Oral Surgery Post-Operation Guide: Kail and Moore

To ensure a speedy recovery from oral surgey procedures, follow Kail and Moore’s post-operation guide based on the operation you underwent. If you have any questions after your surgery, contact our office and our team will assist you in getting back to 100%.

HOME CARE AFTER TOOTH EXTRACTION SURGERY

Please follow these instructions after you have had tooth extraction surgery

After tooth extraction, it is important for a blood clot to form to stop the bleeding and begin the healing process. Bite firmly on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to stop the flow of blood. Remember, pressure will stop bleeding, chewing on the gauze or loosely holding it in your mouth will further disturb the clot and prolong bleeding

After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will minimize swelling. Take pain medications as prescribed. The swelling usually subsides after 48 hours but may last for 7-10 days.

Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean. Avoid brushing the surgical site for at least 2 weeks.

After a few days you should feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, worsening swelling after 3-5 days, or a reaction to the medication, call our office immediately at 412-343-7855.

HOME CARE AFTER BONE GRAFTING SURGERY

The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant replacement of the extracted tooth.

Your bone graft may be made up of a clot only or many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. Its normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:

Do not disturb or touch the wound.
Avoid rinsing or spitting for 2 days to allow blood clot and graft material stabilization.
Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
Do not smoke.

Following the second day, gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules. If a partial denture or a flipper was placed in your mouth, you may have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.

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.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection.

Oral Hygiene

Do not rinse or spit on the day of your surgery. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. You should not have a significant amount of blood in your mouth. Saliva can be swallowed, even if slightly blood tinged.

Keeping your mouth clean after surgery is essential to reduce the risk of infection. Start salt water rinses the day following your procedure. Use one-half teaspoon 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 as often as you like, but at least four-to-five times daily and always after eating for the next five days.

Do not brush the teeth in the area of surgery for 48 hours. When brushing, be very gentle. When expectorating, also be gentle.

We may prescribe an antibiotic rinse (Chlorhexadine, PerioGard®, Peridex) for certain procedures. This rinse should be used in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse. Using this rinse for longer than two weeks may cause staining of your teeth but this will be able to be removed at your next dental cleaning

Smoking

Do not smoke for at least two weeks after surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of bone graft and sinus augmentation failure.

Wearing your Prosthesis or Nightguards

Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there are any questions. If you have a temporary flipper to wear do not insert it until the numbness in the area is gone. When it is inserted, it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial, or complete denture, do not wear it until your general dentist or our office can see you.

Post-Operative Problems or Complications

As with any procedure, unexpected post-operative healing can occur. If you notice the unexpected flow of air or liquids between your mouth and nose, please let us know immediately.

If you are aware of several small particles of graft material being discharged from your nose, let us know as well.

If you experience sinus or nasal congestion on the side your surgery was performed, let us know.

If there is an increase in swelling in your mouth, cheek or under your eye after 3 days, let us know.

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 at 412-343-7855

HOME CARE AFTER WISDOM TOOTH REMOVAL SURGERY

Please follow these instructions after you have had wisdom tooth removal surgery

Understanding what to expect and how to care for yourself during this time is crucial for a successful wisdom tooth removal.

IMMEDIATELY AFTER SURGERY

Immediately following your wisdom teeth removal surgery, it’s essential to take certain precautions to ensure a smooth recovery. Here’s what you need to know:
Keep the gauze pad placed over the surgical area in place and bite firmly for at least 30 minutes to control bleeding.
Avoid vigorous mouth rinsing or touching the wound area to prevent dislodging the blood clot.
Take prescribed pain medications before you begin to feel discomfort, typically when you get home but before the local anesthetic wears off.
Restrict your activities on the day of surgery and gradually resume normal activity as you feel comfortable.
Apply an ice pack to the affected area to reduce swelling and discomfort.

SENSATIONS TO EXPECT

Temporary numbness of the lip, chin, or tongue is normal.
Slight fever is common immediately after surgery.
Exercise caution when transitioning from lying down to standing to prevent lightheadedness.
Hard projections in the mouth are normal and usually resolve on their own.
Keep lips moist with an ointment like petroleum jelly if corners become stretched or cracked.
A sore throat and pain when swallowing is common and will subside in 2–3 days.
Jaw stiffness (Trismus) may occur but will resolve in time.

