These instructions are intended to help you with recovery from oral surgery. A pamphlet with this information was/ will be provided to you in office on the day of your procedure. Please take time to read these instructions carefully. You may wish to refer back to these instructions for advice within the first post-operative week. Not all of the following information may apply to you. Instructions will be reviewed at your appointment prior to discharge by a member of our staff.

In the event you experience problems or have questions that are not discussed here, please call the office at (585) 413-0132. In the case of a dental emergency outside of our office hours, you can contact Dr. Johnson on his personal cellphone. His number is listed on the bottom of the post-operative pamphlet and on the office phone’s voicemail recording.

Recovery:

Your recovery from oral surgery will be influenced by a number of factors. These variables exert influences with regard to the level of pain, swelling, bleeding, and temporary functional limitations following the procedure. The type of surgery you undergo is one of the most significant factors. Other factors that may influence the patient’s recovery include: age, general health, surgical complications, pre- and post- operative oral hygiene, nutrition, and the presence or development of infection.

Bleeding:

Some continued bleeding is to be expected after surgery. Applying pressure to the bleeding sites will control and stop the bleeding. Bite firmly on the gauze pads provided to you post-procedure for periods of at least 30 to 40 minutes at a time. Make sure gauze pads are folded tightly and placed directly over the site of bleeding. Once the appropriate amount of time has passed, you may remove the pads and inspect the site for bleeding. Replace the gauze pads and resume biting if bleeding is still present. Biting pressure should only be stopped when all visible bleeding has stopped. All patients who have been under anesthesia should have another person change the gauze pads to assure that they are in the proper position. You can also use a tea bag placed in the same fashion as the gauze pads to help with clotting. Some oozing of blood may be seen for a period of 1 to 3 days. This is normal. Be careful when eating and brushing for the first two weeks following surgery to avoid further bleeding. 

Oral Hygiene:

Do not rinse vigorously, spit, or use commercial mouthwash on the day of surgery. Using a toothbrush on the first day around the surgical sites is not advised. These actions are likely to cause additional bleeding. Resume normal mouth cleaning on the day following the surgery. This will have to be done gently to avoid pain or early loss of stitches. Warm, salt water rinses (1/4 tsp. salt in 10 oz. of warm water) should be done 4 to 6 times a day for the first 3 to 5 days, starting the day after surgery. An irrigation syringe may be given to you to use for rinsing the surgical area directly (with the salt water rinse). This should only be used after day 5, so as not to disrupt the blood clot and to avoid additional bleeding. Food debris can be kept out of the socket with this device. You may find this useful for several weeks.

Nausea:

Nausea isn’t uncommon in the first 24 hours after oral surgery. There may be a number of causes. The most common causes are the presence of swallowed blood in the stomach, or sensitivity to pain medication. Thus, it is important to stop any bleeding as quickly as possible and to avoid narcotic pain medications, which cause nausea more often than compared to Tylenol or ibuprofen, as much as possible. You may vomit if blood is in your stomach. This is a normal reaction and may alleviate your nausea. Avoiding unnecessary movement and sipping carbonated liquids seems to help in most cases. Stay on liquids until nausea stops. You may be provided with medication for nausea which can be used as directed. If nausea is related to pain medication, stop taking the medication. If you cannot get pain under control with Tylenol, aspirin, or ibuprofen, another pain reliever will be prescribed. Contact Dr. Johnson if nausea persists beyond 24 hours.

Pain:

Pain is variable following oral surgery. In many cases pain will be mild and is best managed by nonprescription medications. Aspirin, acetaminophen, ibuprofen, or naproxen may be recommended. Dr. Johnson will write a prescription if the need for stronger medication is likely. Take your pain medication before the sensation of “numbness” wears off completely post-procedure and thereafter as directed until you are comfortable without medication. You may find a mild pain reliever is needed for up to a week following initial surgical pain.

Expect the first 3 to 5 hours following the return of sensation to be most uncomfortable. You may require a combination of pain medications during the first 24 hours. Alternating your prescription with aspirin, acetaminophen, or ibuprofen may be suggested to control pain that is more severe. Placing ice over the affected area will also be helpful.

Swelling:

Ice packs to the face for 35 to 45 minutes each hour for the first 24 hours is ESSENTIAL if you wish to minimize facial jaw swelling. Keep your head elevated (even while sleeping) during the first 48 hours. When swelling does occur, it is usually associated with jaw stiffness. Swelling will likely begin to resolve on the 3rd to 4th day after surgery and is usually completely gone by the end of the first week, post-op. If swelling returns after having gone away initially, you should contact the office as this may indicate the development of an infection.

Diet:

The type and complexity of your surgery will influence your post-operative diet. In some cases, a normal diet can be resumed the day of the surgery. Dietary restrictions may be advised to promote better healing. Generally, a liquid or soft diet will be advised for the day of the surgery. You may progress to a regular diet as tolerated. Avoid foods that are uncomfortable to chew. Clear liquids such as fruit juice, soda, broth, or Jello tend to settle best with patients who have had sedation/general anesthesia and/or wisdom teeth surgery. Drink plenty of liquids while you are not eating solid food.  Liquid diet supplements may be advised if a regular diet cannot be resumed within 3 or 4 days.

Activity:

Rest is generally recommended following surgery of any kind. Your head should remain elevated at all times for the first 48 hours, even while sleeping. This will minimize the amount of bleeding, swelling, and pain you experience. Once bleeding has stopped, activity may be resumed for those patients having minor surgical procedures. Resting for the entire day is essential for patients undergoing more involved procedures, or those who have had IV sedation or general anesthesia. If you will be out of work or school for an extended period of time, a doctor’s excuse will be provided upon request.

Dry Socket:

The development of a “dry socket” is probably the most common complication following the removal of teeth. This happens almost exclusively in the lower jaw, and is generally associated with the removal of impacted teeth, surgery in affected areas, or teeth that are difficult to remove. This condition is classically described as moderate to sever pain in the area of surgery 5 to 7 days after the procedure. Radiation of pain to the ear or to other teeth and surrounding areas is common. A bad taste or odor typically accompanies the pain. Even narcotic pain medication seems relatively ineffective in managing pain for a patient with a dry socket.

There is no clear understanding today what causes a dry socket. Your risk for a dry socket can be minimized by avoiding smoking, vigorous mouth rinsing, spitting, and drinking through a straw in the first week post-op. There is currently no protocol to completely prevent a dry socket. If you develop the symptoms of a dry socket, please contact the office so that treatment can be arranged. This usually involves the placement of a medicated dressing in the tooth socket. In most cases this completely eliminates or dramatically reduces pain rapidly. Dressing changes will be arranged to keep you comfortable while the condition is resolving.

Post-Operative Appointment

A post-op appointment is not routinely made for most procedures unless scheduled for you by Dr. Johnson. Please call the office if you haven’t been scheduled for a post-op appointment and feel that you need to be seen for any reason.