Post-Operative Instructions Day 1

Care of the mouth after surgery has an important effect on healing.  SWELLING, DISCOMFORT, RESTRICTED JAW FUNCTION IS EXPECTED, and need not cause alarm.  Following these instructions may minimize these.  Please read them carefully. 

HEMORRHAGE CONTROLS:  When the gauze placed over your surgical site becomes saturated and soggy it is time to change it.

  1. Place the slightly moist gauze directly over the surgical site (wet sparingly with cool water).  It is easy to displace the gauze (especially if you are numb) so you may want to have some assistance to ensure the gauze is directly over the surgical site
  1. Gently close your teeth placing firm (but not painful) pressure on the gauze. Please take care not to bite your tongue or cheek during this process if you are still numb.
  1. Maintain the gauze in this position with light biting pressure until it is fully saturated. You may then change it. Check the saturation no more than once an hour. You will find that your first few pieces of gauze will be in for shorter periods of time.  As your bleeding slows you will have the subsequent pieces of gauze in for longer periods of time.
  1. Please be sure the gauze is fully saturated before removing it.  If it is rather dry and you need to remove it, use a little bit of water from a cup to moisten it before removal.  This will reduce the likelihood of your newly formed blood clots from being displaced or adhering to the gauze when you change it.
  1. Bleeding typically lasts for 4-6 hrs. It is normal to have ‘oozing’ from the surgery sites for 24 hours.  You may find blood-tinged saliva on your pillow the next morning so it is advisable to use an old pillowcase the first night.
  1. If bleeding persists, remove the gauze, slightly moisten a teabag, place over the extraction site and bite down firmly for 30 minutes.  The tannic acid in the teabag will help stop the bleeding.  Herbal teas do not contain tannic acid and are not effective to control the bleeding.
  1. Keep your head elevated above your heart with pillows while in bed, or use a lounge chair the first 24 hours after surgery.
  1. Do not spit, rinse or use a straw the first 5-7 days after surgery as these movements can displace the newly formed blood clots and prolong bleeding.
  1. Do not smoke for 5-7 days after surgery as this can increase bleeding as well as interfere with healing.

PAIN AND INFECTION CONTROL:  Ordinarily, the use of over the counter medications, such as ibuprofen (Advil) or Tylenol will adequately relieve pain when taken 2 tablets every 4 hours.  Children should receive a smaller dose of between 1/6 and ½ the adult dose, and only if necessary.  If you have been given a prescription, have it filled and take as directed on the package.  If you develop hives or a rash, discontinue all medication and immediately contact our office.  Always eat food when taking pain medications.

WHEN YOU ARRIVE AT HOME:  Eat First, take 1 Vicodin tablet.  Take an ibuprofen 2-3 hours later.  Take the ibuprofen around the clock – every 4-6 hours, at meal times and with snacks.  Take the Vicodin every 4 hours if needed for acute pain. 

 

******WARNING******

DO NOT DRIVE OR OPERATE MECHANICAL EQUIPMENT AFTER TAKING PAIN MEDICATION.  CODEINE AND RELATED NARCOTIC PRODUCTS CAN CAUSE RESPIRATORY DEPRESSION.  TAKE ONLY AS DIRECTED.  CALL THIS OFFICE IF ANY BREATHING DIFFICULTIES ARISE.

 

SWELLING CONTROL:  Apply an ice pack to the jaw immediately upon your return home, 20 minutes ON and 20 minutes OFF.  Continue using the ice packs for 8-10 hours.  Your largest swelling (peak swelling) usually occurs at the end of the third post-surgical day.  This increased swelling can result in increased discomfort during this period.  The more you apply ice to your face the first 8-12 hours post surgically the smaller this swelling will be and as a result the more comfortable you will be.  This first 8-12 hours is the optimum window of opportunity to use ice to control your  swelling.

DIET:  A cool semi-liquid diet is recommended the day of surgery, such as applesauce, Jell-O, yogurt, smoothies/milkshakes… Please do not choose hot foods or drinks the day of surgery—as this encourages bleeding. Soft foods are recommended for another two days (well cooked pasta, soup, eggs…).  Increase your fluid intake.  Resume your normal diet as soon as possible. (Popcorn, nuts, seeds not a good idea.)  DO NOT USE STRAWS for 7 days!   This will increase bleeding.

NAUSEA:  A small amount of a carbonated drink, flat Coca-Cola or ginger ale, every 5 or 6 hours will usually terminate nausea.  Follow this with mild tea or clear soup, etc.  Please avoid foods high in acids (e.g. orange juice, pineapple juice, cranberry juice) as they can contribute to nausea.  If fruit juices are desired, try less acid juices such as apple, white-grape or carrot juice.  If nausea persists, contact this office for assistance.

Sports/Exercise: Please refrain from activities that increase heart rate for the first week after surgery. Listen to your body. If while exercising you notice throbbing or bleeding-STOP. Contact our office with any concerns.

 

IN CASE OF ANY ABNORMAL DISTURBANCE, CONTACT THIS OFFICE AT:

Santa Cruz Office Phone Number 831-475-0221

If you are unable to reach a doctor, contact:

Dominican Santa Cruz Hospital (831) 462-7730