MANAGING BLEEDING & SWELLING

Bleeding and swelling are common after wisdom teeth removal. Some bleeding is normal after surgery, and it’s common to experience slight bleeding, oozing, or redness in the saliva.

If bleeding becomes excessive, you can take steps to control it:

For bleeding, gently bite on damp gauze for one hour after extraction and repeat as needed. If bleeding persists, try biting on a moistened black tea bag for thirty minutes. The tannic acid in black tea can help form a clot by contracting bleeding vessels.
Avoid lying flat and elevate your head with a pillow.
To reduce swelling, apply ice packs to the sides of your face where the surgery was performed for the first 24 hours. Afterward, switch to warm compresses.

PAIN MANAGEMENT & MEDICATION

Post-operative discomfort is normal after wisdom teeth removal.
For moderate pain relief, you can take one or two tablets of Tylenol or Extra Strength Tylenol every 3-4 hours. Alternatively, you may opt for Ibuprofen (Advil or Motrin) instead of Tylenol. Over-the-counter Ibuprofen typically comes in 200 mg tablets, and you can take 2-3 tablets up to four times a day, with a maximum daily dosage of 3200mg for adults. If you’re under 18, please consult our practice before taking these medications. It’s important not to take both medications simultaneously.
Take prescribed pain medication as directed, but avoid operating machinery or driving while under its influence.
Pain typically peaks 24-48 hours after surgery and gradually subsides. If pain persists or worsens, contact your oral surgeon for further instruction.
Avoid these medications if allergic or advised by your doctor.

DIETARY GUIDELINES

Maintaining a soft diet is crucial during the initial stages of recovery. High calorie and high protein intake is also very important for recovery. Our staff can provide suggested diet instructions.

What to eat and avoid:

Start with clear liquids and advance to soft, non-chewy foods like mashed potatoes, scrambled eggs, and pasta.
Avoid hot liquids and smoking, as these can interfere with healing and increase the risk of complications.
Drink from a glass and do not use a straw.
Drink at least 5-6 glasses of liquid per day.

ORAL HYGIENE & MOUTH CARE

Keeping your mouth clean is essential for preventing infection.

Oral hygiene tips:

Avoid vigorous rinsing for the first 24 hours, then rinse gently with warm salt water or prescribed mouthwash.
The day after surgery, rinse your mouth 5–6 times a day, especially after eating, with warm saltwater (1 tsp salt in 1 cup water).
Brush your teeth gently, avoiding the surgical site(s).

DISCOLORATION

Black, blue, green, or yellow discoloration may occur 2–3 days after surgery due to blood spreading beneath the tissues, which is a normal post-operative occurrence.

How to manage discoloration:

Apply moist heat to the area to help speed up the removal of discoloration.

ANTIBIOTICS

Antibiotics are prescribed post surgery to help prevent infection.

Take antibiotics as directed to prevent infection.
Discontinue use if any unfavorable reactions occur and contact our office immediately.

NAUSEA AND VOMITING

In the event of nausea and/or vomiting following surgery:

Refrain from taking anything by mouth for at least one hour if you experience nausea or vomiting.
Sip slowly on cola, tea, or ginger ale over fifteen minutes once the nausea subsides, then begin solid foods and prescribed medicine.

COMPLICATIONS & WARNING SIGNS

While complications are rare, it’s essential to be aware of potential warning signs.

Contact your oral surgeon if you experience:

Excessive bleeding that cannot be controlled with gauze.
Persistent pain, nausea, vomiting, swelling, or fever.
Dry socket symptoms, such as increased pain and a bad taste in your mouth.
Any concerns or questions about your recovery progress.

FINALLY

Sutures placed after surgery help minimize bleeding and aid healing; removal occurs approximately one week later.
The void left by the removed tooth will gradually fill with new tissue over the next month.
Each case is unique; consult with our experts for personalized care.
Adjust exercise routines due to reduced nourishment intake and potential weakness.

Have a question about how you are feeling? Not sure what to do next? Call our team at Kail and Moore Oral Surgery and we will guide you each step of the way

HOME CARE AFTER IMPLANT SURGERY

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Your dental implants most often have a “healing abutment” protruding through the gingiva. This eventually gets thrown away once the tooth or prosthesis is made, and provides an opening through your gums to access the implant. If it is not present, your implant will likely be “uncovered” via a local anesthesia procedure in 3-6 months.

