be able to open and close your mouth.   They will be helping to guide you into your “new bite.”  They should be changed on a daily basis.  During the first week if you are not comfortable changing them DO NOT TAKE THEM OFF.  We will help you at your first post-operative visit.  If you are comfortable changing them, take them off to eat, drink and brush your teeth, then replace them with new ones.
• THE MOST IMPORTANT PEARL!  We cannot enough stress the importance of oral hygiene.  Keeping your mouth as clean as possible will help lower the risk of infection.  After surgery it is imperative that you brush your teeth at least 5 times a day using normal toothpaste and a soft toothbrush.  The incisions are far from your teeth, you will not cause any harm by brushing, you will however cause harm by not brushing.  Twice a day you will be required to use an antimicrobial rinse which you have been prescribed.  The remainder of the time we encourage you to rinse with warm salt water.