Medications
If you are presently using birth control pills and taking antibiotics, it is advisable to use an additional method of birth control as antibiotics will lessen the effectiveness of the oral contraceptives.
Take the remainder of your medications as per your normal instructions. Typically, patients are given pain medications to help with any pain or discomfort. Follow the directions for these pain medications and take medication as needed for pain or discomfort. Take the first dose of pain medication as soon as convenient and before the local anesthesia begins to wear off. If you experience any problems with your medication discontinue its use and call our office at (402) 421-3401.
Bleeding
Following oral surgery, bleeding is normal for up to 24 hours. Gauze will be placed at the surgery site before you leave our office and can be discarded after about 30 - 60 minutes. A small amount of oozing is expected, and should not be dealt with by repeated insertion of additional gauze, as this can worsen bleeding. If bleeding becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp-dry) for an additional hour. Notify our office if bleeding continues and cannot be easily controlled.
Do not spit, rinse aggressively, smoke or use straws. They increase bleeding. If the above measures fail to slow or stop the bleeding, please notify our office at (402) 421-3401.
Discomfort
It is normal to experience pain following most oral surgery. The amount of discomfort and its duration will relate to the nature of your surgery and your ability to tolerate pain. Mild to moderate pain can be controlled with ibuprofen or Tylenol, taken as directed.
More severe pain is best treated by a combination an anti-inflammatory drug such as ibuprofen and a prescription medication (i.e. vicodin, darvocet). The over-the-counter medication (ibuprofen) should be taken at scheduled intervals over a 5-7 day period, with doses of the prescription medication taken in between doses of the over-the-counter medication. Example: take 3 tablets of 200mg ibuprofen (600mg) every 6 hours on a scheduled basis, and one vicodin in between (three hours after) doses of ibuprofen if needed.
Please take care not to ingest more than the recommended dose of any medication, as this will not aid in further pain relief and may in fact be harmful to your health.
Exercise Care
One of the most important factors in proper healing of oral surgical wounds is avoidance of disturbing the wound. Do your best to leave the surgical area ALONE for the first several days. DO NOT AGGRESSIVELY RINSE your mouth (gentle rinsing is okay) or probe the area with any objects (i.e. fingers). You may brush your teeth gently, taking care to stay on your teeth and avoid the gum in the surgical area. Avoid smoking for the first week as this is very detrimental to healing.
Swelling and Bruising
Following the removal of impacted wisdom teeth or other extensive surgery, it is expected that patients will experience a certain amount of swelling and bruising. Swelling becomes more noticeable the first day after surgery and typically increases until the third postoperative day. Sometimes swelling lasts seven to fourteen days. To minimize swelling, it is recommended to place ice packs (cubes in a washcloth, bag of frozen peas) over the area of the surgery for twenty minutes, with ten minute rest intervals. This can be done for up to 12-36 hours. Beginning the third postoperative day, the use of moist heat (hot, damp washcloth) will assist in the resolution of swelling.
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Diet
For patients having general anesthesia or with extensive surgical procedures, the stomach may be upset for one to two days postoperatively. Nausea and vomiting are not uncommon problems. Patients are encouraged to eat as soon as convenience permits after surgery, particularly prior to the use of narcotic pain medications. Clear liquids and broth are excellent to start. As the patient becomes more comfortable and the appetite increases, foods of a non-particulate nature such as cooked cereal, mashed potatoes, applesauce, gelatin desserts, puddings, and similar foods may be added. You should only eat soft, strained (no particles) foods the first day following surgery.
For patients having had local anesthetics, or after the initial period of stomach upset passes, it is suggested that a regular diet be eaten. All patients should avoid food with small particles such as chips, nuts, seeds, etc., which can become trapped in open sockets and surgical wounds, causing inflammation and discomfort.
Nausea
Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medications. Nausea may be reduced by preceding each dose of medication (including your first dose) with a small amount of soft food, then taking the pill with a moderate volume of water. Try to keep taking clear fluids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem. Cola drinks that have less carbonation may help with nausea.
Sutures
Sutures are often placed at the time of surgery. Resorbable sutures will become loose and fall out after several days. Loose sutures are not a cause for concern, though if they cause significant discomfort or become a nuisance, please notify us at (402) 421-3401.
Oral Hygiene
Brushing and gentle rinsing with warm salt water ( 1cup of water, 1 teaspoon of salt) can be done anytime after surgery, though should be gentle (no “swishing”) for the first couple of postoperative days. Care should be taken to avoid the gum tissue in the surgical area with tooth brushing for the first 3-4 days if sutures were placed. Commericial mouth rinses should be avoided for the first week. Any mouth rinse given by our office can be used gently/anytime after surgery.
Irrigation
Patients having had removal of impacted wisdom teeth or lower molars may have been given an irrigation syringe. There will be a small space where the teeth used to be, which will have a tendency to trap small particles of food. This syringe IS NOT to be used during the first 4-5 postoperative days, as brisk irrigation can cause loss of your blood clots and formation of a “dry socket”. You may rinse gently with warm salt water as described above prior to irrigation. After one week has passed, the syringe may be used to irrigate and clean the lower extraction sockets with warm salt water. It is recommended that this be done after each meal until the spaces have closed or are no longer trapping food.
Sharp Edges
If you feel sharp edges in the surgical areas with your tongue, it is probably the bony walls which originally supported the teeth. Occasionally small slivers of bone may work themselves out during the first several weeks after surgery. They are not pieces of tooth and, if necessary, we will remove them. Please call the office if you are concerned.
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