Postoperative Instructions

For Instructions in Spanish, click here

PLEASE READ ALL OF THESE INSTRUCTIONS CAREFULLY!

Sometimes the after-effects of oral surgery are minimal, so not all of these instructions apply to all patients.   Common sense will often dictate what you should do.  When in doubt, follow these guidelines or call our office for clarification.  Have an adult stay with you after surgery to help as needed.

GENERAL WOUND CARE

  • Do not disturb, probe or poke the surgical area
  • Do not rinse or spit vigorously or use straws for one week
  • Do not smoke or vape for two weeks after your surgery. Smoking causes delayed healing and increased pain. We do not advise smoking at all, but if you must resume do not smoke until you are fully healed
  • If you have stitches, they will dissolve on their own unless your surgeon told you otherwise
  • Plan rest and only light activity for the first few days after your surgery; you can then resume normal activity as tolerated as long as you follow any additional restrictions your doctor reviewed with you.

RINSING AND BRUSHING

Do not rinse your mouth on the day of surgery since it can disturb the clot and cause more bleeding. Avoid vigorous rinsing and spitting for one week.

If you would like to rinse on the second day after surgery or afterwards, you may use ¼ teaspoon of salt dissolved in an 8-ounce glass of warm water.  Gently rinse and gently spit out. If you were prescribed a mouth rinse, use this as directed. Avoid over the counter mouth rinses for one week unless your doctor instructed you otherwise.

Starting the day after surgery, brush your teeth twice daily. Do not brush directly on the surgical areas and avoid an electric toothbrush for one week.

INTERMITTENT BLEEDING/OOZING

It is normal to have blood-tinged saliva for several days after surgery. Intermittent bleeding is also common. If you have active bleeding, place fresh gauze over the surgical areas. Moisten the gauze, fold it into a small square, and place it directly on the surgical site. Make the gauze large enough that it puts pressure on the surgical site when you bite down. Bite firmly for 30-60 minutes.

STEADY BLEEDING

Bleeding should never be severe.  If it is, it usually means that the gauze is being clenched between your teeth or “bridged” over the surgical site rather than putting pressure directly on the surgical area.  First try repositioning with fresh gauze (see above).  If the bleeding persists or becomes heavy, you may bite on a black tea bag (soaked in warm water and squeezed damp-dry), or on gauze moistened in a strong cup of black tea; bite firmly for 30-60 minutes.  If you are still bleeding excessively, please call our office.

SWELLING/MOUTH OPENING

Some swelling is normal, and swelling usually worsens over the first 2-3 days after surgery. 

Tips to help minimize swelling:

  • Sleep with your head elevated above your heart
  • Apply ice (use a gel pack or bag of ice, frozen vegetables, or frozen popcorn kernels wrapped in a light towel) to the outside of your face over the surgical area for 20 minutes at a time during the first 24-48 hours after surgery. You may continue to use ice after this time period if the ice feels soothing
  • If you were prescribed ibuprofen or another anti-inflammatory, take it as directed

After removal of wisdom teeth or multiple teeth many patients feel stiff when they open their mouths. You may gently stretch after the first few days, and can apply heat along the sides of your jaws for 20 minutes at a time after the first few days. Do not sleep with heat in place. Mouth opening is usually back to normal by 1-2 weeks after surgery.

MEDICATIONS

  • Take postoperative medications as prescribed
  • If you have any complications or reactions related to the medications that have been prescribed, contact us immediately. For severe reactions seek emergent medical attention.

If you are a woman taking birth control medication, please know that antibiotics can decrease the effectiveness of the birth control medication. If indicated, use supplemental birth control precautions.

PAIN

Unfortunately, most oral surgery causes some discomfort; the pain is usually the most bothersome for the first few days after surgery. Over the counter pain medications such as ibuprofen and acetaminophen (provided these are safe for you to take) are best for pain control after tooth extractions and minor oral surgery. Take your first dose of pain medication before the numbing medication wears off to stay as comfortable as possible.

Your team will review your pain management plan with you and will give you a prescription medication if necessary. Take all pain medications with food, and do not take higher than recommended doses.

DIET

Eat nourishing food that is comfortable to eat. Follow a soft diet for the first week after surgery. Avoid crunchy foods and foods with small pieces (nuts, seeds, chips, popcorn, etc.) for at least one week to prevent damage to the surgical areas and to keep food trapping to a minimum.  Avoid straws for one week.

Do not skip meals, especially if you are taking pain medication or antibiotics. Eating regularly will help you feel better and may help you heal faster. If you have diabetes, maintain your normal eating habits as much as possible, and follow instructions from us or from your physician about your medications. Aim to keep your blood sugar well controlled.

NAUSEA

Nausea is not uncommon after oral surgery and can be caused by stronger pain medicines. 

Tips to reduce nausea:

  • Make sure your bleeding has stopped, and replace gauze if needed to help stop the bleeding.
  • Take pain medications with food
  • Do not take more pain medication than you need to stay comfortable
  • Stay hydrated

Please call us if you do not feel better or if you have repeated vomiting.

AFTER SEDATION

If you received IV sedation or were “put to sleep” for your procedure, drink clear liquids such as water or juice before eating soft foods. Do not drive, drink alcohol, or make important decisions for 24 hours after your procedure. A responsible adult must be with you for 24 hours after the procedure.

DRY SOCKETS

After tooth extractions pain typically begins to improve steadily after the third day.

A dry socket causes severe, persistent, or worsening pain after the third day. This pain can radiate to the ear and to other teeth. If you are concerned that you have a dry socket, please call (ideally during business hours) so we can evaluate you and help you feel comfortable while you heal. 

In case of problems . . .

You should experience no trouble if you follow the instructions and suggestions as outlined above. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, please do not hesitate to call our office immediately for further instructions or additional treatment.