POST OPERATIVE INSTRUCTIONS FOLLOWING MINOR ORAL SURGERY PROCEDURES PLEASE READ THESE INSTRUCTIONS COMPLETELY AND CAREFULLY.
Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. However, when in doubt, follow these guidelines or call our office any time for clarification. It is always good practice to rest after surgery and to let a family member or friend know that you have been through this procedure.
Day of Surgery
First Hour: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is not being controlled. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. The gauze may be changed as necessary and may be dampened and/or folded for more comfortable positioning.
Exercise Care: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing. DO NOT DRINK ALCOHOL, alcohol may affect the ability to form a blood clot or interact with postoperative medication.
First Hour: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is not being controlled. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. The gauze may be changed as necessary and may be dampened and/or folded for more comfortable positioning.
Oozing: Intermittent bleeding or oozing is normal. It may be controlled by placing fresh gauze over the surgical areas and biting down firmly for 30-60 minutes.
Steady Bleeding: Bleeding should never be severe. If it is, it many times means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas. Try repositioning fresh packs and placing pressure. Try to avoid spitting and rinsing as this disrupts the newly made clot. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in warm water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office. After office hours, Dr. Vella Caruana can be reached on Emergency cell: 905 630 2551.
Blood Loss: If bleeding does not stop, please call our emergency number. In some cases, the dentist may need to clean the area and place materials and sutures to assist the blood clot. If you are concerned about a severe amount of blood loss, or a medical emergency including fainting or unconsciousness please have a relative or friend call hospital emergency. Please note: hospital emergency services are busy with many types of emergencies. Hospital emergency departments will triage and prioritize emergencies according to seriousness. There may be a wait at hospital emergency services. Please remember to take your OHIP card, a list of medications taken if this is easily available and money for parking. (see the bottom of this instruction sheet for emergency phone numbers)
SwellingOften there is some swelling associated with oral surgery. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 12 to 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. After 24 hours, it is usually best to switch from ice to moist heat to the same areas. If swelling is rapid and places pressure on the neck, causes wheezing, difficulty breathing or difficult talking – this is a medical emergency. Please contact hospital emergency services (911).
Pain: Unfortunately most oral surgery is accompanied by some degree of discomfort. You may have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Effects of pain medicines vary widely among individuals. Remember that the most severe discomfort is usually within the first day after the anesthetic wears off; after that your need for medicine should lessen.
Nausea: Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem.
Diet: Eat nourishing food that can be taken with comfort. Temperature of the food doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to restrict the first day’s intake to bland liquids or pureed foods (creamed soups, puddings, yogurt, milk shakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.
Instructions for Second and Third Days
Mouth Rinses:Keeping your mouth clean after surgery is essential. Use ¼ tsp. of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat two or three times daily for the next five days.
Brushing: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.
Syringe: If you were given an irrigating syringe at your first office visit, start using it the third day after surgery to keep sockets clean. Fill it with warm water and irrigate any open sockets gently, especially after eating.
One Week Post-Op
Pain: Most significant pain should be resolved, although local discomfort may persist for 2-3 weeks. It is usually resolved with pain relieving medication such as Tylenol or ibuprofen. Pain which increases or fails to resolve may be due to dry socket, infection, or other problems. Please contact our office is pain persists.
Swelling: Swelling should resolve 7-10 days after surgery. Facial bruising may persist for up to 10-14 days. Local heat, a heating pad set on “low”, or warm compress will help things return to normal more quickly. Swelling which appears or increases after the first 3-4 days may indicate infection.
Jaw Stiffness: This is normal and should be expected following surgery. You must make a conscious effort several times a day to stretch your jaws open wide. Local heat and ibuprofen (if you are able to take ibuprofen) can help the associated discomfort and inflammation.
Oral Hygiene: By a week after surgery, you should be back to brushing your teeth as normal, hopefully several times per day. Thorough rinsing with tap water or salt water helps maintain cleanliness at the surgical sites. There is no need for excessive use of mouthwashes; in fact it may be harmful. Extra attention at the extraction sites may be necessary for up to 3-4 weeks after teeth are removed until tissue healing has filled the defect.
Diet: Approximately 1 week after surgery your diet should be returning to normal. You may require an additional week to be able to consume hot, spicy, or tough types of foods without difficulty.
Activity: By approximately 1 week after surgery, most routine activities may be resumed. It is usually advisable to avoid swimming or diving for 10-14 days. Routine dental work is best postponed for 2-3 weeks.
Medication: Any antibiotics should be taken until gone. Pain medication should only be taken as prescribed to relieve discomfort. Remember, narcotic-based pain relievers can cause drowsiness and decrease coordination. You should refrain from using alcohol or other sedative-type drugs while using them.
Bite: It is not uncommon for the bite to feel “different”, or that the lower teeth have “shifted” following third molar surgery. This is usually due to stiffness in the muscles resulting in a slight repositioning of the lower jaw or release of pressure on the adjacent molar teeth and thus a change in the way the teeth meet. This situation generally returns to normal in 1-2 weeks.
Emergency Contact Information
Dr. Elizabeth Vella Caruana
During office hours, please call 905-690-4040, and after hours call 905-630-2551