Post-Operative Instructions

First 24 Hours

  • Go Home and get some rest, keeping your activities to a minimum.
  • Keep your head elevated while resting and sleeping.
  • It is important to take your medications as directed. You may have been given several prescriptions, please follow the instructions on each bottle carefully.
  • Avoid taking pain medications on an empty stomach.
  • If given an antibiotic, take it as prescribed until it is gone. Using an OTC probiotic such as Floragen3 is recommended in addition to your antibiotic.
  • Avoid brushing, or flossing your teeth today.
  • Avoid smoking for as long as possible after surgery. This can cause delayed healing, decreased success, and unnecessary pain.
  • Use Ice! The use of ice is essential in the control of swelling and discomfort. Alternate ice application 20 minutes on and 20 minutes off cold in the mouth will have optimal benefit.
  • Soft, cool or cold foods are recommended for today.

After 24 Hours

  • Brushing and flossing of the areas unaffected by surgery may resume today. Avoid all brushing, flossing at the surgical site. Use the recommended mouth rinse to soak the surgical site for 30-60 seconds 2-3 times daily. Warm salt water rinses several times a day may also be used if desired. (1 tsp salt per 8oz of water)
  • A warm compress may now be used for any swelling that has occurred and ice discontinued. The gel pack given to you after the surgery may be warmed in the microwave for 15-20 second intervals. (Do not overheat)
  • Continue on a soft diet for the next 5-7 days avoiding foods with small seeds. If your surgical site includes the front teeth, avoid biting foods with your front teeth cutting foods and chewing on back teeth only.

The of ice is a most important consideration in the control of swelling and discomfort. Swelling may occur as part of the healing response. An ice bag, used 12-24 hours following surgery, will reduce the amount of swelling and therefore reduce discomfort. Apply ice to the outside of your face in the area involved with the surgery. Letting ice rest in your mouth, eating ice cream, frozen yogurt, or drinking cold drinks are all beneficial.

Take your prescriptions as directed. You may have been given several prescriptions. Please follow the instructions on each bottle carefully. Pain medication should be taken with food or after you have eaten something to minimize the chances of nausea. If the pain medication is too strong or causing uncomfortable side effects, a non-aspirin compound such as Tylenol or Ibuprofen (Advil) may be substituted.

A sore throat may occur the day of or the day after surgery. It generally subsides within 48 hours. If this should occur, use a salt water gargle.

Discomfort varies greatly from one person to the next. Most occurs within the first 4 days and is generally mild to moderate in range. A person’s ability to tolerate discomfort can be improved by adequate rest, nutrition, and psychological preparation.

After the first few days the discomfort should diminish. Sometimes on or after the third day you will begin to feel more uncomfortable. This is bone ache and is part of the normal healing process. Ibuprofen (Advil) or similar medication is very effective for this. The teeth may become sore to bite on; therefore, soft foods are recommended. Please do not “clench or grind” your teeth together as this will increase the discomfort. It is typical to try to “feel” the teeth with the opposing teeth since they feel different after surgery.

A minor elevation in body temperature may be noticeable following surgery. This is normal and will disappear within 48 hours.

Other Considerations

  • The operated area may swell.
  • You may have a slight earache.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with cream or ointment.
  • Activity – some patients may feel tired for several days postoperatively. You will have less discomfort if you keep yourself busy; however, we encourage you to take it a bit easier for the first few days. Try to get as much rest as you can, at least eight hours of sleep per night.
  • Never mix pain medication and alcohol.
  • Smoking is an irritant that delays healing; the more you smoke, the slower the healing will be. Please try to minimize smoking as much as you can. We strongly recommend against any smoking for the first few hours postoperatively because excess bleeding may occur.

Dressing or Pack

With some surgeries, the dressing must stay in place for a full week. We will tell you if your dressing must stay in place. Otherwise, the protective dressing that may have been placed is for your comfort only. It does not affect healing. If the dressing falls off, don’t be alarmed. Most of the time the dressing does not need to be replaced. If there is a question about whether the packing should be replaced, please call our office. In general, if it feels comfortable, it does not need to be replaced. If a large piece is lost or if you are uncomfortable, we will be happy to apply a new dressing to the area.

