Post-Surgical Instructions

In the days immediately following surgery, proper care can ensure that the surgical area heals properly and that the risk of infection is minimized. You will receive detailed instructions for your specific case following your surgery. To better prepare, here you will find some of the recommendations you will likely receive.

What to Do for Bleeding

Some bleeding is expected for up to 24 hours after oral surgery, such as tooth extraction. Place a gauze pad over the area and bite firmly for thirty minutes to control bleeding. If bleeding persists, you can bite on a moistened tea bag for thirty minutes. The tea bag’s tannic acid contracts blood vessels, which can help form a clot. It will also help minimize bleeding if you remain calm, sit upright, and avoid activity.

When going to bed at night, we recommend sleeping on a recliner sofa or at a 45-degree angle for the first night. If bleeding continues without improvement, call for further instructions.

What to Do for Swelling

Some swelling proportional to the surgery performed is expected around the mouth, cheeks, eyes, and sides of the face. However, you can minimize swelling by applying ice packs immediately. Leave the ice packs on continuously while you are awake. 

After 36 hours, ice will no longer affect swelling. Begin using moist heat after that time. Post-operative swelling peaks two to three days following the surgery and may not become apparent until the day following surgery. Some swelling or jaw stiffness may persist for several days. This is a normal reaction to surgery.

Controlling Pain

For moderate pain, you can take 1 Tylenol (325mg) tablet and ibuprofen (Motrin or Advil 600mg) tablet at the same time every 6 hours as needed for pain. Studies have shown that a combination of Tylenol and Ibuprofen is as effective as a narcotic pain medicine. 

Dr. Dawood may allow you to take some prescription pain medication for severe pain. Please take it as directed. Please minimize narcotic pain medication and avoid it as much as possible unless absolutely needed. If pain persists, call the office.

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Nausea and Vomiting

If you experience nausea and/or vomiting following surgery, do not take anything by mouth, including medicine. After an hour, you can sip slowly over 15 minutes on tea or ginger ale. Once nausea subsides, you can resume eating solid foods and taking any medication as prescribed.

Post – Op Instructions for implants and bone grafting:

In cases of dental implant surgery, there might be a metallic healing abutment( cover) placed on top of the implant. This will stick out on top of your gums by a few millimeters. This is normal. Occasionally this abutment may get loose or fall off. If it does, please call the office and we will place it back.

If bone grafting is performed either by itself or during the time of implant placement, you will notice some granules fall into your mouth with time. This feels like sand particles and is totally normal. It is safe to swallow it or gently spit it out. Also, there may be a dressing( (band-aid type material) placed on top of the bone graft. This will fall off in the first few days of surgery and it feels like a small sponge. This is normal as well.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures should be used as directed by your surgeon in your post-surgery instructions. If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Post-op Instructions after sinus surgery/extractions of teeth close to the sinus 

The sinus cavity is the hollow air space above and near the teeth on either side of your upper back jaw, which lies alongside and connects with your nose. .  Because your sinus is unusually large, your roots long, or a combination of both Patients that have had a tooth removed near the sinus cavity or an implant procedure/bone grafting involving the sinus need to follow some special post-operative precautions  to protect your sinuses and to help prevent complications.

Please Follow These Instructions For 14 Days

  • DO NOT blow your nose. Air pressure must not be increased in the nasal or sinus cavities.
  • TRY NOT to sneeze. If you do sneeze, sneeze with your mouth open—do NOT block the sneeze by pinching your nose.
  • DO NOT use a straw.
  • DO NOT spit.
  • DO NOT rinse vigorously for several days. Chew on the opposite side as much as possible.
  • DO NOT fly in an airplane.
  • DO NOT swim or submerge your head.
  • DO NOT do any vigorous exercising.
  • DO NOT SMOKE.
  • Avoid swimming, scuba diving, playing a wind instrument, blowing up balloons, or other things that cause pressure changes in your mouth.
  • It is not uncommon to have blood in the nasal discharge for several days. Notify the office if any symptoms develop that seem unusual to you
  • If you feel congested or have a runny nose, use an over-the-counter nasal decongestant or antihistamine (Sudafed®, Claritin-D® 24, Afrin nasal spray etc.).
  • Do not use Afrin nasal spray for more than 3 days