Diet

Drink plenty of fluids, and avoid very hot liquids the day of surgery. Soft foods and should be eaten on the day of surgery, especially while still numb from the local anesthesia. Avoid abrasive foods, such as crusty breads, bagels, sharp chips, etc. in this area for about 5 days. These can break down the incision lines. At about 2 weeks the tissue around the implant’s healing abutment has matured enough you typically cannot hurt the implant or tissue with foods.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, wear the supplied ice packs, or apply an ice bag or a plastic bag or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously as much as possible for the first 36 hours. Swelling often peaks 48 -72 hours later, and a red flushness to the face often occurs on the third or fourth day after surgery.

Bleeding

Some bleeding or redness in the saliva is normal for 24-48 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. It is important not to move or disturb the gauze pad for these 30 minutes. This process may need to be repeated every 30 minutes for the first day after surgery. If bleeding continues, please call for further assistance.

Sutures

The sutures usually dissolve in 7-14 days. Your surgeon will let you know if any sutures are non-resorbable and need to be removed at a later date.

Pain

You should begin taking pain medication before you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil® or Motrin®) may be taken instead of Tylenol® and typically is much more effective. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets (400-600 mg) may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed narcotic medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it. Also, aspirin should not be taken at the same time as Ibuprofen or Aleve® (Naproxen).

Oral Hygiene

Good oral hygiene is essential to good healing. The day after surgery, the prescribed Peridex rinse should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 60 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) can be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas. Always use the softest toothbrush you can buy.

Loosening of the Healing Abutment

The healing abutment is hand-tightened onto your dental implant. There is no lock washer to keep it from unscrewing. On occasion therefore the healing abutment can become loose or come out. If it is loose for more than 1 day, typically your gums will grow underneath it, and will require local anesthesia to trim them and replace it. If it becomes loose during the first 3-6 weeks, depending on the situation, we often wait for more bone maturation until we go back and uncover the implant, replacing the healing abutment. Your implant will be just fine without the healing abutment on it.

Exercise

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise. If your implant was placed without a bone graft – there are minimal limitations on exercising starting the next day, as long as you can tolerate it.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures can often be worn after surgery, after your surgeon has adjusted them to fit, without pressure on the wound. It is very important to bring all prosthesis you wear to your consult and surgery appointments, so instruction and/or adjustments can be done for their use.

Post-Operative Depression

In many surgical procedures, intravenous and post-op steroids (usually dexamethasone) are administered to help control and minimize swelling. These typically give you a boost in energy and mood the first 2 days or so. Unfortunately, they often cause a mild rebound depression on the fourth or fifth day. This may be manifest as feeling slightly lethargic, having a poor pain tolerance, and sometimes grumpiness. By day six or seven, this usually resolves.

SOFT DIET SUGGESTIONS

Yogurt

Chef Boyardee or other canned pasta

Pudding

Soup

Mashed potatoes

Rice

Spaghetti (cut up)

Pancakes

Milkshakes

Eggs (scrambled, poached, etc.)

Smoothies

Grits, Oatmeal, etc.

Ice Cream (without nuts)

Macaroni & Cheese

Pasta Roni (cut up)

Baked Potatoes

Apple sauce

Jell-O

Carnation Instant Breakfast

Baby Food

** Remember, the rule is: If it can be cut with a soft plastic fork, it is usually safe to eat. Please call our office if you have any specific questions.

HOME CARE AFTER ORTHOGNATHIC (JAW) SURGERY

Following home care instructions is very important and will help with healing after surgery to minimize pain, discomfort, and swelling, while allowing the surrounding tissues to keep clean, aid with healing, and help to prevent potential complications.

BLEEDING:

Mild intermittent bleeding is common after surgery from the oral cavity, the nose, or both depending upon the surgery that took place. If upper jaw surgery is completed some bleeding from the nose is common after surgery as the surgical site continues healing and new tissues develop. Common causes of nose bleeding can be from quick positional head changes, excessive nose blowing, or exercising too soon. Sometimes bleeding from the nose can happen after a warm shower. If bleeding were to occur, gently tip your head back while gently pinching the bridge of your nose. Bleeding should stop within a few minutes. Typically, nose bleeding will have darker red color, and will bleed slowly. One to two sprays per nostril of oxymetazoline (Afrin) nasal spray can also help to constrict blood vessels and decrease bleeding. Continue to use saline nasal spray when you get home to prevent nasal crusting.