Bleeding

Do not rinse your mouth for the first day. Slow oozing is normal for the first 24 hours following surgery. One drop of blood will discolor saliva to a light red color. Do not spit; just wipe away the oozing. If significant bleeding should occur, apply a moistened regular tea bag over the area and dressing material. Press down firmly using the thumb and forefinger. Apply firm pressure for twenty full minutes by the clock. This will usually stop the bleeding.

Avoid heavy lifting, excessive exercise, and bending over for the first 48 hours. When you lie down, prop your head up with 2 or more pillows to keep your head elevated above your heart. You may want to cover your pillow with an old pillowcase the first night following surgery as you may ooze a bit of blood while sleeping.

Avoid unnecessary spitting and/or rinsing. If excessive bleeding continues, telephone the office, (605) 348-2556 (phone answered 24 hours).

Diet

You will heal faster and better if you eat well. Don’t go on a reducing diet. Your gums are made of almost 100% protein, so you need protein to repair them. Carbohydrates give you quick energy and a feeling of well-being. Force yourself to eat and drink plenty of fluids. This is often a difficult recommendation as the medications for discomfort tend to decrease your appetite, and it may be uncomfortable to eat. Try eating small amounts of soft food at frequent intervals.

The protective dressings can be dislodged easily; therefore, soft foods such as eggs, ground meat, milk, cheese, beans, etc. are a good idea.

If you feel your diet is inadequate, supplement it with breakfast shakes or a similar protein supplement.

It is best to eat cold or cool foods the first eight hours after surgery in order to keep the swelling down.

IMPORTANT: A hungry person becomes irritable. It is a fact that a patient in this state is more susceptible to pain. The importance of a good diet cannot be overstressed, especially following surgery.

Dietary Suggestions

  • Avoid extremely hot food or drinks, letting them cool to a warm temperature.
  • Fruits: Soft and seedless such as bananas, applesauce, pears, peaches, etc.
  • Cereals such as oatmeal, rice, cream of wheat.
  • Eggs, soft breads, pancakes, soups, cottage cheese, jello.
  • Ground meats, fish.
  • Vegetables, potatoes, pasta, sufficiently cooked to soften.
  • Ice cream, milk shakes, smoothies, protein shakes, puddings, custard.
  • Avoid using a straw to prevent a suction effect.

Sinus Lift Surgery

Over the Counter Medications:

  • Sudafed – Take one tablet three times per day for three days, starting the day of surgery
  • Afrin or Vicks Nasal Spray – Use, if needed, for no longer than three days

Precautions:

  • Do not blow your nose. If you must sneeze, do so with your mouth open. This will avoid unnecessary pressure on the sinus.
  • Do not smoke or use smokeless tobacco. (for at least one day after surgery; two weeks is preferred)
  • Do not use a straw.
  • Do not pull up your lip to look at the stitches!
  • It is NOT UNUSUAL to feel small granules of graft material in your mouth.

Prescriptions

It is best to take all medication with food unless instructed otherwise.

  • Vicodin (Hydrocodone) This is a narcotic medication for discomfort. Take 1 every 4-6 hours as needed.
  • Ibuprofen (Advil) This is a non-narcotic medication for discomfort. Take 1 every 6-8 hours as needed for pain. This can be taken with Vicodin. Advil is very effective for post operative discomfort.
  • Antibiotic
    • Amoxicillin or Cleocin: Take 1 tab 3 times a day until all are taken.
    • Minocycline: Take 1 tab 2 times a day for first day, then 1 pill daily until all taken.
    • Other: follow instructions given
  • Medrol Dosepak (Methylprednisolone) Take as directed on package.
  • Mouth Rinse. Soak with 15ml morning & night.

Contact our office if:

  • A fever in excess of 101º F (38.3º C).
  • Excessive bleeding. For more information, see the “Bleeding” section.
  • Painful swelling beneath the lower jaw or ears.
  • Unusual reaction to any prescribed medication.

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