It is possible that even with all these precautions, an opening from your sinus to your mouth may develop and persist. In this event, the surgical closure of this opening will be required to assure the complete healing of the extraction site and sinus cavity

Oral Heat Therapy

Liquid heat therapy is a complementary therapy that is highly effective for the following:

  1. Promotion of healing after oral surgery
  2. For the treatment of infections
  3. Prevention of infections during wound healing after surgery

How does it work?:

Heat creates higher tissue temperatures, which produces vasodilation that increases the supply of oxygen, nutrients, immune factors, antibiotics, and the elimination of carbon dioxide and metabolic waste

  1. Increased local circulation allows antibiotics and the immune system to work more effectively
  2. Promotes proper drainage of stagnant old blood after surgery.
  3. Local heat promotes proper drainage of infection if infection is present. Drainage is key to successful resolution of infections.
  4. Increases local circulation and allows antibiotics and the immune system to work more effectively

How to do heat therapy:

  1. Gently rinse the inside of the mouth with warm-hot Saline (1/2 Teaspoon of salt to a 12 oz glass of warm water). Do this several times a day for one week after surgery. The more frequently the better. Take care to not burn yourself
  2. Drink warm teas (preferably herbal) and gently circulate the tea in the mouth before swallowing,
  3. Take a towel, put it in moderately hot water and apply to your face

What to Eat

You should limit your diet to soft foods for a few days following your oral surgery. For the first day, begin with clear fluids (juice, broth, tea, Jell-O) and progress slowly to more solid foods that can be easily chewed. Remember, it is essential to maintain nutrition so you do not delay healing. 

Drink fluids to keep yourself hydrated, but do not use a straw. Using a straw can lead to a painful condition known as a dry socket if you dislodged the blood clot at the surgical or extraction site. For at least the first week following surgery, you should avoid the following foods before returning to a regular diet:

  • Spicy Foods
  • Foods that are difficult to chew
  • Popcorn & Chips (avoid for a month)
  • French bread loaves and Baguettes
  • Alcoholic Beverages
  • Citric foods and juices (orange juice)
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Oral Hygiene

Good oral hygiene is essential for keeping the mouth clean to avoid complications from an infection. Do not perform rinsing of any kind until the day following surgery. You can still brush your teeth the night of surgery while gently avoiding the surgical site but gently rinse.

You should begin rinsing at least 5-6 times a day the next day, especially after eating a meal or snack. Use a cup of warm water mixed with a teaspoon of salt.

Post-Operative Instructions

At Virginia Oral Surgery Specialists, we strive to make your recuperation as easy and comfortable as possible. You can reduce pain and swelling, as well as the risk of infection and complications, by carefully following these guidelines.

Bleeding

  • A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for up to 24 hours after surgery.
  • Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes.
  • Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes.
  • The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise.
  • When going to bed at night, please do not lay flat on bed. For the first night sleep in a recliner sofa or at a 45 degree angle.
  • If bleeding does not subside, call for further instructions.

Swelling

  • The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon.
  • This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively.
  • However, the swelling may be minimized by the immediate use of ice packs. Two bags filled with ice or ice packs should be applied to the sides of the face where surgery was performed.
  • The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect.
  • If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
  • Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

  • For moderate pain, two tablets of Tylenol (325mg) may be taken every 6 hours not to exceed 3gm or Ibuprofen, (Motrin or Advil) 600mg tablets may be taken every 6 hours. You can take 1 Tylenol( 325mg) tablet and Motrin (600mg) tablet at the same time every 6 hours as needed for pain. Studies have shown that a combination of Tylenol and Ibuprofen is as effective as a narcotic pain medicine.
  • For severe pain, narcotic pain medicine may be prescribed. Take is as directed. Please minimize the use of narcotic pain medicine and avoid it as much as possible unless absolutely needed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages while on pain medicine. Please have someone around you on the first day of surgery to help you with activities.
  • Pain or discomfort following surgery should subside more and more every day.
  • If pain persists, it may require attention and you should call the office.

Bruising

  • ·Bruising often shows 3-5 days following surgery and is normal. This will improve on its own.
  •  Bruising may occur either above or below the location that oral surgery took place and extend down your neck.

