FAQS

WHAT DO I DO IF THERE IS BLEEDING?

Oozing or bleeding after oral surgery is normal and is to be expected. We will place gauze packs over the surgical areas for you to bite firmly on, which will help stop and shorten bleeding times. The gauze packs should be replaced with a new piece every 20-30 minutes only if the gauze is saturated and is the color of dark red wine or there are clots present. If the gauze is light red or pink after 30 minutes of use, it is time to discontinue the gauze. Any use of gauze should be discontinued within 2 hours following surgery unless you have been instructed otherwise. When biting on the gauze don’t talk or check it frequently, otherwise the gauze rubs on the surgical sites, which will prolong bleeding times. After the gauze has been discontinued, it’s normal to have periodically bloody saliva throughout the next few days. Don’t replace the gauze at this point.

HOW CAN I REDUCE THE SWELLING?

The level of pain and discomfort during the recovery period is primarily determined by the amount of swelling the patient has. The less swelling the patient acquires, the more comfortable they usually are. Facial swelling will peak a few days after surgery, usually the 3rd or 4th day. There are a few things that patients can do in the first few days after surgery to help decrease the swelling. First, patients should sleep upright for a few nights, in a recliner or propped up with a lot of pillows. This will elevate the patient’s head, keeping their cheeks above their heart. Second, place ice packs on the patient’s cheeks the day of surgery and the day after. The ice packs should be on the patients cheeks for 20 minutes then taken off for 20 minutes to prevent frostbite. Do this rotation all day long, both days. There is no need to use ice during the night as long as the patient is sleeping upright. After 48 hours the ice will not help with swelling but some patients continue using ice for its soothing effect. Finally, we have sent the patient home with a prescription for a large dose of Ibuprofen. This medication should be taken 3 times a day, approximately every 8 hours. Ibuprofen has been prescribed to the patient for the main purpose of decreasing swelling although, it may also help with pain. Because it takes a few days for the swelling to peak, most patients do well the day of surgery and the day after but then go backwards and feel worse the next two days. Continue to sleep upright, use ice and take Ibuprofen the first few days regardless if your recovery is going well to ensure that you have tolerable swelling at its peak.

HOW DO I DECREASE THE PAIN?

Some amount of discomfort usually occurs after oral surgery. Most patients will be comfortable for several hours after surgery due to the numbing effect of the local anesthetic. Patients who have had IV sedation CANNOT have any food, medicine or liquids after surgery until their stomach is awake, which is typically a few hours after surgery. We usually send patients home with a prescription for Ibuprofen that will help decrease swelling and help with pain. Patients should take this medicine 3 times a day, spaced out around every 8 hours. It is important to take the Ibuprofen as instructed for the first 2-3 days even if the patient is not experiencing much discomfort. Most patients will also be sent home with a prescription narcotic. This narcotic should be used when the Ibuprofen is not enough to control the pain. If the patient needs to take the narcotic, they should NOT stop taking the Ibuprofen. Ibuprofen is still needed to decrease swelling, even if it is not helping with pain. The narcotic can be taken at the same time as the Ibuprofen or at a different time. The two medicines will not interact with each other. The narcotic is a strong pain medicine that impairs judgment and behavior. Therefore, patients cannot drive, sign papers or return to work if they are under the influence of that medicine. It also means that patients shouldn’t take it as part of a routine. Instead it should be taken only when the pain is not being controlled by the Ibuprofen. A substantial amount of food should be eaten 1 hour prior to taking the narcotic or patients will likely have nausea. Finally, call our office right away if the two pain pills are not helping with pain or if the patient experiences a rash or other side effect.

WHAT CAN I EAT?

Patients who have had IV sedation CANNOT have any food, medicine or liquids until their stomach is awake which is typically a few hours after surgery. On the day of surgery, when the patient is ready to eat, they will need foods that are cool and soft. Hot foods may cause the surgical area to begin oozing blood. Soft foods will help prevent the patient from chewing on their tongue or cheeks while they are still numb from the local anesthetic. Regular foods can be eaten the day after surgery, although, many patients prefer a cool soft diet for several days

HOW DO I TAKE CARE OF THE SURGICAL SITES?

There are a few factors that can adversely affect the healing surgical areas. Dry sockets and infections are among the most common healing complications. Both of these complications can usually be avoided by following a few simple precautions. Dry sockets are a painful side effect that can occur when the healing blood clots in the lower extraction sites come loose and dislodge from the sockets. This exposes the nerve and bone to the air and can be very painful. Most dry sockets are caused by smoking, playing a wind instrument, using straws or rinsing vigorously. Please avoid smoking, using straws, and playing wind instruments for 2 weeks or longer if instructed. Most patients will be sent home with a prescription for a mouth rinse. This rinse can be started the day following surgery but must be used very gently to avoid dry sockets. The patient should place the liquid medicine in their mouth and then tip their head from side to side to allow the medicine to pool over the surgical areas before spitting gently into the sink. Do not swallow the liquid medicine. Use this medicine 2-3 times a day to keep the surgical areas clean. Patients should begin to brush the teeth adjacent to the surgical area the night of surgery.

Small slivers of bone occasionally work out of the extraction socket over the next several weeks. If they cause concern or discomfort, please call the office. The healing socket often appears white; this is the normal appearance of healing tissue in the mouth and should not cause concern.

Patients who have had lower wisdom teeth removed will be given a curved-tip syringe. Do NOT use this syringe sooner than 5 days after surgery to avoid a dry socket. Dry sockets are no longer a concern five days following surgery. On the fifth day, the syringe should be used 3-4 times a day to flush food and particles out of the healing socket. The syringe should be inserted down to the bottom of the socket to insure that all particles have been released. Please refer to the syringe instructions insert for a more detailed explanation of its use. Patients should begin to brush the surgical sites at this time.

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