Make sure the patient is accompanied by a responsible adult until they are alert and coordinated enough to walk without the danger of falling. This is particularly important if the patient should rise on the evening of surgery to use the bathroom. The patient should not drive or operate machinery until the effects of the anesthetic agents have dissipated. The time required will vary with the length of the anesthetic procedure. This will take at least 24 hours.
It is important not to consume any hot food or drink or chew any solid food until the effects of the local anesthetic are totally gone. This is particularly important in children.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 30 minutes. You may have to do this several times. Oftentimes, the gauze will act as a wick and be blood-tinged or soaked when removed from the mouth. This wicking can last for 24 hours or more. This is not unusual and does not constitute active bleeding. (Looking at blood-soaked gauze is not a true indicator of active bleeding.) If you look at the surgical site (after using the gauze for the prescribed time) and do not see blood dripping like a slow faucet from the upper sockets or welling up to the naked eye from the lower sockets, there is usually not a problem. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright, use ice packs, avoid strenuous activity, and do not become excited. If bleeding does not subside, call for further instructions.
Flying after surgery is usually not a problem. Tooth removal sockets are open and not water-tight. Air can get in and out of the surgical areas, and no pressure differences should occur or cause a problem.
Routine exercise is permitted 4 days after surgery. Heavy or competitive exercise before this can potentially cause bleeding. After this 4-day period, if you do exercise or play competitive sports, you may experience throbbing pain in your jaws as there is more blood flow to this area during the healing process. As you raise your heart rate and blood pressure during exercise or playing sports, you may experience this throbbing. While this may cause pain, it won't hurt the wounds. If the pain is not tolerable, you may want to wait a few more days to attempt vigorous activity.
It is not uncommon to experience nausea after surgery and general anesthesia. This can be decreased by having the patient lie flat or with the head slightly elevated and having minimal movement. Any time the patient gets up, he or she should do so with slow movements and assistance. Ingest only clear liquids to help minimize nausea (water, 7-Up®, ginger ale). Stay on clear liquids until the nausea passes.
Use your prescription only as directed on the label. The patient will be comfortable following surgery due to the local anesthetic placed in surgical sites during the procedure. When the local anesthetic wears off, the patient will experience pain. It is best to stay ahead of the pain by taking your prescribed pain medication. You should take the pain medication before the local anesthetic wears off. You may take one pain pill as soon as you get home and then another one as soon as any pain is felt. After taking the second pill, take the remainder as prescribed on the label. Most pain medications are narcotics and may cause nausea. Take a full 8 ounces of a clear liquid (water, 7-UpTM, or ginger ale) when taking the pain pills to minimize nausea.
If not allergic, you may take 600 mg of ibuprofen.
(Advil, Motrin) every 6 hours to help with pain control. It is best to keep 2 separate time logs as the narcotic that was prescribed is given every 4–6 hours and the ibuprofen is given every 6 hours.
The use of ibuprofen may lessen the use of the narcotic and lessen the side effects of the narcotic (nausea, vomiting, dizziness, constipation). Do NOT take acetaminophen (Tylenol®) with the prescribed narcotic as the formulation prescribed has acetaminophen (Tylenol) in it.
It is best to call the doctor during business hours to get any needed refill. We are open Mon–Thu 8:00 a.m. to 5:00 p.m. We close around 3:00 p.m. on Fridays. Recent federal changes in issuing prescriptions FORBID the doctor from calling in refills for some medications. Please prepare accordingly.
Begin rinsing with warm water gently around the surgical site the day following the surgery. Rinse with a full glass of warm water. Perform this rinsing 4 times per day, if possible. You may also resume brushing your teeth, avoiding the surgical sites.
Over the next few days, you may start brushing over the surgical sites gently, gradually increasing the force of cleansing in these areas. Avoid foods like nuts, popcorn, and raw vegetables until the sockets are totally closed (6–8 weeks).
ImplantSwelling is normally expected after oral surgery and may be minimized by the immediate use of COLD packs for the first 8–12 hours. Apply the cold pack to the outside of the face directly over the surgical sites. Do this 30 minutes on and 30 minutes off while awake. The swelling is usually the greatest on the second to fourth day after surgery and then slowly resolves. WARM MOIST HEAT (a hot water bottle or a warm moist towel) may be used over the outside of the face 30 minutes on and 30 minutes off, starting on the SECOND DAY AFTER surgery and continuing until all swelling and/or bruising is gone.
It is important to maintain an adequate intake of fluids and nourishment for optimum healing. A high-calorie, high-protein diet is recommended. Chewing may be a problem, and food choice is therefore limited. If solid foods cannot be taken, supplement a balanced soft diet with 2 or 3 servings of a liquid dietary supplement such as Meritene®, Ensure®, Sustacal®, Nurrament®, or Instant Breakfast®. (All of these products can be obtained at a pharmacy without a prescription.) Avoid hot or hard foods for 48 hours because these can dissolve or dislodge the clot. Also avoid using straws or spitting because the negative pressure created may cause premature loss of the blood clot, resulting in a dry socket. Some food suggestions include the following:
Smoking increases the incidence of post-operative complications (specifically dry socket) and should be avoided for 1 week following oral surgery.
If these were prescribed, please take as directed until they are all gone. If you take birth control pills, their effectiveness may be decreased, and you may have an increased chance of pregnancy while simultaneously taking birth control pills and antibiotics. During the time you are taking antibiotics, you should use another form of birth control.
The patient should improve daily. If you are in doubt about any of the above instructions or the status of the patient, call our office at (916) 773-1188.
There is a doctor on call 24 hours, every day. If you have any questions, please try to call Dr. Martin during working hours as he will be familiar with your surgery. If urgent questions or problems arise after hours, call the office and follow the prompts to be connected to the doctor on call.
