Post Surgery Instructions

Immediately Following Surgery

• DO NOT TOUCH THE SITE. Avoid exploring the area with your tongue or fingers. By touching the area with your tongue, you will irritate the tissues which can lead to increased pain, poor healing, and tissue loss.
• Keep the gauze pad placed over the surgical site and gently bite down for 30 minutes, after which it should be removed and discarded
• Starting on Day 3, gently rinse with warm salt water 5-6 times. Avoid aggressive mouth -rinsing rinsing for 24 -48 hours.
• Take the medications prescribed (if given) as soon as you have something to eat. Do not wait until you feel pain, which generally happens around the time the anesthetic starts to wear off. If you were prescribed any antibiotics, take them as directed. It is ok to start them the next day if you have not received them yet.
• Limit your activities on the day of surgery. It is okay to resume light activity such as house chores the following day or when you begin feeling comfortable. No strenuous activity for one week following surgery.
• Place ice packs on your cheeks over the surgery site. Refer to the section “Swelling” below.
• For the first 3 days after surgery, avoid spitting or drinking with a straw.
• It is very important not to smoke for 5–7 days after surgery. Smoking, even electronic cigarettes, will increase your pain and delay healing, resulting in a dry socket resulting in exposed bone and can be very painful, usually in the fourth or fifth day after surgery.
• Sleep with your head elevated for the first 3 days. This can be done by propping extra pillows under your head. This is very important to help reduce swelling.
• Eat soft COLD foods for the first 24 hours (yogurt, applesauce, jello). Food can be warmed after the first day. No hard or crunchy foods like toast, nuts, chips. More solid foods like soft pasta, pulled chicken, can be eaten on day 2.
• Use a Qtip and gently apply the “Oxyfresh Dental Gel” around the surgical site 3-5 times a day to enhance healing. This is safe to swallow. You can also fold a gauze, small paper towel, etc and place the gel on that and bite down over the extraction site too.
• Depending on the supply chain, your post op bag may or may not have this gel present.
• DO NOT drive for 24 hours if any medical scripts for Oral Sedation were taken, and/or until the effects of the anesthetic have completely subsided, or while taking narcotic pain medication.

Bleeding

Light pink blood on the gauze is normal. This is caused by very small amounts of blood mixing with your saliva. This may take up to 48 hours to completely stop. You may also notice a little bleeding after you brush your teeth or eat for the first few days after surgery. This is normal. You can control this by gently biting on a gauze pad placed over the wound for 30 minutes. Preferably with the Oxyfresh Gel, but if you do not have it or cannot find it then gently moisten gauze and bite down. This can be repeated if necessary. Additionally, you can gently bite down on a COLD-moistened tea bag for 30 minutes to reduce bleeding. If this excessive bleeding continues longer than 1-2 days, please call our office for instructions.

Swelling

Swelling after surgery is normal and can be expected around the mouth, cheeks, eyes, and sides of the face. You may not notice this right after the surgery. Swelling will increase and be worse the first 2-3 days after your surgery. To minimize the swelling, place ice packs on each side of the face immediately following surgery. Continue to use ice every 20-30 minutes for the first 48 hours. After 48 hours post-surgery, you can switch to moist heat, which will continue to reduce swelling. The ice packs have instructions for warming as well. Follow the instructions closely and be careful not to burn the skin. You can cover them with a warm moist towel. The directions for ice packs are below and on the back of the ice packs given at the office.

Pain “Do not take any medications if allergic (these are generalized guidelines).

Once you are able to have some liquids or soft foods after surgery, you should start taking pain medication. Begin with Ibuprofen and gradually progress to stronger prescribed medication as needed. DO NOT wait until the anesthesia wears off and you feel pain to begin your medication. It is better to manage the pain with medications early on. If you are experiencing moderate pain, 1 or 2 Tylenol (325mg) or Extra Strength Tylenol (500mg) can be taken every 3-4 hours. If you prefer, Ibuprofen (Advil or Motrin) can be taken instead. Ibuprofen bought over-the-counter comes in 200mg tablets; 2-3 tablets (400-600 mg) can be taken every 3-4 hours. These can be taken with your prescribed medications (if you were given any) as well. If the pain persists or grows worse after 2-3 days, it may require attention. Please call the office so we can help better control your pain. If you are allergic to any of the above medications or have otherwise been instructed not to take them, do not take them.

Prescribed Medication: Please take according to directions

Over the Counter (consult your doctor if unsure, and be mindful of allergies or other health concerns)

Mild to Moderate pain: Every 4-6 hours can take Aleve 500mg, Ibuprofen 400-600mg, Tylenol/extra strength 325mg-500mg

Moderate to Severe Pain: Take either Aleve or ibuprofen (as directed above) WITH Tylenol together. This is called “stacking” and will be stronger together. When “stacking” , repeat every 8-12 hours.

