Post-Operative Instructions in Caldwell and Florham Park, NJ
It is our goal at the NJ Center for Oral Surgery that your recovery be as smooth and comfortable as possible. By carefully following these instruction you will minimize any pain and swelling and lessen the chance for infection and complications.
- PAIN MEDICATION – If instructed by your surgeon, you should take over-the-counter Motrin or Advil, 2 tablets every 6 hours continuously for the first two days. The active generic ingredient is ibuprofen and you may find the store brand equally effective and less expensive. Take the first dose immediately and before the local anesthesia has worn off. You may use the prescription medication on top of and in-addition-to the Motrin/Advil tablets as needed.
- GAUZE PRESSURE – Bite down firmly on the gauze packs that have been placed over the surgical areas, make sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is heavy. After 30 minutes, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 20 to 30 minutes). It is best to slightly moisten the gauze with tap water and loosely fluff for more comfortable positioning. Bleeding from oral surgery may take 24 hours to fully stop. Read below.
- PROTECTING THE BLOOD CLOT – Do not rinse, smoke, or drink with a straw for at least 48 hours after your surgery. If you have been prescribed an antibiotic mouthwash, you may begin to use it gently at bedtime the night of your surgery.
The chemicals in cigarettes are caustic and will significantly delay healing, increase post-operative pain, swelling, risk of infection, and dry socket.
- ICE PACKS – Swelling is common following oral surgery. Swelling can be minimized by using cold packs, or a bag of frozen peas applied firmly to the cheek nearest to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. Do not use any ice after the first 48 hours.
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- PROBIOTICS may prevent and relieve some of the common side effects of antibiotics such as nausea, stomach upset, and diarrhea. Probiotics are considered safe and are naturally contained in products such as yogurt. We recommend taking PROBIOTICS while you are taking antibiotics we prescribe for you. Probiotics come in several forms and can be obtained over-the-counter at your local pharmacy or supermarket. It is important that you notify your doctor if you experience side effects as they may also be a sign of other serious conditions that may require medical attention.
AFTER THE FIRST HOUR
- PERSISTENT BLEEDING – Mild bleeding or oozing is normal during the first 24 hours. If necessary reposition the gauze packs directly over the surgical site. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. The tea contains a beneficial chemical that locally constricts blood vessels. If bleeding remains uncontrolled after a full hour of using the tea bags, call our office. Remove the gauze while you eat and sleep. Place an old towel over your pillow, as one drop of blood will turn a mouth full of saliva red. It is completely normal to experience mild oozing of blood from the surgical area for a full 24 hrs. Once the bleeding has stopped you do not have to use anymore gauze.
- STEROIDS – If you have been prescribed medicine to minimize swelling, be sure to take as directed on the box. You should take the first group of day 1 pills all together at bedtime tonight.
- MOUTH OPENING EXERCISES – Jaw stiffness is common following oral surgery. You can reduce this stiffness by stretching your mouth open with two fingers each hour.
- MANAGING POST-OPERATIVE PAIN – Unfortunately, most oral surgery is accompanied by some degree of discomfort and you may be given a prescription for pain medication. To best manage your discomfort, you should take the first pill before the numbness has worn off. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. You must call for a refill during normal weekday business hours, if you anticipate needing more pain medication for the weekend.
- NAUSEA – Nausea can occur after anesthesia or surgery. It generally improves within 4-6 hours. Nausea following anesthesia is best managed by avoiding all foods until you are feeling hungry. Try sipping small amounts of clear liquids to prevent dehydration. If the pain medication is the cause, try taking Maalox immediately before the medication and drink plenty of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may also help with nausea.
- PAIN MEDICATION PRECAUTIONS – The prescription pain medication given to you by the doctor may cause drowsiness, decreased reaction time, blurred vision and change in mental status. Do not drive, operate dangerous machinery, make important decisions or perform strenuous exercises while taking these medications. Failure to follow these instructions increases your risk of causing injury to yourself and others.
POST-OP DAY #2 AND BEYOND
- ORAL HYGIENE – Keeping your mouth clean after surgery is essential. In addition to any prescription mouthwashes you may have been given, you may use 1/4 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 twice a day. Avoid commercial mouthwashes, the alcohol they contain may irritate the surgical site. Please exercise caution when brushing around the surgical site by doing so very gently for the first two weeks. We do encourage you to brush and floss all other areas as you normally would. Good oral hygiene is key to a healthy surgical site.
- HEALING – Normal healing after tooth extraction should be as follows: The first three days after surgery are generally the most uncomfortable and there is usually some swelling. On the 4th day you should be more comfortable and, although still swollen, can usually begin a more normal diet. The remainder of the post-operative course should be a gradual, steady improvement. If you do not see continued improvement, please call our office.
- DRY SOCKET – A dry socket is a painful condition that results from premature loss of the blood clot. Risk factors for developing a dry socket are extracting painful or infected teeth, wisdom tooth surgery, females, smokers, and oral contraceptives. Symptoms of a dry socket typically occur on the 3rd or 4th post-operative day. Severe throbbing pain, which is not responsive to pain medications and bad breath, are the usual complaints. This condition requires an office visit where your surgeon will gently place a medicated dressing into the tooth socket. Pain relief is often immediate once the site is treated. A few visits may be necessary in some cases.
- SHARP EDGES/SUTURES – If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the bony walls, which once supported the extracted teeth or the ends of the sutures. Occasionally small slivers of bone may work themselves out during the following weeks. This is normal but if they cause concern or discomfort, please call the office. Dissolvable stitches begin to melt away as you heal. Loose ends may be cut short with a clean sharp scissors or gently pulled.
Following these instructions will assist you, but if you have questions about your progress, please call the office. Calling during office hours will result in a faster response to your question or concern. PLEASE NOTE: Telephone calls for renewing narcotic (pain killer) prescriptions must be made during regular office hours as pharmacy’s do not accept over-the-phone narcotic refills.