Advice for After Oral Surgery in Carlsbad

Immediately Following Surgery

• The gauze pads placed over the surgical area should be kept in place for 10-20 minutes and changed until the bleeding stops. Do not sleep with gauze in your mouth.
• Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the formed blood clot to become dislodged.
• Take the prescribed medications as directed.
• Restrict your activities for the first 4-5 days after surgery and resume normal activity when you feel comfortable.
• Place ice packs on the sides of your face where surgery was performed for the first 24-48 hours. Refer to the section on swelling for a more thorough explanation.

Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Direct pressure by biting on a gauze pad will decrease the bleeding. Extra gauze will be given to you after surgery to take home to switch out every 10-20 minutes and change until the bleeding stops. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in black tea helps form a clot by contracting the blood vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding is uncontrollable and is not slowing down after 24 hours, please call for further instructions.

Swelling
The swelling that is normally expected is usually proportional to the extent of the surgery. Swelling around the mouth, cheeks, eyes, and 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 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed for the first 24 hours. The ice packs should be used intermittently every 20 minutes while you are awake. After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. 48 hours after surgery, applying moist heat to the sides of the face can help reduce swelling.

Diet
Drink from a glass and do not use straws. Do not have hot foods. Warm and cold soft foods are ok. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high-calorie, high-protein intake is very important. Our staff can provide dietary recommendations. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.

Pain
You should begin taking pain medication before the local anesthetic wears off. Initially, it is recommended you take a combination of ibuprofen and Tylenol. Some patients will receive a narcotic prescription as a backup. We recommend that when you get home, you eat a little food. At post-op, you will be directed as to how to handle your pain medications. Do not take any of the above medications if you are allergic to them, or have been instructed by your doctor not to take them. Do not drive an automobile or work around machinery if taking a narcotic. Avoid alcoholic beverages. Pain or discomfort following surgery should gradually subside each day. If pain persists, it may require attention, and you should call the office.

Keep the mouth clean
Good oral hygiene is essential to good healing. You should also be rinsing with warm salt water rinses (one teaspoon of salt in a cup of warm water) 2-3 times a day. All rinsing should be performed gently and without spitting. Once you are through rinsing, you should lean forward over the sink and let the liquid fall out of your mouth without spitting. Be sure to rinse for at least 30 seconds. Brush your teeth, and be careful as you approach the extraction sites so you don’t disrupt the healing tissue. Be gentle initially while brushing around the surgical areas.

Discoloration
In some cases, skin discoloration follows swelling. This is not an unusual post-op occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration. Discolored lines may appear at the corner of the mouth after surgery, which typically resolve within 1 week.

Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on a sugared soda. You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. Contact the office if it does not resolve.

Other Complications

• If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. You will be numb for the first 4-6 hours after surgery from the local anesthetic. As reviewed in your consultation,, numbness is usually temporary. You should be aware that if your lip or tongue is numb, you could bite it without feeling it. Call Dr. Tracy if you have any questions.
• A slight elevation in 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 the lying down position to standing. You could get lightheaded from low blood sugar or medications. Before standing up, 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 that support the tooth. These projections usually smooth out over time as the bone remodels. If not, they can be removed.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
• Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
• Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve with time.

Finally
Sutures are often placed in the surgical area to minimize postoperative bleeding and promote healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures are dissolvable and should fall out within a few days to a week. The pain and swelling should subside further each day following surgery. If your post-operative pain or swelling worsens, or if you experience unusual symptoms, call our office for instructions.

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

Your case is unique; no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Tracy or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

A dry socket is an occasional complication that is not serious. Symptoms of pain at the surgical site and even pain near the ear may occur 3-5 days following surgery. Call the office if this occurs.

If you are regularly active, you should stop exercising for 7 days after surgery. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get lightheaded, stop exercising.