Sutures

  • Sutures (stiches) are placed to help control bleeding and promote healing.
  • Some sutures will dissolve and do not need to be removed while others will be removed at your follow-up appointment.
  • Do not be alarmed if the stiches come out on their own at any time.

Nasal Congestion

  • Nasal congestion is common after upper wisdom teeth removal for up to 2 weeks.
  • You may use over-the-counter nasal sprays such Afrin and Flonase, or over the counter decongestants such as Sudafed.

Removable Appliances

  • If you currently wear a retainer, full or partial denture, or a single tooth prosthesis (a “flipper”) you can wear your appliance immediately after surgery unless your oral surgeon instructs you otherwise.
  • Some appliances may require adjustment after surgery.
  • If you are in pain due to unusual pressure from your appliance, do not wear it until you have seen either your dentist or your oral surgeon.

What To Do

  • Once you are at home, it is important that you rest a minimum 24 hours following surgery.
  • For the first 24-48 hours, you should maintain a diet of soft, cool/room temperature foods such as: gelatin, pudding, yogurt, mashed potatoes, soups, or anything that can be cut with a fork.
  • Avoid hot foods until numbness is resolved.
  • By day 3, you may eat any solids that you can tolerate.
  • Try to drink large amounts of liquid ( water, sport drinks or juice)
  • After 24 hours, you can rinse your mouth gently after each meal with warm salt water or prescribed mouth rinse.
  • Start oral hygiene on morning after surgery.

What To Avoid

  • Do not spit or suck through a straw for 72 hours.
  • Avoid all rinsing for 24 hours after surgery
  • Smoking should be stopped following surgery for 1 week. Smoking dries out the oral tissue and can hinder the healing and success of an implant.
  • Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
  • Do not disturb the wound. By doing so, you may cause irritations, infection and/ or bleeding.

Additional Normal Symptoms You May Experience

  • Trismus (tightness) of the muscles may cause difficulty in opening your mouth and may persist for one week.
  •  You may experience a slight earache
  •  You may develop a sore throat
  • Numbness may occur at the corner of your mouth or chin on the side where you had surgery
  • Other teeth may ache or become sensitive; this is a temporary condition.
  • Your temperature may be elevated for 48-72 hours, but please contact us if it is above 101 degree.
  • If you were sedated, a bruise may appear around your injection site; this is normal and will disappear within a few days.

Things To Avoid After Sinus Surgery

 The sinus cavity is the hollow air space above and near the teeth on either side of your upper back jaw, which lies alongside and connects with your nose. .  Because your sinus is unusually large, your roots long, or a combination of both Patients that have had a tooth removed near the sinus cavity or an implant procedure/bone grafting involving the sinus need to follow some special post-operative precautions  to protect your sinuses and to help prevent complications:

  • DO NOT blow your nose. Air pressure must not be increased in the nasal or sinus cavities.
  • TRY NOT to sneeze.  If you do sneeze, sneeze with your mouth open—do NOT block the sneeze by pinching your nose.
  • DO NOT use a straw.
  • DO NOT 
  • DO NOT rinse vigorously for several days. Chew on the opposite side as much as possible.
  • DO NOT fly in an airplane.
  • DO NOT swim or submerge your head.
  • DO NOT do any vigorous exercising.
  • DO NOT SMOKE.
  • Avoid swimming, scuba diving, playing a wind instrument, blowing up balloons, or other things that cause pressure changes in your mouth.
  • It is not uncommon to have blood in the nasal discharge for several days. Notify the office if any symptoms develop that seem unusual to you
  • If you feel congested or have a runny nose, use an over-the-counter nasal decongestant or antihistamine (Sudafed®, Claritin-D® 24, Afrin nasal spray etc.).
  • Do not use Afrin nasal spray for more than 3 days

It is possible that even with all these precautions, an opening from your sinus to your mouth may develop and persist. In this event, the surgical closure of this opening will be required to assure the complete healing of the extraction site and sinus cavity.

Call Our Office With Questions

If you have any concerns or questions about your post-operative care, call our office at 703-520-2300.

Book Appointment

The first step towards getting the beautiful, healthy smile you’ve always wanted is to schedule an appointment with our office. You can contact us by phone or submit the appointment request form online and our office staff will contact you to confirm your appointment.