You have just had a surgical procedure that requires some personal home care on your part. A certain amount of pain, bleeding and swelling is to be expected and should not be cause for worry. Everyone in this office is interested in your comfort and speedy recovery. Your cooperation with the following instructions will go a long way toward helping you have a smooth and uneventful postoperative course. Postoperative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if you follow the instructions carefully.
We normally expect swelling proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and the 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 two to three days postoperatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw-stiffness persists for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain – One or two tablets of Tylenol®, Extra Strength Tylenol® or ibuprofen (Motrin® or Advil®) 200 mg tablets may be taken every three to four hours. Be sure to take pain medication on a full stomach to avoid stomach trouble.
For severe pain – Take the prescribed narcotic as directed. The narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Do not smoke for at least four days following surgery. Smoking will delay normal healing and increase the intensity and duration of your postoperative pain.
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 rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened, squeeze-dried tea bag for sixty minutes and repeat as necessary. The tannic acid in the dry tea bag helps to form a clot by contracting the bleeding vessels. To minimize further bleeding: relax, sit upright and avoid exercise. If bleeding does not subside, call for further instructions.
After general anesthetic or IV sedation, take liquids – we recommend any sports drink – once the numbness wears off. Do not use a straw; drink from a glass. Sucking on a straw can cause more bleeding by dislodging the blood clot. You may eat anything soft, but chew away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. Consume at least five to six glasses of liquid daily in order to prevent dehydration. Your food intake will be limited for the first few days, so compensate for this by increasing your fluid intake. Try not to miss a single meal. You will feel better, have more strength, experience less discomfort and heal faster, if you continue to eat.
Caution: If you suddenly sit or stand up from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep the Mouth Clean
No rinsing or spitting of any kind should be performed, until the day following surgery. You can brush your teeth the night of surgery, but rinse gently. The day after surgery you should begin rinsing at least five or six times a day, especially after eating. Use a cup of warm water mixed with a teaspoon of salt.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days postoperatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. We will give you antibiotics to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, take nothing by mouth for at least an hour, including the prescribed medicine. You should then sip on Coke, tea or ginger ale. Sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine; but stop the narcotic pain medication.
- If numbness of the lip, chin or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Dr. Cherry if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol® or ibuprofen should be taken to reduce the fever.
- You should be careful going from lying down to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light-headed if you stand up suddenly. Before standing up, you should sit for one minute.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Cherry.
- If the corners of your mouth are stretched, they may dry out and crack. Keep your lips moist with an ointment such as Vaseline®.
- Sore throat and pain when swallowing is not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two or three days.
- Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal postoperative event which will resolve in time.
Sutures closing the area of surgery minimize postoperative bleeding and help healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the dislodged suture from your mouth and discard it. We will remove the sutures approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about. The pain and swelling should subside more and more each day following surgery. If your postoperative pain or swelling worsens or unusual symptoms occur, call the office for instructions. There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, keep the area clean, especially after meals, with saltwater rinses or a toothbrush. Your case is individual; no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Cherry or your family dentist. Brushing your teeth is okay – just be gentle at the surgical sites. A dry socket is when the blood clot dissolves from the tooth socket prematurely. Symptoms of pain at the surgical site, and even pain to the ear, may occur two or three days following surgery. Pain should not increase with time. Call the office if this occurs. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light-headed, stop exercising.