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Care of the mouth after surgery has an important effect on healing. Swelling, discomfort, bleeding and restricted jaw opening may occur, depending on the extent and location of the surgery. These problems need not cause alarm and may be minimized if the following instructions are followed carefully.

BLEEDING CONTROL

Bleeding is to be expected. A folded gauze sponge has been placed in the areas of surgery prior to your leaving the office. Keep gauze pack in place for two hours with constant, firm biting pressure. After 2 hours, or as directed, remove the gauze. Usually, the gauze sponges will be moist and red. This does not mean that there is active bleeding, but only that there was bleeding at the time of surgery. To determine whether there is active bleeding, look in a mirror. If you see no blood in your mouth except for a small amount immediately around the surgical site(s), or streaked in the saliva, then the bleeding has stopped and the gauze sponges may be left out. If there is any active bleeding, place another folded sponge (or a moistened tea bag) over the surgical area(s) and bite firmly for several more hours, with constant pressure. Repeat as needed until bleeding stops. Avoid spitting, excessive use of your jaws, sipping through straws and rinsing your mouth. If in bed, assume a semi-upright position to help stop the bleeding. Place a towel on your pillow to prevent staining the linen with blood, which may be in your saliva for several days after surgery. Firm, continuous biting pressure on gauze placed in the surgical area(s) is the most effective means of stopping bleeding. If excessive bleeding persists, please call our office.

PAIN CONTROL

If pain medication has been prescribed, take as directed. Otherwise, take Advil, Extra Strength Tylenol or other pain medication with which you are familiar. If you develop a rash or if you become nauseated, discontinue the medication and contact this office. Do not drive or operate machinery while taking medications.

SWELLING CONTROL

If it has been suggested, apply ice to the face in the area(s) of surgery, as soon as you arrive home. Place ice bag or cold towels to face, 10 minutes on and 5 minutes off. The ice may be placed in a plastic bag and covered with a thin towel or a dish towel before applying to the face. Use the ice as much as possible for the remainder of the day and the next day as well. Facial swelling normally reaches its peak two to four days after surgery and then gradually disappears over a period of several days.

NAUSEA

If you experience nausea or vomiting, sips of cola or other carbonated soda may be helpful. The prescribed pain medication may cause nausea and may have to be discontinued. Contact this office if the nausea persists.

DIZZINESS

Pain medication may cause dizziness. You must be careful, especially when getting up or going to the bathroom. There have been instances of patients falling because of dizziness.

DIET

Follow you natural inclination as to diet, but avoid foods that are hard in consistency. If eating causes pain or bleeding, limit yourself to liquids and soft foods. The more extensive the surgery, e.g. impacted teeth, the more you should modify your diet. Patients who have had impacted teeth removed should begin to take liquids only, after the bleeding has stopped. The liquid diet (soups, juices, soft ice cream, blenderized foods, etc.) should be continued until more solid food can be taken gradually with comfort and without disturbing the area(s) of surgery. Adequate nutrition and fluids are important to insure rapid healing.

ORAL HYGIENE

Do not rinse your mouth on the day of surgery. The day after surgery, if bleeding has stopped, rinse with warm salt water (1/2 teaspoon salt/glass of warm water) 5 to 6 times daily after eating and for the next few days between meals. The teeth may be given their usual care, except for the operated area(s) which should be treated more gently. Do not blow your nose or spit forcibly until the following day.

SMOKING

Avoid smoking after surgery. Smoke is an irritant and may delay healing.

ALCOHOL

Do not drink alcoholic beverages. Alcohol may react adversely with the drugs you have taken or have been prescribed.

LIPS

Lips and the corners of the mouth become irritated by stretching of the mouth during surgery. Keep them lubricated with Vaseline to avoid dryness, cracking and soreness.

BLACK AND BLUE

Do not be alarmed if a yellow blue-black discoloration appears on your face and/or neck after surgery. It will take a week or more to fade away.

ANTIBIOTICS

If you are given a prescription for an antibiotic, have it filled and take all of the medication according to the instructions on the label.

SUTURES

Occasionally sutures (stitches) are placed. Although you may feel them with your tongue, it is best to leave them alone. Gut sutures will dissolve or fall out in 2-5 days. If silk or synthetic suture materials are used, they will be removed by your doctor on your next visit.

POSSIBLE COMPLICATIONS

Following any oral surgical procedure (particularly the removal of impacted lower wisdom teeth) several undesirable effects may occur.

1. You may have pain that becomes worse after a few days and does not respond to the medication you are taking. This may indicate an inflammation of the bone socket. It is necessary for you to call the office and arrange to come in for a sedative dressing.
2. Other teeth on the same side may ache temporarily.
3. You may have a sore throat or earache for a few days.
4. If the medication you are taking does not make you comfortable, call the office.
5. If you develop a fever, call the office.
6. Numbness of the lower lip may persist on the same side as the surgery. Mention this at your post-operative visit.
7. There may be a "hole" in your gum after surgery. This is the tooth socket. It will fill in with time. Rinse your mouth after meals to keep it clean.
8. After teeth are removed you may feel hard, sharp projections in your mouth. These are usually portions of the bone that surround the roots. They will usually disappear gradually, but if they are annoying, return to our office for further examination.
9. Infection can occur weeks following tooth removal. If you notice renewed pain, swelling, or drainage, please contact our office.
10. Jaw joint pain and noises may occur following oral surgery. Please advise us if these symptoms persist.
11. Jaw stiffness or limited opening of the mouth are expected consequences of tooth removal and should resolve gradually.
12. Although it rarely occurs, removal of teeth can weaken the jaw, making it more susceptible to fracture. Please advise us if you notice a change in your bite or in the way your teeth come together.
13. If you are in doubt about your post-operative course, phone the office.

POST-OP VISITS

To make certain healing is progressing satisfactorily, you should return to the office for your post-operative visits at the suggested times. However, feel free to call if you are having any problems before your next visit.

IN CASE OF PROBLEMS, OR IF YOU HAVE ANY QUESTIONS, PLEASE CALL OUR OFFICE AT (415) 587-1200 OR E-MAIL US AT SMILE@RAGADIO.COM.