PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY. The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please feel free to call our office any time should you have any questions, or are experiencing any unusual symptoms following your treatment.
DAY OF SURGERY:
IMMEDIATELY AFTER SURGERY. Patients who received a general anesthetic should return home from the office immediately upon discharge, and lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects vary by individual, and you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours or longer if you feel any residual effect from the anesthetic.
1. Do not drive or use appliances or equipment that could be dangerous. These medications can make you drowsy.
2. Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.
3. Do not make any important decisions. You may change your mind tomorrow.
4. Do not drink any alcoholic beverages. The drugs in your body may cause your reaction to alcohol to be dangerous.
5. If you feel nauseated or sick to your stomach, drink clear liquids like sprite, broth, apple juice, ginger ale, tea. Once you are able to tolerate liquids you can try eating soft foods like potatoes, pudding, jello, smoothies,(NO DRINKING THROUGH A STRAW). Eat any nourishing food that can be taken with comfort. Over the next several days, you may progress to more solid foods.
ORAL HYGIENE AND CARE. Do not disturb the surgical area today. Bite down gently but firmly on the gauze pack that we have initially placed over the surgical area, making sure that they remain in place. Do not change them for the first hour unless the bleeding is not being controlled. This is important to allow blood clot formation on the surgery site. The gauze may be changed when necessary and/or repositioned for comfort. DO NOT drink with a straw and DO NOT rinse or brush your teeth vigorously or probe the area with the tongue, any objects or your fingers. You may brush your teeth gently, carefully avoiding the surgical site. DO NOT SMOKE for at least 48 hours, since it is detrimental to the healing process.
Evening after surgery or day two, start rinsing your mouth with a warm salt water rinse (1/2 tsp. salt with 1 cup water) every 2-3 hours. Continue this for several days, then rinse 3-4 times a day for the next 2 weeks. You may start normal tooth brushing the day after the surgery or after bleeding is controlled. It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.
BLEEDING. Some bleeding is normal, and blood-tinged saliva may be present for 24 hours. This may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes. Do not keep changing the gauze because you see blood – you will keep pulling out the blood clot. Lease the gauze in place as long as possible. Bleeding should not be severe. If bleeding persists, this may due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgery site. Try repositioning the gauze. If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in hot water, squeezed dry and wrapped in a moist gauze) on the area for 20-30 minutes. If bleeding continues, please call our office.
FEVER. An increased temperature of 100-101 is not unusual for a few days following surgery. If after the third postoperative day your temperature is greater than 101, please contact our office.
SWELLING OR BRUISING. Swelling is to be expected, and usually reaches its maximum in 48 hours. To minimize swelling, cold packs or ice bag wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied 20 minutes on then removed for 20 minutes during the first 12-24 hours after surgery. If you were prescribed medicine for the control of swelling, be sure to take it as directed. After 24 hours, it is usually best to switch from using the cold pack to applying moist heat or heating pad to the same area, until swelling has receded. Bruising may also occur, but should disappear soon. Tightness of the jaw muscles may cause difficulty in opening the mouth. This should disappear within 7 days. Keep lips moist with cream or vaseline to prevent cracking or chapping. When an anti-swelling medication such as Medrol Dose Pack (Methylprednisolone) is prescribed your face may feel warm and appear red. This is a side effect of this medication and is not an allergy. To correct these problems discontinue the medication. It will take a few days for the symptoms to disappear. Occasionally these medications can cause hiccups as well.
DIET. It is advisable to confine the first day’s food intake to bland liquids or pureed or soft foods. Avoid foods like nuts, sunflower seeds or popcorn, which may get lodged in the socket areas. Over the next several days, you may progress to more solid foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.
NAUSEA/VOMITING. After IV sedation or general anesthesia, some patients may feel nauseated and vomit. To help avoid this problem, do not take your medications on an empty stomach. Hold off on your medications if possible until nausea subsides. If you were prescribed Phenergan for nausea/vomiting take medication as needed. Try to stay hydrated with liquids. Sometimes, patients feel nauseated from the prescribed pain medications, particularly the stronger pain medications, Try stopping the pain medications and see if nausea subsides. If you have continued nausea and vomiting, call our office for further instructions.
PAIN AND MEDICATIONS. Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication prescribed as directed. The local anesthetic administered with the general anesthetic during your surgery normally has a 3-hour duration, and it may be difficult to control the pain once the anesthetic wears off. We therefore, advise you to take the pain medication 2 hours immediately after your surgery. If you do not achieve adequate pain relief, you may supplement each pill with an analgesic such as aspirin or acetaminophen. Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset.
If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
SUTURES. Sutures (stitches) are placed in the area of surgery to minimize post-operative bleeding and to facilitate healing. We use absorbable sutures which may break into fragments as they begin to dissolve. Do not be alarmed as this is completely normal. Remove any dislodged suture from your mouth and discard it.
SHARP EDGES. If your feel something hard or sharp in the surgical areas, it is likely you are feeling pieces of bone which once supported the teeth extracted. Occasionally small slivers of bones may work themselves out. If they cause concern or discomfort, please call the office. These bumps usually smooth out on their own. If not, they can be removed by the doctor.
ORTHODONTIC APPLIANCES. If you wear orthodontic appliances, replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.
SORE THROAT/STIFF MUSCLES. The muscles get swollen and this may make swallowing painful. This should go away on its own in 2-3 days. This may cause a limitation in opening the mouth wide for a few days after surgery. this is normal post-operative even that usually resolves during the week after surgery. Stretching these muscles may help speed up resolution of this problem.
INSTRUCTIONS FOR THE FOLLOWING DAYS:
ORAL HYGIENE. Keeping your mouth clean after oral surgery is essential. Keep using warm salt water rinses to rinse your mouth at least 2-3 times daily for the next five days. Begin your normal tooth brushing routine as soon as possible after surgery. Soreness and swelling may prevent rigorous brushing of all areas, but make every effort to clean your teeth within your comfort level.
CARE OF SURGICAL AREA. Apply warm compresses to the skin overlying areas of swelling for 20 minutes on and 20 minutes off to help soothe these tender areas. This will also aid in reducing swelling and stiffness. If you were given an irrigating syringe, start using it the third day after surgery to keep the sockets clean. Fill it with warm salt water and irrigate any open sockets gently, especially after eating.
OTHER POSSIBLE POST-SURGERY EFFECTS:
DRY SOCKETS. The blood clot on the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. If you do not see steady improvement during the first few days after surgery or if severe pain persists, please call the office to report these symptoms.
SKIN DISCOLORATION. This may be expected, and is usually limited to the neck or cheek area near the surgical site. This is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week for this to completely disappear. Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. Aspirin and application of heat on the area will usually correct these symptoms.
NUMBNESS. Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.
YOUR CASE IS INDIVIDUAL. NO TWO MOUTHS ARE ALIKE. DISCUSS YOUR PROBLEM WITH THE PERSON BEST ABLE TO EFFECTIVELY HELP YOU, YOU SURGEON!
It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at 504-468-8300. After office hours, Dr. Dongieux may be reached at 504-491-8570 and he will contact you as soon as possible. Call 911 if you have a medical emergency.