Post Operative Guide

After your operation you were taken to the recovery room where you were carefully monitored. There is no need for concern if you feel dizzy or dopey since the anesthetic can affect your vision, hearing and sense of balance. The recovery time varies from patient to patient depending on age, general health and the difficulty of the procedure. Rest, proper nutrition, adequate fluids, and attitude influence the healing process. 

A responsible adult must drive the patient home and remain with them for a period of hours until the patient is able to function safely on their own.

As the anesthetic wears off, you may begin to feel some discomfort. Your Doctor has prescribed a pain medication for you. It is advisable to take a pain pill prior to the freezing coming out to minimize the discomfort. If the Doctor has prescribed an antibiotic, you can begin taking this medication at supper time. Nausea and vomiting can be caused by any medications you are taking and should not alarm you if they occur. 

Usually the most uncomfortable time is the third or fourth postoperative day. This is the day when swelling and discomfort can be at their greatest. Remember that your body needs time to heal, so it will probably take several days to a week until you feel as strong as you did before the surgery 

1. BLEEDING 

Bleeding from the surgery site is unavoidable. However, careful observation of the following instructions should help you bring the bleeding under control quite rapidly. Bite on the gauze you left the office with for approximately 30 minutes. Firm biting pressure should be applied. Change the gauze every 20 to 30 minutes until the bleeding comes under control.

  THE “DO’S” 

• Place gauze directly over surgery site and bite firmly.   
• Maintain moderate steady pressure until bleeding stops.   
• Change gauze every 20 to 30 minutes.   
• If you run out of gauze, you can use a tea bag.   
• Rinse your mouth with warm salt water 4 times a day starting 24 hours after the surgery.  

  THE “DO NOT’S” 

• Do not spit forcefully.   
• Do not drink through a straw.   
• Do not rinse your mouth for 24 hours.   
• Do not smoke.   
• Do not eat, drink or sleep with gauze in your mouth.  

A slight oozing of blood is expected the first day or two following surgery. Remember that bleeding is normal and that the best way to stop bleeding is firm biting pressure. If the bleeding persists after these measures, please call our office. 

2. PAIN

Pain and stiffness of the jaw is generally expected following oral surgery. The amount of discomfort varies considerably from one person to another. You have been prescribed pain medication to ease the pain. 

  THE “DO’S”   

• Take a pain pill just as soon as you can; this will provide you with relief when the freezing is coming out.   
• This medication may affect your judgement and reflexes which may cause you to be sleepy/nauseous and light-headed.   

  THE “DO NOT’S”   

• Do not drink alcohol for 18 hours. 
• Do not operate a vehicle or machinery for 24 hours.   

Pain usually subsides gradually following surgery. Should the pain appear to worsen 4 to 5 days following extraction, this may indicate the presence of a dry socket. This can be treated, so please contact our office.  

3. SWELLING  

Everyone swells after surgery, some more than others. A “chipmunk” appearance is not uncommon, especially if wisdom teeth were removed. 

For the first 24 hours, place an ice pack to the sides of your face. (20 minutes on and 20 minutes off). Do not apply ice directly to the skin; wrap it in a towel. A frozen bag of peas works well also. DO NOT APPLY ICE AFTER 48 HOURS since it is not effective. Apply moist heat to the affected area after 48 hours to help relieve the swelling. You can use moist towels placed in the microwave.   

4. BRUISING 

A black and blue discolouration of the skin sometimes occurs. This will normally turn a few different colours and then gradually fade within 5 – 7 days. 

5. DIET   

• Stay on a soft diet for a few days: soup, eggs, mashed potatoes, etc.   
• Drink plenty of fluids: water, juices, etc.   
• Your blender can be used to puree most foods.   
• Advance your diet to harder foods as you can tolerate. It may take you more than a week. 

6. ORAL HYGIENE

Starting the day after surgery, gently rinse your mouth with warm salt water. Dilute on teaspoon of salt into an 8 oz. glass of warm water. Rinse after each meal. Brush your teeth as usual, except for the surgical site. 

7. BONE 

Sometimes after a tooth is extracted, a portion of the bone around the tooth may be exposed. You may be able to feel this exposed bone with your tongue as a sharp edge. It is very common for patients to mistake this as a piece of tooth, but it is not. As your gums heal, this bone will eventually be covered with gum tissue. This can take several weeks to occur. On occasion after multiple extractions, very small bone fragments may remain under the gum tissue. These small pieces of bone will often work their way through the gum and fall out on their own. Others may require removal by the surgeon. 

8. DRY SOCKET

A dry socket is a painful condition that can occur after an extraction. It happens when the healing clot that has formed in the tooth socket becomes dislodged, exposing the underlying nerves and bone. The most common cause of dry socket is smoking. Other possible causes are forceful spitting, drinking through a straw, or rinsing your mouth too soon after surgery. These can all result in pushing the clot out of the socket. The pain from this is often not relieved by your pain pills and may require placing a dressing soaked in Oil of Cloves into the socket to relieve your discomfort. *See Oil of Cloves

9. OIL OF CLOVES (EUGENOL)

This oil is very effective for relieving the pain from a dry socket or a difficult extraction. If you are experiencing pain that is not being relieved by your medication, you may need to return to the office to have a Eugenol dressing placed into the painful socket. It is also possible, (if you are unable to come in to see the surgeon) to purchase some oil of cloves at a pharmacy or health food store. By placing a few drops of clove oil on a small piece of gauze and placing into the painful area (socket) you should feel more comfortable within an hour.  

10. MEDICATIONS 

After your surgery you are usually prescribed pain medication and antibiotics. Very often you will be given two types of pain medication, one for moderate pain (i.e. Tylenol #3) and a second one for more severe pain; (i.e. Demerol or Percocet). We recommend that you start by filling only the one prescribed for moderate pain (i.e. Tylenol #3) as very often this is all that you will need. With Tylenol #3 you may take one or two tablets every three to four hours as required. If however the Tylenol #3 is not effective in relieving your pain, you may have to fill your back up prescription for Demerol or Percocet. 

If you have been given antibiotics you should start taking them the day of your surgery. The antibiotics that we most commonly prescribe are Penicillin or Erythromycin. It is important to take your antibiotics at properly spaced intervals and to finish taking all the medication. 

11. SMOKING 

We recommend that you do not smoke for one week following surgery. Smoking is the most common cause of a painful dry socket which will delay the healing process and make your recovery uncomfortable. Do your best to avoid it for as long as possible after surgery.  

12. NAUSEA 

Nausea may occur after an anesthetic or from some medications you are taking. Gravol can be purchased over the counter at any pharmacy and is very helpful for nausea. Flat Coca-Cola also alleviates nausea. To flatten Coke, just ad a teaspoon of sugar to a glass of Coke. 

13. WOMEN ONLY 

Antibiotics may cause birth control pills to become ineffective. Please consult your physician for alternative birth control methods. 

14. DENTURES 

If you had teeth extracted and a denture placed, try to leave the denture in overnight. If you are unable to stop the bleeding with the dentures in place, then remove the dentures and follow the steps outlined in the section on bleeding. The following day, remove the dentures and rinse the mouth with warm salt water. Replace the dentures as soon as possible. Sore spots are common with new dentures and denture appointments may have to be made by your dentist. 

IF, FOR ANY REASON, YOU ARE WORRIED ABOUT THE CONDITION OF YOUR MOUTH, OR IF ANY UNEXPECTED DEVELOPMENT SHOULD CAUSE CONCERN, PLEASE CALL OUR OFFICE FOR FURTHER INSTRUCTIONS OR TREATMENT.