Diet
Anesthesia medications can make you feel nauseous after surgery. Start slowly with COLD liquids such as juice, smoothie, milkshake, etc. Avoid straws and drink directly from the glass instead. Dehydration can happen very quickly, making you feel tired and ill, and will slow your recovery. It is very important to drink plenty of fluids - at least 5 to 6 glasses every day. Even if you do not feel like eating solid foods, make sure to drink plenty of liquids. Juice and sports drinks will help replenish electrolytes. Avoid carbonated beverages such as soda. You can eat soft foods, but care should be taken to eat in areas of the mouth away from the surgical site(s). Avoid HOT food for 24 hours after surgery as they can increase bleeding and cause burning of the mouth while you are still numb. Foods similar to yogurt, apple sauce, soft pasta, mashed potatoes are all OK. Avoid hard crunchy foods such as nuts, chips, hard toast, etc for 5-7 days.

Oral Hygiene
Brush your teeth normally. Slight bleeding from the surgical site is normal. Avoid aggressively spitting the first 3 days. Avoid ALL over the counter mouthwash for one week as the alcohol can damage the healing tissue and cause worsening pain. You can start gently rinsing with warm salt water on Day 3 after surgery (one teaspoon of salt dissolved in a cup of warm water) at least 5-6 times per day. Gently tilt your head side to side and let the liquid fall out of your mouth, DO NOT SPIT. Rinsing is especially important after meals and snacks. Increased pain levels are usually from food being trapped in the surgical site. On day 3 you can begin to rinse more aggressively. Always use FILTERED water.

If you were given a syringe, you can begin to use the syringe on day 3 after surgery. Fill the syringe with warm salt water, or with a rinse if you were prescribed one. Point it towards the area, but do not stick it in the surgical site. Push the syringe plunger down to let out all the fluid and rinse any food that may be stuck in the socket. It is important to do this each time you eat for days 3-7 after surgery.

Nausea and Vomiting
If you begin feeling nauseated or vomit, avoid taking anything by mouth (including prescribed medications) for at least one hour. We recommend slowly sipping ginger ale, carbonated beverages, juice, or tea over 15 minutes. After the nausea subsides, you can resume eating solid foods and taking the prescribed medications. Benadryl (25-50mg) over the counter will help. If the nausea or vomiting continues for more than 24-48 hours after surgery please contact the office.

Finally
Sometimes the dissolvable sutures placed after surgery to minimize bleeding and aid in healing may become dislodged. This is no cause for alarm - simply remove the suture from your mouth and discard it. Most often, the sutures will dissolve on their own in 3-7 days.

It is normal if there was a bone graft placed that some may come out post surgery. They may feel gritty, and coarse. This is to be expected and not to be alarmed. Avoiding straws, spitting, and sneezing the first 3 days will help minimize this.

Pain and swelling will be the worst at days 2-3 but should begin to diminish with each day that passes after that. If at any time it begins to worsen or if unusual symptoms appear, please call our office for further instructions.

Where we remove the tooth, there will be a cavity or hole left behind. This area will begin to fill with tissue as it heals over the next several months. During this time, extra care should be taken to keep the area clean, especially after meals. You can do this by rinsing with warm salt water and brushing regularly.

A “dry socket” may occur if the blood clot becomes dislodged too early from the tooth socket. Symptoms may include pain at the surgical site, in the jaw, or ear pain and usually starts 3-5 days post-surgery. If this happens, call the office.

No two mouths are alike, and your case is unique to you. While friends and family may offer some advice on their experience, we recommend that you discuss any problems with our highly trained staff.

---

Reusable Ice & Heat Pack Instructions:

Post Surgical/Injury Recommendations: (Consult your Doctor for Personalized Guidelines)

• First 48 Hours: Apply cooling (~15 min on/off) to reduce swelling and soothe discomfort.
• After 48 Hours: Use heating to decrease and disperse residual swelling.
• Post 48 Hours: Alternating cool and heat is optional; heating is recommended once swelling has subsided.

Usage (Always check the temperature before use and wrap in fabric if needed!)

1. Cooling: Freeze the pack for 40-60 minutes.
2. Heating: Microwave on a paper towel for 5-10 seconds or submerge in hot water (55-65℃, not boiling) for 5 minutes.

Safety Information:

•  Avoid overheating & boiling; it can cause damage and burns. Do not use iron.
• Discard if there are punctures, leaks or bursts. contents are non toxic and non-caustic.
• Remove immediately if uncomfortable.

Important Notes:

• Adjust usage to preference and comfort.
• Store in a refrigerator or a cool, dry place.
• Follow professional advice for specific application duration and frequency.
• Seek medical advice if discomfort, swelling, or other concerns arise during recovery.