After Oral Surgery
Immediately Following Surgery: Even for the most simple-seeming procedures, post-operative care is very important. Unnecessary pain and complications can be minimized if these instructions are followed carefully. Your case is individual, no two mouths are alike. Do not accept well-intended advice from people who may have had the same procedure. Please discuss any questions or problems with the persons who are able to effectively help you: Dr. Jessen and his staff.
- The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
- Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
- You should not drive a car, operate machinery, or perform any other tasks which require concentration while you are taking narcotic pain medications or for 6 hours thereafter.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for detailed instructions.
Keep the Mouth Clean
Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal. Brush your teeth as best you can and rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day, starting day after surgery. Continue this procedure until healing is complete. REMEMBER: A clean wound heals better and faster.
You should also avoid rinsing with alcohol-containing mouthwash (Scope, Listerine, etc.) during this time, as it will be very uncomfortable for the healing tissues.
Syringe Use *** If you were provided and instructed to use***
After 7 days it is vital that you start to use your Monoject syringe to irrigate the lower extraction sites. You will use this syringe at minimum, 2 times a day but ideally after every time you eat.
To use, fill the syringe with plain water and pull cheeks back; there will be a small opening where the wisdom tooth used to be. Put the syringe tip inside the site and push water into the site. It is important to create turbulence to make sure food and debris leave the site. If you experience bleeding from the site, don’t worry, this stimulates healing. Continue to use the syringe until the sites are fully healed over.
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 gently rinsing or wiping any old clots from your mouth, then placing a moist gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Ice to the face for 20 minutes on the side of the bleeding can also help constrict blood vessels. To minimize further bleeding, sit upright and do not exert yourself. If bleeding does not subside after implementing these measures, please call us for further instructions.
The swelling that is expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs.
Two Ziploc bags filled with ice or ice packs should be applied to the sides of the face where surgery was performed. Bags of frozen vegetables such as peas are also very effective. The ice packs may be left on continuously as tolerated while you are awake. After 72 hours, ice has no effect on swelling.
Sitting upright while awake and sleeping in a semi-elevated position will also help minimize and reduce swelling. If swelling or jaw stiffness persists for several days, there is no cause for alarm. This is a normal reaction to surgery. Seventy-two hours following surgery, the application of moist heat to the sides of the face can help in reducing stiffness.
For moderate pain for teen and adult patients who are able to take Ibuprofen, we recommend 600-800 mg Ibuprofen (Motrin or Advil) every 6 hours as needed. For severe pain, we prescribe narcotic-containing medications. These medications will make you groggy and will slow down your reflexes. DO NOT take medication with alcohol. You should not drive a car, operate machinery, or perform any other tasks which require concentration while you are taking narcotic pain medications or for 6 hours thereafter.
Pain or discomfort following surgery should subside more and more every day. If pain worsens or does not improve after several days, it may require attention and you should call the office.
After any oral surgery procedure, liquids should be initially taken to avoid stomach upset. Do not use straws for 5-7 days; drink from a glass instead. The sucking motion can cause more bleeding or “dry sockets” by dislodging the blood clot. Avoid hard, crunchy foods such as chips, nuts and popcorn for 7-10 days.
High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
Caution: When lying down, make sure you sit for one minute before standing. If you suddenly sit up or stand from a lying position while on a limited diet you may become dizzy which can cause you to become shaky and even pass out. This can be confused with having a seizure, but be assured that this is NOT a seizure. If you experience this make sure to lie down, elevate your feet and drink a lot of fluids.
Dry sockets (alveolitis) occur almost exclusively with the removal of impacted wisdom teeth from the lower jaw. They are very uncommon and are caused by dislodgement of the blood clot from the extraction site. Activities such as smoking or sucking through straws can increase the risk of developing a dry socket. Symptoms of new, severe pain at the surgical site and even pain to the ear 4 days following surgery are the usual signs of a dry socket. Call us if this occurs, so that we can evaluate you.
Sutures (stitches) are sometimes placed in the area of surgery to minimize post-operative bleeding and to help healing. The materials Dr. Jessen uses are almost always dissolvable, and will eventually fall out or unravel. This is no cause for alarm. Just remove the thread from your mouth and discard it. If you have non-dissolving sutures, we will arrange to have you return to the office for removal. The removal of sutures is very simple, and does not require any shots.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration on the face and neck is due to fluid spreading beneath the tissues, and then draining through the lymphatic system via gravity. This is a normal occurrence after surgery, which may occur several days after surgery as swelling begins to decline. Moist heat applied to the area may speed up resolution of this process, after day three.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help treat or prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if this occurs.
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including prescribed medications. You should then slowly resume oral intake with sips of clear liquids such as apple juice, soft drinks, sports drinks or herbal tea. You should sip slowly, taking in approximately 8 ounces over a fifteen-minute period. When the nausea subsides you can begin taking more fluids, solid foods and resume prescribed medications.
Other Common Issues
- Fever: Slight elevation of temperature immediately following surgery is not uncommon. If a temperature above 101.5º persists, please notify our office. Acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can be taken to reduce elevated temperatures.
- Dizziness: You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery, and may be slightly dehydrated. You could get light headed when you stand up suddenly. Taking certain pain medications can make you dizzy. Before standing up, you should sit for one minute then slowly get up.
- Cracked lips: If the corners of your mouth were stretched, they may dry out and crack. Your lips may be kept slightly moist with an ointment such as Vaseline to promote healing.
- Weakness: For the first few days after surgery, be aware that your normal nourishment intake may be reduced. You may not have the energy reserves to participate in your normal activities. If you get light headed during exercise or physical exertion, stop, take a break, and then slowly increase your activity as tolerated.