SWELLING:

After a jaw surgery procedure, there will be facial swelling and some swelling associated with the gum tissues around the surgical site. This can be present for several days to a few weeks after the procedure. Swelling typically develops over the first 1-2 days after the procedure and peaks 2-3 days after surgery. Most of this swelling will be gone within 2 weeks but it may take 6-8 weeks until the swelling is completely resolved. Some mild bruising may develop over the skin near the surgery sites 1-2 days after the procedure. This bruising can also last for a few weeks.

IBUPROFEN (MOTRIN AND ADVIL) AND ACETAMINOPHEN (TYLENOL):

These medications are the most commonly used medications for management of pain or discomfort after oral surgery procedures. These will help not only to minimize pain but also aid in reducing potential swelling.

Ibuprofen is typically prescribed as 600mg to be taken every 6 hours. This can be taken up to 5-7 days post-operatively if the patient has no medical reason to avoid this medication.

Acetaminophen is typically prescribed as 500mg to be taken every 6 hours. This can be done up to 5-7 days post-operatively if the patient has no medical reason to avoid this medication.

Please discuss any medication or dosage questions with your surgeon.

NARCOTIC (OPIOID) PAIN MEDICATION:

Post-operative discomfort is most often managed with only ibuprofen and acetaminophen, but you may be prescribed a narcotic (opioid) pain medication depending upon your procedure. Narcotic pain medication is generally only necessary during the first 3-4 days after surgery. It can be taken alternating with or at the same time as ibuprofen.

Discomfort after oral surgery procedures is most commonly felt 1-2 days after the surgical procedure and lasting up to a week. Some patients do have pain that lasts for several weeks, though this is not common.

Take narcotic medication with food, as a possible side effect of this medication is an upset stomach. Narcotics can also cause constipation. Drink fluids and use an over-the-counter stool softener if this occurs.

Narcotic pain medication is not a requirement after oral surgery procedures and should only be used as needed. This type of medication requires a paper prescription and cannot be called into a local pharmacy over the phone. If you do not use all of your narcotic pain medication, please return it to your local pharmacy for proper disposal. Discuss any questions about medication with your surgeon.

ANTIBIOTICS:

After your procedure, you may be prescribed antibiotics to prevent infection and help ensure healing. This medication should be started the day your procedure was completed. If you are nauseated, the medication can wait until morning. It is recommended to take this medication with food and/or a probiotic, as antibiotics can cause your stomach to become upset. If you experience gastrointestinal discomfort or diarrhea, please contact our office.

ICE APPLICATION:

Ice packs can help with post-operative swelling and pain discomfort. Apply the ice pack to the outside of the face over the cheek regions where the oral surgery procedure was completed. During the first 24 hours after a procedure, apply the ice packs for 30 minutes at a time and then remove the ice packs for 30 minutes. Repeat this process as necessary. Do not leave the ice in place for more than 30 minutes at a time, as this may irritate your skin.

DIET: “WHAT CAN I EAT AFTER MY JAW SURGERY?”

It is important that you eat a healthy diet after your jaw surgery. Proper nutrition will aid in the surgical site healing. Adhere to a strict, soft non-chew diet is very important to allow for the tissues to heal properly. A non-chew diet will be required typically for a minimum of 6 weeks after surgery has been completed. Foods that are typically well tolerated right after jaw surgery are soft, cool, non-chew foods such as yogurt, ice cream, or smoothies. Additional foods such as soup, pasta, macaroni, scrambled eggs, oatmeal, and cottage cheese, are also safe to eat as you continue to heal. Avoid food items that are sharp, crunchy, or sticky like chips, crackers, peanuts, toast, rice or fruits with lots of seeds. Any food requiring ripping or tearing or aggressive chewing (bagels, pizza crust, etc.) should also be avoided. Your doctor will help guide you as to when you can safely advance your diet throughout your healing after surgery.

ORAL HYGIENE AFTER JAW SURGERY: “WHAT SHOULD I DO?”

Good oral hygiene after jaw surgery is extremely important. This will help the surgical sites to heal, prevent infection, and to lesson discomfort in the area. Chlorhexidine mouth rinses three times daily will help to cleanse the oral cavity, especially for the first few days when brushing is uncomfortable. Brushing your teeth twice per day is recommended. You will be advised on how to specifically clean your mouth depending on your surgery. If you are unsure, ask your surgeon for brushing techniques and information.