Instructions Following Oral Surgery

• Your lip, tongue and cheek may be numb for up to twenty-four (24) hours.
• Maintain pressure on the gauze, but be careful not to bite the numb areas.
• While you are still numb, avoid hot food and drink. It is common to have a nose-bleed during this period.
• You may also have oozing or intermittent bleeding from the surgery site.
• The medication given to you in the IV and the prescribed pain medication can make you feel dizzy and impair your judgment.
• It is advisable to have someone help you while walking, climbing stairs or using the restroom during this time. It is advisable to have someone at home with you to assist you for the first 24 hours.
• Apply ice to the treatment area, alternating 30 minutes on, and ten minutes off. Do this for the first 8 to 10 hours after surgery.

Over the next few days, you will experience soreness. Please continue using the prescribed pain medication or you may end up feeling pain unexpectedly. It is typical to experience the most swelling and bruising around the third day. Bruising and swelling all around the face and neck is normal. It is common to experience lower than normal energy levels while you heal due to loss of blood. Get as much rest as possible and drink lots of fluids. Tenderness, bruising, and swelling is normal.

BLEEDING: It is normal to experience some bleeding over the first few days. Over the period of 1 week, the bleeding should decrease and the color should change from red to brown until it disappears. PERSISTENT BLEEDING: If the bleeding has not stopped or the color remains bright red, please call us as we will need to see you to control the bleeding.

SWELLING: Swelling often accompanies surgery. To reduce swelling, wrap a cold pack, an ice bag or a bag of frozen peas in a towel and apply it to the cheek of the surgical area. It should be applied for 30 minutes of every hour during the first 3 days after surgery. Do not leave ice on the area for more than 30 at a time or in direct contact with the skin.

DO NOT DISTURB THE SURGICAL SITE(S): Do NOT forcefully rinse or attempt to clean the area under your new teeth with any instruments. You are encouraged to brush the white part of your teeth gently. DO NOT SMOKE for at least 72 hours since smoking will negatively affect your healing.

PAIN: The days following surgery will most likely be accompanied by some discomfort. You will be prescribed pain medication to ease the discomfort. For best results, take the first pill before the surgical anesthetic wears off. Do not abuse the pain medication; use it according to the prescription.

MEDICATIONS: Pain medication (i.e. Norco): Take pain medication every 4 hours as needed, and stay on top of it to effectively maintain a tolerable pain level. In addition to the pain medication, you may take 1 tablet (600mg) of Ibuprofen (i.e. Motrin or Advil) every 6 hours. Alternating the medications will help them function more effectively (ex. take 1 Norco, then 4 hours later take Ibuprofen...4 hours later take another Norco). DO NOT USE TYLENOL. Remember to take the medication with a small amount of food.

ANTIBIOTICS:

• If taking Amoxicillin:  You will have taken 2 tablets 1 hour before surgery. Take 2 tablets the evening after surgery, then take 3 times a day at breakfast, lunch and dinner until antibiotics are gone.
• If taking Cleocin: Take 4 times a day at breakfast, lunch, dinner and bedtime.

MOUTH RINSES: Rinsing should not start until 48 hours after surgery. It is important to rinse your mouth often in order to keep the environment clean. Dissolve 1/4 teaspoon of salt in 8 ounces of warm water. Then, gradually rinse out your mouth, one sip at a time, over five minutes. Do this as often as you like; at least two or three times a day.

In addition, apply the prescribed Chlorhexidine rinse three times a day with a cotton tipped applicator (Q-tip), for the first two weeks.

NAUSEA: It is common to experience nausea after surgery, and it should pass within a short period of time. If the nausea does not get better in a few days, please call our office.

BRUSHING: Due to soreness and swelling, vigorous brushing may not be possible. It is still important that you make every effort to clean your teeth. Post-surgery, begin gently brushing with a manual toothbrush as you are able. Do not disturb the sutures or healing tissue around the surgical site(s). After about 10 days your sutures will dissolve, but until then only mild brushing is suggested. DO NOT USE A WATERPIK or ROTARY TOOTHBRUSH (i.e. Oral-B Braun).

DO NOT exercise or participate in any strenuous activity for the next 7 days

HOT APPLICATIONS: Use warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pads) for 20 minutes on and 20 minutes off to help soothe tender areas.

HEALING: Normal healing after full arch immediate load implant therapy should be as follows: Days 1-2 will have the most swelling. Day 3 will have the greatest discoloration with bruising. If you feel up to it after the first 3 days, you may begin a more substantial diet but be mindful of the soft food diet suggestions provided. The remainder of the healing should be steady improvement. If you don’t see slow improvement, please contact our office so we can evaluate any issues with healing.

SHARP SPOTS: If you feel something sharp in the surgical areas, it is likely a bone spur from the walls that once supported the extracted teeth. Small slivers of bone due to the extraction procedure may work themselves out of the gum tissue over the healing phase. This is normal. Also, the teeth themselves may have rough or sharp areas. Please contact our offices to set up a visit for evaluation if you have these issues.

DIET: Avoid hot foods and liquid during the first week. Do not use a straw for 72 hours after surgery. Eat very soft or puréed foods as needed until it becomes comfortable enough to have more normal foods. Always refer to the soft food dietary restrictions to make sure you do not harm your implants or your temporary teeth. Do NOT eat foods like chips, crackers, popcorn, etc. which may get stuck in the surgical healing site(s). The soft tissues will heal within 4 weeks, however, the bone around the implants will require 12 weeks to heal. Please be cautious with the temporary teeth.

We will see you back in our office in 10 days.

This appointment is very important. If you have any questions or if an emergency situation arises, please contact our office at (703)263-8640.

PLEASE NOTE: Telephone calls for pain medication prescription refills are ONLY accepted during office hours.