Home Care Instructions After Surgery

Emergency Contact: 503-829-7677 (Bus Hrs) or 503-490-1183 (After Hrs)

Pain:

Normally, the use of acetaminophen (Tylenol) and ibuprofen (Advil) are sufficient to keep you comfortable. Follow the recommendations below to attain the desired level of pain relief.

1. Mild pain: Take 2 200mg over the counter Advil or generics tablets with 1 500mg extra strength Tylenol or generic. 400mg ibuprofen + 500mg acetaminophen every 6 hrs as needed.
2. Moderate pain: Take 1 600-800mg Motrin (or generic ibuprofen) + 2 500mg extra strength Tylenol (or generic). 600-800mg ibuprofen + 1000mg acetaminophen every 6 hrs as needed.
3. Severe pain: Take 1 800mg Motrin (or generic ibuprofen) + 1 Vicodin 5/500 or 1 Percocet 5/325. 800mg ibuprofen + Vicodin, Percocet or comparable narcotic. Do not drive.

In 1 24hr period you should not exceed the following 3200mg ibuprofen (4 800mg Motrin tablets), 4000mg acetaminophen (8 extra strength Tylenol) and 40mg narcotic (8 Vicodin or Percocet).

Bleeding:

Maintain the gauze pressure packs in your mouth for at least one hour after surgery.

The gauze should be folded into a tight square a placed directly over the extraction socket. It is common for mild oozing and bleeding for the next few hours.

After the numbing medication wears off, you may experience rebound bleeding as the blood vessels expand around the extraction socket. If this occurs, remain calm, replace the gauze and apply pressure for at least one hour.

You may also bite on a moistened Lipton tea bag, which will release tannic acid and help form a blood clot by contracting the vessels.

Finally, a cold compress ice pack on the cheek will help slow bleeding.

Swelling:

Facial swelling following oral surgery is normal within the first 48-72 hours.

To minimize swelling apply ice packs during the first 24 hours, 20 minutes on and 5 minutes off.

Three days after surgery heat applied to the jaw will reduce stiffness and increase comfort. Protect the skin by applying a thin towel between the check and heat source. Use heat 20 minutes on and 20 minutes off.

If swelling increases after the third postoperative day, you should call our office and inform the doctor.

Medication:

Continue taking all normal medications prescribed by another physician or dentist unless specifically advised. If antibiotics are prescribed be sure to take all of the medication as directed.

Caution: Antibiotics may alter the effectiveness of oral contraceptives.

If you experience any adverse side effects dizziness, rash, nausea -stop taking the medication and notify our office. If you experience trouble breathing or swellings in your throat call 911 immediately.

Diet:

You must guard against dehydration following oral surgery.

Increase your fluid intake by drinking several glasses of water, juice, or milkshakes on the first day. Avoid hot drinks for the first few days; however warm soups or mashed potatoes are ok.

You might have nausea during the first few hours after surgery. A small amount of carbonated drink such as 7-up or Sprite every hour will usually relive the nausea.

Avoid using a straw since the pressure of sucking through the straw may dislodge the blood clot.

A soft diet high in vitamins and protein is recommended for the second and third day after surgery. Products such as Ensure Plus® are excellent. You will feel better, have more strength and heal faster if you continue to eat.

If you are diabetic, maintain your normal caloric requirements, take your medication as usual, and check your blood sugar frequently.

Oral Hygiene:

Good oral hygiene is essential for wound healing. Food left in the wound invites infection.

1. Do not rinse your mouth for the first 12 hours to promote formation of a blood clot.
2. Starting the second day, gently rinse your mouth with ¼ teaspoon salt in a glass of warm water. Use the irrigating syringe to gently irrigate larger molar sockets. DO NOT SPIT. Let the salt water run out of your mouth.
3. We may prescribe an antibiotic rinse containing Chlorhexidine 0.12%, swish gently after meals and allow running out of your mouth.
4. On the day follow surgery, you may brush your teeth, but do not brush directly over the extraction socket.
5. Do not be intimidated by the presence of stitches, but take care to avoid them. After two to three days, brush over the stitches lightly.

Activities:

1. Avoid any strenuous activities for at least 3 days after surgery.
2. Avoid becoming fatigued. Rest as much as possible during the day and go to bed early.
3. Avoid smoking for at least 48 hrs after surgery as the smoke irritates the fresh oral wound and delays healing.
4. Do not use a straw when drinking as this can dislodge the blood clot.
5. You should not drive a car, operate any machinery or undertake any responsible business matters while taking pain medication.

Side Effects:

Side effects vary with the complexity of the surgical procedure. In addition to swelling and bleeding the following may occur.

1. Stiffness: Stiffness in the jaw muscles may cause difficulty opening the mouth. Use hot and cold compresses as described above. This should resolve in a few days.
2. Earache, Headache or Sore Throat: You may experience any of these conditions temporarily as a result of surgery. Get plenty of rest. Your other teeth may ache as well, this is called referred pain and is usually a temporary condition.
3. Numbness: Numbness of the lower lip, chin, and/or tongue may develop. This is called “parasthesia” and is usually a temporary condition that will resolve within a few days to several months. Inform your doctor about any numbness lasting more than 1 week.
4. Bruising: Black and blue marks may occur in some patients. It will gradually fade over a week or two and may be helped by moist external heat.
5. Infection: Rarely, a localized infection may develop. If you have a sensation of increased pain, fever, increased swelling or stiffness of the jaw after 48-72 hrs call our office.