Post- Procedure Instructions

PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY. The after-effects of oral surgery vary per individual, so not all these instructions may apply. Please feel free to call us at any time if you have any questions or concerns following your treatment. After office hours, if you are experiencing an urgent post-operative concern that cannot wait, please call 911 or visit your nearest emergency room.  Otherwise, please give our office a call and follow the instructions provided to leave Dr. Abel a voice mail message.  Your call will be returned as soon as he is able to do so.

Restrictions

1. Avoid wearing your retainer or CPAP mask on the night of surgery – it is okay to resume wearing these the day after surgery
2. Avoid smoking, drinking through straws, or strenuous physical activity for 1 week after surgery
3. Avoid contact sports or blowing through wind instruments for 2 weeks after surgery
4. Avoid eating crunchy foods (e.g. popcorn, chips, pretzels, nuts) for 4 weeks after surgery
5. Avoid swimming in ocean or lake water for 4 weeks after surgery

Bleeding

Bite down gently but firmly on the gauze packs that have been placed over the surgical area(s), making sure that they remain in place. Do not change them for the first 30-45 minutes after surgery.  If active bleeding persists after 45 minutes, replace with fresh moistened gauze packs over the surgical site(s) to obtain pressure for another 30-45 minutes. The gauze may be changed as necessary every 30-45 minutes and should be moistened with cold tap water prior to placement. If your bleeding is severe, it usually means that the gauze packs are being clenched between your teeth rather than exerting pressure on the surgical site(s). Try repositioning fresh moistened gauze packs. If bleeding persists or becomes heavy, you may substitute a moistened tea bag. DO NOT SLEEP WITH GAUZE IN YOUR MOUTH, unless the gauze has strings attached that hang outside of your mouth. It is normal to have pink or red saliva on your pillow overnight on the night of your procedure.  It is best to sleep with your head and upper body elevated and to cover your pillow with a towel or old pillowcase.

Rest

If you received oral or IV sedation for your procedure, return home as soon as possible upon leaving our facility and have your driver accompany you from the car to a bed, sofa, or recliner.  Remain lying down with your head and upper body elevated until all of the effects of your sedation have disappeared. DO NOT SLEEP WITH GAUZE IN YOUR MOUTH, unless the gauze has strings attached that hang outside of your mouth. Someone should accompany you any time that you are up and moving around. Anesthetic effects vary by individual, and you may feel drowsy for a short period of time or for several hours. If you’ve received sedation of any kind, you should not operate any mechanical equipment nor drive a motor vehicle for the remainder of the day of surgery.

Cold Compresses

Apply cold compresses (e.g. ice packs, bags of frozen peas) externally to your face continuously for 20 minutes on and 20 minutes off on the day of surgery. This will help to lessen bleeding and decrease initial swelling. DO NOT APPLY ICE TO YOUR FACE AFTER THE DAY OF THE PROCEDURE, as this will slow healing.

Food

Be sure to remove any gauze packs from your mouth BEFORE having anything to eat or drink! Immediately following your procedure, start by drinking cold temperature clear liquids without using a straw. If you tolerate clear liquids, you may then progress to cold, soft foods for the remainder of the day of surgery (e.g. yogurt, pudding, ice cream). On the day after surgery, you may have warmer, soft foods (e.g. scrambled eggs, mashed potatoes, pasta).

Pain

Unfortunately, pain and soreness are to be expected on the day of surgery. It is best to “stay ahead of the pain,” by taking acetaminophen (i.e. Tylenol), ibuprofen (i.e. Advil), or naproxen (i.e. Aleve) while you are still numb from your procedure. If Dr. Abel prescribed you prescription-strength ibuprofen (i.e. Motrin), then be sure to take this before the novocaine wears off. If you experience severe pain on the day of the procedure, then supplement the Motrin with either Tylenol or with the prescription-strength opioid (e.g. codeine, hydrocodone, oxycodone) that Dr. Abel prescribed you. Opioid pain medication is addictive and should only be taken for short periods of time at the lowest effective dose. Opioids are most effective when taken in conjunction with NSAIDs (e.g. naproxen, ibuprofen) or with Tylenol. If your opioid pain medication contains acetaminophen, be sure not to take additional Tylenol while you are taking your opioid. Remember, DO NOT OPERATE ANY MECHANICAL EQUIPMENT NOR DRIVE A MOTOR VEHICLE while taking an opioid.

Nausea

Nausea can occur as a side effect of oral or IV sedation, as well as from opioid pain medication. Be sure that you can hold down clear liquids without vomiting before advancing your diet to soft foods. Additionally, opioid pain medication should not be taken on an empty stomach to lessen the chances that it will cause nausea. If Dr. Abel prescribed you anti-nausea medication, be sure to take it if you experience nausea after your procedure to avoid vomiting, if possible.

Mouth Care

It is important to not disturb your surgical site(s) that are still at an early stage in healing. You may brush your teeth away from the site(s) of the procedure, but you should avoid the area(s) right where Dr. Abel worked. Avoid rinsing or spitting on the day of surgery, as this may stimulate further bleeding and could disturb your surgical site(s). If you had teeth extracted or implants placed, you may start rinsing your mouth on the day after surgery by taking a cup of cold water, microwaving it so that it is warm, stirring in a ½ teaspoon of salt, and allowing the warm salt water to soak in your mouth over the surgical site(s) for 30 seconds. Then, gently rinse your mouth and gently spit into a sink. Vigorous mouth rinses could disturb blood clots that are only freshly formed at your surgical site(s). If you underwent a bone grafting or soft tissue grafting procedure, it is best to refrain from rinsing, sucking, or spitting for the first 3 days after surgery.  Aggressive rinsing during the early phases of healing could dislodge bone or soft tissue grafts and impair healing!

Warm Compresses

Begin applying warm compresses (e.g. heating pads, microwaveable gel packs, microwaveable bean bags) externally to your face starting 1-2 days after surgery for 20 minutes 3 times per day for 1 week. This will eventually help to decrease swelling and promote healing.

Syringe

If you were given an irrigating syringe, this syringe is only to be used if food is trapped at your surgical site(s). You may use this syringe to irrigate your mouth gently beginning 3 days after surgery. Draw up a syringe full of warm salt water and gently spray the surgical area(s) from an inch or so away without penetrating the wounds with the syringe tip.

It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions or concerns about your progress, please call our office at 603-622-9441. Calling during normal office hours will get you the fastest response to your problem. After office hours, if you are experiencing an urgent post-operative concern that cannot wait, please call 911 or visit your nearest emergency room.  Otherwise, please give our office a call and follow the instructions provided to leave Dr. Abel a voice mail message.  Your call will be returned as soon as he is able to do so.