It is our desire that your recovery be as smooth and pleasant as possible. After hours, if an emergency arises, Dr. G. Shane Jessen can be contacted at 801-791-2375. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours, Monday through Friday.
POST OPERATIVE IMPLANT INSTRUCTIONS
Please follow these instructions as closely as possible. They are designed to help you heal quickly and comfortably with minimal side effects. If you experience any complications please contact our office.
FOR THE REMAINDER OF THE DAY:
- Do not Use a tissue to wipe your mouth as needed, or swallow your saliva.
- Do not use a drinking straw. Drink straight from the cup.
- Do not Smoke.
- Keep fingers and tongue away from the surgical area. Spitting, the use of a straw, smoking and poking can dislodge the blood clot that is forming; which causes bleeding to persist in the surgical area. Also, smoking can increase the chances of an infection and delay healing.
Some minor bleeding is expected after implant surgery. It will usually subside quickly, and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours. Upper implants may occasionally trigger some bleeding from the nose; this is normal and will stop quickly.
- Keep gauze on the surgical area with some pressure for 30 to 45 minutes.
- Remove the gauze after 30 to 45 minutes, and replace it with a new piece of gauze if you are still bleeding. It is important to make sure the gauze is directly on the surgical site. Firm pressure for another hour should stop the bleeding.
- If you find that this is not working after your third attempt, use a moistened tea bag instead of the gauze. The tannic acid in tea will help to form a clot, and stop the bleeding.
- If all else fails, call the office.
Most patients will experience some swelling after surgery in the mouth. If may be mild or severe, and is different for every patient. The swelling will increase for the first 72 hours before it shows signs of improvement. It is normal for swelling to last for several days, even up to one week after the procedure. Some bruising may also develop on the face, this is normal.
- Use an ice pack on the cheek or face next to the surgical site. Keep it on for 20 minutes, then off for 20 minutes, and repeat until you go to sleep. Start again the next day, this rotation can be beneficial for three days after the procedure.
- Sleep with your head elevated slightly, above the heart. This will keep swelling down.
- On the fourth day, change to moist heat instead of ice packs. This will bring the swelling down quicker.
You may eat soft foods as soon as the anesthetic wears off. Try not to chew directly on the surgical site. You may resume a regular diet as soon as you feel up to it. It is important to stay well nourished and well hydrated, this will encourage faster healing.
You may brush your teeth, avoiding the surgical area, tonight or tomorrow morning. Be gentle and do not spit or rinse forcefully.
You may start rinsing tomorrow, gently, with some warm salt water every few hours. (1 tsp salt to 1 cup of warm water) Do not use alcohol-containing mouth rinses for a few days.
You were probably given one or more prescriptions for medications. Take all medications with a full glass of water, and as directed on the bottle. Call the office if you experience severe nausea, or diarrhea, or cannot swallow your pills.
- Antibiotics: Continue until the bottle is empty. Do not quit halfway.
- Pain Medicine: Continue as necessary. Remember that narcotics can make you drowsy, so no driving, operating machinery or alcoholic beverages while you are taking these medications.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. After hours, if an emergency arises, Dr. G. Shane Jessen can be contact at 801-791-2375. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: Requests for narcotic (pain killer) prescription renewals are ONLY accepted during office hours, Monday thru Friday.
Post-operative information for All-On-Four procedure
Unnecessary pain and complications can be minimized if these instructions are followed carefully. Your case is individual; no two mouths are the same. Do not accept well-intended advice from people who may have had the same procedure. Please discuss any concerns, questions or problems with Dr. Jessen and his staff.
DIET: Only consume foods that can be cut with a plastic fork. This includes cooked vegetables, chicken and fish as an example. Examples of foods to absolutely avoid are nuts, hard candies, raw vegetables and tough meats.
TRANSITIONAL DENTURE: The transitional, or temporary, denture will only have 10 teeth per arch. The final denture you will receive will have the full 12 teeth per arch; this is due to the cantilever forces that would cause the denture to fracture if extended back without titanium bar support, which is placed with final denture. If your transitional denture breaks, contact your dentist immediately.
BITE: During the procedure, your mouth was open for an extended amount of time; this will cause disorientation in your bite. Because of this, your transitional denture may feel foreign. The bite will be adjusted best it can day of surgery, however, an additional visit to your dentist after surgery may be needed to adjust your bite more accurately.
THE GAP: Your denture is made according to your original ridge (roof of mouth) prior to surgery. The alveoloplasty (adjustment of the bone) during surgery removes some of the bone that would normally support a denture. During the transitional period, a gap will form as the tissue heals. The final denture will eliminate the gap and any air space developed during healing.
TRANSITIONAL PERIOD: At this time you will want to be active at deciding what you want the final restoration of your denture to be like; Do you like the overall look? What would you change? How are the teeth shape and color? Is the lip line full? How is the smile line? This is your time to make notes so that the final denture meets your expectations.
HYGIENE: You will use the oral rinse you were prescribed by Dr. Jessen for the first two weeks following surgery. Thereafter, avoid regular toothpaste and abrasive cleaner. Gently clean with a baby toothbrush and use a proxy brush or Waterpik around implants followed by the oral rinse.
*Please note the importance of continued hygiene with your general dentist; 6 month to yearly maintenance appointments should be made to ensure your investment continues to shine!
It is our desire that your recovery be as smooth and pleasant as possible. After hours, if an emergency arises, Dr. Jessen can be contacted at 801-791-2375. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours, Monday through Friday.