Post-operative care is crucial to minimize pain and complications like infection and swelling. Please follow these instructions carefully. Note that some instructions may not apply if the after-effects of surgery are minimal. In case of any doubts, do not hesitate to contact our office.
Immediately Following Surgery:
Keep the gauze pad placed over the surgical area for 30 minutes and change it every 30 minutes until the bleeding stops. Usually, the bleeding will subside within 45 minutes to an hour.
Avoid vigorous mouth rinsing or touching the wound area immediately after surgery as it may cause bleeding. Begin gentle rinsing starting the night of surgery.
Do not blow your nose for the next 4 weeks under any circumstances. This may be longer if recommended by your surgeon. You may sniff, but NO BLOWING.
Try to avoid sneezing. If you have to sneeze, do it with your mouth open. This is important for approximately 4 weeks. If you feel congested, take Sudafed or Dimetapp.
Avoid playing wind instruments, or drinking thru a straw.
Take the prescribed pain medication as soon as you start feeling discomfort. This usually happens when the local anesthetic wears off.
Limit your activities on the day of surgery and resume normal activity when you feel comfortable. It may take up to 7 to 10 days before you feel back to normal and can resume strenuous physical activity and normal eating patterns.
Apply ice packs to the sides of your face where the surgery was performed for the first two days. Refer to the swelling section for further explanation.
Bleeding:
It’s normal to experience some bleeding following surgery. Slight bleeding, oozing, or redness in the saliva is common for up to 72 hours after surgery. To stop bleeding, fold two pieces of damp gauze over the extraction site and bite gently for 30-60 minutes while applying pressure. Rest with your head elevated. If bleeding persists, use gauze for an additional 30 minutes. If bleeding still continues, bite on a moistened tea bag for thirty minutes. Tannic acid in the tea bag can help form a clot by contracting bleeding vessels.
To avoid further bleeding, avoid excitement, sit upright, and refrain from exercising. Do not bend over or lift anything weighing more than 3 pounds. Smoking, forceful spitting, and using a straw may cause bleeding to start again. There’s a possibility of nosebleeds, which are temporary and usually resolve within 3 to 4 days. If it occurs, stop your activity, sit in a chair with your head reclined, and apply an ice pack. If bleeding is uncontrolled or doesn’t stop, contact your doctor.
Swelling:
Swelling after surgery is normal and proportional to the extent of surgery performed. Swelling around the mouth, cheeks, eyes, and sides of the face is common, as it is the body’s natural response to surgery and eventual repair. Swelling typically becomes noticeable the day after surgery and reaches its maximum after 2-3 days.
Immediate use of ice packs can help minimize swelling. Apply the ice packs to the sides of the face where surgery was performed for 20 minutes on and 20 minutes off for the first 48 hours following surgery while awake. Drinking cold fluids with crushed ice is also helpful.
If swelling or jaw stiffness persists for several days, there’s no need for alarm as it is a normal reaction to surgery. After 48 hours, applying moist heat to the sides of the face can help reduce swelling. It’s important to keep your head elevated for 2-3 days following surgery to minimize swelling.
Pain Management:
To minimize pain, it is important to follow the prescribed pain management plan. Take the medication as directed and do not exceed the recommended dosage. For mild pain, taking one or two tablets of Tylenol or Extra Strength Tylenol every three to four hours is recommended. For moderate pain, take the Ibuprofen 800mg as prescribed, but do not exceed 2400 mg in any 24 hour period.
In case of severe pain, take the narcotic pain medication as directed by your doctor. However, note that the prescribed pain medicine may make you groggy and slow down your reflexes. Thus, refrain from driving an automobile or working around machinery while taking it. Also, avoid alcoholic beverages as they will enhance the effect of the narcotic, which is a dangerous combination.
Normally, pain or discomfort following surgery should start to subside after the first three or four days. If pain persists or worsens, it may require attention, and you should contact the office for further guidance.
Diet:
After general anesthesia or I.V. sedation, start with liquids. Avoid hot liquids or foods while numb. You may have applesauce, pudding, or Jell-O. Once the numbness wears off, progress to solid foods and chew away from the surgical site.
For 2 weeks, avoid foods such as nuts, popcorn, sunflower seeds, and any other food where particles can get lodged underneath the tissue within the surgical site (such as pretzels, potato chips, corn chips).
Oral Hygiene:
To keep your mouth clean and prevent infection, it’s important to clean your mouth thoroughly after each meal starting the day after surgery. Use a soft bristle toothbrush and toothpaste after meals and before bed. If bleeding resumes after brushing, use gauze as described earlier. Avoid rinsing your mouth on the day of surgery.
Your doctor may prescribe Peridex (chlorhexidine 0.12%) mouth rinse. Use it in the morning when you wake up and at night before bed, rinsing for 60 seconds and then spitting it out. Use Peridex for at least 10 days. Avoid using a WaterPik in the surgical area for several weeks.
Discoloration:
Sometimes, discoloration of the skin may occur following swelling. Black, blue, green, or yellow discoloration may develop due to blood spreading beneath the tissues. This is a normal occurrence that may happen 2-3 days after surgery in some patients. Applying moist heat to the area may help to speed up the removal of the discoloration. Bruising is rare in younger patients and may be represented as a slight yellow discoloration. However, in older patients, especially the elderly, bruising can be quite significant and may appear as black and blue discoloration. This can even cover a larger area, sometimes involving the neck and upper part of the chest. Bruising of this degree can take around two weeks to resolve.
Antibiotics:
If you have been prescribed antibiotics, it is important to follow the directions carefully. Make sure to take the tablets or liquid exactly as directed and complete the entire prescription, even if you feel better before it’s finished. If you experience a rash or any other negative reaction, stop taking the antibiotics and inform the office immediately. In some cases, taking antibiotics with yogurt can help prevent diarrhea. If you are taking birth control pills, be aware that antibiotics can make them less effective, so it’s important to use a backup form of birth control.
Additional Information:
- It is common to have a slight elevation in temperature immediately after surgery. If the fever persists, notify the office. Tylenol or ibuprofen can be taken to reduce the fever.
- Dryness and cracking of the corners of the mouth may occur if they are stretched. Keep your lips moist with an ointment like Vaseline.
- Pain and sore throat while swallowing are normal due to swollen muscles. This will subside within 2-3 days.
- Trismus or stiffness of the jaw muscles may make it difficult to open your mouth for a few days after surgery. Do not force your mouth open, instead massage the muscles and apply heat. Usually, this will resolve with time.
- Sutures are used to minimize bleeding and promote healing.
- Pain and swelling should decrease each day after surgery. Contact the office if your post-operative pain or swelling worsens or if unusual symptoms occur.
- Avoid scuba diving and flying in pressurized aircraft as they may increase sinus pressure. Decongestants like Drixoral, Dimetapp, or Sudafed can help reduce pressure in the sinuses. Avoid activities that increase nasal or oral pressure, such as lifting heavy objects, blowing up balloons, or playing musical instruments that require a blowing action. You can resume these activities 2-3 weeks after surgery.
- Smoking must be stopped to ensure appropriate healing of the graft and dental implants, if any were placed. Quit smoking well before the surgery.
- There may be temporary loss of feeling in the gums in the operated area, and the teeth may feel loose and sensitive to hot and cold. In most cases, this is temporary.
- You will see the dentist 1 week after surgery to check the surgical site. The dentist will see you again in 3-4 months after the initial surgery to check the site and determine if you are ready for an implant. If an implant was placed during the sinus lift, the dentist will check it in 1 month and then again in 3-4 months to determine if it is ready to be restored.
Dr. Mustafa Alani 